Dear colleagues:

A number of members have contacted me about policy changes the AAAAI has made in response to new rulings of the Accreditation Council on Continuing Medical Education (ACCME). Additionally, many of you are familiar with the requirements for fellowship programs established by the Accreditation Council for Graduate Medical Education (ACGME).

Both accrediting organizations are under scrutiny by members of Congress. Currently, there are voices suggesting that there might be a takeover of accreditation of fellowship and residency programs or continuing medical education by the federal government.

On several occasions last year, Hugh A. Sampson, MD, FAAAAI, explained to AAAAI members the reasons behind AAAAI changes to comply with the regulations put into place by the ACCME. These changes include the stipulation that physicians and investigators whose primary employment is industry (as opposed to a practice or university) are no longer allowed to serve in positions that have any potential influence on programming of the AAAAI. This led to the AAAAI Board of Directors' decision that our industry physicians and scientists may no longer serve on the Continuing Medical Education Committee, the Needs Assessment Committee or the Annual Meeting Program Committee.

Was the Board of Directors happy about making these changes? Not at all. Was there much discussion? Yes. Did we have any leeway? No.

Indeed, if the AAAAI is not accredited, external support for our educational initiatives, programming and fellowships would be reduced or eliminated as pharmaceutical companies would be unlikely, and in many cases unable, to support a non-accredited professional organization.

Our members expect to receive CME from attendance at the AAAAI Annual Meeting. Currently, an industry investigator cannot present a poster or an oral abstract if any CME credit is to be awarded for the session. According to the ACCME regulations, this ruling applies to basic scientists, epidemiologists and clinical trialists. As one can imagine, some industry scientists feel stigmatized and isolated. Their science can be "cutting edge," yet their diminished participation in the Annual Meeting and a select few committees of the AAAAI can truly stifle critical and essential exchange of scientific information.

I believe that because of some high profile lapses of professional ethics (not involving the AAAAI or allergy/immunology), the regulatory climate has swung too far.

Through discussions with representatives from other professional societies, I am seeing that the AAAAI is at the forefront in responding to changing regulations. Yet, much work lies ahead. Here is what we are doing to make certain the AAAAI's voice is heard regarding our concerns and to protect the interests of our organization:

1. I have asked Dr. Sampson to chair a Task Force focusing on industry and potential conflicts of interest related to membership. Task Force members represent the full diversity of our specialty's interests. Their work will take them beyond ACCME regulations and include drafting standards for various levels of involvement within the AAAAI.
2. Throughout the past year, the AAAAI has responded directly to the ACCME regarding its tighter requirements. We've voiced our concerns as a leader in allergy/immunology and we've sent key messages in unison with other professional societies. I'm pleased to report that the ACCME has modified some of its earlier regulations regarding programming "do's and don'ts." Yet, this is a dynamic issue, so our efforts will continue.

The mission of the AAAAI is to advance the knowledge and practice of allergy, asthma and immunology for optimal patient care. In this time of heightened scrutiny, we remain focused on contributing to the discovery of improved methods to diagnose, understand and treat asthma, allergic and immunologic diseases. The AAAAI is leading the way to advocate for all of its members, for patients, and to regulatory organizations and governmental agencies.

I am happy to report that grass finally has grown enough in Chicago to shed pollen. We have our spring triple attack of trees, grasses and mold spores; my colleagues and I are being asked to perform challenges/desensitizations with clopidogrel and aspirin; and a 60 year old patient, who had been hospitalized three times for acute severe asthma, was diagnosed with tracheomalacia as her trachea was found to collapse about 80% on an expiratory film during a CT examination. A/I is an exciting and fun subspecialty. The roadmap for the future may not be perfectly clear, but we can enjoy the journey.

Sincerely,

Paul A. Greenberger, MD, FAAAAI
AAAAI President

Call for Comments on Practice Parameter Draft
At the request of the Joint Task Force on Practice Parameters, AAAAI members are invited to review the draft of Adverse Reactions to Vaccines: A Practice Parameter, which was developed by John M. Kelso, MD, FAAAAI, and James T. Li, MD, PhD, FAAAAI. The Joint Task Force will be taking comments until June 24, 2009.

To provide your suggested revisions and/or comments, please list the page and line number before your revision/recommendation and forward to Ms. Susan Grupe at grupes@jcaai.org. While you are free to use a Word document offering comments referenced to the line number on the PDF file, you may find it easier to make remarks on top of the actual document. Using the editing PDF format will keep the line numbering sequence and allow us to superimpose the comments from the various reviewers. Further directions and the PDF of the draft can be found here. Please take advantage of this opportunity to assist your colleagues in shaping the specialty.

Internet Resource Helps Answer Patient Questions on CAM
Studies suggest that up to 90% of American adults use or would consider using complementary and alternative medicine (CAM) as part of their healthcare regimen. As an AAAAI members-only benefit, the Natural Medicines Comprehensive Database (NMCD), an internationally recognized, evidence-based resource, is available to answer questions on over 40,000 complementary and alternative therapies.

"Our patients are using these products whether we like it or not. Now we have a tool at our fingertips to get scientifically reliable information, and check for adverse reactions and herb-drug interactions," said William S. Silvers, MD, FAAAAI, Chair of the Complementary and Alternative Practices in Allergy Committee.

A 90-day trial of the NMCD was launched in October 2008. The trial allowed members to provide input that helped shape the AAAAI's use of the Database, which resulted in the signing of a one-year agreement to continue offering the NMCD as a member benefit.

The NMCD provides the tools physicians need to quickly determine whether a product is safe and effective or if it interacts with conventional drugs. The Interaction Checker gives data and severity ratings on over 1,600 potential interactions between CAM therapies and drugs.

