The allergist and the intensivist: Not such odd bedfellows

摘要

In 2007, the American College of Allergy, Asthma and Immunology (ACAAI) in a report entitled Graduate Medical Education and Workforce Issues in Allergy and Immunology outlined a future marked by an increasing shortage of allergy and immunology (A/I) specialists. The ACAAI predicted that by 2020 there would be 3,400 practicing allergists, while projecting a demand for 5.550. This followed predictions only a few short years earlier of a golden age of A/I.The role of the allergist in the future years remains unclear. Projections of physician supply and patient demand have become a moving target. We have yet to feel the full impact of a multitude of public policy changes. Proposals for medical homes, accountable care organizations, increasing use of nurse practitioners and physician assistants in specialty practices, growth in the number of employed physicians, fewer small practices, aggregation of practitioners into integrated delivery systems, changes in physician demographics and lifestyle, and partition of practitioners into defined inpatient or outpatient roles will all affect our specialty's future. The Accountable Care Act and the aging patient and physician population will also have a great deal of influence in ways we can only speculate. All of those changes in the practice of medicine do not address the greater interest in providing allergy care exhibited by other specialties, especially otolaryngologists.