Recognizing the allergic child

The delivery of health care is currently in a state of transition with managed care emerging as a frequently used method for health care delivery. A major tenet of many managed care systems is that specialized care is costly and thus is to be delayed or avoided when possible. The end result of this philosophy is that primary care physicians will find themselves providing patient care which, in the past, had been provided by the specialist. In the field of allergy, as in any other specialty, providing adequate and appropriate care to the patient is incumbent on recognizing that the patient's symptoms are allergic in etiology. This is especially true when presenting symptoms are different from the classical signs and symptoms of allergy. This paper presents: (1) specific comments and suggestions which will enable the primary care physician to recognize the allergic child, (2) data from over 800 children referred for allergy evaluation to support the foregoing comments and suggestions and, (3) recommendations as to how primary care physicians might effectively manage most children with certain types of allergic disease without referral to an allergist.