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Curious as to what it takes to become a certified sleep doc?
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TyroneShoes Offline

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Post: #31
RE: Curious as to what it takes to become a certified sleep doc?
I've been researching OSA for about a year. I am here regularly. I tried to find a sleep doc with creds. I'm pretty motivated to be involved, and I show up, and do it.

But somehow I never have heard of a board certification for this.

So while there are a lot of words here in the thread, and many of them valuable, what it seems to boil down to is this:

How do you find a sleep doc with board accreditation?

What constantly seems to stick out is how badly the med profession is at bearing down and treating OSA patients properly. That and DME horror stories. To really get good care, you have to take control yourself, bug the doc to do his job, study the issue, come to this forum, and shop around. Most sleep docs are happy if not eager to charge insurance $3700 for your 5-hour sleep study, but don't really seem motivated to do much but take a cursory glance at the results, throw a dart, and prescribe a xPAP and a pressure setting, and then take a new copay every 3 months while only really checking compliance.

Accreditation would probably help. If the path is as arduous as DocWils is telling us (and I take him at his word), then these are motivated people, so maybe they would be motivated to do a better job, also, as well as being better-informed.

What exactly should we be looking for?
(This post was last modified: 07-01-2015 08:58 PM by TyroneShoes.)
07-01-2015 08:56 PM
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DariaVader Offline
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Post: #32
RE: Curious as to what it takes to become a certified sleep doc?
Docs may have education and certification... but unless they are also genuinely caring, good at their job, relevant experience _and_ skilled at "troubleshooting" its what we in the IT industries call a "paper MCSE" (sub the cert of choice)

For myself, I educate myself! AND I also search out doctors who will partner with me in my care. period. I am not interested in a I-have-the-paper-and-you-do-not attitude. When I come to my doctor I have educated guesses about what is going on. Sometimes I am right, and sometimes I am wrong. My doctor respects my smarts, knowledge, ability to analyze and come to competent conclusions, and I respect that she has training and experience that I do not. We discuss options for my care and come to some level of agreement. Many times we have begun in disagreement and later conceded to the other one. We are both strong minded smart women.

As a child, I told a doctor I had migraine headaches (I did) he laughed for 15 solid minutes wiping his eyes, patted me on the head and told me to stop trying to take on adult problems, I would have them soon enough. I suffered for years with migraines and never mentioned them to a doctor again until I was 50. 2 yrs later when I was 12 and had an ear infection at camp, I went to the camp doctor who gave me a pink and purple capsule and refused to tell me what it was. I got stubborn and refused to take it until he did and after a 20 minute stubborn fest said it was penicillin - to which I had previously had an anaphylactic response - and penicillin allergy was in big red letters at the top of my chart. These stories are the tip of the iceberg - I could continue... but these and others are the beginning of my bad 'tude, and that 'tude has saved my life many times. My digging and educating myself has definitely offended some docs. I prefer to work with docs whose ego can stand it. I fully appreciate and respect those docs - but a piece of paper doesn't earn respect in my field unless it is accompanied by results - I guess you could say I apply that same filter to the medics.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
07-01-2015 09:35 PM
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TyroneShoes Offline

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Post: #33
RE: Curious as to what it takes to become a certified sleep doc?
You seem like a smart person. I enjoyed your cautionary tale. Sadly, it is not unique. This is exactly why I asked the question.
07-04-2015 08:31 PM
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DocWils Offline

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Post: #34
RE: Curious as to what it takes to become a certified sleep doc?
(07-01-2015 08:56 PM)TyroneShoes Wrote:  I've been researching OSA for about a year. I am here regularly. I tried to find a sleep doc with creds. I'm pretty motivated to be involved, and I show up, and do it.

But somehow I never have heard of a board certification for this.

So while there are a lot of words here in the thread, and many of them valuable, what it seems to boil down to is this:

How do you find a sleep doc with board accreditation?

