Words of wisdom from an experienced allergist

I have been fortunate enough to get trained under the stalwarts in the field of Allergy at one of the most respected and well-known institutions in the USA: Children’s Asthma Research Institute and Hospital (CARIH) which merged with National Jewish Hospital (NJH), Denver, Colorado, USA, to be known at present as National Jewish Health (NJH). The greatest discovery in the field of Allergy (IgE) occurred at CARIH in 1968 by the Ishizaka couple.[1] Great personalities like Dr. Elliott Middleton, Dr. Henry Claman, Dr. Harold Nelson, Dr. Hyman Chai and Dr. Charles Kirkpatrick were my mentors at the training program through CARIH. NJH, Fitzsimons Army Medical Center and UCD, Denver, Colorado. I have been functioned as a consultant, teacher, and patient advocate for the past 47 years: almost 30 of those years in delivering charity care through International Asthma Services (IAS) in the developing world.[2] This rich global exposure to allergic diseases prompted me to be the lead author for two leading textbooks in the field of Allergy Asthma and Immunology (AAI). The common thread of issues like ‘anxiety, fear of the unknown, under/over/mal treatment of the ailment, impaired quality of life, physical and mental suffering’ were prevalent in a majority of patients across the globe. This occurs irrespective of genetic, environmental, socioeconomic differences. I suggest the following “simple and effective” steps in both patient management and physician empowerment. Start educating your patients: Over the past five decades of professional life, I have learned that one of the most important items of allergy management is “educating the patient and his/her family” about the ailment and promoting “self-management.” This area unfortunately has been neglected due to the fact it is “time-consuming” and many times not “remunerative” to the care provider. An educated Compliant patient is a pleasure to take care of. Education and compliance have positive results overall and hence beneficial to both the patient and provider.My advice is: (i) spend 5 min more at each patient visit with more education, (ii) inquire regarding any concerns or doubts patients may have, and (iii) train your assistant to share this responsibility. Hence, we have initiated the first allergy asthma assistant course (a 3-month online course) a very important initiative of IAS with Med-Train, Bengaluru, India. Patient support groups under physician supervision is a very effective way of education and self managementEducate yourself continuously: Acquiring knowledge is both beneficial and enjoyable. There is no age limit for this quest. This is the only way to keep abreast of the ever-changing dynamic field of AAI. Start applying thus additional knowledge clinically. My advice is to study at least 1 h a day preferably early in the morning when things are relatively quiet, and mind is fresh Start teaching: By teaching, your learning increases. The field of AAI is relatively “unknown” among your peers. Hence try to share your knowledge among your peers by clinical presentations, hospital CMEs, and regional and national conferences. If attached to medical institutions, share your knowledge among UG and PG students and peers. Based on your location, you may have opportunities to get involved with teaching in AA training programs. With the advent of “online teaching,” distance and traveling are not issues. Online coaching and webinars have been shown to be effective tools for CME Get involved in a charity: Every one of us does a charitable act almost daily in our practices. One of the organized manners is to get involved with an existing medical charity specifically designed for our specialty. One such is the PRAANA Charitable Allergy Asthma Clinics (PCAAC) initiative that was initiated by me in 2019.[3] The concept is to break the “painful gap” which exists between “Providers and Consumers.” Generally, socioeconomics prevents patients from approaching specialists due to fear of high fees and huge unanticipated expenses. In order to break this fear, PCAAC initiative is to open up these “Specialized Services” free or heavily “subsidized” rates. The PRAANA concept has picked up very well and is offered at around 50 locations across India, Nepal, and Barbados WI. Finally, the 10 commandments: Be ethical Be knowledgeable Be compassionate Be an advocate Be an educator Never “bad mouth” your peer Know your patient Be charitable Remember patient is the final judge Never be angry with the patient. I finally thank the editors of this prestigious journal to have allowed me to share my thoughts and suggestions. I wish the readers a successful and enjoyable time in the practice of medicine.