Editorials from the Executive Medical Director
Most of you received a “present” from the ABAI in your inbox to start the new year. The Continuous Assessment Program (CAP) has begun. Will this be the savior of MOC? Will the practicing allergist embrace this format of continuous learning or will it lead to the fall of the ABAI? Already, 21 states have passed or considered legislation to protect physicians who choose not to fulfill American Board of Medical Specialties requirements for MOC. My state of Georgia passed the following in March 2017: “maintenance of certification shall not be required as a condition of licensure to practice medicine, staff privileges, employment in certain facilities, reimbursement, or malpractice insurance coverage…”
One of my favorite websites is Bogleheads.org. In case you are not familiar with this site, it is a forum inspired by the investing philosophy of Jack Bogle. You don’t know Jack? Well, you should. Mr. Bogle was the founder of The Vanguard Group, who developed the world’s first index mutual fund in 1975. It was his idea to just mimic the market with an index fund instead of trying to beat the market and, most importantly, do it at a low cost so that more money would stay in the pocket of the investor.
Recently, I had the pleasure of giving a series of lectures on asthma topics in several respiratory hospitals and at the Sichuan Medical Association meeting in China. It was a great opportunity to spend time in a country that is rivaling the U.S. in economic growth and to get an idea about the health care of patients with respiratory conditions in this country. These maladies make up a large percentage of chronic disease in China, especially as related to the high incidence of smoking in the population (believed to be greater than 30%), and the increasing issue of air pollution in the major cities. In a visit to Shanghai Pulmonary Hospital, the largest pulmonary hospital in Asia, with over 1,000 beds, I toured the Laboratory Functions Labs in the outpatient center.
I hope that you saw the Summer 2017 issue of the College Advantage and specifically the article entitled “A Glimpse into the Future.” The article contained predictions on the future of allergy – made by members on the College’s 50th anniversary in 1992. The predictions were sealed in a time capsule, and revealed and commented on for the 75th anniversary. I found some of the insights into our future fascinating, and was lucky enough to read all the submissions from 25 years ago. I’m going to share with you some more of these predictions – and by the way – not all were about advances in the field of allergy.
My column on single payer system got the following response that I want to share with you.
I also want to make clear that all my past and future columns are my opinion solely, and do not represent the views of the College or its leadership.
Let’s keep the dialogue going. Happy to share my column space with any College member, as we all learn from hearing the opinions of others. Thanks Warner.
I have spent the last week thinking about what you wrote with regards to a single payer system in the U.S.
As I was thinking about what I should write this month that would be of interest to you, I was going back and forth between health care reform and controversies in allergy practice. But, to be honest, I’m so tired of both subjects, and I’ve really had it with the circus in Washington, D.C. Then lo and behold, two of the College staff, Jennifer Pfeifer and Hollis Heavenrich-Jones, came to my rescue. They sent me a fascinating article from Scientific American, which I used to love to read when I was in high school and college. The article was entitled Does Empathy and Warmth Make a Physician Seem More Competent?
Commonly I get calls from allergists wanting to find an associate or looking to sell his or her practice. I hear the same complaint from all of them - I can’t find anybody; no one is interested. In many cases, it is because the young allergist does not want to deal with the business of taking over a practice or is just not interested in a track to partnership. Which begs the question – is allergy a career or a job?
Last week, the new FDA Commissioner, Scott Gottlieb, MD, took steps to increase competition in the prescription drug market and increase access to generics. First, the FDA published a list of off-patent, off-exclusivity branded medications without approved generics. The purpose of this action was to encourage submission of abbreviated new drug applications on medications off patent where there is no competition. This would likely ensure that no one pharmaceutical company could have a monopoly on one of these drugs, which could lead to high costs for the patient.
This spring, two more Rx products for allergic rhinitis went over-the-counter (OTC) – Xyzal and Flonase Sensimist (known as Veramyst as an Rx product). It seems like yesterday when the initial second-generation antihistamines – Claritin, Allegra and Zyrtec – went OTC. In fact, the push to make these treatments available over the counter began in 1998 when Wellpoint filed a petition with the FDA asking they be sold without a prescription. The FDA approved the OTC switch of these antihistamines in November 2002. Next came intranasal corticosteroids, with Nasacort AQ receiving the okay from the FDA to go OTC in 2013. And the floodgates opened.