Editorials from the Executive Medical Director
This December, a draft of the Expert Panel Report 4 (EPR 4) from the National Asthma Education and Prevention Program (NAEPP) was posted for public comment. The deadline to submit your comments is Jan. 6.
Since the publication in 2007 of the EPR 3 from the NAEPP of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, there has been a flood of new data on asthma management. EPR 3 quickly became the bible of the diagnosis and management of asthma in the United States. Numerous new therapies have been approved for our patients suffering with this condition.
It is not uncommon to hear physicians saying they would not want their children to become physicians. Of course, there are many reasons mentioned such as loss of autonomy, high cost that can lead to high debt, time commitment and decreasing incomes. Even with these concerns, there is no shortage of applicants to U.S. medical schools. In 2018 - 2019, 21,622 applicants were accepted to allopathic (MD) medical schools out of the 52,777 who applied, for an overall acceptance rate of 41%. According to the Association of American Medical Colleges, this is the highest number of applications ever. So even with all the negative concerns about the future of medicine in the U.S., it is not affecting the number of young men and women wanting to become doctors.
There are many ways to get allergy education. You can go to national meetings, like the one this week in Houston hosted by the College. There are great regional and state meetings with terrific speakers. Of course, you have the allergy journals like Annals. Webinars on educational topics in allergy and practice management, both live and on demand, are available on the College Learning Connection. But this column is not about all the different ways you can keep up with allergy education from the College. I want to talk about my favorite way to get medical education and, for that matter, all types of education and entertainment. That’s podcasts.
One of the buzzwords in medicine today is diversity. I really like the definition of diversity on the Queensborough Community College site. Diversity means understanding that each individual is unique and recognizing our individual differences. These can be along the dimensions of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs, or other ideologies. Medicine is going through changes with a major emphasis on diversity, and with that, so is allergy. Gone are the days when medicine was thought of as a profession of white males, with nurses being all female. In 2018, for the first time, more than half of the applicants and enrollees in U.S.
Bill Finerfrock, the College’s lobbyist in Washington, DC, sent me a survey that had just been published by The Physicians Foundation. I had never heard of this group. They list themselves as a national, not-for-profit grant-making organization dedicated to advancing the work of practicing physicians and to improving the quality of health care for all Americans. No doubt their mission complements the College’s mission. They were founded in 2003 through the settlement of a class-action lawsuit brought by physicians and state medical associations against private third-party payers. Their Board of Directors is comprised of physician and medical society leaders from around the country. One of their research initiatives has been conducting a nationwide survey every two years called Survey of America’s Physicians.
With the average age of the board-certified allergist in their 50s, many of us are thinking about retirement. But even allergy Fellows-in-Training need to make sure they have a secure retirement plan in place. It is never too early to start saving for your golden years. Before you know it, you have been practicing allergy for 25 or 30 years, and it is time to retire. All of us know allergists – in fact, you may be one of them – who will practice until the day they drag your cold body out of your office. But for most, retirement is the next step in a full life.
I have had a great career in allergy. It would not surprise me if just about every board-certified allergist in their sixties and seventies would agree that it has been a very rewarding field, both in terms of helping patients and financially. But what about the newly-minted allergists just starting their profession, or allergists in the middle of their careers – will they be able to say the same thing when they near retirement?
For most allergists, we are busy enough—in fact, too busy, with more and more patients, time on the EHR and dealing with insurance companies. So why would I waste your time writing about side gigs for allergists? I can think of a few reasons. One, not every allergist may be as “booked” as they would like to be and even if fully booked, with the continued decrease in reimbursement, there may be the need for more income. Two, some allergists might like to cut back on patient care but don’t want to see a loss of income. Third, you may want to branch out beyond patient care. You want to use your knowledge and get paid for it. If you are an employed allergist getting a W-2, then a side gig with 1099 income may have some great tax advantages for deductions and increased retirement savings.
As EMD of the College, I usually don’t take up controversial topics in this column. In fact, the College walks a fine line when we are approached to sign off on letters promoting a particular opinion on a health care issue. So why do I want to sound off on one of the most controversial issues facing our country, which no doubt will occupy our newsfeeds throughout the 2020 elections? Because this is an editorial column, where I can give my opinion. Before I start, let me say that this is my opinion alone and is NOT the opinion of the American College of Allergy, Asthma, and Immunology, its officers or its staff.