What makes a doctor an asthma specialist and how can I find out if my physician is a specialist in asthma care? An asthma specialist is a physician who has a special interest in treating patients with asthma and who has completed postdoctoral training either in adult or pediatric lung diseases (pulmonary medicine) or in allergy and immunology (Table 27). A physician is a medical doctor who has graduated first from college and then from medical school. After medical school, a future asthma specialist will continue postdoctoral training, previously termed internship and residency, for 3–4 years in a broad field such as adult internal medicine, family practice, or pediatrics.
Much of this time is spent in a hospital setting or in a clinic. After internship and residency training, the future asthma specialist will spend an additional 3–5 years in even more specialized training. Such additional training is called a fellowship. Fellowships in the fields of adult pulmonary medicine lead to adult asthma specialization, whereas those in the field of pediatric pulmonology train asthma specialists for children. Fellowships in allergy and immunology train physicians to care for asthma patients of all ages. There are two types of medical schools in the United States. The majority of accredited American medical schools, numbering 131 as of this writing, are allopathic medical schools and grant the M.D. degree after 4 years of postcollege study.
Five states do not have a medical school: Alaska, Delaware, Idaho, Montana, and Wyoming. There are also currently 25 American colleges of osteopathic medicine, offering instruction at 31 locations in 22 states with far fewer students enrolled than in allopathic medical schools. Osteopathic schools grant the D.O. degree. The D.O. stands for doctor of osteopathy. Allopathic medicine has existed for centuries. Andrew Taylor Still founded the discipline of osteopathic medicine less than 150 years ago, in 1874.
The philosophy of osteopathic medicine differs from the allopathic. Osteopathy seeks to treat the whole patient and emphasizes the importance of the musculoskeletal system, as well as the importance of osteopathic manipulative treatment. In the past, requirements for admission to an osteopathic medical school were considered to be less stringent than for admission to an allopathic medical school, but that has changed. The curricula of both schools are quite similar, and state licensing authorities, as well as most hospitals, recognize the M.D. and the D.O. degrees as equivalent.
After medical school, internship, residency, and fellow-ship training, qualified specialist physicians in the United States are permitted to take national, specialized examinations called board examinations. Successful candidates are then said to be board certified in their field, for example, in pulmonary medicine, or in allergy and immunology. Board certification indicates that the physician has met stringent training and testing qualifications. Many asthma specialists also enjoy teaching medical students, interns, residents, and fellows, and choose to become members of a medical school faculty. General pediatricians, who take care of the majority of children with asthma, are experienced in asthma treatment, but are not technically true asthma specialists because they have not completed the specialized training described in this answer.
The same is true for family practitioners and general adult internists who treat adults with asthma. The best way to ascertain whether your treating physician specializes in asthma treatment is to ask the doctor directly. Make sure that your asthma physician is primarily a clinician or a doctor who takes care of patients for a living. Some lung physicians are more accurately described as physician-scientists.
Although trained in respiratory medicine or allergy, they spend the great majority of their professional life in the laboratory, advancing our under-standing and knowledge of the scientific aspects of asthma. Such physician-scientists might, for example, develop a new medication for asthma treatment or research the way asthma genes are transmitted. They are asthma specialists. They advance the knowledge of asthma, but are not involved with the direct delivery of healthcare. The concept of specialization thus includes not only sophisticated medical training beyond that of a general doctor, but also a real and abiding interest in asthma and in caring for people with asthma.