Meet Your Candidates for Secretary-Treasurer of the AAAAI

Secretary-Treasurer candidates, whom if elected eventually ascend to become AAAAI President, answered a series of questions to provide you with a deeper understanding of their goals for the AAAAI as an organization.

This year’s candidates are:

• Mariana C. Castells, MD, PhD, FAAAAI, Editor-in-Chief of Current Allergy and Asthma Reports; Director Drug Hypersensitivity and Desensitization Center, Brigham and Women’s Hospital; Director Mastocytosis Center, Brigham and Women’s Hospital; Professor of Medicine, Harvard Medical School.

• Carla M. Davis, MD, FAAAAI, Professor of Pediatrics, Pathology, and Immunology; Chief, Division of Immunology, Allergy, and Retrovirology; Director, Texas Children's Hospital Food Allergy Program; Janie and Sandra Queen Endowed Chair in Immunology and HIV/AIDS.

If elected, describe your initiative(s) and your plan to achieve it/them? In the context of your Presidential Initiative(s), what would be your overall theme and why would you consider this to be important?

Dr. Castells: If elected, my initiative would be “Allergy Frontiers: Reaching All Patients with Drug Allergy and Mast Cell Activation Disorders.” The allergy field is recognized for its impact in asthma, food allergy and immunodeficiencies among other diseases, yet drug allergy and mast cell disorders have remained orphan areas. While the majority of inpatient allergy consultations involve drug allergy, mast cell activation patients are an imposing clinical burden. Delabeling patients claiming to be allergic to penicillin and other drugs is key to decreasing health care burden and costs and understanding the indications and candidates for drug desensitization increases patient safety and improves the quality of life and life expectancy of patients with cancer, chronic inflammatory diseases and severe infections.

The diagnosis and treatment of mast cell disorders by well-trained allergists is an urgent need. I propose to create a Drug Allergy and Mast Cell Activation School to house teaching materials, to generate practical seminars and teaching courses and workshops with drug allergy and mast cell activation leaders to educate allergists and open to all specialists, physician assistants and nurses.

Dr. Davis: My current administrative leadership roles in academia as a division chief and with practicing allergists in organized medicine as President of the Texas Allergy, Asthma and Immunology Society have given me a unique perspective. Common challenges exist in both settings and my initiatives would address them. Decreased autonomy of physician decision making because of administrative burden and governmental policy has changed allergy/immunology clinical practice and de-emphasized educational and research missions in training programs. Improvement of health care access for allergy/immunology services for all persons in the nation would be my presidential theme. My initiatives would address the above issues through: 1) advocacy for fair reimbursement and decreased administrative burden in both the academic and private settings to bolster clinical practice revenue and foster educational and research support for physician-educators and scientists, 2) expansion of the AAAAI educational offerings to foster engagement from diverse allergy/immunology physician and postdoctoral scientists, and 3) promotion of mentorship through the broad engagement of diverse future allergists/immunologists to increase allergy/immunology healthcare access in all communities.

The field of allergy/immunology faces a number of challenges and opportunities. What would be an example of a particularly important problem or challenge to our field, and how would you address it?

Dr. Castells: Pieces of our specialty are taken by other specialties such as dermatology, pulmonology, ENT, gastroenterology and others, and yet our specialty is the best positioned to alleviate human suffering from allergic and immune diseases by early diagnosis and by using state of the art treatments from expensive monoclonal antibodies to simple food avoidance. The looming threat of allergy specialty extinction has been a common theme of discussion: how viable is our specialty? Are we really necessary? Are insurance companies convinced of our value? To demonstrate our value and critical importance into public health and among the medical specialties, it is of paramount importance to increase the awareness and information about our specialty and the outcomes of allergy treatments across pediatric and adult ages regarding an increase in quality of life and life expectancy. Avoiding extinction requires short- and long-term planning and developing a clear identity for our specialty, whether providing drug and food desensitization, options for mast cell disorders or state of the art treatments for difficult asthma and rhinitis and other allergic conditions.

Dr. Davis: One challenge in our field is the lack of diverse leadership and pathways for diverse trainee mentorship by established investigators and practicing allergists/immunologists. The development of a diverse professional workforce is important for optimal patient care of diverse populations. As president, I would support programming to foster mentoring relationships between seasoned professionals and younger trainees and physicians to expand the diversity of allergy/immunology professionals.

