From the desk of the EMD: Allergy Facebook friends

December 3, 2018

It seems like every day there is an article in the news about social media and especially Facebook. Issues related to Facebook include knowing more about you than you think, selling your data, affecting you mentally by making you feel you are not as cool as some of your friends and even leading to addiction to the site. And it’s hard to ignore the spread of misinformation and fake news as well as private information being hacked, which should disturb all of us. With all these fears about Facebook, why do so many of us still use it? I can think of a few great examples of the good that Facebook can do. They are the closed Facebook groups, Allergists (AAAAI/ACAAI) in Private Practice and the ACAAI Physician Well-being Group.

The Allergists in Private Practice group was started in May of this year by Harold DelasAlas, MD, PharmD, FACAAI, and Thamiris V. Palacios-Kibler, DO, and already has 359 members. The group was created out of a need for community since allergy and immunology is such a small subspecialty. For Dr. Palacios-Kibler, she had recently transitioned from academics to private practice and this was a huge learning curve for her regarding the business and financial aspects of running a clinic. She thought co-creating a group with Dr. DelasAlas, where other allergists can commiserate, would help her learn and prevent her from making crucial financial mistakes in the future. It’s a great place where you can learn everything from how to obtain certain studies/tests to finding medications that aren’t readily available for patients. According to Dr. DelasAlas and Dr. Palacios-Kibler, this group has been a wonderful way for other colleagues to post their questions anonymously, which has helped many that otherwise would not have a venue to get answers.

To become a member of this closed group, you must respond to the following which are reviewed by one of the moderators:

  1. Are you a board-certified allergist in private practice?
  2. Please put your website link with your name so we can verify who you are.
  3. Do you promise to treat the members within with respect, as you would want to be treated?

This part is important as there have been many examples of non-allergists and spammers/bots attempting to join the group, often to advertise.

Why is this group important? What is its value? Recent demographics of the College membership show about 25% of allergists are in solo practice. These allergists may not have the ability to bounce questions related to clinical and practice management issues off other allergists. Also, “hearing” what issues and concerns that allergists around the country are having and seeing wide-ranging answers from peers may benefit all in practice. Others may find usefulness in this group by giving their expertise to some of the various questions posted.

In looking at some posts over the last few months, there appears to be about 50% clinical questions and 50% practice management questions. Here are just a couple of examples of some recent questions and comments:

Do you all "mandate" flu vaccine for your employees? If they don't want vaccine do they have to wear a mask? This year I have a significant number of employees declining vaccination. I'm very concerned about the implications to our patients and my other staff.

Comments:

  1. Mandate with no refusals yet. We see a ton of primary immunodeficiency so it’s not an option.
  2. We do not mandate, but we offer it for free.
  3. My clinic mandates them and for those that don’t get them, they have to provide their supervisor an explanation.

 

If you learn half way through testing that the test is invalid because the patient took an OTC antihistamine, do you charge for the test? If yes, do you charge for the repeat test too? (Which may hit over max pricks covered for some insurances like Medicare) Or how do you handle this situation from billing perspective? Frustrating because you wasted time but got no good results.

Comments:

  1. I don’t because at that point the mistake is ours; should ask before testing, explicitly.
  2. I charge for the first test and sometimes do ImmunoCaps instead of skin testing again.
  3. I do charge if it wasn't our mistake (i.e. patient "remembered" halfway through test) -- we are still using time, devices and antigen and should be reimbursed!
  4. We charge for the first test, but not the second. But if it is our mistake we don’t charge.

 

Another group feature is helpful polls. A recent one surveyed the group members with the following question: “How many of you bill allergic reactions to their allergy shots?” The most popular answer was “Bill E/M code and medications/nebs” with the next most popular answer “Don’t bill out of courtesy to our patients.” I got a laugh out of the answer that came in third “Don’t bill but will now after reading this post!”

If you think you would benefit from being a member of this closed Facebook group, send in a request. We all learn from each other. Thanks to Dr. DelasAlas and Dr. Palacios-Kibler for starting this group and showing the good that Facebook can do.

The College’s Physician Wellness Task Force, led by Annals of Allergy, Asthma  and  Immunology Editor-in-Chief Gailen Marshall Jr., MD, PhD, FACAAI, wanted to create an easily-accessible, comfortable and safe space where allergists could share tips, resources and experiences related to well-being. And the ACAAI Physician Well-being Group was born.

Similar to the first group, you do need to request to join - it helps keep out spammers while also ensuring that this is a space just for College members to share without any outsiders watching. It’s currently a small group but is growing every day. Several College leaders are part of the group so aside from the helpful resources and articles, it also is a wonderful place to network and connect with other allergists outside of your immediate location. And the variety of articles shared is great - a good way to diversify what you read online.

From academic journal articles to reports from the press, College members are spreading the word about what’s affecting physicians and how we can take better care of ourselves. And with all the helpful group tools Facebook offers like comments, polls and more, the College’s well-being group is a great way to fill your newsfeed with positivity every day.

So next time you’re on Facebook, search for these groups and request to join. Become a key part of the growing online allergy community and be there to support your fellow allergists - whether it’s through clinical advice, practice management tips or self-care hints. See you there!

Michael Blaiss, MD, FACAAI, Executive Medical Director