WHO WILL OVERSEE MY ALLERGY CARE?
Allergist /Immunologist (www.abms.org). Dr. Murphy completed medical school and a three-year residency at Penn State Milton S. Hershey Medical Center. Subsequently, he went on to complete a two-year fellowship and a year additional training as junior faculty in pediatric and adult allergy at the University of Virginia. Dr. Murphy had been board certified since1997 and then was re-certified in 2007 by the American Board of Allergy and Immunology (www.abai.org). He actively participates in the ABAI Maintenance of Certification (MOC) program, which works to ensure continued professional education and practice improvement.
DOES BOARD CERTIFICATION IN ALLERGY MATTER?
Yes, it does matter! Board Certification and participation in Maintenance of Certification in Allergy/Immunology (A/I) assure that you, the healthcare consumer, are seeing a physician who has been extensively trained in A/I and continues to update his or her A/I education. It has been estimated that to become board certified in allergy, physicians will spend in range of 15,000 to 20,000 hours in training. In addition, board certified allergists continue to spend hundreds of hours a year in A/I specialty education through participation in Maintenance of Certification and continued medical education, attendance of national meetings and, in the case of Dr. Murphy, teaching and training the next generation of A/I physicians.
ARE THE CLINICAL ALLERGY STAFF LICENSED HEALTH CARE PROFESSIONALS?
All of the clinical staff at Asthma, Allergy and Sinus Center are licensed nursing professionals by the state of Pennsylvania. We do not hire non-nursing or non-licensed healthcare professionals to provide care under Dr. Murphy’s supervision.
DOES THAT MATTER?
Absolutely! Having licensed trained nursing professionals working alongside Dr. Murphy is an incredible asset to the care you will receive. By employing licensed nursing professionals, we are demonstrating our commitment to provide quality allergy care. This is in contrast to some practices that may hire non-healthcare professionals or non-licensed healthcare professionals and have these individuals provide allergy care that may or may not be under the supervision of a board certified allergist.
HOW IS ALLERGY TESTING PERFORMED, AND IS IT PAINFUL?
Allergy testing is not painful. There are two types of allergy testing that may be done. The first type is called “prick testing” (PST). PST involves taking a small drop of allergen and making a small “prick” or “scratch” on your skin with a skin test device. This will result in a microscopic break in your skin that will allow the allergen to interact with the allergy cells in your skin. The second type of allergy testing that may be done, and this will vary from patient to patient, is called the “intradermal skin test” (IST). The IST uses a very fine needle that injects a small amount of allergen into the top layers of your skin. A positive test will appear as a raised, red bump on the skin, similar to a mosquito bite.
HOW LONG DOES ALLERGY TESTING TAKE?
Allergy testing can be done very quickly, typically on the same day as your visit. After the nurses or the doctor places the prick test, we wait 20 minutes to see if a reaction has occurred. If needed and ordered by the doctor, the IST may be done, which would require another 20 minutes of waiting. In general, we ask that patients budget about an hour of time for testing—especially if both levels of testing are needed.
WHO CAN BE TESTED?
Patients of any age can be tested for allergies. The myth that only patients of certain ages can be tested is not true.
WHICH ALLERGENS WILL I BE TESTED FOR?
You will be tested for the allergens that are relevant for the diagnosis being investigated. For example, if you are being evaluated for food allergy, then you will be tested for food allergens. If you are being evaluated for airborne allergens, we will test you for those allergens. These allergens typically include dust mites, cat, dog and other animals, trees, grass and weed pollens, molds and cockroach droppings.
WHAT IF I AM CURRENTLY TAKING ANTIHISTAMINES?
The allergy skin test looks for a histamine reaction to the allergen tested, so your test results will not be accurate if you are taking an antihistamine. Therefore, prior to skin testing, you will need to be off all antihistamines for about a week. If you are not sure what medicines are antihistamines, please call the office for guidance.
WHAT IS THE BENEFIT OF ALLERGY TESTING?
The benefit of allergy testing is to clearly define what may or may not be causing your symptoms. If you are found to be allergic to various allergens, this is very empowering information. You now know what is potentially the root cause of your allergy symptoms. With this knowledge, you will know what your allergy triggers are, when and where to expect to find your allergy triggers, and you will be armed with information on how to avoid these allergens. Very few diseases will ever allow you to clearly define the root cause of your symptoms and how to avoid those causes.
WHAT IS IMMUNOTHERAPY?
Allergen immunotherapy is a form of treatment aimed at decreasing your sensitivity to substances called allergens. Immunotherapy involves two phases: a build-up phase and a maintenance phase. During the build-up phase, you will receive increasing doses of allergen on a weekly basis. It takes approximately six months until you reach the full volume and full-strength dose. At this point you will enter into the maintenance phase where you will continue to receive the full dose treatment, but now it will be every two weeks. If you continue to do well, the dosing interval will be spaced out ideally to once a month.
HOW LONG WILL I HAVE TO BE ON IMMUNOTHERAPY?
The course of immunotherapy is generally four to five years. You should expect to be reevaluated every six months by Dr. Murphy to see how you are doing and how your allergen immunotherapy is going.
HOW SOON WILL I SEE RESULTS FROM IMMUNOTHERAPY?
The time to see the benefits of immunotherapy will vary from patient to patient. In general it will take several months before a full benefit will be seen.
WHAT ARE THE BENEFITS OF ALLERGY IMMUNOTHERAPY?
The clinical goal of allergen immunotherapy is several fold: to gain better control of your symptoms, to reduce complications from allergic disease (for example: sinus infections, asthma flares) and to reduce the amount of medications you may be using. The immunologic goal of allergen immunotherapy is to change your immune system so that it no longer recognizes and reacts to the allergens identified during your testing and targeted during your immunotherapy.
IS IMMUNOTHERAPY EFFECTIVE?
Yes, immunotherapy is effective in 80-85% of patients. So like most medications that are used in medicine, immunotherapy is effective in the vast majority of people who use this treatment.
WHERE IS ALLERGEN IMMUNOTHERAPY ADMINISTERED?
Allergen immunotherapy must be administered in a medically supervised setting. With allergy immunotherapy there is a chance, albeit small, for you to have an allergic reaction to the vaccine. These reactions can be very brisk and require physicians who know how to recognize and treat these allergic reactions. The American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology both have practice parameters that suggest the allergy immunotherapy be administered in a medically supervised setting. Both the organizations have recently re-emphasized the importance of this concept.
ARE TESTING AND IMMUNOTHERAPY COVERED BY INSURANCE?
In general, most insurance plans cover allergy testing and immunotherapy. However, a lot of insurance plans now have deductibles and co insurance so there may be an out of pocket expense. If you have any questions, please call the office and we will be glad to work with you to verify your insurance coverage and any out of pocket expenses. If you have significant out of pocket expenses, please talk with Crystal or Dr Murphy. Our goal is to provide you the appropriate allergy care that you need and is not a significant financial burden.
IS THERE AN OFFICE VISIT CHARGE WITH THE ALLERGY VACCINE THERAPY?
We do not charge for an office visit when you receive your allergy vaccine. We are aware that some offices will charge an office visit code and vaccine administration code when you receive an allergy vaccine. We disagree with that policy. We follow the American Medical Association’s billing guidelines for medical services, and these guidelines suggest that it is not proper to bill an office visit code when administering an allergy vaccine. Accordingly, you will find our fees for allergy vaccine administration to be very reasonable.