Successfully starting a new Allergy practice?

[ihearthives]

Hello all. Does anyone have any stories about people recently starting a new Allergy practice successfully? Or maybe even buying one? The job outlook right now appears terrible and so I have considered this option but wanted to see if there are any success stories out there...thanks!

---

Members don't see this ad.

 

[bronx43]

Hello all. Does anyone have any stories about people recently starting a new Allergy practice successfully? Or maybe even buying one? The job outlook right now appears terrible and so I have considered this option but wanted to see if there are any success stories out there...thanks!

Yeah, the job market is the main reason why I chose not to go into allergy. Doing two years of fellowship and coming out with no job offers was unpalatable to me. That plus the steeps cuts in allergy reimbursement. On the other hand, I think there is good demand in the general public for allergists depending on your location. It really depends on the size of your city and the number of established allergists. One of the allergists in my city (medium city in the Midwest) opened up shop 3-4 years ago. He's a business and marketing whiz and he was able to take a HUGE chunk of the market. Last I heard, he was pulling over a mil a year. This isn't the norm, but it does show you that starting up your own PP is possible.

 

[Spt30]

Yeah, the job market is the main reason why I chose not to go into allergy. Doing two years of fellowship and coming out with no job offers was unpalatable to me. That plus the steeps cuts in allergy reimbursement. On the other hand, I think there is good demand in the general public for allergists depending on your location. It really depends on the size of your city and the number of established allergists. One of the allergists in my city (medium city in the Midwest) opened up shop 3-4 years ago. He's a business and marketing whiz and he was able to take a HUGE chunk of the market. Last I heard, he was pulling over a mil a year. This isn't the norm, but it does show you that starting up your own PP is possible.

Sad to hear you didn't end up pursuing allergy. What sub-specialty if any did you pursue?

 

[drkristy85]

Hello all. Does anyone have any stories about people recently starting a new Allergy practice successfully? Or maybe even buying one? The job outlook right now appears terrible and so I have considered this option but wanted to see if there are any success stories out there...thanks!

Job outlook getting worse for Allergy, for sure. One of my med school friends has a dad who's an allergist. She was gonna do A/I, but her dad convinced her not to. Reimbursements are declining, and other specialties are taking over allergy territory. ENTs are doing rhinoscopy and treating allergy, prescribing IT. Pulmonologists are treating asthma. PCP's are becoming more confident with treating allergy & asthma...Flonase is now available OTC, no Rx needed from an allergist.

But worst of all is "Allergy clinics" where allergy skin testing are done, and pts are prescribed Immunotherapy, but these "Allergy clinics" are run by Primary care physicians, sometimes even posing as "Allergy trained"!!! Yes, I am not kidding...I found out about this from my friend's dad, who is board certified A/I. One of these Family practice guys opened up near him & is stealing patients....if you look, they are mostly Family practice but some are even Optometrists, Anesthesiologists, ER docs, etc. who have zero allergy training....My advice to anyone who is interested in doing private practice Immunotherapy/allergy skin testing is to do 3 yr Family Med residency, then hey, go open up your own allergy clinic! (tongue in cheek)


http://www.warnerfamilypractice.net/allergy_and _asthma.html

http://www.colonialfamilypractice.com/AboutUs/AllergySinusAsthma.aspx

http://www.fallsfamilypractice.com/allergy_testing.html

http://www.allergyandfamilymedicine.com/

http://www.clearlakefamily.org/allergy_testing.html

 

[drkristy85]

Job outlook getting worse for Allergy, for sure. One of my med school friends has a dad who's an allergist. She was gonna do A/I, but her dad convinced her not to. Reimbursements are declining, and other specialties are taking over allergy territory. ENTs are doing rhinoscopy and treating allergy, prescribing IT. Pulmonologists are treating asthma. PCP's are becoming more confident with treating allergy & asthma...Flonase is now available OTC, no Rx needed from an allergist.

