Keeping up with allergy and immunology
The science changes every day
Ves Dimov is an assistant professor at the University of Chicago and board certified in allergy/immunology and internal medicine. He has published more than 140 scientific papers, book chapters, and abstracts, and has been an investigator on 57 research projects and clinical trials. He coauthored the World Allergy Organization Anaphylaxis Guidelines in 2012 and 2013. He has launched several educational websites and he is known as one of the “Top Twitter Doctors” specialising in allergy/immunology.
Why did you choose to become a doctor?
I wanted to help people and make a difference, and studying medicine is still one of the best ways to achieve this. Also, I had asthma as a child and had to visit the pulmonary clinic quite a few times. In my 6 year old mind, I thought it would be easier if I could become a doctor as soon as possible. I know better now.
Why did you choose immunology?
Clinical immunology is a fascinating discipline. The science behind clinical immunology changes every day and you must always stay up to date. Immunology on its own is incredibly complicated; for example, there are more than 300 CD [cluster of differentiation] markers, and more than 180 different primary immunodeficiencies. The challenge is to bring this enormous amount of basic data to the patient in front of you.
Allergic diseases are extremely common. Allergic rhinitis affects between 20% and 40% of people. Asthma is the most common chronic lung disease and affects up to 10% of people at some point of their lives. Every three minutes a food allergy reaction sends a patient to the emergency department in the United States. Many of these visits could be prevented by establishing care with an allergist or immunologist. There are effective drugs for many allergic diseases and patients improve quickly if the diagnosis is correct and the right treatment approach is selected. This is satisfying for the patient and the healthcare workers.
What are the best and worst parts of a career as a clinical immunologist?
The best part of being a clinical immunologist is seeing improvement in a patient after the correct diagnosis is established and the appropriate treatment is started. Many patients are able to lead normal and fulfilling lives. The worst part of the career as a clinical immunologist is realising that for many primary immunodeficiencies we still do not have a curative treatment, and this can lead to bad outcomes when therapeutic options are exhausted.
As a clinical immunologist, what do you consider your greatest achievement?
While serving on the Allergy Organization anaphylaxis committee, I coauthored the World Allergy Organization Anaphylaxis Guidelines in 2012 and 2013. One of my greatest professional achievements was the launch of several educational websites focused on clinical medicine, allergy and immunology, for example ClinicalCases.org, AllergyCases.org (for physicians) and AllergyGoAway.com (for patients).
What role does social media play in relation to your clinical practice?
I use social media for patient and physician education. For example, I select top 10 allergy/immunology articles from the medical journals and websites I read and publish them as 10 tweets the next day during most weekdays. Then, I select one of those articles and write a longer blog post three times per week. This and other similar methods have the potential to bring positive outcomes which I have summarised with the mnemonic “EQUALS.”
- Energised patients and healthcare staff
- Quality of life is improved
- Understanding of patient condition is improved
- “Affinity,”—that is, better physician-patient relationship
- Lower rate of emergency department visits, hospital admissions, phone calls
- Savings for patient and health system
How will clinical immunology develop over the coming years?
At this time the diagnostic certainty for each primary immunodeficiency is divided into three categories: definitive, probable, and possible. Patients with a definitive diagnosis are assumed to have a greater than 98% probability that in 20 years they will still be given the same diagnosis. As we gain better understanding of the molecular basis of primary immunodeficiencies, we will be able to make a definitive diagnosis for more patients, which will probably lead to better and more targeted therapies.Cassim Akhoon, third year medical student
1King’s College London, UK
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
- Simons FER, Ardusso LRF, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol 2013;162:193-204.
- Dimov V. Social media in medicine: How to be a Twitter rockstar and help your patients and your practice.2011 http://casesblog.blogspot.co.uk/2011/10/social-media-in-medicine-how-to-be.html?utm_content=buffer29e41&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer.
Cite this as: Student BMJ 2014;22:g3838