I currently work for a private allergy practice and recently our back office registered medical assistant left the company. The doctor just hired an unlicensed individual to perform back office duties including prick testing. This person holds no professional license or certification and has absolutely no prior medical experience or training. Is this considered acceptable or does someone who performs these tasks be certified and/or have some medical training?


Thank you for your inquiry.

The best source for determining the qualifications of personnel performing duties in an allergist-immunologist office regarding the administration of allergen immunotherapy and activities surrounding this administration is our Joint Task Force Immunotherapy Parameters (1).

I have copied for you below a direct quote taken from this document referring to the suggested requirements for personnel preparing allergy extracts. I do this so that you will understand there are recommendations regarding the training of personnel for certain activities in an allergist-immunologist office. However, this document does not contain any mention of these requirements relative to the performance of prick testing. In other words, to my knowledge, it is recommended that some activities be performed by individuals who have received formal training and are certified in various disciplines, and this issue is left void for other activities. To the best of my knowledge, prick testing is one of those activities for which no specific requirements have been recommended.


"Allergen immunotherapy extracts carry the risk for anaphylaxis. Compounding personnel should be appropriately trained health professionals, including, but not limited to, registered nurses, licensed practical nurses, medical technicians, medical assistants, physician assistants, advanced practice nurses, and physicians."

Thank you again for your inquiry and we hope this response is helpful to you.

1. Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter, third update. Journal of Allergy and Clinical Immunology, January 2011; Volume 127 (1), Supplement, page S1-S55.

Phil Lieberman, M.D.

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