Clinical physiology

Clinical physiology is both an academic discipline within the medical sciences and a clinical medical specialty for physicians in the health care systems of Sweden,[1] Denmark and Finland. Clinical Physiology is characterized as a branch of physiology that uses a functional approach to understand the pathophysiology of a disease.[2] As a specialty for medical doctors, Clinical Physiology is a diagnostic specialty to which patients are referred to undergo specialized tests of functions of the heart, blood vessels, lungs, kidneys and gastrointestinal tract, and other organs. Testing methods include evaluation of electrical activity (e.g. electrocardiogram of the heart), blood pressure (e.g. ankle brachial pressure index), and air flow (e.g. pulmonary function testing using spirometry). In addition, Clinical Physiologists measure movements, velocities, and metabolic processes through imaging techniques such as ultrasound, echocardiography, magnetic resonance imaging (MRI), x-ray computed tomography (CT), and nuclear medicine scanners (e.g. single photon emission computed tomography (SPECT) and positron emission tomography (PET) with and without CT or MRI).

History

This branch of physiology was founded by Professor Torgny Sjöstrand in Germany and continues to make its way around the world in other hospitals and academic environments.[3] Sjöstrand first established the new branch because of his work at the Karolinksa Hospital in Stockholm.[3] Along with Sjöstrand another influential name in clinical physiology was P.K Anokhin. Anohkin heavily contributed to the branch of physiology working diligently to use his theories of functional systems to solve medical mysteries amongst his patients.[4]

Clinical physiology was originally its own discipline, however, between 2008-2015, clinical physiology was categorized as a sub-discipline to radiology.[1] For this reason, those pursuing a career in clinical physiology had to first become registered and certified radiologists before becoming clinical physiologists. Since 2015, it is once again possible to train to be a clinical physiologist, with clinical physiology being its own discipline independent of radiology.

Role

Human physiology is the study of bodily functions. Clinical physiology examinations typically involve assessment of such functions as opposed to assessment of structures and anatomy. The specialty encompasses the development of new physiological tests for medical diagnostics. Using equipments to measure, monitor and record patients proves very helpful for patients in many hospitals. Moreover it is helpful to doctors, making it possible for patients to be diagnosed correctly.[5] Some Clinical Physiology departments perform tests from related medical specialties including nuclear medicine, clinical neurophysiology, and radiology. In the health care systems of countries that lack this specialty, the tests performed in clinical physiology are often performed by the various organ-specific specialties in internal medicine, such as cardiology, pulmonology, nephrology, and others.

In Australia, the United Kingdom as well as many other commonwealth and European countries, clinical physiology is not a medical specialty for physicians. It is its own non-medical health profession - scientist, physiologist or technologist - who may practice as a cardiac scientist, vascular scientist, respiratory scientist, sleep scientist or in Ophthalmic and Vision Science as an Ophthalmic Science Practitioner (UK).[6] These professionals also aid in the diagnosis of disease and manage patients, with an emphasis on understanding physiological and pathophysiological pathways.[6] Disciplines within clinical physiology field include audiologists, cardiac physiologists, gastro-intestinal physiologists, neurophysiologists, respiratory physiologists, and sleep physiologists.

References
  1. Arheden H (December 2009). "Clinical physiology: a successful academic and clinical discipline is threatened in Sweden". Advances in Physiology Education. 33 (4): 265–7. doi:10.1152/advan.00072.2009. PMID 19948671. S2CID 12888994.
  2. Arheden, Håkan (2009-12-01). "Clinical physiology: a successful academic and clinical discipline is threatened in Sweden". Advances in Physiology Education. 33 (4): 265–267. doi:10.1152/advan.00072.2009. ISSN 1043-4046.
  3. Linderholm, H. (May 10, 1990). "Clinical physiology: an accepted branch of physiology". Clinical Physiology. 10 (3): 215–219. doi:10.1111/j.1475-097X.1990.tb00089.x. ISSN 0144-5979.
  4. Makarov, V. A. (1997). "[Contribution of P.K. Anokhin to the development of clinical physiology]". Vestnik Rossiiskoi Akademii Meditsinskikh Nauk (12): 56–61. ISSN 0869-6047. PMID 9484016.
  5. "Clinical Physiologist". www.careers.govt.nz. Retrieved 2021-02-04.
  6. "Clinical Physiology." Archived 2013-04-20 at the Wayback Machine from Griffith University. Retrieved December 2013
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