Editorials from the Executive Medical Director
What do you get for the patient who has everything? It’s almost as hard as finding something for your spouse. They know you love them, but they still want some tangible evidence of caring.
How about food? Nah, they’ll trash your waiting room and it’s just your luck a peanut cookie will sneak through — and cause a disaster. Spike the food, and move on.
Clothing? Nah, just like your spouse, patients are hard to fit and change sizes all the time. Forget the clothes. (Although I am still thinking about a free T-shirt extolling the benefits of allergy relief with my phone number, Twitter handle, maybe my photo. Hmmm … I might have to reconsider.)
The Medical Council of India announced to a joint delegation of the American College of Allergy, Asthma and Immunology and the American Association of Allergists and Immunologists of Indian Origin (AAAII) recently in Delhi, India, creating the foundation of a formal specialty of allergy and clinical immunology in the world’s largest democracy.
“It’s the realization of a dream,” notes Jayesh Kanuga, MD, FACAAI, former president of AAAII. “We would like to acknowledge the important role of the American College of Allergy, Asthma and Immunology. The College has stood by us from the beginning.”
Finding that the ACGME was asking for comment on the ABAI proposal to allow changes to the requirements for the training of allergists, the College responded nimbly to the task. Inside of two weeks, we issued a blast email survey and an editorial concern in the August issue of e-News to which we had well over 500 member and fellow responses. While a few responses were supportive of the ABAI suggestion that family practitioners be admitted for training to allergy-immunology, the great majority was not supportive at all. Most believe a more reasoned discussion of the issue should follow before sweeping changes are made to the allergy specialty.
You read it right. The American Board of Allergy and Immunology (ABAI) together with the American Family Practice Board have jointly petitioned the ACGME to allow family physicians to enter allergy-immunology training along with pediatricians and internists, which will allow them to become board-certified allergists. ABAI made this suggestion with assertions that more allergists are needed.
The negotiations apparently have been going on between the boards for years. They worked out the kinks, and it appears ready to happen. We have until September 24 to render comment. Think for a minute: In less than one month our specialty could undergo monumental change.
You are afraid to say it; I am not. The ABAI has jumped the shark. For you millenniums, that’s a “Happy Days” reference, which is now used to mark the episode when a TV series has gone too far. In this case, while stretching a plot line, Fonzie water-skied and jumped over a huge shark in a freshwater lake.
The ABAI is using severely flawed, outdated educational theory, and, like the Fonz, it has jumped the shark. I am sitting deep in my bunker, heavily fortified awaiting your response, lovingly fingering my “gold card,” which means I don’t have to recertify because I am grandfathered. It also means I have the right to be grouchy and speak the truth a lot without worrying what anybody says, such as “don’t pay any attention to him, he’s getting long in the tooth, you know.”
Those of us out there in “flyover” country — which I’m defining as outside the Washington beltway — would be well advised to visit our capitol in the springtime. It is glorious! It’s green, the cherry blossoms are still hanging on and the government grounds are just gorgeous.
And to see the hoards of children decked out in their school colors, departing from buses and marching with troop leaders to visit their Congressmen is truly impressive and inspiring. Walking down the streets looking at the massive edifices, one has to think that America could never end. It’s just too big to fail, too glorious, too blessed. It fills you with a sense of pride. We did this. Men in my family died for this.
Although it is well known among members that the College and Academy collaborate in a number of areas — such as the JCAAI, Certification/Maintenance of Certification Board Review Course, the Program Directors Assembly Winter Meeting, practice parameters and other joint task forces — the staffs of the two organizations also collaborate behind the scenes. They often work together and help each other with massive undertakings. I’ve asked Rick Slawny, our executive director, to provide his insight on these inner workings.
Having just returned from the AAAAI Annual Meeting in San Diego, I want to personally thank Kay Whalen, AAAAI executive director, and her staff for the assistance they provided.
Bobby Q. Lanier, MD, FACAAI
Executive Medical Director
A very distinguished internist of Indian origin in a finely tailored suit, who has risen to the ranks of CEO of a major health consortium, commented to me during a lecture question and answer session. He said, “We never see you, not in the doctors’ lounge, not in the hospital cafeterias, not at our staff breakfasts. Finding an allergist is like finding the Abominable Snowman.”
I am going to stick it out another year (maybe a bunch more), but I resolve to enjoy it more and worry less about the things I cannot control. I am waiting.
I have some big advantages over you younger guys: the ABAI harassment doesn’t bother me, my house is paid for, and my family is healthy. Heck, I have the best job in the world, but sometimes I get depressed about being supervised and systemized. You kids out there, you are the ones to have the gripes and groans, but strangely you are not the ones complaining. There are two reasons, I think. First you may be afraid to complain, much for fear of retaliation, and just keep your head down and not make trouble. Old guys — having no fear, and confident in our assessment of our own competence — don’t mind speaking out. Both groups have something to learn from each other.