• Alan Borthwick

Podiatric Dermatology or Dermatological Podiatry?

And now for something a little different. A recent conversation between myself and Alan Borthwick over semantics sparked a discussion over terminology. The result was this grammatical conundrum! Thank you to Alan for taking the time to capture this with the article below.

It has now become common parlance within the profession to refer to a podiatrist who specialises in dermatology as practising “podiatric dermatology”. At one level, this seems a reasonable phrasing, given that the use of the term “podiatric surgery” has also become part of the lexicon of terms prevalent within the world of podiatry.

It may also be reasonable to question whether or not its use is truly grammatical. We are likely to agree that the term or phrase, “podiatric dermatology” is a common noun (to denote a general way of classifying something, such as in the case of professions like ‘doctor’, ‘police officer’ or ‘nurse’). As a rule, such terms are not capitalised. In this particular case, our term “podiatric dermatology” is also a ‘compound noun’, a noun comprising two or more words. It comprises a single noun which is modified by the addition of another noun or an adjective, such as “full moon” (adjective and noun) or “washing machine” (two nouns) or even where a noun serves as an adjective, as in “history teacher”. In our case it comprises an adjective “podiatric” with a noun “dermatology”.

But is that the right way around? Which term should be the adjective and which the noun? Indeed, should it be “dermatological podiatry”? Should “podiatric surgeon” be “surgical podiatrist”? To examine this point may require looking at other common exemplars. Nurses that specialise in treating older patients belong to the speciality field known as “gerontological nursing” rather than “nurse gerontology”. However, “dental surgery” is not usually, if ever, referred to as “surgical dentistry”, although it is practiced by dentists qualified in surgery. How is the matter determined?

Is podiatric dermatology practiced by a podiatric dermatologist or a dermatological podiatrist? Would it be practised by a dermatologist interested in feet or a podiatrist interested in dermatology? How do you draw a distinction between a podiatrist specialising in dermatology, and a dermatologist specialising in skin disorders of the foot?

In compound nouns, the rule is usually that the second word is often the “main” word (or “head” noun), with the first word modifying it or adding to its meaning. Thus a “podiatric dermatologist” would be a dermatologist with speciality interest in podiatric issues relevant to it. The “head” of a phrase is the word which defines the syntactical category of that phrase. If the term in question is “handbag”, the head of the compound noun is “bag”, because the handbag is a bag, not a hand. The other elements modify the head, and are known as “dependent” modifiers. This suggests that the answer to our question might be “dermatological podiatrist” if it refers to the professional engaged in the field, because he or she is a qualified podiatrist interested in, or specialising in, dermatology. But what of the speciality field, “podiatric dermatology”? The term “dental surgery” springs to mind, yet someone engaging in that practice is a dentist trained in surgery, known generally as a “dental surgeon”, not a “surgical dentist”. It seems there is no definitive right or wrong here, as long as the meaning is clear. How do we know if it is clear? Perhaps if it is part of common parlance, over time it becomes so.