AAAAI 17 #AAAAI17

[ajasfolks2]

Well, seeing some Twitter chatter and following, when lo and behold this comes across (about an hour ago):

Tweeted by Matthew Bowdish, MD of California
@MatthewBowdish

Sicherer: Not every family needs a 504 plan - mainly for kids who are not getting what they need from the school
#AAAI17

So, just want to say "thank you" to Dr. Sicherer for giving the refuse-meaningful-504-schools and districts this century's version of FAAN's old "false sense of security" . . . .


grrrrrrr . . . . . . . .


How hard do we have to continue to work on this to get medical profession to GET IT too??  (Or to at least get them to NOT make a blanket statement that is not based in study data or law???)

[ajasfolks2]

Is there link to video of conference?

Is there possible transcript of presentations?

Has Sicherer been quoted as saying this same thing previously?

[ajasfolks2]

I'm pretty sure the legal minds would take issue with statement.

http://www.wrightslaw.com/blog/tag/food-allergies/

http://allergylawproject.com/

To include those attorneys at OCR who have been overwhelmed with work and take on NEW student food allergy discrimination cases DAILY.  Those same, lovely OCR attorneys who issue marvellous letters to schools in order to get the schools to comply with the LAW:

OCR Ruling on 504 Ineligibility--Gloucester

GLOUCESTER - OCR Case: *** Section 504 Plan ***

OCR Union County, NORTH CAROLINA Documents (ajasfolks2)

OCR - Virginia Beach City Schools 2012

(Just to post a few links)


And currently, from the Dept of Ed:
Dept Ed Updated 504 Guide

[Mr. Barlow]

Hashtagged medicine in 140 characters does not help actual patients.  Even if Sicherer released an official statement correcting the position it won't outpace the speed of retweeting grossly ignorant or inaccurate statements.

[Mr. Barlow]

Wow.  I'm too tired to deal with this. 

Sicherer: will sometimes put food in some child's hand in clinic to demonstrate to pt & parents that they can live around allergen

[ajasfolks2]

Yeah, saw that and literally shouted WTF in my kitchen.

So, cannot wait for this to become new "standard practice"

What the ever loving   _____  ??!!!

[spoiler]Just wait 'til schools decide this needs to be done as part of "proving" the anaphylaxis and granting accommodations.[/spoiler]

[gvmom]

I listened to a radio interview with him once... year or two ago.... something...

... and I was not impressed... at least with his handling of how the information he was saying could be twisted to fit another agenda. 

I think it is possible to be factually correct, completely logical, but miss the actual problem with stating things in a certain way... because... yes..... school districts that suck tend to use that against you.

Technical accuracy shouldn't be used to negate actual necessity.  Like, yes, you can hold a peanut in your hand but that doesn't mean you don't need a 504. 

[Mr. Barlow]

Lacking external validity is a legitimate challenge.  Problem is from highly cited subject matter expert to layperson ears (or eyes) in the public.  We can't let our own allergists do the driving if the rest are shouting over them in a bid for global dominance or final words. 

I'm in transit from a education and disability law conference.  Good year at the appellate level for sped case law; unfortunately that doesn't do much to prevent drama at the classroom level.  I do wish doctors would stop trying to practice medicine and law on Twitter.

[gvmom]

I do wish doctors would stop trying to practice medicine and law on Twitter.

[Mr. Barlow]

Please note the following is in no way legal advice.  It part personal opinion, part administrative analysis.  The Schools subforum has plenty of existing resources to advocate for your child's educational and disability rights for whosoever should want them.  I would point towards Wrightslaw as the best single starting point.   

Students with disability who qualify for protections under IDEA, 504, and ADA do not lose those rights simply because a doctor tweets his personal belief.  Rather, to do so may constitute discrimination by stating a class of protected persons based solely on their disability should be treated DIFFERENTLY than any other student with disability eligible for the same protections.  Replace anaphylaxis with HIV or diabetes and it will become more obvious how contrary to nondiscrimination such gross statements are.