The AAAAI continues to face many challenges and opportunities as well. A) Give an example of an important challenge to our organization, and how would you address it?

Dr. Castells: We have been learning in the last 10 years that allergy is not a popular specialty among medical specialties with decreasing numbers of candidates for fellowship. The perception is that it may be too competitive, maybe not challenging enough or not well compensated. The AAAAI is poised to generate renewed interest in our specialty as a branching specialty which can address the increasing allergic problems of the general population, whether asthma, allergic rhinitis, food allergies, drug allergies, mast cell activation disorders and immune deficiencies, by providing educational and promotional tools to be used in medical schools and residency programs. Allergy as a specialty is for everyone and encompasses basic, translational and clinical research. Many medical school and residency programs across the country lack allergy and medical schools and residency programs do not teach allergy. The AAAAI, alone or teaming up with other allergy organizations, can create a friendly and appealing face for the allergy specialty at the local and national level.

Dr. Davis: The AAAAI has a history of being the premier organization for presenting the latest scientific advances during its annual meeting. The organizational challenge is to maintain the highest level of scientific standards in our educational offerings while serving practicing allergists who desire practical clinical information. As president, I would charge the Annual Meeting Planning Committee (AMPC) to promote both the academic and scientific community through the expansion of cutting-edge scientific content while preserving practical educational content at the annual meeting.

B) Give an example of an opportunity for the AAAAI and how this could be utilized to advance its mission?

Dr. Castells: Patients suffer from simple allergies to life-threatening food induced anaphylaxis but there is no connection or education of the public in general about the immune system and its role in allergic reactions. We need to propose a nationwide general campaign regarding the immune system and its allergic manifestations. While social media can provide short and practical messages, teaching the general public should be part of our mission, which ultimately will lead to an improved quality of life with advancing the allergist mission. Connecting sneezing with histamine and the use of antihistamines can be taught with cartoons and short, user friendly videos. The AAAAI is poised to promote, inform and be a source of awareness for the importance of the allergy specialty.

Dr. Davis: One of the major AAAAI goals critical to our field’s sustainability is to fund research and training so leaders are developed to attract and train future allergists/immunologists. The AAAAI Foundation has limited resources to support all the deserving young physician-scientists interested in allergy/immunology. An opportunity exists to obtain funding from outside sources including the NIH to support the development of diverse physician-scientists. For example, the Maximizing Opportunities for Scientific and Academic Independent Careers (MOSAIC) Institutionally-Focused Research Education Award (UE5) could enhance the AAAAI’s ability to support physician scientists. I would support applying to external opportunities to advance this important mission.

Why do you want to be President of the AAAAI?

Dr. Castells: It would be a privilege and a great honor to serve as the AAAAI President to be able to represent and promote our specialty. My first encounter with the AAAAI was in 1984 when I presented my first abstract at the NY annual meeting proposing a new allergy to potato and defining its allergens from a little girl who suffered from asthma when inhaling pollen from potato plants and when eating foods containing potato. My poster was chosen for an award and promoted for high visibility and I gave a local TV interview which allowed me to have a first glimpse at the power of public speaking. I have incredible memories of my time on the AAAAI Board of Directors, being part of the elite group of allergists who shape our specialty and who define our identity in the complex health care system. I would like to continue contributing to further define the importance of our specialty, promoting excellence in clinical practice and research for the next generations while serving the needs of the allergic population.

Dr. Davis: My love for the patients we, as A/I physicians, serve, practicing allergists/immunologist colleagues and the field of allergy/immunology are behind my desire to be president of the AAAAI. First, I want to facilitate patient care through initiatives that will improve health care access for allergy/immunology services through physicians with allergy/immunology expertise. Secondly, I want my colleagues to experience the joy of helping patients through clinical care, education and research without the administrative burdens that are fueling the high burnout rate. Finally, I want the field of allergy/immunology to flourish through immunologic discovery and therapeutic advancement, as well as be recognized by all other physicians and patients as essential to superlative health for patients. As an African-American woman allergist/immunologist, I recognize that diverse representation is an important contributor to the most optimal outcomes in any field or project. Diversity in leadership provides an opportunity to bring together the most ideas to achieve the best outcomes. I want to be president to empower allergists/immunologists so that they and their patients can thrive in this challenging healthcare environment.

Click here to learn more about both candidates, read their full Q&A and cast your votes.

All ballots must be cast online or postmarked on or before January 5 at TBD CT.

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