The Future of the Allergy and Immunology Workforce

A recent study by the Allergy and Immunology Physician Workforce Study concluded that if current trends continue there will be a shortage of Allergists in the near future. This is based on an analysis of existing data, a survey of physicians providing allergy services, and surveys of allergy fellows completing allergy training programs and their program directors in 1999. Not only has their been a decline of 34 percent of physicians entering allergy training programs, but many of the graduates of allergy programs return to their native countries to assist in immunology programs in those regions. Clearly, medical schools are not supplying enough trained allergists to maintain the current number of allergy practitioners, and certainly not enough to keep up with the growth of the US population and the increasing prevalence and awareness of allergic disease.

Many practices, including VAPA, have begun to utilize physician extenders to meet the increasing demand for allergy services and to provide more efficient care. The Medicare program recognizes physician extenders by allowing payment in full for an episode of care if the extender is supervised onsite by a medical doctor, but reducing payment by 15 percent if the extender provides care without the onsite presence of a physician.

VAPA engaged the services of an allergy trained Family Nurse Practitioner in April, 1999. Since that time, Mary Lou Hayden, MS, FNP, has seen patients as follow-ups or overflow for VAPA physicians, and had developed a following of her own patients. Physician extenders generally have prescriptive authority, and work under the supervision of a medical doctor. The Nurse Practitioner also works closely with the entire clinical staff, developing and improving practice protocols and standards of care.

The future of the allergy practice and the availability of allergy practitioners has made identifying creative options, such as the use of a Nurse Practitioner, more relevant. VAPA is proud to be on the cutting edge of this approach to the effective delivery of healthcare in the 21st century.