One of the greatest dangers facing the practicing allergist today is simply becoming "irrelevant" to the public at large when it comes to seeking allergy care.  We face competition from many specialties.  Let me site an example:

"Patient John Doe sees me in my office.  He has come in for a "second opinion" on whether or not he has "allergies."  He's confused.  He wants reassurance he's on the "right track" with his health.  He has had 4 years of sinus problems.  He saw an ENT, and was reassured that he had no structural abnormalities contributing to his problems.  He was told to see an allergist.  He was given a few perfunctory prick tests, told they were "negative" and he had no allergies.  "So what's causing my sinus problems?" he asks.  The allergist shrugs, and hands him a steroid nasal spray and says "something about nonallergic rhinitis".  He doesn't like the explanation, and he only gets partial relief of his symptoms.   He continues to "shop around", sees a chiropractor who does kinesiology, he is told to stop using all dairy products, and his sinus problems go away.  He stops the nasal spray.  He's better.  Guess who John Doe is going to refer patients to in the future?  The allergist?  Or the chiropractor?

 By limiting our diagnostic testing and treatment options, many patients simply don't get the relief they want from the "routine" allergy referral. Patients see little difference in what the allergist offers, and what their family physician offers.  Many patients enthusiastically self-refer family members to alternative care practitioners, chiropracters, etc. but I have NEVER seen such enthusiasm for the traditional allergist.  Is our focus to narrow?  Do we overlook and not emphasize areas of IMPORTANCE to the PUBLIC--like food sensitivity/intolerance?  yeast allergy?  food additive intolerance?  mold allergy? 

These matters might matter little to the academic, on-tenure allergist, but they matter greatly to the community allergist.  For therein lays our livelihood--and our oath:  to help our patients.