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    What’s in a Name? Inference Abounds

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    Richard P. Mills, MD, MPH

    By Richard P. Mills, MD, MPH, Chief Medical Editor, EyeNet

    What’s in a name? that which we call a rose
    By any other name would smell as sweet.

    In these imploring lines, Juliet is trying to forget that Romeo is a Montague and a sworn enemy of her family. She argues that names of things do not matter, only what things “are.” But soon we learn the tragic consequences of that argument in a world where names do matter. They matter because they carry implied meaning, partly from their etymology and partly from the ornamentation they accrue through popular usage. When we hear the name of a thing uttered, our minds rush to inferences about that thing, the first impression gained thereby being strong indeed. To a Capulet—other than to Juliet, who is in denial—the name Montague makes the blood boil.

    From there, my thoughts turned to our professional organization, the American Academy of Ophthalmology. It could just as easily have been called the American Academy of Ophthalmologists. So why wasn’t it? Did the founders choose the name wisely? Come along with me as I examine the inferences induced by the two alternatives. First, the semasiology, or search for meaning, of the root structure: We all know that ophthalmos comes from the Greek word for “eye,” and logia means “study.” These roots are common to both ophthalmology and ophthalmologist. The suffix -ist (a bound morpheme to the lexical nerds out there) is the key difference between the two and means “a person, one who does an action.” Common usage has limited ophthalmologist to a specific medical professional who studies and treats the eye, while ophthalmology has a much wider coverage of people and of activities, even including public health. So, by inference, an Academy of Ophthalmologists might be expected to concentrate solely on supporting the members’ interests, while an Academy of Ophthalmology would represent the members, their patients, and the profession.

    Almost all trade unions are named for their members, for example, the International Association of Machinists and Aerospace Workers, the Teamsters, and the United Auto Workers. Medical societies are evenly split between those named for their disciplines and those named for their members. Examples of the former include the American College of Cardiology (not Cardiologists), the American Medical (not Doctors) Association, and the American Academy of Neurology. Examples of the latter are the American Society of Anesthesiologists, the American Academy of Family Physicians (not Practice), and the American College of Surgeons.

    The forerunners of professional organizations are often said to be the medieval guilds, whose job it was to control secret knowledge, the “arts” or “mysteries” of their crafts. Yet guilds practically disappeared in the 19th century, as free trade swept through the developed world. It was much later, in the 20th century, that medical professional organizations began to flourish. Their structure and purpose were certainly reminiscent of guilds, even though not directly evolved from them. So could it have been that, in 1903, when the founders officially named the American Academy of Ophthalmology and Otolaryngology, they wanted to steer clear of guild inference? They called it an Academy, implying a society of distinguished scholars, and opted for -ogy instead of -ists. It’s what’s in a name.