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Letters to the Editor  |   December 2010
It Means Just What I Choose It to Mean—Neither More nor Less
Tyler C. Cymet, DO
Author Affiliations
  • Tyler C. Cymet, DO
    Associate Vice President for Medical Education, American Association of Colleges of Osteopathic Medicine
Article Information
Medical Education / Being a DO
Letters to the Editor   |   December 2010
It Means Just What I Choose It to Mean—Neither More nor Less
The Journal of the American Osteopathic Association, December 2010, Vol. 110, 745-746. doi:10.7556/jaoa.2010.110.12.745
The Journal of the American Osteopathic Association, December 2010, Vol. 110, 745-746. doi:10.7556/jaoa.2010.110.12.745
To the Editor:  
The late Sen Daniel Patrick Moynihan (D, NY) was fond of saying, “We are all entitled to our own opinions, but not to our own facts.”1 I would add that we are not entitled to our own professional language choices, either. 
To be a profession, a group should share a body of knowledge and skills.2 Although professionals are granted considerable autonomy in practice and the privilege of self-regulation, certain boundaries must be respected. It is my opinion that we need to maintain a consistent standard of language in describing osteopathic medicine and that the Glossary of Osteopathic Terminology3 defines that standard. 
The American Osteopathic Association's Foundations for Osteopathic Medicine4 textbook includes the following statement related to osteopathic medical terminology: 

The evolution, growth, and teaching of osteopathic philosophy have been coordinated through the Educational Council on Osteopathic Principles (ECOP) of the American Association of Colleges of Osteopathic Medicine. This organization consists of the chairs of the departments of osteopathic manipulative medicine and osteopathic principles and practice from each osteopathic medical school.... One of ECOP's charges is to obtain consensus on the usage of terms within the profession.

 
The terminology preferences of JAOA—-The Journal of the American Osteopathic Association differ from the Glossary3 in certain cases, based on AOA policy (Michael Fitzgerald, BA, personal communication, May 11, 2010). Although I am not arguing that either the JAOA or the Glossary of Osteopathic Terminology3 is right or wrong, I am arguing that we need to use a common language to describe what we do as osteopathic physicians. 
In the early days of the osteopathic medical profession, each school of osteopathy developed its own language to describe the manual medicine taught at the school. The resulting inconsistencies made developing state licensing examinations, national board examinations, and objective standards difficult by allowing for a bias that benefited individuals based on the schools they attended rather than on the merits of those being tested. 
In 1969, ECOP was established to standardize osteopathic medical terminology and osteopathic principles and practice. Twelve years elapsed before ECOP reached agreement and the first edition of its Glossary was published in the JAOA's April 1981 issue.5 
Currently, the criteria6 for including terms in the glossary are as follows: 
  • Words to be included must have special significance to the osteopathic [medical] profession.
  • Words must be a part of our language or appear in the osteopathic [medical] literature.
  • Terms that [are] defined in medical dictionaries [are] excluded, unless they [have] a special significance to osteopathic physicians.
Osteopathic physicians from different specialties often speak different professional languages—even if they all use English as their vernacular language. Yet standardization of professional terminology facilitates discussions among different specialists.7 Furthermore, the increasing importance of clear communication within interdisciplinary healthcare teams means that we must be consistent with our language. 
The JAOA often determines the issues discussed within the osteopathic medical profession, and the language used in the JAOA will be repeated, quoted, and cited. If the JAOA decides to use its own language—separate from that taught in osteopathic medical schools—unnecessary confusion will cloud professional discussions. 
Discussions, as well as scientific research, cannot be accurate or productive without a standard vocabulary. People can easily talk past each other or use the same words to talk about very different things. The work of the JAOA is too important for it to occur outside of the academic work of osteopathic medical schools. 
A system is in place for considering changes to the Glossary of Osteopathic Terminology—including openness to input and lively discussion (http://www.aacom.org/people/councils/Documents/Glossary_Guidelines.pdf). I respectfully request that the JAOA work with ECOP to maintain standardization in the language used within the osteopathic medical profession. 
 Editor's note: Dr Cymet is affiliated with the American Association of Colleges of Osteopathic Medicine, which holds the rights to publication of the Glossary of Osteopathic Terminology.
 
 Dr Cymet is also a member of the JAOA Editorial Board. He was not involved in the decision to publish this letter.
 
Mike McCurry's tribute to Daniel Patrick Moynihan. The American Academy of Political and Social Science Web site. June 18, 2010. http://www.aapss.org/news/2010/06/18/mike-mccurry-ldquo-we-should-always-find-a-place-to-honor-pat-moynihan-rsquo-s-kind-of-insight-and-service-rdquo. Accessed November 23, 2010.
Cruess SR, Johnston S, Cruess RL. “Profession”: a working definition for medical educators. Teach Learn Med. 2004;16(1):74-76.
Educational Council on Osteopathic Principles of the American Association of Colleges of Osteopathic Medicine. Glossary of Osteopathic Terminology. Rev ed. Chevy Chase, MD: American Association of Colleges of Osteopathic Medicine; April 2009. http://www.aacom.org/resources/Documents/Downloads/GOT2009ed.pdf. Accessed November 23, 2010.
Seffinger MA, King HH, Ward RC, Jones JM, Rogers FJ, Patterson MM. Osteopathic philosophy. In: Ward RC, ed. Foundations for Osteopathic Medicine. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:3-18.
The Project on Osteopathic Principles Education. Glossary of osteopathic terminology. J Am Osteopath Assoc. 1981;80(8):552-567.
Kuchera WA. Introduction. In: Ward RC, ed. Foundations for Osteopathic Medicine. Baltimore, MD: Williams & Wilkins;1997 : 1126.
Coren JS, Filipetto FA, Weiss LB. Eliminating barriers for patients with limited English proficiency. J Am Osteopath Assoc. 2009;109(12):634-640. http://www.jaoa.org/cgi/reprint/109/12/634. Accessed November 23, 2010.