Editorials from the Executive Medical Director
Why didn’t they teach me how to write a medical opinion column in college or medical school?
For the last seven years, Bob Lanier, MD, FACAAI, has been the Executive Medical Director (EMD) of the College. So what is the big deal? The College has a president, president-elect, vice president, and treasurer, along with the Board of Regents – don’t they lead the College? Isn’t there an administrative staff in Chicago that conducts the day-to-day business and all the activities related to the Annual Scientific Meeting? Why do we need an EMD? In fact, what is an EMD? What has Dr. Lanier really done for you and me in this post over the last seven years?
I see patients from Tricare, Medicaid, every off-brand insurance I can think of – shoot, I even have “Bob’s System” where I see patients from school nurses for kids that need it and have no insurance, no referrals with no charges at all. But I can’t see new Medicare patients anymore.
You may have missed this notation in your rounds of national newspapers, but recently a big city allergist, who is not a College member, had his license suspended for using nosodes.
Edward Jenner used nosodes in his revolutionary observations on cowpox and small pox. In case you missed it, a nosode “is a homeopathic remedy prepared from a pathological specimen. The specimen is taken from a diseased animal or person and may consist of saliva, pus, urine, blood or diseased tissue.”
In this case, our modern day ingenious allergist used cat saliva mixed with vodka to vaccinate children, and in some cases, babies. Apparently he used only top shelf vodka and an AKC certified Persian cat!!
As I was walking my jumping, snarling, twirling, Italian greyhound puppy last night, I noticed a familiar “buzz” in the air. I am used to mosquitoes – I grew up on the Texas coast. As a child I remember running behind the DDT sprayer truck without a shirt on to get covered with the spray so I could play without being bitten so much. But now it’s different, and every newspaper I get warns of some new catastrophic virus. First it was West Nile, and now it’s Zika.
Just ask me – I dare you! The perils of being a medical expert.
My young partner often confounds me asking questions I can’t answer. After practicing 40 years, you would think I would have seen one of everything, but no, my partner has an amazing propensity to expose my knowledge gaps. But while I may not know the answer, I certainly know people who do know.
While I hate to bother them, I’m sometimes reduced to calling people on the phone, admitting my incompetence. I either get reinforcement that no one knows the answer, or that there has been “a very recent article on that very subject in the Journal of the Leptoneese Immunology and Cryptic Allergy Society this month.”
Kathleen May, MD, FACAAI, Advocacy Council member, in Maryland, was the first to pick it up – that something was going to happen about compounding in her state that would affect us all. It was an astute observation and led to the tremendous program we have developed to preserve allergy injections for our patients. At that time, USP was pretty much unknown amongst allergists. But when USP mentioned in a conference call that we were allowed to listen in to – that allergists would no longer have the traditional carve-out for compounding allergy vaccines – the allergist world was turned upside down.
“USA Today has come out with a new survey – apparently, three out of every four people make up 75% of the population.” – David Letterman
At last look, I counted eleventy-seven million surveys unanswered in my Gmail box. I don’t know why I just don’t delete them. I have a feeling I’m never going to do them, but I feel guilty about the fact that some people spent a lot of time trying to find out what’s gonna make me happy and then I don’t help them.
Don’t make me beg: Please take my survey.
If the question makes you a bit uncomfortable, you aren’t alone. Less than one percent of respondents to Medscape’s allergy compensation quiz were allergists this year, but those that did respond produced some startling results.
In a ranking of 26 specialty groups, the study indicates that the average allergist made approximately $222,000 last year, which makes them fifth from the bottom over the perennial bottom feeders; pediatrics. We pediatricians wear a hair shirt and a red badge of honor over being the lowest paid of all doctors for the umpteenth year in a row. It’s just not a profession to go into if finances are the goal.
“While I’m here, would you mind skin testing the twins?” FYI: the twins were not patients.
What? People never used to ask that sort of thing. One wonders if surgeons get snap requests for gallbladders during lunch hours, or quad bypasses on weekends.
Or here is the lesser ask: What do you say when a patient asks you to “just look at my other child’s ear for a quick second.”
Let’s look at the second patient first. Do you go new school, hard line and say “I can only see people I have worked up properly,” or do you fall back (old school) as I do, and say, “I only see ears on Tuesday, sorry.”