What sort of doctor are you?

When people ask me that I usually say, “a pretty good one”, followed by “stomach doctor” and then sometimes “gastroenterologist”. That is a mouthfull (sic) and a friend always calls me a “gastrologist”

The label suggests that I and my colleagues work only in the gaster (stomach) and enterons (intestines). Using endoscopes I have had a passing (literal) interest in the stomach, and a little distance beyond that into in the biliary tree and pancreas, but not much else. Others spend most of their time in the small intestine or the colon. Many do not use endoscopes at all, not least liver specialists, who call themselves “hepatologists”.

Is there a better name for this broad church. How about “Digestivism and Digestivist”? I introduced that idea when naming the Digestive Disease Center and indeed the British Society for Digestive Endoscopy. It doesn’t seem to have caught on. Maybe “digestive” sounds too much like food, but why not, is that not what we are trying to manage?

The famous British hepatologist Sheila Sherlock once told me that “gastroenterology is the practice of helping people get square meals through round holes”. Our hospitals could vie for Michelin stars (although perhaps not for their food).

What about the sub-specialty focus for many of us “digestivists”? My colleagues could call me a “digestive endoscopist (retired)”, or to go to the heart (sic) of the matter and mirror the cardiologists, with “interventional digestive endoscopist” or just “interventional digestivist”. Most accurate would be “interventional digestive biliopancreatic endoscopist”. That is clearly too much, and “idbpeist” doesn’t slip off the tongue. I do use “ERCPist” in medical company, although that would exclude those “idbpe” doctors who do other procedures like EUS. Some with extra training and skills like to be called “advanced endoscopist”.

Note that many of these labels end in “ist”. You will recall that this derives from Greek istes and Latin ista, meaning “one who does/practices/believes” something.

Surgeons have addressed the same issue in describing their sub-specialists. Thus, general surgeons, trauma surgeons, colo-rectal surgeons, HPB (hepatobiliarypancreatic) surgeons, upper GI surgeons, and transplant surgeons.

And you might wonder where the word “surgery” comes from. My friend Google AI tells me that it “comes from the Ancient Greek term kheirourgía (χειρουργία), combining kheír (χείρ, meaning “hand”) and érgon (ἔργον, meaning “work”), highlighting its origin as manual craft. This Greek term passed through Latin (chirurgia) and Old French (surgerie) before entering Middle English around the 1300s as “surgerie,” evolving into the modern “surgery”.

One more nomenclature issue, the MD degree. It is apparently Latin for Medicinae Doctor. In USA and many countries it is the graduating degree, enabling medical students to call themselves “doctor”. I have an MD, and proud of it (along with MA, MB, BChir, DCH, FRCP, FRCS, MASGE, also windows cleaned) but MD in England is different. It is only gained by thesis (like PhD) after a tough spell in full-time research.

My MD thesis waxed lyrical about the lipids of the rats small intestine. That was not a huge contribution to human knowledge, but it taught me that I was not destined for a career in basic science and should look elsewhere. Luckily.

Of course, there are other types of “doctor”. Acedemics in many fields study for years to get to PhD, literally Doctor of Philosophy. Some of them like to be called “doctor”, most simply add it after their names in correspondence.

The “doctor” label has been perloined by others in USA. Tooth doctors (dentists) are called doctor. There are also tree doctors (surgeons) and ads for help from plumbing doctors, computer doctors and others.

All part of life’s rich tapestry.

 

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