JMIR Publications

ABSTRACT

Background:

Despite its potential far-reaching implications for research, education, policy making, service provision and funding decisions within the healthcare sector, and for human life at large, the meaning of the word "medicine" has received very little attention. To the best of our knowledge, this is the first attempt to identify and compile published efforts to define and conceptualize it.

Objective:

This study aims at collating and summarizing written efforts to capture the meaning of the term "medicine" to date, as a means to support clinical, educational, academic, managerial and policy decisions that could shape the "next normal" of the healthcare system in 21st century.

Methods:

Eligibility criteria: Any text-based definition or conceptualization of the term "medicine" published in English. Sources of evidence: Bibliographic databases (Pubmed, Embase, and Cochrane Database of Systematic Reviews), Google Scholar, the top-11 English dictionaries, and the websites of the top-10 ranked medical schools in the world, all 113 members of the World Medical association, the US Institute of Medicine, the World Federation for Medical Education and the World Health Organization; and Google Scholar up to March 2020. Charting methods: Data on the authors, sources and publication dates were extracted, in duplicate, using a form created, tested and refined by the team in advance. Eligible definitions or conceptualizations were copied verbatim in all cases.

Results:

The bibliographic databases yielded 5341 citations, of which 17 included eligible definitions or conceptualizations. Of these, 12 mentioned health, 10 considered medicine as a science, and nine focused on the prevention, treatment or cure of diseases. All of the dictionaries provided at least one eligible statement. Nine focused on diseases and two on illness, while five mentioned health. None of the medical schools, associations or institutions provided a definition or conceptualization. No source described a systematic, replicable process to capture the meaning of "medicine".

Conclusions:

This scoping review offers the first list of written definitions and conceptualizations of medicine published to date. It reveals the lack of a systematic attempt to reach consensus about the meaning of a term that plays a significant role in all aspects of human life. Bold, systematic and replicable initiatives are needed to fill this gap, as a mean to guide the contributions of the medical profession, governments, academia and corporations; to separate medicine from other professions, and to clarify its role in the creation and preservation of health beyond the chemical-mechanical view of patients and their diseases.