Women physicians should get involved, seek out opportunities to advance in leadership

Key takeaways:

• Luz S. Fonacier, MD, FACAAI, FAAAAI, was the fourth woman and first Asian American ACAAI president.
• As president, Fonacier’s theme was to “innovate, diversity and expand” via patient and provider education.

Luz S. Fonacier, MD, FACAAI, FAAAAI, has shattered multiple glass ceilings in her career as an allergist.

From becoming the first woman to be named a full professor of medicine at Winthrop University Hospital – Long Island in 2009 to becoming the fourth female and first Asian American president of the American College of Allergy, Asthma & Immunology in 2020, Fonacier has paved the way for more women to become leaders in the allergy field.

Today, Fonacier is the training program director of the allergy and immunology fellowship program and head of allergy at NYU Grossman School of Medicine– Long Island, is still extremely active with ACAAI, and serves on Healio’s Women in Allergy Peer Perspective Board.

Using leadership positions ‘to do more’ for physicians, patients

Fonacier’s medical career began in Manila, Philippines, where she graduated cum laude from her medical school and completed her first residency in dermatology at Philippine General Hospital at University of the Philippines Manila.

During her residency, Fonacier became interested in allergic skin diseases, and decided to move to New York for a dermal immunology fellowship.

“Concentrating on allergic skin diseases, autoimmune blistering diseases and the immunology of the skin made me gravitate toward allergy and immunology,” she said.

After finishing her first fellowship in dermal immunology, Fonacier took on a second residency in internal medicine at NYU Lutheran Medical Center, followed by a fellowship in allergy/immunology at The New York Hospital – Cornell Medical Center.

Fonacier joined NYU Langone Hospital, then called Winthrop University Hospital, in 1992, and she has been working with patients and teaching there ever since.

“After 11 years of training, it was natural that I chose to go into an academic practice,” Fonacier said.

Fonacier said she was proud to watch the allergy department grow from just her to five allergist/immunologists. In 2008, she started a fellowship program, which has been recognized as a World Allergy Organization Center of Excellence.

“We are seeing patients from birth to end of life,” Fonacier said. “We are a referral center for difficult allergic and immunologic cases and procedures, and we are one of few centers performing chemotherapy desensitization in our area.”

Outside the hospital, Fonacier is extremely active in professional organizations. While serving as ACAAI president, Fonacier also was named chair of the American Board of Allergy and Immunology, becoming the first person to take on both roles at the same time. Fonacier has been a member of the House of Delegates for the World Allergy Organization, and is currently chair of their Atopic Dermatitis and Other Eczemas Committee.

“This allowed me to do more for the specialty, physicians and patients,” Fonacier said. “I was able to reach out not only regionally, but also nationally and then internationally.”

Focusing on diversity

As ACAAI president, Fonacier’s theme was to “innovate, diversify and expand.” This included educating health care workers about how allergic and immunologic symptoms may present differently across races and ethnicities, as well as how socioeconomic status and access to care affect patients’ outcomes.

“We have created and curated numerous informational and educational resources not only for members, but also for patients,” Fonacier said.

These resources included a webinar, online resource and podcast about atopic dermatitis in skin of color, as well as educational modules about genetic, social and environmental risk factors for immunologic conditions. The ACAAI also added more translated material to its Spanish website while Fonacier was president.

One of Fonacier’s goals as a leader in the allergy/immunology field is to identify and address health disparities. Fonacier said in 2021 the ACAAI conducted a roundtable study, which was published last year in Annals of Allergy, Asthma & Immunology, that found physicians are underinformed about racial disparities among people with atopic dermatitis and food allergies and identified obstacles people of color face in getting care for allergic and immunologic diseases.

“Black and Hispanic children have more asthma and allergic diseases,” Fonacier said. “And there are a lot of socioeconomic issues associated with that. It can cause them to miss school, and parents to miss work; it disrupts their routine, decreasing their quality of life. Children with food allergies have less access to safe food because it is more expensive for them.”

The study also included an ACAAI member survey, where three-quarters of respondents said they had no valuable resources to help patients of color with care access and cost.

Along with creating resources for allergists and their patients, the ACAAI Foundation has also awarded nearly $100,000 in Community Grant Awards to fund research focusing on health disparities.

Along these lines, Fonacier also aimed to diversify the allergy/immunology field by specifically targeting medical students. Under her leadership, the ACAAI expanded its SPARK program, which provides travel grants for first- or second-year residents to attend the ACAAI Annual Meeting, to set aside grants for students from historically Black medical schools, as well as international fellows.

“You have to start in medical school,” Fonacier said. “We need more physicians of color, and that is why we expanded the SPARK program specifically for Black students and students in predominantly Black medical schools.”

Shaping the future

The allergy field has come a long way in becoming more welcoming to women, Fonacier said. When the ACAAI was founded in 1942, two of 45 elected members were women. In 2020, she said 58% of members were women.

“The growth of women in allergy is phenomenal, but [representation among] the leadership, however, is not growing as fast,” she said.

Fonacier said the first woman president of the ACAAI was selected in 1994 — 52 years after the organization was founded. In 2020, when Fonacier became president, she was only the fourth woman to take on the role.

Women comprised just 5% of leadership in the allergy/immunology field in 2020, something Fonacier said she personally wants to improve through mentorship.

“We are definitely seeing changes and we need to keep the momentum going,” Fonacier said. “If you look at the board of the College, and the number of women who are on track to becoming leaders, I believe the proportion of women in leadership could reflect that of membership.”

So, how can women allergists become leaders in the field like Fonacier?

“Getting involved is key,” Fonacier said. “I started as a member of the dermatology committee. In time I became the chair, and I joined other committees. Then I became a board member and the treasurer, and eventually the president.”

Fonacier said a great way for young women allergists to start getting involved would be joining the ACAAI Women in Allergy Committee, a group she has been a member of since its inception in 1999.

“It is a supportive group; it understands women’s challenges and roles,” she said. “It involves not only physicians, but also other women in the field of allergy, including allied health [professionals], nurses and aspiring allergists.”

When they are ready, women should seek out opportunities and say yes when they are offered, Fonacier said. She also encourages women to work hard toward their goals, to have an open mind, seek a mentor if needed and to embrace diversity.

“I had to break through multiple glass ceilings to get to where I am, and not just the ceiling for being female, or a minority,” Fonacier said. “It was not easy, but with persistence and hard work, I believe that these opportunities are open to anyone of any gender, race and background.”

References:

• American College of Allergy, Asthma & Immunology – Spanish. https://acaai.org/espanol/. Accessed April 29, 2024.
• Corbett M, et al. Ann Allergy Asthma Immunol. 2022;doi:10.1016/j.anai.2022.12.017.
• How does the atopic march differ in Black and white children? https://college.acaai.org/podcasts/how-does-the-atopic-march-differ-in-black-and-white-children/. Published Dec. 21, 2023. Accessed April 29, 2024.
• What is eczema in skin of color? https://eczemainskinofcolor.org/what-is-atopic-dermatitis-ad/. Accessed April 29, 2024.

For more information:

Luz S. Fonacier, MD, FACAAI, FAAAAI, can be reached at luz.fonacier@nyulangone.org.