But worst of all is "Allergy clinics" where allergy skin testing are done, and pts are prescribed Immunotherapy, but these "Allergy clinics" are run by Primary care physicians, sometimes even posing as "Allergy trained"!!! Yes, I am not kidding...I found out about this from my friend's dad, who is board certified A/I. One of these Family practice guys opened up near him & is stealing patients....if you look, they are mostly Family practice but some are even Optometrists, Anesthesiologists, ER docs, etc. who have zero allergy training....My advice to anyone who is interested in doing private practice Immunotherapy/allergy skin testing is to do 3 yr Family Med residency, then hey, go open up your own allergy clinic! (tongue in cheek)


http://www.warnerfamilypractice.net/allergy_and _asthma.html

http://www.colonialfamilypractice.com/AboutUs/AllergySinusAsthma.aspx

http://www.fallsfamilypractice.com/allergy_testing.html

http://www.allergyandfamilymedicine.com/

http://www.clearlakefamily.org/allergy_testing.html

Almost forgot to mention that the new A/I grads are having a rough time finding jobs.... :/

 

[Spt30]

Doom and gloom is common in medicine. Job demand is also dependent on local factors. Majority of immunotherapy in this country are not administered by an allergist. This is nothing new. There are not enough allergists to go around.

Turf battles are also not unique in allergy. In my experience I tend to collaborate with my colleagues in ENT, pulmonary, and dermatology.

Although allergic rhinitis is the cash cow of A/I. it doesn't define the specialty. In a typical day I see patients with food allergies, drug allergies, chronic urticaria, allergic asthma, eczema, primary Immunodeficiencies, bee venom allergies, etc.

Unfortunately economics and job security plays a big role in specialty selection. I hope medical students and residents continue to choose this field as a career.

The lifestyle is great and the patient population are relatively young and healthy. There's also lot of opportunities in academics and research. Biggest plus; I love my job!

 

[bronx43]

Sad to hear you didn't end up pursuing allergy. What sub-specialty if any did you pursue?

I am planning on doing a startup business while holding down a hospitalist gig next year. If all fails, may go back and do subspecialty, but honestly, the financial benefits are getting slimmer by the year.

I would love to have gone into allergy, but this is the problem when a field has an attribution rate approaching zero (you can practice until you're 80).

 

[bronx43]

Almost forgot to mention that the new A/I grads are having a rough time finding jobs.... :/

One of our second year A/I fellows is doing a third "research" year in fellowship because there aren't any jobs in the area. The hope for the fellow is that it will maybe land them an academic research job, but... yeah, idk.

 

[IgEdoc]

and the problems you encounter as an allergist may go beyond the specialty, so you need to stay alert:
CSF rhinorhea referred as chronic rhinitis
Colon CA in situ in a patient with "pruritis" (must be an allergy, right?)
Severe hypothyroidism in a patient with chronic recurring skin infectiona (a rule out immunodeficiency consult - guy was scratching madly at his dry skin)
Lymphoma in a patient with wheezing/sob (prednisone seemed helpful, of course)
Lots of GERD as chronic rhinitis or asthma
the list goes on and on......

 

[MATV78]

Theres so many jobs now on the Academy of Allergy's job board. I remember when I was looking for jobs in 2009 when I graduated the market sucked. Thats why I started my own thing.
But then again it sucked for everything. Maybe the economy is getting better, more insurance etc.

Now I need to hire another associate. I read another post about someone who opened up in the midwest. But was very savvy in terms of business. Totally agree.
I can hire another allergist, nurse or NP. And maybe the allergist would be a better doc than me perhaps. But the business aspect is terribly difficult. Its harder to put the wheels in motion and understand our convoluted system. And keep those wheels spinning because the insurances are always changing policies. And your wheels will get stuck in the mud from time to time. Sometimes real stuck.

Also it is becoming increasingly harder for other specialties to get reimbursed for doing allergy testing and shots. I think its because the insurances would rather pay less people.
Not because they want to help our specialty. That being said, those that do practice better know the ins and outs of business, insurance, credentialing. Coding and how each insurance company is specific to allergy billing.
Thats why you have so many ENT practices throughout the country trying to hire allergists.

And we get audited like crazy, so you have to be really prepared. This will not go away. Justify things and code properly. And be honest with what you do. Maybe the audits are deterring people from doing AI. Especially if folks want to do it as a means to provide additional income source. Audits are scary crazy, but I always do whats right for my patients and I document heavily. No matter how tired I may be.

Starting practice sucks, and you learn a lot about the true economic, political perspective we would never know as being a 9-5 doc. But its sucks the life out of you for the first few years.
If I had the job market thats out there right now (some damn freaking good jobs) there would be no flipping way I would repeat.