Allergy care shifting from smaller specialty practices to multispecialty groups
Key takeaways:
- The size of allergist-only groups grew from a mean of 16 in 2015 to 23 in 2023.
- 42% of allergists who graduated medical school before 2010 and 65% of those who graduated later work for multispecialty groups.
SAN DIEGO — Allergy care is shifting from smaller allergist-only practices to larger multispecialty groups, according to a presentation at the 2025 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress.
This reflects a trend that has seen smaller practices consolidate into larger groups across all specialties, Bryan Witt, MD, pediatric resident, and Christine Rukasin, MD, FAAAAI, allergist and clinical immunologist, Phoenix Children’s Hospital, told Healio.
“We were interested to see if allergy and immunology as a field was following a similar trend,” Witt and Rukasin said in a joint statement.
Using Centers for Medicare & Medicaid Services Provider Data Catalogs, the researchers obtained individual and group information such as sex, year of graduation from medical school, and group name and size between 2015 and 2023. Practices were classified as solo practices, allergist-only practices or multispecialty groups.
“The median group size has shifted from five physicians in 2015 to 22 physicians in 2023,” Witt and Rukasin said. “There was an increase in total allergists included in this group of 309 over the 8-year period.”
The balance between male and female allergists has shifted as well, they continued, from 64% male and 36% female in 2015 to 56% male and 44% female in 2023. However, the researchers noted, they did not have any data pertaining to race.
The proportion of allergists who practiced with a multispecialty group increased from 35% in 2015 to 47% in 2023. Proportions of allergists who practiced in allergist-only practices fell from 40% to 33% in that timeframe, and proportions of solo practitioners fell from 25% to 20%.
However, allergist-only groups grew from a mean size of 16 physicians to 23. Also, 42% of allergists who graduated from medical school before 2010 worked for multi-specialty groups in 2023, compared with 65% of allergists who graduated from medical school after 2010.
These shifts are happening across the country as well, the researchers said.
“The states in 2015 that had a mix of small practices and large practices are now more large practices,” Witt and Rukasin said. “In 2023, there were only three states that had a majority of allergy-only or solo practices: Idaho, Georgia and Vermont.”
Wyoming was the only state that did not have a practicing allergist in the database in 2023.
The researchers said that the transition to larger practices probably is multifactorial.
“We see that new graduates tend to join multispecialty groups or academic medical centers,” Witt and Rukasin said. “This study did not evaluate the causes of the shift, but we hypothesize that there are individual financial reasons, trends and shifts in health care as a whole, and development of subspecialized allergy niches.”
Based on these findings, the researchers called for further attention on the effects of this shift from smaller allergy-only practices to larger multispecialty groups on the quality of patient care.
“This was not specifically evaluated in the study, but we suspect that this shift has decreased allergy practices in less populated areas,” Witt and Rukasin said.
Research is needed to evaluate how this shift has impacted physician wellness as well, they added.
“On one hand, larger practices may allow for less administrative burden for individual physicians, different negotiating opportunities with insurance companies, and easier collaboration with other physicians,” Witt and Rukasin said.
“However, larger practices are also usually associated with decreased autonomy in medical decision-making, decreased salary and less patient continuity,” they said.
For more information:
Bryan Witt, MD, can be reached at bwitt@phoenixchildrens.com. Christine Rukasin, MD, FAAAAI, can be reached at crukasin@phoenixchildrens.com.