What's in a name?

March 1, 1999

We speak a common language when we discuss and try to provide optimal health care for children. However ambiguous and misleading those other words may be, "pediatrician" is a word we understand.

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What's in a name?

"Duh" (that's du-uh) is a new word introduced into the Englishlanguage by teenagers sometime around 1996 or 1997. Even if you've beenon Mars for the past few years, you probably would understand when you heardit that it means something like "I can't believe you didn't know that."Teens have contributed lots of words to their (and sometimes our) everydayspeech that adults understand without explanation. "Bites," asin "That bites!" is a word that conveys the ultimate in cynicalcompassion as it emanates from the expressive teenage mouth.

The terms adults make up are often more complicated. In health care we'vecome to accept "primary care," "ambulatory pediatrics,"and "academics," as though we really know what they mean. We oftenrefer to the pediatrician in community practice as a "primary careprovider." When a patient with diabetes mellitus shows up for caredoes the same pediatrician turn into a secondary care provider? And does"ambulatory pediatrics" mean caring for patients who can walk?If so, the term describes only a fraction of the pediatric patients in theusual office or clinic. We usually reserve "academic pediatrician"for those who teach, investigate, and see patients within the walls of amedical school-affiliated hospital complex. What, then, is the pediatricianwho teaches medical students or residents and does office-based researchin a community setting?

Fortunately we don't have to accept the limitations of the words sometimesapplied to what we do. We speak a common language when we discuss and tryto provide optimal health care for children. However ambiguous and misleadingthose other words may be, "pediatrician" is a word we understand.Duh!



Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics, isVice Chair, Pediatric Education, and Director, Residency Training, JohnsHopkins University School of Medicine, Baltimore.