Editor—The specialty of geriatric medicine has not settled on a name, so I was interested to find out which name was the most popular. Additionally, I want to make a case for the use of a single name.
The “geriatric medicine” and “medicine” subsections of the BMJ's classified jobs section were surveyed for six months (May to October 2000 inclusive). The job title displayed in the heading or departmental title for each post was recorded. Jobs in all grades were recorded, providing the post had a “geriatric” component.
Altogether 478 posts in “geriatric medicine” were advertised in 24 issues. The table shows the frequency with which each job title was cited. Commonest was “medicine for the elderly” (116 advertisements; 24%), then “geriatric medicine” (100; 21%), and “care of the elderly” (96; 20%). The words “medicine” or “medical” were used in 317 entries (66%).
The word “geriatrics” was coined by Nascher in 1909 from the Greek geros, meaning old man, and iatrikos, meaning “pertaining to a physician” (from iatreia: cure).1 But geriatrics has not settled on a generic name for itself like similar specialties that combine titles, such as paediatrics or orthopaedics, perhaps because the term is thought to be stigmatising by many patients, the public, and some medical staff.
Having multiple titles for a single specialty implies impermanence and uncertainty, and it could increase confusion as to the function of the specialty. The BMJ and royal colleges have always called it “geriatric medicine.”
I propose that departments should follow this established lead, but we must recognise that there are simply too many barriers to the universal adoption of the term “geriatric medicine.” I believe that the English version of “geriatrics”—that is, “medicine for the elderly”—would be less troubling to the non-geriatrician, as well as being a term already included in two thirds of departmental names.
The National Service Framework for Older People requires that elderly people be treated with equality2; our specialty needs a single title that can be used when bidding for the health resources that older people are due. If the specialty is to continue as a specialty, it needs to establish to which mast it will nail its flag. The late Bernard Isaacs, professor of geriatric medicine at Birmingham University, said: “It is better to change the fame of geriatrics, than the name,” but it is more realistic for us all to practise medicine for the elderly.3
Table.
Job titles displayed in the geriatric medicine and medicine sections of the BMJ 's classified section, May-October 2000
| Departmental title | No (%) of entries (n=478) | Departmental title | No (%) of entries (n=478) |
|---|---|---|---|
| Medicine for the elderly | 116 (24) | Integrated medicine for the elderly | 2 (0.4) |
| Geriatric medicine | 100 (21) | Special responsibility for the elderly | 2 (0.4) |
| Care of the elderly | 96 (20) | Age related medicine | 2 (0.4) |
| Elderly medicine | 48 (10) | Adult medicine | 2 (0.4) |
| Elderly care | 31 (6) | Care of older people | 2 (0.4) |
| Integrated medicine | 20 (4) | Care of the elderly medicine | 2 (0.4) |
| Elderly care medicine | 15 (3) | Medical services for elderly people | 2 (0.4) |
| Geriatrics | 13 (3) | Medical services for older people | 2 (0.4) |
| Elderly services | 5 (1) | Elderly | 2 (0.4) |
| Health care of the elderly | 4 (1) | Medical health care of the elderly | 1 (0.2) |
| Health care of older people | 4 (1) | Integrated general medicine | 1 (0.2) |
| Medicine for elderly people | 3 (1) | Medicine of the elderly | 1 (0.2) |
References
- 1.Nascher IL. Geriatrics. New York Medical Journal 1909:358-9.
- 2.Department of Health. National service framework for older people. London: DoH; 2001. [Google Scholar]
- 3.Isaacs B. The challenge of geriatric medicine. Oxford: Oxford University Press; 1992. [Google Scholar]