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Top Docs 2009: The Specialists

You need good medical care. How do you know who gives it? We asked the doctors who of their peers they’d trust enough to recommend to a loved one. Here are their picks.
(To download the complete list of 2009 Top Docs, go to page 6 and click on the link.)

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Allergy-Immunology | Gregory Marcotte, MD

Delaware is highly industrialized, so “pollution from fossil fuel creates ozone, nitrogen dioxide, sulfur dioxide and particulate matter that can exacerbate asthma, hay fever and sinus disease,” says Dr. Gregory Marcotte of Wilmington. “And the greenhouse gases we hear about that are raising the global temperatures? Plants breathe CO2 and like warmth, and studies have shown that higher CO2 levels and warmer temperatures induce plants to produce more pollen.”

It’s a vicious cycle that means asthma, allergy and sinus sufferers are in big trouble. “I don’t have to convince my patients that we have more than enough pollen in Delaware,” Marcotte says. “We also are already on the EPA’s naughty list for having unsafe levels of ozone and particulate matter, as well as high levels of air toxins that can be carcinogens.”

So Marcotte takes a three-pronged approach to allergic diseases and food allergies: Identify allergens, show patients how to avoid them, then treat with medication. If that doesn’t work, he’ll suggest allergy shots every two to four weeks for three to five years. Because a body can build immunity, many can eventually stop the shots and decrease medication—some entirely.

Marcotte designed his office to make life more bearable for patients. To discourage dust mites, he replaced carpet with bamboo flooring and upholstered chairs with vinyl. He also used locally made products to decrease pollution from shipping. Everyone can breathe easier.

Beware of big words Allergy reaction-inducing foods such as eggs and nuts can be hard to identify on food packages, so be careful. Ovalbumin is another word for egg. Casein is a milk protein. Miso means soy. The FDA mandated that labels be simplified in 2006, but the big words still appear.

Costly Comfort Allergy medicine can be expensive. Antihistamines such as Claritin have jumped over the counter, but still cost more than a dollar a day. Steroid nasal sprays such as Flonase or Veramyst remain the standard, but they are available only by prescription.

Always ask about your food Why did Marcotte’s peanut-allergic young patient have such a severe reaction to a bowl of chili? It was thickened with a secret ingredient: peanut butter. Always ask the cook.
 

Page 6: Pain Management | Rachael Smith, DO