Acronym Acrimony

Abstract

The beginning of wisdom is to call things by their right names. —Chinese proverb We are the beneficiaries of a rich and comprehensive specialty, which gives rise to a nearly incomprehensible name. How many of us have tried in vain to explain to our mothers-in-law or our young children what these words mean? Or, heaven forbid, resort to a lesser, 2-word version? “Oral and maxillofacial surgery” (OMS) is a long and complex moniker begging for a tidy acronym. OMS is the logical choice, using the key words and burdening us with the fewest number of letters. This is consistent with the treatment used by many of our leading professional organizations, most importantly the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the Journal of Oral and Maxillofacial Surgery (JOMS). To my surprise, however, I commonly see “oral and maxillofacial surgery” abbreviated as “OMFS,” particularly in academic departments and private practices. This bimodal distribution of acronyms is perplexing, because it disrupts the unity of our specialty and weakens our brand. Furthermore, “OMS” rolls trippingly off the tongue, whereas “OMFS”, when spoken, may be misheard as “OMSS” or “OMFF.” Sometimes, when I see “OMSF” (Oral and Maxillofacial Surgery Foundation) in print, I check twice to see whether the publisher has made a typographic error. When I notice an inexplicable variation in behavior, my first instinct is to seek a rigorous scientific investigation. In this spirit, I set out to examine the use of acronyms in the OMS community. Specifically, among those who need to use the term “oral and maxillofacial surgery,” which is the more prevalent abbreviation, OMS or OMFS? I hypothesized that OMS is the more usual or frequent form of the abbreviation. As such, my specific aims were to 1) estimate and compare the frequencies of the use of these 2 abbreviations and 2) measure the correlation between the use and users of the abbreviation. In pursuit of this goal, I designed and implemented a cross-sectional study. The sample was composed of the major users of the terms “oral and maxillofacial surgery” and “oral and maxillofacial surgeon.” The primary predictor variable was user, grouped into the following organizational levels: individual, regional, institutional, national, or international. The primary outcome variable was the predominant abbreviation, OMS or OMFS, used in the title or in the description of services on the organizational Web site. Appropriate uni- and bivariate statistics were computed. The results showed some surprising trends. All (100%) the major specialty organizations or journals at the national and international levels (eg, JOMS, American Board of Oral and Maxillofacial Surgery, AAOMS, International Association of Oral and Maxillofacial Surgeons, International Journal of Oral and Maxillofacial Surgery, and the OMS Foundation) incorporate OMS into their standard acronyms. At institutional Web sites for OMS (OMFS) teaching programs, of the 40 sites I reviewed, 11 (27.5%) used OMS preferentially. Ten (25%) institutions used OMFS. Five (12.5%) programs were ecumenical, using OMS and OMFS interchangeably. A surprising finding, however, was that 14 programs (35%) elected not to use abbreviations at all. This mirrored an informal survey of private practitioners’ Web sites (ie, “Googling” colleagues who came to mind) where none (0%) used acronyms to abbreviate “oral and maxillofacial surgery” or “oral and maxillofacial surgeon.” The results of this “rigorous” investigation support my hypothesis that “OMS” is the preferred abbreviation of those who practice the specialty of oral and maxillofacial surgery. The most interesting finding, however, is that the predominant tendency in teaching institutions and among private practitioners was to shun abbreviations altogether, preferring to spell out “oral and maxillofacial surgery” rather than abbreviate the name or the impact of our specialty. I take my hat off to those who resist abbreviation entirely, resolute in their belief that the breadth of our specialty demands bold articulation. At 11 syllables, “oral and maxillofacial surgery” is not only the longest-named medical specialty, it is also a mouthful. Nonetheless, the rewards are there for those who state clearly for their patients the scope and range of their expertise. Unifying our specialty’s acronym may seem to be a “first-world problem.” Fair enough, but why leave ourselves open to confusion or derision? We spend so much energy educating the patient population about what we do and when to seek our care, it would be a shame to muddy the waters with imprecise labels. Variation in how we present our specialty leads to the sense that we are not clear about who we are. We should not allow a letter to divide us. It’s time to get the “F” out of there.