The Expanding Definition of a Clinician

 

Who is a Clinician? 

During my years of service at the Institute for Medical Research, the term clinician was commonly and quite naturally reserved for our medical colleagues, and also doctors working in hospitals who directly attended to patients. It was a term that denoted those in the medical profession engaged in hands-on care, and our use of it reflected this understanding.

However, over the years, my perception of the word began to shift. I first encountered this broader application when I learned that my sister-in-law, a nursing graduate working at the National University Hospital in Singapore, was referred to as a nurse clinician. It intrigued me that the title extended beyond doctors to include nurses. Further conversations with friends from the healthcare field revealed that other professionals such as pharmacists, therapists, and various allied health workers were also being called clinicians.

To explore this further, I turned to official sources. A quick search brought me to the definition provided by the Centers for Medicare & Medicaid Services (CMS) in the United States, which affirmed this broader use. According to CMS, a clinician is any healthcare professional qualified in the clinical practice of medicine who provides direct care to patients. This definition is not limited to medical doctors but includes a wide spectrum of healthcare providers, such as nurses, nurse practitioners, pharmacists, physician assistants, and allied health professionals.

The defining characteristic of a clinician is direct patient care. Clinicians are the ones who assess patients, diagnose illnesses, implement treatment plans, monitor progress, and provide follow-up care. Whether the care is ongoing, such as in the management of chronic diseases, or during a specific episode like hospitalization, clinicians are deeply involved in the patient’s healthcare journey. Some may provide primary care without a defined endpoint in the relationship, while others offer care upon referral or as ordered by another clinician.

What sets clinicians apart is not only their involvement in patient care but also their formal qualifications. They must have the appropriate education, clinical training, and licensure to practice in their respective fields. Moreover, each clinician works within a defined scope of practice established by professional and regulatory bodies, ensuring safety, accountability, and quality in the healthcare system.

It is also important to distinguish between clinicians and clinical staff. While clinical staff such as medical assistants or licensed practical nurses may support patient care, they typically do not operate independently or provide professional services under their own authority. Clinicians, in contrast, have the autonomy to assess, treat, and document care decisions directly.

Interestingly, the concept of a clinician is not confined solely to practitioners of modern or Western medicine. In countries like Malaysia, where traditional and complementary medicine (T&CM) is formally recognized, registered practitioners of these disciplines may also be considered clinicians, so long as they are legally authorized to practice. The Traditional and Complementary Medicine Act 2016, for example, regulates the qualifications and registration of practitioners in fields such as Traditional Chinese Medicine (TCM), Traditional Malay Medicine, Ayurveda, and others. These practitioners provide direct patient care through diagnosis, treatment, and holistic management, within their own systems of healing. They too are clinicians in their systems of medicine and healthcare

While their methods may differ from those of modern medical doctors, their role in healthcare and their patient-facing responsibilities meet the criteria of a clinician. The critical distinction lies in the system of training and the framework of regulation under which they operate.

In conclusion, the term clinician has evolved to encompass a wide and diverse range of healthcare professionals, those who are qualified, authorized, and actively engaged in the direct care of patients. From doctors and nurses to pharmacists, therapists, and even traditional medicine practitioners, clinicians represent the heart of patient-centered healthcare. Recognizing the breadth of this term not only brings clarity but also deepens our appreciation for the many hands and hearts involved in the healing process.