Why Your Doctor Might Not Know How to Help With Food Allergies—And What's Changing

If you have a food allergy, you probably expect your primary care doctor to know how to help you manage it. But here's something that might surprise you: many doctors—even those who see food allergy patients regularly—don't feel confident counseling patients on how to use an epinephrine auto-injector, the emergency medication that can save your life during a severe allergic reaction. A new study is changing that, and it could mean better care for millions of people with food allergies.

The Problem: Doctors Lacking Confidence

Food allergies affect roughly 32 million Americans, and they're on the rise. Yet internal medicine residents—doctors in training who often become primary care physicians—frequently lack the confidence to properly prescribe and teach patients about self-injectable epinephrine, which is the first line of defense against anaphylaxis, a life-threatening allergic reaction.

This matters because confidence matters. When doctors aren't sure about something, patients pick up on it. "You can prescribe the medication, but if you don't teach them how to use it, then patients will be hesitant to pick it up or use it," explains Dr. Sai Nimmagadda from Lurie Children's Hospital of Chicago. "You'd be surprised how often a person with food allergies doesn't use their device."

A Simple Solution With Big Results

Researchers led by Dr. Scott Sicherer at Mount Sinai's Jaffe Food Allergy Institute decided to test whether a brief educational module could help. They studied 54 internal medicine residents, asking them to complete surveys before and after viewing an online educational presentation about food allergy management and epinephrine auto-injectors.

The results were striking. Of the 34 residents who completed both surveys, nearly all reported improvement in their comfort levels for both prescribing and counseling patients on epinephrine use. Here are the specific improvements:

• Knowledge about the correct location for epinephrine injection jumped from 83% to 97%
• Identifying appropriate scenarios for prescribing auto-injectors improved from 37% to 65%
• Comfort with prescribing epinephrine increased from 4.02 to 5.95 on a 7-point scale
• Comfort with counseling patients on its use rose from 4.13 to 6.08 on a 7-point scale
• Familiarity with four common types of auto-injectors showed significant improvement
• 94% of participants rated the intervention as helpful

Why This Matters Beyond the Doctor's Office

The ripple effects of doctor confidence are real. When physicians feel competent and can explain how to use an epinephrine auto-injector clearly, patients are more likely to actually carry and use the device when needed. Dr. Nimmagadda points to a parallel in asthma care: "It's been shown that the more education in clinicians, the more education the patient also has, and so the more likely they are to use their inhaler."

The timing is important too. Food allergies are increasing tremendously, and many patients see their primary care doctor first—sometimes waiting a month or more to see an allergist. Having confident, well-trained primary care doctors means faster, better initial guidance for people at risk.

What Happens Next

The good news: Dr. Sicherer and his team are making the educational slides publicly available for other doctors and training programs to use. "The educational slide set is included with our published study showing its effectiveness and can be downloaded by readers," Sicherer said. The slides will need periodic updates as guidelines and medications change, but the framework is there.

If you have a food allergy, this research suggests that your doctor—whether they're in training or already established in practice—can quickly gain the knowledge and confidence needed to help you manage your condition safely. And that's something worth knowing.