I’m an allergist and immunologist.
How would you describe what you do?
We treat and diagnose diseases that are produced by disorders of the immune system. And they include conditions such as respiratory allergies, which are allergic and non-allergic rhinitis and asthma, acute systemic allergic reactions known as anaphylaxis, and also patients who have immune deficiency disorders. So it is a very broad based sub-specialty of the specialties known as internal medicine and pediatrics.
What does your work entail?
It entails seeing patients on a daily basis who suffer from the above diseases. 90% of our work is in office, and perhaps 10% is involved in hospital for the majority of allergists and immunologists.
In our discipline….we have very little to do with our hands, but a great deal to do with our minds.
We do have emergencies, we do admit asthmatics, and people who go into anaphylactic or allergic shock, and we do get called for consultations in hospitals as well when we are on call.
What does a typical workweek look like?
A work week can vary from anywhere about forty hours to a maximum of seventy to eighty hours a week, depending upon the work load and the number of consults that we receive.
How did you get started in this career?
Going into this career one has to follow the following path. First of all you go to college and take pre-med courses, and then you are accepted into medical school. The usual time that it takes to complete that stage of your training is about eight years. After medical school, one then enrolls in an internship and a residency and that usually is three to four years. To get into allergy one has to do either an internal medicine residency, or a pediatric residency. My own personal duration in residency was four years. After completion of residency, one enters what is called a fellowship program. The fellowship program runs for another two to three years. After completion of the fellowship and passing ones board examinations in internal medicine, pediatrics, or both and then allergy and immunology, one becomes a board certified allergist immunologist.
I chose immunology because it is a fascinating subject and it covers diseases of all organs. For example, there are immunologic diseases of the heart, lungs, kidneys, and the skin. So it is a fascinating disorder, and allergists are trained in all of these disciplines.
What do you like about what you do?
What I do is great fun. We have a chance to deal with people in an intimate environment in office where we have all the tools that we need to help them in a very efficient manner. We deal with diseases that impact people’s lives and we have a great opportunity to lesson the burden of disease on these people’s lives and improve their quality of life. And in addition, the basic science that underlines what we do is fascinating and constantly changing, and there is never a day where there is a dull moment.
What do you dislike about what you do?
I assume there is no job that you can have where there isn’t some aspect that is a nuisance. In my job, dealing with regulations set by the government, regulations set by insurance companies, and the paperwork involved in getting through this mass of rules is something that I think no one likes to do.
How do you make money or how are you compensated in this career?
90% of our compensation comes directly from insurance companies, either private insurance companies or the government, and a small percent comes from direct payments by patients.
How much money do you make?
The minimum is usually low hundred thousands and goes up to maybe $300,000.
How much money did you make starting out in this career?
The usual starting salary is close to $100,000.
What education or skills would you say are needed to do this?
You have roughly thirteen or fourteen years of your life devoted to learning the discipline, and during that time of course the intellectual activity is extremely vigorous; medical school, the residencies, passing ones board exams, and then subsequent to that one has to re-certify every ten years. So you have to have the desire to be constantly studying and learning new things. In our discipline, the entire difficulty is the intellectual. We have very little to do with our hands, but a great deal to do with our minds.
What would you say is most challenging about what you do?
Well the most challenging is clearly the intellectual aspect. We see challenging patients which require research on our part and the work therefore extends far beyond the actual work day. Most of us spend nights and weekends learning about problems that we see during the day.
What is most rewarding about this?
Most rewarding thing is when you have been successful in helping someone through their health care difficulties. I think all of us in medicine find that to be the most rewarding aspect. But also rewarding to me is the fact that not a day goes by when we don’t learn something new, so we are kept on our toes and I find that a very gratifying way to live.
What advice would you offer someone considering this career?
I think it is important to understand that you have a long way to go before you are going to be, for lack of a better term, hanging up the shingle. Therefore you will see your friends who have taken shorter paths to earning a living already out and enjoying a full capacity life, so they should prepare themselves for that marathon that you go through, and one has to want to work hard. One has to be prepared not to work only during the day but to work at night and be on call, both in their training and perhaps to a lesser extent in their final practice, but still it does exist. And then finally, one has to want to help people.
How much time off do you get or take with this career?
Most allergists practice five days a week and take call on the weekends and nights. Time off varies tremendously on whether or not you work in a large group or whether or not you have a single practice or whether or not you are employed by a very large clinic. If one works, for example, in a five man/woman group you will take call roughly every fifth weekend. If you work by yourself you may take call every weekend that you practice, so the time off varies considerably depending on where you work, how many people are employed by your group and whether or not you are an individual practioner or work for a large clinic.
What is a common misconception that people have about what you do?
I think the most common misconception that I see in my own practice is the lack of understanding between what a dermatologist does and what an allergist does. Dermatologists take care of multiple skin diseases. Almost 90% of allergy involves internal diseases and are the internal organs, and only a very small percent of all practices see skin diseases per se. So each day in my practice I am referred a patient or two who really belongs at a dermatologist who takes care of the vast majority of skin diseases.
What are your goals and dreams for the future in this career?
You could not believe the advances that have occurred in our field since I began practicing, which is well over thirty years ago, and I think it is not unreasonable to assume that the same degree of advances will occur in the future. When I began practice I had at least ten people in the hospital each and every day. My hospital practice now is usually never more than one or at maximum two people in the hospital, and most of the time it is zero. So we have been able to almost stamp out hospitalizations for the majority of diseases that we treat, and in the future I think we will make the same advances, because our knowledge is expanding along the way.
What else would you like people to know about what you do?
I think that people should understand that we are a very capable sub-specialty, which can exert profound changes in people’s lives for the better when they suffer from allergic and immunologic disorders.