Where do we go from here?

May 18, 2020

“If you don't know where you are going, you'll end up someplace else.” Those words were spoken by Yankees Hall of Famer Yogi Berra along with many other memorable quotes like, “The future ain’t what it used to be” and “You can observe a lot by just watching.” As many of you know, I am a big baseball fan, and the 2019 ACAAI President’s Reception at Minute Maid Park was a real treat for me!  So, what do Yogi’s words say to us today?

The sobering results of our survey on the impact of the COVID crisis were discussed in last week’s webinar. Many of our fellow allergists are suffering and are concerned things may not return to normal soon enough for them to survive. The College hears you and has developed a host of valuable resources as you transition to an uncertain future. Our webinars focus on tough human resource topics, securing financing and safely returning your practice to profitability.

Even before the current crisis, we were observing “a lot by just watching.” Recent trends had already been suggesting, “The future ain’t what it used to be.” The allergy workforce is changing. The influx of the “millennial allergist” suggests there will be fewer “entrepreneur allergists” and more employed allergists.  Many of our younger members value carved-out family time and prize experiences more than things; they have high educational debt and need a secure salary.

The new generation of allergists are more ethnically diverse, with a higher percentage of women than men. I have heard many times that, “These young doctors just don’t want to work.” But that’s just looking at half the issue. In reality, they don’t want to work the way the baby boomer allergist worked, missing precious time with their family at home. Do you blame them?

The era of the “Mom & Pop” allergy practice may have already been coming to a close, accelerated by recent events. The trend toward larger practices and private equity acquisition of physician practices was already accelerating for allergy, much like the earlier trend in dermatology.

None of us would have chosen for a sea change to be spurred by a pandemic. But the overall trend that started before this may not be a bad one for us. Bigger, corporately owned practices somewhat shield us from managing a crisis like the current one. They provide us with opportunities that only big practices enjoy, like:

  • Sharing the cost of government regulatory (MIPS, USP) oversight.
  • Better leverage with managed care and vendors.
  • Better opportunities to participate in integrated systems, insure patient flow.
  • More marketing power.

Few things about the future are certain, but I think we can count on a few truths:

  • The solutions of the past will not be the solutions of the future.
  • Subcutaneous Immunotherapy will remain a profit center for allergists.
  • College resources can help reduce the burden.

I am reminded of a GIANT in our field, Don Aaronson, MD, JD, MPH, FACAAI. He has had a unique appreciation about how our specialty should evolve and thrive. I am proud to know him, and thankful we didn’t “end up someplace else” because of his vision. He has done more than any other individual to ensure fair payment for the services we offer.

Know that the College is remaining vigilant and here as your trusted partner. Until next time…

J. Allen Meadows, MD, FACAAI
College president