A Word from the President
It’s a new year and a new round of headaches in obtaining prior authorizations for our patients’ medications. Let’s look at three issues practicing allergists face every day and especially at the start of each year.
First, formularies change frequently, and especially in January after insurance companies have made new deals with employers for coverage. I hope you like solving puzzles, because each insurance company likely has a new set of prior authorization rules – and it’s up to allergy practices to figure them out. This results in needing to, yet again, get prior authorizations for existing patients to continue their medications, or be shifted to different medications which are now covered because the ones they were previously on are no longer covered. Is your head spinning yet?
Not everyone is naturally comfortable being a leader. And that’s only one reason why the College is hosting its Leadership Summit, Generation Next, for the second year in a row. The Summit, which is for allergists 45 years or younger or who have been in practice 10 years or less, is designed to help young, up-and-coming allergists get more involved in the College. It’s also a great way to take home important leadership skills tailored specifically for allergists.
During my year as president, we will embrace the theme of this year’s Annual Scientific Meeting – Precision Medicine in Allergy Practice. Our main goal is to educate allergists to improve their patients’ clinical outcomes. We are going to guide you in the application of very expensive new technologies and how they can be used to determine the phenotypes and endotypes in asthma and atopic dermatitis.
Following are just some of the ways we are looking ahead with precision.
We will continue to produce yardsticks. The atopic dermatitis yardstick will be published in the January issue of Annals. The pediatric severe asthma yardstick will be submitted for publication in early 2018. We have implemented a taskforce to determine the topics for future yardsticks.
In previous Insider articles I have commented on our Vision 2020 strategic initiative in general terms, highlighting the major changes that have taken place since its implementation began in 2015. After three years, all the new parts are up and running at full throttle, including our re-vamped governance structure, our website (including our online educational portal called the College Learning Connection), and the Advocacy Council. In addition, our flagship journal – the Annals of Allergy, Asthma, and Immunology - just finished its own major tune-up and is cruising in a new direction.
Three months ago, I reported in this column that the Annals of Allergy, Asthma, and Immunology had changed course, including re-hiring Gailen Marshall, MD, PhD, FACAAI as editor-in-chief and adding Donald Leung, MD, FACAAI as executive editor. I stated that our intent is to raise the impact factor enough for the Annals to increase its ranking as a top tier allergy journal while retaining its appeal to the practicing allergist.
Accomplishing this would be no small feat given the superb journals that already serve the specialty. The College feels strongly that our goals for the Annals are realistic, and that there is a desirable niche that is not yet occupied.
As I suspect most of you have heard, there was a recent fatality during a supervised oral food challenge in a three-year-old boy in Alabama. As a grandfather, I can only imagine the grief his family and friends are enduring. I also feel for the traumatic effect this may have had on the team of health care professionals involved with his care. As reported in a joint communication between the American College of Allergy, Asthma, and Immunology, the American Academy of Allergy, Asthma, and Immunology, and the Canadian Society of Allergy and Clinical Immunology, we do not know the critical details of this event.
As you may have noticed, registration has begun for the College’s upcoming Annual Scientific Meeting at Boston’s Hynes Convention Center on Oct. 26-30. Located in Boston’s Back Bay, the venue is the perfect size and location for the College meeting. We are especially excited this year because we will be celebrating the 75th anniversary of the College while embracing the theme of “Precision Medicine in Allergy Practice”.
They say that “everything happens for a reason” and “somehow good things fall apart so that better things can fall together.” These themes come to mind over the past two months with respect to the editorial team of the Annals of Allergy, Asthma, and Immunology. As you may recall, Gailen Marshall Jr., MD, Phd, FACAAI, had planned on stepping down on January 1, 2018, after an unprecedented 12 years as editor-in-chief (EIC) of the Annals. Last year, after a thorough nationwide search led by Bryan Martin, DO, FACAAI, the College proudly announced Rohit Katial, MD, FACAAI, as the incoming EIC. However, after several months of Annals transition planning, Dr. Katial was lured away from academics to pursue an exciting new career opportunity. This meant he could not assume the Annals EIC role in 2018. The College completely understood Dr.
We live in unsettled times. The fate of our health care system is up in the air, the majority of physicians are burned out, and our specialty’s traditional private practice model has become a less attractive option for young allergy/immunology specialists. Even practice parameters, the low-drama evidence-based tools that many of us refer to regularly, are changing dramatically. In addition to serving as a practical reference for practicing allergy/immunology specialists, practice parameters have gained increasing importance as tools used by third party payers.
Attempting to document continued competency in medical practice is challenging, not just for allergy/immunology, but also for all the primary specialties and sub-specialties served by the American Board of Medical Specialties (ABMS). I initially hesitated to devote a College Insider column to Maintenance of Certification (MOC). In part because it is a hot button area for some of our members, but also because of my own conflict of interest as a member of the American Board of Allergy and Immunology (ABAI). However, significant changes are taking place in the ABAI MOC process that I believe are of interest to College members, including the emergence of inherent flexibility of certain MOC requirements. I therefore decided to share my perspective.