And looking to the future
....... the myth of “a rose by any other name....” - Cameron Swift reflects

We live in a culture where names have become important (whether we like it or not)

Any reconsideration of nomenclature should be closely argued (as to its functions and appropriateness) before any "referendum". A rational option appraisal might, after groundwork and open debate, be put to the membership with a recommendation from the governing body.

Any new nomenclature would after 50+ years seem very strange for a while and entail a difficult period of readjustment and "identity" both for us and for others. There would need to be a very real appetite for change to survive this.

We should decide on the basis of a clear rationale or shelve further debate for a further 5 years.

Nomenclature is targeted at a wide variety of "consumers". These include:

• Ourselves. Our current nomenclature is steeped in history and tradition of which we are (or should be) rightly proud. We hold the term geriatrics and our identity as geriatricians with deep affection and esteem. It has specificity and brevity. It invariably triggers a response and often an opportunity for
  education amongst those we meet. It defines us professionally.
• Our patients. Our own affection for current terminology is probably not widely shared by patients.
• Professions allied to medicine, not all of whom share the long tradition of specialism now built up by physicians. How helpful is the current terminology to them?
• Politicians and management. We are engaged in a recurring cycle of laborious re-education of successive generations of both. Current terminology probably predisposes to "stereotypic ageism" within the respective organisations.
• The general public and the press. Current terminology has become pejorative and devalued. At best it is equated with self-deprecatory stoicism and at worst with stigmatised and outdated concepts of custodialism. Overall it is probably a barrier to public education.
• Potential resource donors. The earlier penchant for charitable endowment of units and academic chairs has largely waned in the UK, though is still strong in the USA and in countries where a strong need to "do something" by way of kick-starting standards in the care of older people is still perceived. There is a need in this country to "move on" in the battle for resources. The current terminology may not be helpful.
• Academic institutions. Other than highly prescriptive endowments, organised clinical academic endeavour in the field as currently identified is struggling to survive. In particular, the knowledge base defined by current terminology is commonly characterised as a loss leader, as lacking academic focus, or both. There is also a need to focus academic endeavour on clear programmes which address the important questions presented by medicine and ageing.

The main problem historically has been to come up with acceptable alternatives that might gain support as an improvement.

Soley to trigger debate (again!) and to test the appetite for change, I offer some options that have emerged in informal discussion with colleagues:

• We might re-label the field of knowledge and research (and academic departments, divisions or groupings) "medical gerontology", meaning the understanding and study of ageing as applied to the science and practice of medicine. This focuses the knowledge base on ageing and its consequences for individuals and populations. "Medical" here is no less multidisciplinary than "geriatric medicine" (the birthplace of meaningful multidisciplinary practice!) has always been. The term brings the field academically into harmony with biological gerontology and social gerontology, whilst ensuring the centrality of medicine to its identity. "Clinical" (as an alternative to "medical") has little meaning to the wider public and to allied professions outside the ranks of physicians. "Geratology" is for demographic reasons linguistically correct (very Oxford!) in its derivation, but possibly a touch esoteric in the marketplace? People would ultimately get used to physicians who are also medical gerontologists.
• We might re-name NHS departments, "Departments of Ageing & Health", either within or incorporating medical inpatient, outpatient and day-patient facilities.
• We might re-name the Society "Ageing and Health UK". This rather modernising radical departure asserts the Society's remit to embody expertise in health and ageing and opens its profile to wider public, multi-professional, political and media support. We already have open membership (for example in SIG's). It does, however, lose in the name much of the focus on medical specialisation. It is also rather like "Diabetes UK" which originates from patient rather than medical representation. The "British Society of Medical Gerontology" is longer, rather stuffy, more inward directed, but more accurate and possibly more geared to professional expertise and training. It could be incorporated within "Ageing & Health UK" as the repository of voting rights.

I could probably live with at least some of the above. Others will doubtless have better ideas.

Or not? Do we really need or want to change?