The nomination for the Gold Headed Cane award is an honor, and I appreciate the Gold Headed Cane Committee and the Board of Regents for putting my name forward for consideration. Our specialty has been a major part of my life for the past 50 years.
After completing my fellowship in Denver in 1974, I returned to Dallas where I was “the allergist and asthma specialist” in the Pulmonary Disease Section of the Department of Internal Medicine at the University of Texas Southwestern Medical School. In addition to teaching responsibilities, I investigated immune defense mechanisms of the lung. Our multiple publications during those years gave me better insight into how to critically review scientific articles. The final publication I had as a full-time faculty member related to a new medication to treat asthmatics. This paper also marked my transition to full-time private practice with an emphasis on clinical research. Ultimately, I became interested in billing and coding in addition to pharmaceutical research.
After becoming a Fellow of the College in 1986, my participation in other activities of our specialty expanded. In 1991 I was given the opportunity to serve as a representative to the Joint Council of Allergy, Asthma, and Immunology (JCAAI). I had the chance to learn about the socio-economic aspects of our specialty. That education was further enhanced and formalized when I was asked to serve as the Executive Vice President of JCAAI. In that capacity I had the opportunity to represent our specialty to Medicare, commercial insurance companies, and the AMA committees responsible for deciding on CPT codes and payments.
It was during this time that I found myself as one of two doctors representing the specialty of allergy before the USP committee to determine the revision of sterile compounding that we now know as chapter 797. In that capacity I was able to influence the guidelines released in December 2007 that provided specific regulations for immunotherapy and vial preparation. This “carve out” of the broader sterile medication guidelines allows practicing allergists to continue to formulate patient vials as we have done for years.
During my years of service for JCAAI and subsequently ACAAI’s Advocacy Council, I served as a CPT Advisor and answered hundreds of emails from our members regarding coding. I have also had the opportunity to present coding workshops at various locations and to give annual reviews of coding guidelines at our national meetings.
The specialty of allergy and immunology allows us to expand our horizons. In addition to the rewards of patient care and the lasting friendships we develop with our patients and their families, we can extend our reach into teaching younger physicians and helping mold the ethical and quality values we hold important. One may also decide to branch out into clinical research and socio-economic areas as I have done. Through serving on College committees, working with JCAAI, and attending annual meetings, my life has been enriched with friendships and opportunities that have made the practice of allergy a rewarding and gratifying part of my life. Thanks to my mentors, colleagues, and friends who have made this journey possible.