ENT and allergy

[Oto2008]

Are there any good examples of Otolaryngology groups in or out of TX that do a significant amount of allergy?

How do most residency programs include allergy training, ie clinic once a month, learning allergy testing, option to attend a certification course, etc.

What are the benefits beyond being able to bring in money while not seeing the patients every visit?

How would the scope of an ENT allergy practice be similar/different from an allergy/immunology MD's allergy office?

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[resxn]

Are there any good examples of Otolaryngology groups in or out of TX that do a significant amount of allergy?

How do most residency programs include allergy training, ie clinic once a month, learning allergy testing, option to attend a certification course, etc.

What are the benefits beyond being able to bring in money while not seeing the patients every visit?

How would the scope of an ENT allergy practice be similar/different from an allergy/immunology MD's allergy office?

1 - several in my area and I know of several around the country in places I've lived before.
2 - in my residency, we were sent to the allergy course if we wanted to go. We had little formal allergy training, but we could spend time with the allergist if we wanted. It really wasn't emphasized any more than what was necessary to pass the boards. I would have liked to have more.
3 - do you need any other benefits? seriously?
4 - well, as an ENT when the medical stuff fails, your patient population is captured for surgical intervention. You don't have to worry about an allergist referring to your competitor down the street. On the other hand, you won't get as many referrals from the allergist because you're his competitor--he'll send out to an ENT who doesn't do allergiest (like me). I have several allergists who refer only to me because I'm the only ENT of the 4 practices within 20 minutes who doesn't do allergy treatments in the office. I won't speak to how adding allergy will change a practice since I don't have that service, but I doubt it changes much for the doc accept it's very lucrative.

 

[Oto2008]

My personal allergist told me the same thing. Her reasons for ENTs to not do allergy were 2-fold. First, she said they (ENTs) are not as good at it. Second, she thought that the referrals for sinus cases from allergists would earn you more money than your own allergy practice. However I've heard that a busy allergy practice can earn well over 100K. It's hard to justify her monetary reasoning if the number is correct, as you don't have to spend the same amount of time with the allergy patient as you do surgical patients. I guess it also depends on how much sinus surgery you can do from those referrals, how proficient you are at it, and how many people have allergic rhinitis in your area. But when my insurance gets billed $500 for the serum every 12 shots, and $23 every time I get a shot without seeing an MD, I find that doing your own allergy is more profitable.

 

[forbin]

The first point is certainly debatable and probably true to some extent. It's hard to argue that an ENT knows more about allergy than someone who spends all their time treating allergies. That being said, any ENT who puts the time in to learn about allergy and become certified should be more than competent.
The second point may have been true 15 years ago, but these days a busy allergy practice pays MUCH better than any number of sinonasal procedures. It's not everyone's cup of tea, though (I personally find allergy a little boring, but its hard to argue with the $$$).

My personal allergist told me the same thing. Her reasons for ENTs to not do allergy were 2-fold. First, she said they (ENTs) are not as good at it. Second, she thought that the referrals for sinus cases from allergists would earn you more money than your own allergy practice. However I've heard that a busy allergy practice can earn well over 100K. It's hard to justify her monetary reasoning if the number is correct, as you don't have to spend the same amount of time with the allergy patient as you do surgical patients. I guess it also depends on how much sinus surgery you can do from those referrals, how proficient you are at it, and how many people have allergic rhinitis in your area. But when my insurance gets billed $500 for the serum every 12 shots, and $23 every time I get a shot without seeing an MD, I find that doing your own allergy is more profitable.

 

[resxn]

You can't be serious telling me that a medical allergist will be "better" at allergies than an ENT. That's a stupid argument allergists make to keep ENT's out of their territory. It's just as stupid as an ENT saying that a general surgeon should not do thyroids because we do more in the neck. Really, once you've done 50 thyroids, it doesn't matter if you're an ENT or a general surgeon, all things being equal, for that procedure, you'll both be facile.

Also, allergy is only a part of the medical allergist's practice, just as it with an ENT. Remember, they also do immunology.

Furthermore, allergy itself is seriously not time-intensive for the physician--it is far moreso for the nurse who's really doing the work. It's relatively the opposite compared to most other fellowship equivalent specialties.