Two studies published in 2015 have shown gaps in physicians’ knowledge about allergies.

The Asthma and Allergy Foundation of America (AAFA) published a study in January 2015. It found large differences in knowledge and attitudes about anaphylaxis among physician groups.

Last month, another study showed knowledge gaps among primary care physicians. Two of KFA’s medical advisors conducted the study:

- David Stukus, MD, from Nationwide Children’s Hospital

- Todd Green, MD, from Children’s Hospital of Pittsburgh

Dr. Stukus and Dr. Green gave a multiple-choice test to 408 pediatricians and internal medicine doctors. The test asked about diagnosing and treating allergies. Some of the doctors who took the test were still in training as medical residents. None were board-certified allergists.

Dr. Stukus and Dr. Green, both board-certified allergists, spoke with KFA about the results.

KFA: Can you tell us a little about this test?

Dr. Stukus: The participants were all at one of two large academic medical centers. We kept the test short. Internal medicine specialists answered six questions. Pediatricians answered nine questions, including three about childhood allergies. The questions were about both food allergies and environmental allergies.

KFA: What were the results?

Dr. Stukus: Well, the number of incorrect answers was surprising. Over 92% got more than half the questions wrong and 12.3% got them all wrong. On most questions, less than 30% chose the correct answer.

KFA: Why do you think so few doctors “passed” the test?

Dr. Green: The reality is primary care doctors deal with a lot. They diagnose and treat many diseases and conditions. It’s very difficult to keep up with the latest findings on each of them. Meanwhile, things are always changing in the allergy field. As specialists, board-certified allergists can stay up-to-date with this.

For example, not that long ago, we thought that certain vaccines were not safe for those with egg allergy. Now studies have shown safe ways for these patients to get these vaccines. But as our study showed, many primary care doctors are not aware that the guidelines have changed.

Dr. Stukus: Allergy is not the only area where non-specialists are not always aware of the latest information. The medical field changes often. No doctor can stay up-to-date on everything.

Dr. Green: Plus, medical school residencies tend to focus on inpatient medicine. Allergic conditions are mostly outpatient issues. Many medical schools do not present lectures from allergists at all.

KFA: What is the key take-away for our members?

Dr. Stukus: Board-certified allergists are the best qualified doctors to treat allergic conditions. As specialists, they are able to keep up-to-date about allergic diseases.

Dr. Green: Allergic diseases have become more common. While many primary care doctors handle them well, there can be shortcomings. This is especially true when information changes quickly. We found that many of these well-trained doctors could not answer specific questions that come up often for allergists.

Dr. Stukus: Unfortunately, a lack of knowledge can result in sub-optimal care. Primary care doctors may not be up-to-date about allergic conditions. When possible, we recommend that patients see a trained, board-certified specialist. An allergy specialist is the best physician to see if:

• There are questions about diagnosis, or 
• If symptoms continue after the initial treatment.

Dr. David Stukus and Dr. Todd Green are both members of the Medical Scientific Council for the Asthma and Allergy Foundation of America. Kids With Food Allergies is a division of AAFA. Both are members of the Council's subcommittee on Food Allergy and Anaphylaxis. Dr. Stukus serves as Chair of the Food Allergy and Anaphylaxis subcommittee and also sits on AAFA's Board of Directors.

Dr. David Stukus is an Assistant Professor of Pediatrics in the Section of Allergy/Immunology at Nationwide Children’s Hospital in Columbus, Ohio. In addition to his interest in caring for families with food allergies and other allergic conditions, he also serves as the Director of the Complex Asthma Clinic. He previously completed his residency at Nationwide Children’s Hospital and his fellowship at the Cleveland Clinic. You can follow him on Twitter @AllergyKidsDoc.

Dr. Todd Green is an allergist/immunologist in the Division of Pulmonary Medicine, Allergy and Immunology at Children’s Hospital of Pittsburgh, Director of the University of Pittsburgh Medical Center Allergy/Immunology Fellowship Program, and an Assistant Professor of Pediatrics at the University of Pittsburgh School of Medicine. He is also on the Board of Regents of the Pennsylvania Allergy and Asthma Association. Dr. Green attended medical school at the University of Pittsburgh School of Medicine. He completed his residency at The Barbara Bush Children’s Hospital at Maine Medical Center and his fellowship at Duke University Medical Center. He is Board Certified in Allergy/Immunology and Pediatrics.

References

Stukus, D. R., Green, T., Montandon, S. V., & Wada, K. J. (2015). Deficits in allergy knowledge among physicians at academic medical centers. Annals of Allergy, Asthma & Immunology.