From the Desk of the EMD: Remote practice of allergy – what can you do?

February 3, 2020

One of the most common emails that the College receives from members is “Why can’t the College do something about the remote practice of allergy?” We are hearing more and more about physicians who are not fellowship-trained or board-certified allergists doing allergy testing and even placing patients on immunotherapy. It is not uncommon to hear about non-medical doctors such as chiropractors and naturopaths treating allergy and asthma patients. You may have seen ads on TV and social media hawking blood tests for “food sensitivities,” which measure IgG in the blood to different foods.

Yes, it is frustrating for all of us when we hear about patients not receiving what we perceive as quality care for their allergy and asthma conditions. So why can’t the College do something about it? It is not just the College, but no one can stop these practices at this time. It goes to the issue of restraint of trade. Merriam Webster Dictionary defines it as “an attempt or intent to eliminate or stifle competition, to effect a monopoly, to maintain prices artificially, or otherwise hamper or obstruct the course of trade and commerce as it would be if left to the control of natural and economic forces.” All the examples of remote practice above, if criticized directly by the College or by you, could be construed as a restraint of trade, as there is nothing illegal about these which I mentioned.

It begs the question: What legally can be done? You can promote yourself and your practice as to what a board-certified allergist is and what you do. You can use social media to get the word out. You can give talks to your community physicians and patient groups to explain your training and your role in the care of allergy and asthma patients. Make yourself available to local TV, radio and newspaper outlets to give interviews on allergy topics. In an interview, be careful to explain only what you do, and don’t disparage in any way what you may perceive as poor care from others. In other words, promote your value and refrain from any negative comments on other practitioners or other practices. You take the high road.

What if a patient sees you and expresses concern about the evaluation they have received from another health care provider for their allergy/asthma condition? Don’t criticize that person or clinic. You can refer the patient to the state’s Board of Medical Examiners to file a complaint.

The College will continue to promote the practicing allergist and is looking at new ways of doing this as we embark on our Strategic Planning 2021-2023. One approach will be educating allied health in primary care on the role of the board-certified allergist in patient management. Also, we will be looking at directed advertising in social media in promoting the board-certified allergist. For payers and policymakers, we’ll continue to provide current data and information to demonstrate how allergists provide better outcomes at lower cost.

The remote practice of allergy is not going away, but we must continue to “get the word out” on the expertise of the board-certified allergist.

Michael Blaiss, MD, FACAAI, Executive Medical Director