Being an Allergist/Immunologist can be quite interesting. We hear a variety of issues from patients and some can be quite perplexing. It can feel like being a detective, trying to use the patient’s signs & symptoms (clues) to properly diagnose them.

We do different types of skin testing (for environmental, food, medication, chemical allergies). Sometimes if we need to confirm something, we will actually do a food or medication oral challenge where the patient consumes that particular thing (such as peanut butter or shrimp) in small amounts over time, and then we monitor them for a few hours for any reactions.

We also administer allergy immunotherapy/shots which is a potential cure for their environmental allergies. There are now customized injectable medications for asthma and eczema called biologics which we also administer.

For allergy shots and oral challenges, there is a risk of anaphylaxis so we must be ready to treat an allergic reaction at all times! They are unpredictable so we never know who will react or when.

We also treat asthma, hives, eczema, immunodeficiencies, and a host of other issues.

What does your typical day look like?

I get in at 9 am and look at my schedule of patients to get an idea of what they are coming in for (there are notes in their chart), if they are new or follow-up patients. I start seeing them. Sometimes if they need specific testing, we must get authorization from their insurance to do it. If not, we proceed with testing if necessary. The most common testing is skin prick testing for environmentals and foods which takes about 10-15 minutes once placed. We often do virtual meetings with the pharma companies to discuss the various products/insurance coverage/how patients are doing on certain meds, etc. around noon. Throughout the day, I have to answer patient calls (these could be for anything: refills, side effects, reactions, etc).

I work with a PA and nurse who often ask me questions throughout the day for their patients, and at times I will go see their patients if something is a bit too complicated for them. I also have to review/edit and sign off on their notes for every patient they see. If there are any sudden anaphylactic reactions, we treat them immediately with epinephrine, antihistamines, steroids, etc. Then we monitor for a few hours or send them to the ER depending on severity/situation. I continue seeing patients until around 4 pm. and then finish up my notes prior to going home.

Pros

Allergy/Immunology is one of the few specialties where you get to treat both adults and children! Most other specialities, you must choose one. We greatly improve patients’ quality of life which can be very rewarding. Lifestyle is mostly outpatient providing a nice work life balance. Each day provides an interesting case usually, as you could potentially be allergic to almost anything!

Cons

You must be ready at all times to treat anaphylaxis/allergic reactions which can be stressful at times especially if you have a busy schedule that day. Some things in allergy can be a bit gray and difficult to figure out (not a lot of studies/research for some diseases) which can leave patients feeling dissatisfied. Allergy/Immunology is a relatively small field so if you have a very rare condition, it may be difficult to find an expert in the area.

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