Osteology: further debate.

Abstract

The recent letter from Dr. Mautalen (J Bone Miner Res 14:155) comes at a time when a number of us in the United States have been independently asking a similar question from a somewhat tangenitial perspective. Isn’t it time to establish the field of Disorders of Bone and Mineral Metabolism as a distinct specialty recognized as such by the American Medical Association through its Council on Medical Subspecialties? This calls for the establishment of a specialty Board in the discipline “Disorders of Bone and Mineral Metabolism.” The terminology is indeed a mouthful but successful qualifiers at the board certifying examination would not need larger business cards to accommodate FACBMD after their name. Such a long name, as opposed to Dr. Mautalen’s initial suggestion of “osteology,” has many advantages. It clearly encompasses all basic and clinical research and all clinical aspects of our discipline. Perhaps more importantly it would have almost instant meaning to all practitioners and their patients. Our specialty societies (ASBMR, IBMS) encompass bone and mineral in their names, as does this Journal. The primer published by the ASBMR is “The Primer on Metabolic Bone Diseases and Disorders of Mineral Metabolism.” This primer would of course serve as the foundation for curriculum development. This broader terminology would not preclude individuals from focusing on specific aspects of this discipline, such as osteoporosis, renal osteodystrophy, and hypercalcemia. This is the usual state of affairs for most specialty societies. Endocrinologists “specialize” in diabetes, thyroid diseases, bone diseases, etc. Cardiologists specialize in “invasive” or “noninvasive” cardiology. Rheumatologists specialize in autoimmune diseases, inflammatory arthritidies, etc. We recall that this concept of a specialty board in our discipline was proposed to the ASBMR Council some years ago but was not warmly received. In retrospect, while a good idea even then, it was premature. We submit that this is no longer the case and encourage wide discussion of this concept through the pages of this Journal and at the Council of the ASBMR.