Tensions at the Local Level
Will the increased cooperation at the leadership level translate to smoother relationships at the private practice level? According to Dr. Marple, “the answer is partially yes and partially no. In the Dallas/Fort Worth area, we have very strong relationships between otolaryngologists and allergists.” As a result, he said, allergy patients treated in that community do very well.
Dr. Aaronson conceded that the general membership of the related societies may be a “few steps behind” the leadership when it comes to cooperating with related subspecialists. “When we talk to our cospecialists in our specific individual fields, we need to make them more aware of the level of cooperation that exists. The fact that we are cooperating does not mean that we each endorse each other’s practices with which we may not agree. It means that we respect each other. Then it becomes possible for everybody to work together.”
Sources point to the increased burden of allergic and respiratory disease, and to diminished numbers of internists who are doing residencies in allergy. “Each of our groups is small,” noted Dr. Krouse. “There are perhaps 4000 allergist/immunologists and about the same number of otolaryngologists doing allergy practice. If the prevalence of allergy is 25 percent to 30 percent, there are probably 75 million Americans with allergies, so this is a significant burden of disease.”