leonardoflyingmachine.jpegHow can we "fix" our field, with so many  things wrong in it?  I have a few ideas, and again the list is not to be meant all-inclusive:

1.  Get back to what we do best:  immunotherapy.   This is what truly sets us apart from our ENT, pulmonary, and dermatology colleagues.

2.  Be open to new ideas--and embrace SLIT:   SLIT is the wave of the future, and it's here now.  The La Crosse Method offers vast advantages over the just-approved sublingual grass and ragweed tablets.  (See my lecture on sublingual protocols in "powerpoint presentations" for details.)  Let's quit sticking our head in the sand and sit up and look around.  An effective, safe, convenient form of immunotherapy is available.  Let's use it. 

3.  Be open to non-IgE mediated illness and learn how to manage it effectively:   Let's get real.  Non-IgE illness abounds in our field.  We simply have ignored it.  Late phase reactions to dust and mold can be effectively treated with SLIT.  Do it.  And non-IgE mediated late-phase reactions to foods are more common than most allergists think.  Let's get to work on those too.

4.  Rearrange our priorities: First--immunotherapy.  Second--environmental control.  And last?  drugs. Too many allergies have these priorities reversed (drugs first, environmental control second, immunotherapy last). 

5.  Be open to treating other illnesses that can have an allergy component.  Too many allergists think in terms of "black and white".  Either an illness is ALL allergy (i.e., allergic rhinitis) or HAS NOTHING TO DO with allergy (i.e., Alzheimer's disease).  There is, however, rich ground to plow in other areas--a middle ground between these "black and white" illnesses where allergy may have a component in the problem--illnesses such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome come to mind.  See this article to open your minds a little: Allergy Asthma Proc 2005 Jan-Feb; 26(1):19-28.  Are attention deficity hyperactivity disorder and chronic fatigue syndrome allergy related?  What is fibromyalgia? 

6.  Get more active with colleagues in other fields that interface with allergic disease:  Express your willingness to work with other physicians on allergy issues affecting other parts of the body!  As allergists we should care more about things than runny noses and snot...be interested in treating chronic urticaria--call your staff dermatologist and work with him/her...be interested in treating allergic vaginitis--call your staff gynecologist...be interested in treating irritable bowel issues...call your staff gastroenterologist...be interested in issues involving chronic fatigue and rheumatic disease in patients with histories of allergy--call your staff internist... We need to have an age of enlightment in allergy--we need to be broadminded Renaissance Allergists--not just asthma doctors!