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“Yes,” said 82 percent of readers responding, the College should include workshops at the annual meeting about physician dissatisfaction, stress and burnout.

A word from President Michael Blaiss, M.D.

It’s About Time!
I had just finished writing a column for the New Year, stating that this time of year is slow for news that affects the allergy community and reviewing the upcoming events for 2004. I was about to send it to the Web masters for placement in the e-newsletter you now are reading when the news hit: Ephedra will be banned from use in the United States.

All I can say is that it’s about time. I’m sure you have had patients who use ephedra. It is primarily taken for weight loss and increased energy, but it is also marketed for use in the treatment of allergic rhinitis and asthma. It contains different alkaloids, including ephedrine and norephedrine, which are the basis for its use for the above conditions. You may also see it called by its Chinese name Ma Haung, as it is a Chinese herb taken from a shrub grown in Central Asia.

What’s the problem with ephedra? It has been linked to strokes, myocardial infarctions, and death. In 2000, a New England Journal of Medicine article reviewed 140 reports of adverse events associated with the use of ephedra. In fact, several high profile athletes’ deaths have been linked to ephedra. This “natural” supplement has already been banned by the NCAA, NFL, the U.S. Armed Services, and the International Olympic Committee, along with three states.

Why did it take so long for the FDA to ban this agent? If it had been a prescription medication, it would have been removed years ago. It goes back to the Dietary Supplement Health and Education Act (DSHEA) of 1994. Under this law, a product (other than tobacco) taken by mouth that contains a “dietary ingredient” intended to supplement the diet is protected. Dietary ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, and metabolites. “Dietary ingredients” are exempted from requirements of prescription and OTC medications by this law, and in fact, the FDA must show a “dietary ingredient” to be unsafe before it can be removed from the market.

I’m hopeful the public will realize with the banning of ephedra that just because a substance is “natural” doesn’t mean it is safe. As allergists, we work daily to educate our patients about the risks and benefits of each medication we prescribe. Unfortunately, more and more of our patients end up at the health food store because they believe “natural” treatments are safer and better. By better educating the general public about efficacy and safety of herbal products, we may be able to stem this tide.

I want to praise FDA Commissioner Mark McClellan, M.D., for taking this important step, but it must not stop there. We need to push further. You can still get the dietary supplement kava off the shelf. It is made from the dried root of the pepper plant and is used to treat anxiety. This herb has been linked to liver toxicity, extrapyamidal side effects, and dermapathy. Many European countries have banned this substance and it needs to be banned in the United States, too. The major problem is the Dietary Supplement Health and Education Act. We need to lobby our legislators to change this law and require the same standards of efficacy, safety, and purity for “dietary ingredients” as we do of our prescription and OTC medications. That is the only fair way to ensure the health of the American public.

Michael Blaiss, M.D.

Annual Meeting captured on CD-ROM and now also on DVD
Plenary sessions from the 2003 ACAAI Annual Meeting are available for the first time on DVD as well as CD-ROM, made possible by an educational grant from Aventis Pharmaceuticals.

Both formats contain 16 hours of annual meeting presentations for both Macintosh and Windows platforms. The program includes copies of all slides, original presenters’ audio narration and interactive questions. As an accelerated learning activity, it offers 16 hours of CME credit.

• CD-ROM: The six-disc collection is available for $125 per set.

• DVD: The one-disc package is priced at $100.

Michael S. Blaiss, M.D., has served as medical editor since 1993, when the College became the first medical association to capture and distribute its Annual Meeting on CD-ROM.

The Annual Meeting CD-ROM set or DVD may be purchased through VioWorks. For ordering information visit: http://www.vioworks.com/clients/acaai2003/order.asp

Compliance training right at your desktop
Medicare excluded an average of 5.8 physicians per day between January and June 2003 because of fraudulent billing practices. The office of the Inspector General of CMS has essentially mandated that all physicians implement a compliance plan that will help to prevent this kind of outcome.

The JCAAI has developed a compliance plan specifically for allergists. It is Internet-based and available 24/7. It is more than a compliance plan, however; it is also a business plan. It has been developed in association with Karen Zupko and Associates, a practice management consulting firm. It is a plan not only for physicians, but as required by CMS, for all of your staff.

The price is far below the price of any other compliance plan. If you are a JCAAI member, your cost will be about $180 for a one-physician, five-employee office. If you are not a JCAAI member, the price will be $360, but that also entitles you a one-year JCAAI membership, so you can find out what you are missing. Watch for specific announcements, which will be emailed to you by the JCAAI.

2004 CME-initiative will help you streamline your practice
In a recent survey, 83 percent of allergists who participated in The Patient-Centered Allergy Practice, a CME Series in Practice  Management, said it improved their practices’ efficiency.

This complimentary CME series on allergy practice management is helping physicians across the country streamline their allergy practices and make their offices patient-centered. To register for the new 2004 program or for more advice from the series, call (800) 781-2211, ext. 100, or e-mail info@physicianspractice.com. Visit www.acaai.org for a copy of the series’ CME-accredited white paper.

All program materials are complimentary. The Patient-Centered Allergy Practice is sponsored by Professional Education Services Group, supported through an unrestricted educational grant from Aventis Pharmaceuticals and endorsed by the American College of Allergy, Asthma & Immunology.