Then again, the AMA leaders in keeping “physician” out of reach of other professions are probably not as comfortable with the additional 2008-2009 language: “MDs are also known as allopathic physicians.” The modifier “allopathic” is a hole in the dike through which may flow naturopathic physicians, chiropractic physicians, perhaps more acupuncture physicians, and the first through, osteopathic physicians.
Can Webster be a guide to who uses “physician”?
“Battle lines are being drawn,” Stephen Stills once wrote in his song “For What It’s Worth.” (10) The physician term is power. Professions so denominated stand at the top of the hill, waving about highfalutin reasons why their recognition as such is in the public good. The sub-text includes the know motivator that the title lands one on the road to the bank. The recent chiropractic battle with the Blues is a case in point. For what it’s worth, Stephen Stills’ next lines are that “nobody’s right if everybody’s wrong.”
Perhaps Webster can help us sort this out. I read 2 definitions while writing this column. Notably, neither states that “physician” denotes a practitioner who stands at the receiving end of medicine’s money shoot. That commercial application of the title has not reached definitional status.
The #1 definition for physician in the 50th anniversary edition of Webster’s New World Collegiate Dictionary (2001) is “a person licensed to practice medicine; a doctor of medicine.”
Common usage suggests that this refers only to MDs. Yet while some chiropractors are not sure they want to be associated with “medicine” and entry-level training for most acupuncturists is not presently as doctors, there is room in this definition to include all practitioners who are doctors and practice medicine. The New World Collegiate’s definition #2, however, shifts the puck toward the AMA hardliners: “Any medical doctor other than one specializing in surgery.”
I then turned to the Big Book, my inherited, coffee-table sized 2600 page Webster’s Third New International Dictionary inscribed With love to all, Happy Valentine’s Day, 1965, Dad. This weighty volume offers a potentially threatening definition #1: “A person skilled in the art of healing.”
Making the case for reimbursing the historic role of the physician
Does any practitioner of any stripe caught in the rapid-fire, reactive, insurance-based system who is merely dispensing therapies, whether legend drugs, herbs, remedies, needles, vitamins or manual manipulation, have the right to this title of physician as healer? Nobody’s right if everybody’s wrong, indeed. Definition #2 poses a similarly sobering, poorly reimbursed challenge: “One who restores.”
Trends noted here suggest that common and professional usage, despite the AMA’s rearguard actions, will increasingly accept that various healthcare professionals are physicians. This direction reflects the pluralism in the globe we inhabit and the populations practitioners serve. But maybe once U.S. medicine embodies the view that there is more than one road to becoming a “physician,” we should strip all of the professions of the pecuniary value of the term (before it is burned into Webster) and tell all physicians they can only earn their compensation back only if they show that their practices are “skilled in the art of healing” and in “restoring health.”
Better yet, these relative newcomers should join with their integrative MD colleagues and aggressively articulate the case for re-engaging, and creating payment for, these under-appreciated meanings of “physician.”