The Database focuses on providing physicians with practical answers to questions patients are likely to ask. For example, the Database can help you discover:

• Why echinacea should be avoided by most patients with seasonal allergies.
• How bitter orange interacts with Claritin-D to increase the risk of cardiotoxicity.
• Why Pelargonium sidoides (aka Umckaloabo) is being used by thousands of patients with upper respiratory tract infections.
• Why patients with atopic dermatitis shouldn't rely on evening primrose oil.
• What type of butterbur extract is comparable to Zyrtec for symptoms of allergic rhinitis.

Answers to these questions and thousands more are readily available from the NMCD.

To get started, log in to the Members Only area and click on the NMCD logo. For questions, contact Amanda Rodman at arodman@aaaai.org.

"New Research" Section Debuts on www.aaaai.org
To make searching for literature easier for members and patients alike, the AAAAI has launched a "New Research" section on www.aaaai.org.

"New Research" features summaries of recent articles from The Journal of Allergy and Clinical Immunology. These summaries are aimed at medical professionals as well as health-savvy patients. Also included are important research highlights from other leading medical journals, written by Phillip L. Lieberman, MD, FAAAAI. In addition, visitors can now easily search an archive of all previous research highlights. Check out "New Research" today!

These changes are part of the AAAAI's ongoing efforts to create a more user-friendly Web site experience. By uniting disparate resources and creating a "one-stop-shop" for all visitors to www.aaaai.org, we hope that everyone will be better able to access key online tools. Keep an eye out for more changes in the coming months!

Don't Get Left Behind: Register Now to Attend the 2009 Practice Management Workshop
The AAAAI Practice Management Workshop is designed for both seasoned and new physicians, office managers/administrators and fellows-in-training. Book your hotel NOW, as our housing block closes on Saturday, June 20. Registration for the workshop closes on June 30, so make your plans to attend today. We'll be unable to accommodate registrations received after this date. Please also note there is no onsite registration in Boston. More information, including a downloadable PDF of the course brochure, is available by clicking here.

New Work Group Report: Cephalosporin Administration to Patients with a History of Penicillin Allergy
Read the new AAAAI work group report, "Cephalosporin Administration to Patients with a History of Penicillin Allergy," from the Adverse Reactions to Drugs, Biologicals and Latex Committee. To see all AAAAI position statements and work group reports, click here.

Take the 2009 Practice Management Financial Data Survey
This annual survey developed by the Practice Management Committee collects and analyzes data regarding financial issues and manpower utilization in an effort to establish allergy-specific benchmarks. These benchmarks are used for internal comparisons by our members to assess how their specific practice is doing compared to national and regional standards. Click here to download the 2009 survey or view past results.

The Physicians' Perspective: Medical Practice in 2008
A recent survey released by The Physicians' Foundation examined the causes behind primary care doctors' dissatisfaction, the state of their practices and the future of patient care. Download a PDF of the results.

”Red Flags” Rule Compliance Date Moved to August 1
Physician practices now have until August 1 to comply with the Federal Trade Commission's (FTC) "red flags" rule, which requires physicians to institute policies to identify, detect and respond to potential risks of identity theft. Originally, the rule was scheduled to take effect May 1, but the FTC voted on April 30 to delay the compliance date. The American Medical Association (AMA) has indicated it will use this time to convince the FTC and Congress that physicians are not "creditors" and thus should not be subject to the rule. For more information, the AMA has several resources available online.

Policy Options for Financing Healthcare Reform
The Senate Finance Committee recently released policy options for financing reform of America's healthcare system. This is the third and final round of policy options for discussion before the Finance Committee marks up legislation this month. View a PDF of the report.

Elements of Allergy & Asthma: The Truth about Pet Allergies
Pets provide companionship and fun, but for some people a dog or cat can also trigger sneezing, sniffles and worse. Does an animal allergy mean a life without Fido? Point your patients to this educational feature for more information and tips on how to reduce suffering from pet allergies.

Summer Allergy & Asthma Issues
This time of year, your patients are looking for information related to summer activities such as the sting of fire ants and how to prepare for summer skin flare-ups. For easy distribution to your patients, visit here to download a PDF version of this timely member-benefit resource.

Asthma Action Plan
To help your patients better manage their asthma, download the AAAAI's new Asthma Action Plan

Looking to keep your PR efforts on track? Look to the Promoting your Practice area located within the members only section of www.aaaai.org. Use these winning tactics to create your own success!

Branding is more than publicizing your name. Let's use Nike as an example. Branding is not the quality of their shoes; that's their product. The brand isn't the "swoosh;" that's a logo. It's not "Just do it;" that's a memorable slogan. Branding encompasses the entire experience for the consumer-from name recognition through a positive experience with the product.

Whether you are branding shoes or an allergy practice, a solid strategy focuses on the connection you make with your potential and current consumers/patients. It starts with a few simple, yet resonating words and visuals demonstrating to consumers that you understand what is important to them.

A good branding strategy:

• Defines your target market(s)
• Connects with your target prospects on their level
• Motivates people to act
• Builds patient loyalty

You know you are on the right track if your outreach efforts and messages focus on the patient, not your practice.

For other tips, tactics and templates, visit the Promoting your Practice area of the AAAAI Web site.

Food Allergy-Free Summer Recipes
Picnics, barbecues and more. Summertime dining can pose challenges for those with food allergies, but with a few simple recipes and fresh, seasonal ingredients, it's easy to put together a summer meal that everyone can enjoy. Have your patients try one of our allergy-free recipes. Each is marked with a key designating which major allergens have been omitted.