Allergy testing by primary care physicians

Primary care physicians will treat allergy to some degree purely because of supply and demand. The effectiveness of treatment depends on their interest and involvement. A thorough history and physical examination are essential. Physicians should not depend on a remote, computerized plan for diagnosis and treatment. Various diagnostic tests are available, some appropriate to nearly all levels of interest. Primary care physicians must choose between referral, pharmacotherapy, or more extensive involvement in allergy care. Immunotherapy involves some risk and a better possibility of pure result, but it requires additional training. Food allergy cannot be diagnosed by in vitro tests. Elimination and challenge with subsequent long-term elimination of offending foods is the only practical course for primary care physicians.