Whether that individual should hypothetically be held accountable through a wide variety of accountability mechanisms will be up to: if those accountability mechanisms are brought into play; by whom; and if implemented in an effective manner (i.e., not malicious).  Accountability mechanisms could be employer policies or administration, state law, city ordinance, federal law, agency regulation, ethics committee, hospital or city ADA coordinator, professional nongovernmental oversight (such as bar association or state licensure), or private right of action under 504 or ADA for damages.

There may have to be a course correction implemented by large hospitals to hold their physicians accountable for statements that may cause harms, especially when they violate institution nondiscrimination policies, or constitute unauthorized practice of law.  I can't imagine many medical schools attached to state or publicly funded institutions having risk management departments that would not be sensitive to such events once they are made aware of them.

One should be aware of the caveats in seeking accountability of persons in high profile professions.  Expect an institution to circle wagons over liability concerns for its employee and potential law suits (even where there is no litigious intent whatsoever), retaliation and character assassination of the person filing the complaint ("you are a dumb Facebook mom/anxious/hysterical/helicopter parent", ad infinitum), rationalization or justification for the person's actions or statements ("I'm only trying to help, why do you hate kids/facts/reason."), and to get blocked by administration. 

A reasonable expectation in this hypothesis is some internal institutional corrective action in exchange for your individual humiliation getting dragged by their social network including sycophants, perhaps with a hint or so of sexism by resolution phase.  No one will ever admit any wrongdoing even when it does truly amount to simple error in judgment.

[Mr. Barlow]

In closing I'd like to remind all readers here and whoever may have seen statements attributed to Sicherer on Twitter, it is my opinion that is not remotely enough evidence of what he may have actually said.  Until then it seems like someone trying to instigate drama using 140 characters.  No offense to Twitter but you have to own what you put out there.  And right now, that isn't Sicherer doing it.

[ajasfolks2]

It was an MD who tweeted abt Sicherer . . . . likely as the talk was happening?

[Mr. Barlow]

Treating this as a hypothetical:

I understand Dr. Bowdish made the decision to issue his own proxy he attributed to Dr. Sicherer via social media.  However, before I would even begin to think (again, as a hypothetical academic exercise) of holding any other person accountable for a potentially discriminatory, harmful, or reckless statement, I need a much more conclusive set of demonstrable facts forming a pattern that supports or suggests it deserves attention or intervention from the state or nongovernmental organization with jurisdiction.

Take the Tweet at face value.  These aren't lawyers or K12 educators who would use this area of administrative law in their profession.  They are laypersons when it comes to education and civil rights protections.  Viewed in the best possible light, the statement attributed to Sicherer in short form might relay Sicherer's anecdotal experience viewed through a layperson's lens.  He may not be aware that nondiscrimination laws in education are in effect whether or not a written 504 is in place.  He is likely unaware that child find is a mandate under law that is the K12 educational institution's responsibility, not the parents' or student's.

It would be a rather reckless statement with great potential for harm, and I'd be curious what the liability is for institutions whose spokespersons make such statements that result in harms regardless if they have policies in place or valid nondiscrimination statements.  Remember when everyone thought the EpiPen 4 Schools was a great program?  Anyone questioning Mylan sponsorship was a witch hunter?  Here we are a few antitrust suits, a Congressional and Medicare investigation later.

I think, ajas, there's some value in seeing where this is all going as well.  What is the agenda of both individuals and organizations?  How are US allergists intending to respond to those who point out replication of hypotheses that are largely US-centric do not enjoy validity outside the region?  How are the studies funded?  Do they intentionally ignore well structured, rigorous studies that challenge their findings?  Do they keep themselves in an echo chamber?

[Mr. Barlow]

Sources I've made passing reference to with regard to global consensus and unintended consequences since this is an AAAAI thread.

LEAPing forward with new guidelines

Allergy and infant feeding guidelines in the context of resource-constrained settings

[gvmom]

https://www.cdc.gov/healthyyouth/foodallergies/pdf/13_243135_a_food_allergy_web_508.pdf

Just as a point of interest, and relevant only as interest possibly to me..... given note to special acknowledgements and whether or not individuals have an awareness of issues raised.