In Elan, the position of a medical caregiver has existed since the First Age, but the development of the role of physicians has changed over the history of Elan. Recent efforts by the Elanite Board of Physicians (EBP) seek to better document the history of medicine during Elan for future physicians. The EBP wishes to have physicians in Elan understand their past, so that mistakes are not repeated.
Not much is known of the practice of medicine during the Lost Times, but it is theorized that it was much like during the years of the Great Empire of Theradurn. What is known from the Lost Times is that Elanites moved from a hunter-gatherer society to developing agriculture, settled communities, and specialized fields and roles in a community. Those who practiced those early forms of medicine in the Great Empire were primarily called allopaths, as well as herbalists and healers. Other names in antiquity existed (and still exist today) on regional levels, but the term allopaths is believed to have been the most common.
Allopaths were often older people within a village, who had apprenticed for the same role in their youth. From birth until death, they were tasked with supporting the health of their communities. This often embedded them into the structure and management of their society. Allopaths had various tasks to complete as a part of their duties: gathering herbs and other supplies for medical remedies, completing visits with those who are ill or home-bound, and educating their apprentices. In this sense, the spread of medical knowledge was limited and highly regional.
During the later decades of the Great Empire, allopaths began to write pamphlets on their practices for their apprentices. With the increase of connection between settlements, they would also exchange them with couriers for pamphlets from other communities. This allowed allopaths from across the empire to learn from each other. It is also in this period where the Elanites’ aversion to practices of cruelty and harm (including ableism and eugenics) was first established in this fledgling medical literature. The beliefs of the time valued all members of the community regardless of their abilities or needs. This shaped physicians into providing care and seeking out new treatments for people with various ailments and disabilities that do not cause excessive pain or an undue risk.
The transition into the age of the Middle Kingdom led to allopaths being employed and sometimes overseen by the governing forces. This mainly happened to those in the burgeoning cities and more populous towns and allopaths who lived outside of these areas maintained the same independence as the age before. This continued into the Twelve Kingdoms period, which led to even more oversight and heightening of importance for those practicing medicine.
The Twelve Kingdom Wars led to allopaths beginning to travel with armies to support the wounded. The first use of the term, "sawbones", was found in a document in 1217, distinguishing the medical practitioners of villages and cities rather than just from those who traveled with armies of the Twelve Houses. Since there was much mixing of people in the wars, sawbones would pioneer the first rudimentary studies of anatomy and surgery. This knowledge accumulated over the course of the war and was recorded by many. These early studies of human anatomy and surgery were often limited to those with bodies able to fight in the wars, and written accounts were often biased towards certain sawbones and kingdoms, but it was still essential medical literature for the time. At the end of the Twelve Kingdom Wars, most sawbones ended their work within the armies and returned to work in their communities. Eventually allopaths and sawbones as terms would begin to fade from use, to be replaced by "doctor" as a colloquial attempt to universalize the terms for the same services.
In the three centuries after the founding of the Kingdom of Elan, doctors would frequently move between working within their own communities and working with armed forces involved in conflicts. This included the schism of the Church, which, while not necessarily bloody, did take its toll on the health of many.
The later years of The Kingdom of Elan saw the greatest expansion in medicine. A notable famine that began in 1651 led to the pandemic of redpox that began in 1670. The great loss of life led to a push from Elan's aristocracy to find a vaccine. Funding was pushed towards chemists, doctors, hospitals, and medical schools to promote such a development. This in turn led to a flourishing of a new generation of doctors and scientists in Elan, even after the cure was found in 1689.
As new hospitals and medical schools were established in major cities throughout Elan, the Royal Association of Physicians was founded in 1717. This organization was made up of volunteers who sought to establish a rudimentary code of ethics to address some failings in the practice of medicine, especially those identified during the redpox pandemic. The code was inconsistently followed and not enforceable, but it was an important step towards the medical code of ethics that Elan has today.
The new Republic of Elan turned its funding focus to industry and the military, often leaving funding in the field of medicine to private sources. With industrialization, there came great advancements in the studies of anatomy, surgery, epidemiology, obstetrics, genetics, psychology, and psychiatry.
While private medicinal clinics and hospitals appeared throughout Elan, the private industry of medicine saw its greatest expansion in Gauld. The capital of Sootsnap and the rest of the desert territory developed into a haven for health and wellness clinics and practitioners. Many throughout Elan, and even some visitors from neighboring countries, would travel to Gauld to receive the health benefits of the climate and the various cure-alls that were advertised far and wide. While many would leave Gauld proclaiming the benefits of a visit to the region, some left feeling they were cheated by charlatans or had their conditions worsened by improper treatment. Many physicians began to protest against it and argue that medical practitioners throughout Elan must follow the same ethical code and do right by their patients before themselves.
Dr. Christophe Becket was the head of the Board of the Physicians of the Republic (formerly Royal Association of Physicians) at the turn of the 19th century. He held the same beliefs about unregulated wellness practices and felt it was necessary to make a change in the profession. Becket worked with individual medical practitioners and the organizations that oversaw private clinics and hospitals to collectively push Elan's prime minister into making a governmental body that would supervise all in the profession with the power of legal regulation behind it.
While the collective wellness industry in Gauld attempted to push against this effort, Becket's initiative found receptive ears in Elan's government and the Elanite Board of Physicians was founded in 1831. The first act of the Board was to create a formalized written Code of Ethics, which was first published the next year. The Medical Code of Ethics was made to be modified by the Board, which consistently meets to edit it every ten years, though there are times when there are intermediate edits to wording. All physicians were also required to be registered with the organization upon completion of a qualified, formal education in universities, medical colleges, or practicum training centers.
The transition from a volunteer organization to a governmental body went smoothly, even with the protests. This was later attributed to the pre-existing medical infrastructure that was funded by the Elanite government in the previous century. While the EBP was already a neutral body before it was absorbed by the government, it still sought out perspectives of those not in medical practice in establishing its rules. The Board listened to the beliefs and ethics of many groups in Elan and mostly managed to avoid complaints of favoritism when establishing its code. In the modern day, the Board carefully balances its duties and remains one of the most approved-of governmental bodies.