As medicine becomes more and more specialized, and moves further and further from the general physician, becoming increasingly subspecialized, it can be difficult to know where we fi t in to the general scheme of things. What ties a public health physician to a neurosurgeon? Why does a dermatologist require the same early training as a gastroenterologist? What makes an academic nephrologist similar to a general practitioner? To answer these questions we need to go back to the definition of a physician. The word physician comes from the Greek physica, or natural science, and the Latin physicus, or one who undertakes the study of nature. A physician therefore is one who has studied nature and natural sciences, although the word has been adapted to mean one who has studied healing and medicine.
We can think also about the word medicine, originally from the Latin stem med, to think or reflect on.
A medical person, or medicus, originally meant someone who knew the best course of action for a disease, having spent time thinking or refl ecting on the problem in front of them.
As physicians, we continue to specialize in ever more diverse conditions, complex scientifi c mechanisms, external interests ranging from academia to education, from public health and government policy to managerial posts. At the heart of this we should remember that all physicians enter into medicine with a shared goal, to understand the human body, what makes it go wrong, and how to treat that disease.
We all study natural science, and must have a good evidence base for what we do, for without evidence, and knowledge, how are we to refl ect on the patient and the problem they bring to us, and therefore understand the best course of action to take? This is not always a drug or an operation; we must work holistically and treat the whole patient, not just the problem they present with; for this reason we need psychiatrists as much as cardiothoracic surgeons, public health physicians as much as intensive care physicians. For each problem, and each patient, the best and most appropriate course of action will be diff erent. It is no longer possible to be a true general physician, there is too much to know, too much detail, too many treatments and options. Strive instead to be the best medic that you can, knowing enough to understand the best course of action, whether that be to reassure, to treat, to refer or to palliate.
In this book, we join the minds of an academic clinical pharmacologist, a general practitioner, a nephrologist, and a GP registrar. Four physicians, each very different in their interests and approaches, and yet each bringing their own knowledge and expertise, which, combined with that of our specialist readers, we hope creates a book that is greater than the sum of its parts.
1. Thinking about medicine
2. History and examination
3. Cardiovascular medicine
4. Chest medicine
7. Renal medicine
9. Infectious diseases
11. Oncology and palliative care
15. Clinical chemistry
16. Eponymous syndromes
18. Reference intervals, etc.
19. Practical procedures
Title: Oxford Handbook of Clinical Medicine
Edition: 9th Edition
Authors: MURRAY LONGMORE, IAN B. WILKINSON, ANDREW BALDWIN, ELIZABETH WALLIN