Critical Shortage of Allergists

There is a growing shortage of allergists in the United States. Without intervention, it is estimated that the number of full-time equivalent (FTE) allergist/immunologists will decline about 7% from 2016 to 2029. Meanwhile, demand for these physicians is projected to increase by 28% over the same period. New and larger residency programs are needed in allergy and immunology to meet growing patient demand.

Supply and Demand Forecast for Allergy/Immunology Physicians
YearA/I Physician DemandA/I Physician SupplyA/I Shortage
Source: Center for Health Workforce Studies; School of Public Health, University at Albany, State University of New York


Allergic and Immunologic Diseases Have Become Much More Common

The prevalence of asthma and allergy-related disorders in the U.S. continues to increase.

Allergies affect as many as 50 million people in the U.S.,[1] and more than half of the U.S. population tests positive to one or more allergens.[2]

In addition, approximately 34 million people in the U.S. have been diagnosed with asthma.[3] The annual economic cost of asthma is 19.7 billion dollars – 14.7 billion in direct costs, and 5 billion more in lost productivity and other indirect costs. Medical expenses associated with asthma increased from 48.6 billion dollars in 2002 to 50.1 billion dollars in 2007. Asthma is responsible for 13 million missed school days and 10 million missed work days every year[4] and accounts for 217,000 emergency room visits and more than 10 million physician office visits annually.[5]

Despite the pervasiveness of asthma- and allergy-related disorders in the U.S., only a relatively small population of physicians practices in the medical specialty of allergy and immunology (A/I).

In 1990, there were 86 allergy and immunology training programs in the U.S. In 2016, there are just 73. Limited funding is cited as the primary reason for these drastic reductions, which are projected to continue unless action is taken. To keep pace with the growing demand for allergist/immunologists, training programs will need to increase the number of specialists trained by an additional 120 per year.

[1] Airborne Allergens: Something in the Air. National Institute of Allergy and Infectious Diseases NIH Publication No. 03-0745; 2003.

[2] Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the Third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116:377-383.

[3] American Lung Association. Epidemiology & Statistics Unit. Research and Program Services. Trends in Asthma Morbidity and Mortality. November 2007.

[4] Akinbami L. Asthma prevalence, health care use and mortality: United States 2003-05, CDC National Center for Health Statistics, 2006.

[5] Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. National health statistics reports; no 7. Hyattsville, MD: National Center for Health Statistics; 2008.

Attempts to Solve the Problem

Attempts to solve the problem – which have fallen short of addressing the need – include: self-funding (no salary); support from practicing allergists; pharmaceutical industry funding; local endowment funds; funding by national allergy-immunology organizations; hospital funding and local, state and federal funding.

Despite innovative funding mechanisms, we need policy changes at the national level to provide additional support for Graduate Medical Education (GME) programs in allergy and immunology. Meeting this goal will take time and hard work. To start an immediate action program, ACAAI Foundation support is necessary now.

Actions Being Taken by ACAAI and Its Foundation

A coordinated public-private initiative to fund additional GME positions, including subspecialty positions such as allergy and immunology, deserves the attention of federal policy makers and practicing allergists.  We at ACAAI are eager to participate in efforts to find solutions for this pressing problem.  The Advocacy Council is doing its part at the federal level – now, we need to provide support at the grass roots level.

In 2017, the ACAAI Foundation will launch a program which will provide seed money for starting new allergy/immunology training programs or adding slots to existing training programs. We plan to make an impact, and we can’t do it alone. We need your help.

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