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Western Medicine

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Western Medicine

Historical Overview
"Western medicine" is a term used to refer to all scientific and science based medical practices. It is used in contrast with the term 'eastern medicine' which refers to medical practices which were founded or significantly influenced by Chinese, Hindu and other Asian cultures. Today western medicine encompasses the fields of medical doctors (MDs), specialists, physicians' assistants, registered nurses (RNs), and nurse practitioners.

Hippocrates, an ancient Greek physician, is considered the father of western medicine for having introduced a rational approach to treatment and his legacy lives on in the Hippocratic Oath which is still administered to all MDs today. Ancient Greek medicine was based on the Humoural system - also known as the four temperaments - black bile, yellow bile, phlegm, and blood and was systemized around 400 B.C. According to this, a healthy person had all four temperaments in balance while a sick or diseased person had an excess or deficit of one or more. The theory of the four temperaments persisted through the Middle Ages and colonial times with various refinements in treatments but basically relied on herbs and spirituality, bloodletting, emetics and cupping. The period from 1780 to 1850 was known as the Age of Heroic Medicine due to the intensity and audacity of its methods when it was said one was just as likely to die from the treatment as from the disease itself.

The discovery of the smallpox vaccination by Edward Jenner in 1796 paved the way for the invention of Modern Medicine in the 1800s when a new understanding of cellular pathologies emerged changing peoples' perception of sickness and disease. In 1900 with the advent of antibiotics, another enormous expansion of medical knowledge ensued thanks to the contributions of Alexander Fleming, Harvey Cushing, Claude Bernard, Nikolai Korotkov, and many other researchers. As knowledge grew so did the reliance on medications for treatment. Pharmacology developed out of herbalism, and grew to include antibiotics, vaccinations, and other pharmaceuticals used to treat symptoms and diseases.

Despite the many advances in science, the medical profession of the 19th century was loosely organized and required only 2 years of training and very little to no practical experience. Medical schools were run for profit by doctors who taught part-time and there was no oversight or regulation by state or local governments. The Flexner report issued in 1904 by the Carnegie Foundation urged US medical colleges to enact higher admission and graduation standards, establish a minimum of 4 years of study, and impose state regulation on all medical schools. The recommendations of this report were largely adopted by the medical community. As a result, several changes followed beginning with a large consolidation of American Medical Colleges and Universities, the birth of more rigorous medical standards, and many other improvements to the study and practice of medicine. Today, admissions into American medical schools are some of the most highly sought after in the world.

Treatment Method
Western medicine encompasses a wide ranging set of medical specialties and is based on a strict adherence to the formal scientific process. In western medicine doctors rely heavily on medication, testing and technology. Treatments range from industrially produced medications to chemotherapy and physical therapy to surgery. After taking a patient's history and listening to the chief complaint(s), a doctor may perform tests and/or an examination in order to arrive at a diagnosis. Western science uses pharmaceuticals targeted at certain diseases and surgical treatments as necessary and practitioners are trained to diagnose a variety of ailments based on their specialties. These diagnoses can range from observations of the skin to neurological and cardiovascular analysis. Thanks to the advent of modern technology, modern western medicine has a huge scope and increasing accuracy in diagnosis.

Provider’s Training
Providers of Western Medicine include physicians (MDs), nurses (RNs), Nurse Practitioners, osteopaths (DOs), and physical, occupational, and respiratory therapists. Each receives different training based on their specialty.

MDs and DOs must complete 4 years of undergraduate study then 4 years of medical school. After medical school they do a 3 to 5 year residency in a hospital depending on their chosen area. Beyond residency, doctors can do additional training as part of a fellowship program.

NPs and PAs are mid-level medical professionals who practice under the supervision of a doctor. Depending on the state where they practice, they may have a greater or lesser degree of autonomy. Nurses and nurse practitioners need to earn a master’s degree in their field to become certified as an RN (registered nurse) or NP and even then they may only prescribe some over-the-counter drugs.

There are also Foreign Medical Graduates who practice in the US. These FMGs are required to pass a three part board exam and do residency again in US.

Credentials and Regulation Bodies
Providers of Western Medicine must be licensed by the state in which they practice. Each state has a regulation body that sets and maintains specific professional standards for each of the types of practitioners. Providers have a wide array of credentials, depending on their profession -- physicians have the suffix of MD (Medical Doctor), nurses have the credential of RN (registered nurse), clinical psychologists have the suffix of either PhD (Doctor of Philosophy) or PsyD (Doctor of Psychology). Therapists will have the credentials of their particular field, such as PT (licensed Physical Therapist). In addition to these basic credentials, many practitioners will have additional certifications in specializations.

MDs and DOs must pass a general board exam (and specialty board to practice a given specialty). Specialty exams must be retaken and the doctor recertified every 10 years.

Professional Associations
Each different profession that falls under the heading of Western Medicine has its own national professional association and many have state associations. Physicians who are MDs (Medical Doctors) or DOs (Doctors of Osteopathy), resident physicians, and medical students pursuing an MD or DO degree form the American Medical Association (AMA). This is the largest association for Western Medicine, and aims to advance the science of medicine and improve public health. Each specialty has it's own organization and most MDs are active within their specialty or within their state.

The national association for registered nurses is the American Association for Nurse Practitioners (AANP), while the national organization for psychologists is the American Psychological Association (APA). Occupational therapists have formed an organization called the American Occupational Therapy Association (AOTA), Respiratory therapists belong to the American Association for Respiratory Care (AARC), and physical therapists are part of the American Physical Therapy Association (APTA).

For more information on Western Medicine, visit the U.S. Department of Health sponsored National Institutes of Health (NIH) at www.nih.gov.

Generally, treatment by a Western Medicine practitioner is covered by insurance. Inquire with your insurance provider to understand your scope of coverage.

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