Physician specialists: What's in a name?

 Most of my medical posts are in Medicine and Social Justice (https://medicinesocialjustice.blogspot.com), but this one, although about medicine, is not about social justice and seemed more a musing appropriate to this blog...

 

I had a recent conversation with someone who said that they were looking for a gerontologist for their parents. Since they were talking about a physician, I noted that the correct term is “geriatrician”, one who practices geriatrics; a gerontologist is someone who studies aging but is not a physician. Geriatrician is parallel to pediatrics/pediatrician or obstetrics/obstetrician.

But it is not at all obvious. Indeed, most medical specialties and their physician practitioners follow the “ology/ologist” model: anesthesiology, radiology, neurology, cardiology, and so on. Therefore, it made sense to think a physician caring for older adults might be a gerontologist. But it isn’t.

There are other terms for physicians in other specialties, and I guess you have to know each one. Sort of parallel to geriatrics/gerontology might be psychiatry/psychology, but the physicians who practices psychiatry is a psychiatrist, and psychologists can also be clinical practitioners, if not physicians. Following this psychiatry/psychiatrist model, the specialty that used to be called physical medicine is now called physiatry, and physicians practicing it are physiatrists. The parallel to psychology might be physiology, but physiologists, though they can have MD degrees, are researchers in physical function, not clinicians.

And the physicians who practice orthopedics, which seems similar to geriatrics/pediatrics and obstetrics are called orthopedists, not orthopedicians. The same ending is used for genetics and ethics, geneticist and ethicist, and these can be either physicians or other professionals! The general physician for adults is called an internist, but practices internal medicine, not internics. Internal medicine subspecialists are almost all “ologists” (cardiologists, gastroenterologists, nephrologists, rheumatologists, etc.). And now some internists have become “hospitalists”, based on taking care of only hospitalized patients, and we are also hearing not only the opposite, “ambulists”, but subtypes of hospitalists based on when they work – “nocturnists” and even “weekendists”!

The specialty of family medicine is practiced by family physicians or family doctors; the old terms family practice and family practitioner are no longer used. Of course, there are family nurse practitioners, generalists in the field, compared with pediatric, psychiatric, and adult (not internal medicine) nurse practitioners. Those who do solely women’s reproductive health may be called women’s health or OB-Gyn nurse practitioners, but the nurses trained to deliver babies are nurse-midwives. 

A lot of these names are from Greek and Latin, and sometimes both are used in ways that can be confusing: pediatrics comes from the Greek for child, while podiatrist (a foot doctor, a DPM, not an MD) comes from the same root as pedal, the Latin for foot. Indeed, in anatomy, while the larger bone in the lower leg, the tibia, has a tibial artery, tibial vein, and tibial nerve, the smaller, the fibula (from Latin) has a peroneal artery, vein, and nerve, from the Greek for the same bone! 

I have observed that, while to a health professional, the difference between orthopedics (bones) and orthodontics (straightening teeth) is clear, it is also obvious why these names might be confusing to a regular person. Knowing this stuff as a health professional makes you part of the in-group; knowing it as anyone else means you spend too much time at the doctor's!

You really can’t tell the players without a scorecard!