F. Miranda notes that the surname comes from the Latin physicarius, a term with which in republican Rome one of the most relevant medical specialists was designated, an expert in internal medicine. The surname would have arisen, then, from the activity exercised by the first bearer of the name.

V. Blunda proposes a different route of transmission: the surname would derive from the Sicilian dialectal word fìsicu, meaning "physician", a term that reached Sicilian from the Latin physicus through medieval Arabic. According to Blunda, this word designated the professional trained in academic medicine, in contrast with empirical healers. The surname could have originated in the trade of an ancestor graduated in the faculties of Messina or Catania, or trained in the Arab-Norman hospitals of Palermo.

As for its geographical distribution, Miranda indicates that it is a surname of Sicilian origin, with strong presence in the Syracuse area —in localities such as Lentini, Ferla, Carlentini and Floridia—, and also documented in the Catania area.