What constantly seems to stick out is how badly the med profession is at bearing down and treating OSA patients properly. That and DME horror stories. To really get good care, you have to take control yourself, bug the doc to do his job, study the issue, come to this forum, and shop around. Most sleep docs are happy if not eager to charge insurance $3700 for your 5-hour sleep study, but don't really seem motivated to do much but take a cursory glance at the results, throw a dart, and prescribe a xPAP and a pressure setting, and then take a new copay every 3 months while only really checking compliance.

Accreditation would probably help. If the path is as arduous as DocWils is telling us (and I take him at his word), then these are motivated people, so maybe they would be motivated to do a better job, also, as well as being better-informed.

What exactly should we be looking for?


Well, to start with, you are not likely to find many board certified sleep docs who are not attached to hospitals or clinics. Although there are some in private practice, because of the equipment and support needs, on the whole they tend to work within the larger structures of hospitals and clinics, integrated into larger speciality areas (Neuro, pneumo, cardio), so finding sleep clinics in major teaching hospitals is your best bet. The department heads will be board certified for sure, and most of the their senior staff should be. Private sleep clinics may or may not have board certification in the US, although more and more do as the industry around sleep therapy becomes larger and more tightly regulated and watched, but there are lots of cowboys out there still, making money by getting around the edges of regulation, which is a worry but one that accompanies any growth area in medicine in a country that still allows patent medicines and hucksterism (call it the price you Americans pay for being so anti-regulation and so determined to have a free market in every branch of your economy - don't blame doctors for that, blame your politicians and blame mostly your voters for constantly voting against their best interests and buying time and again the shinola that so many free market and libertarian politicians sell). GPs are most definitely NOT qualified, having done at most a three month rotation that touched on sleep medicine, most of that in the neuro lab and maybe a bit again in their ENT rotation. The most a GP can do is suspect that you have it and refer you to a specialist - although they have the power to write a script for a machine (script writing ability for CPAP devices is not restricted to specialists, although various insurance companies may or may not cover you only if the script is from a specialist), they don't have the knowledge really. The should be lists of board certified practitioners in your area on the AMA website and the websites of various Lung Associations or Leagues, and certain insurance companies may also have lists of physicians that they will accept as qualified to write a script that they will cover, although other insurance companies may take the script from anyone with a license, including a PA - that is up to the insurance company's rules, not the regulatory bodies.
(This post was last modified: 07-05-2015 05:24 AM by DocWils.)
07-05-2015 05:17 AM
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Mosquitobait Offline

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Post: #35
RE: Curious as to what it takes to become a certified sleep doc?
(07-01-2015 08:56 PM)TyroneShoes Wrote:  I've been researching OSA for about a year. I am here regularly. I tried to find a sleep doc with creds. I'm pretty motivated to be involved, and I show up, and do it.

But somehow I never have heard of a board certification for this.

So while there are a lot of words here in the thread, and many of them valuable, what it seems to boil down to is this:

How do you find a sleep doc with board accreditation?

This won't guarantee that you will get the kind of patient focused doc you want, but call any major hospital and tell them that you are looking for suggested sleep centers that they can recommend. The American Academy of Sleep Medicine site doesn't appear to list approved practioners, so that's the best you can do. Also, call your insurance company and ask them about area approved sleep centers. In my area, sleep studies in an actual hospital are now limited to people who may need immediate medical care or need additional cardiac monitoring (multi-purpose). So, like someone with COPD or other complicated issues.

Just a note - if you have had neurological issues, I'd focus on a sleep center that has a neurologist associated with the clinic. For cardiac, I THINK they focus on pulmonologists, at least they do here.
(This post was last modified: 07-07-2015 02:21 PM by Mosquitobait.)
07-07-2015 02:15 PM
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Mark Douglas Offline

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Post: #36
RE: Curious as to what it takes to become a certified sleep doc?

Doc FYI "cowboys" are darned hard working dependable yet independent people.
You may have watched too many Hollywood movies while you were here..

I assume you are tired and your feet hurt but far as our political problems perhaps that ought to be an Off-Topic Forum subject? For example even though you are a physician I assume you won't be voting for the Freisinnig-Demokratische Partei as they are big on personal liberties?
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07-07-2015 03:23 PM
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DocWils Offline

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Post: #37
RE: Curious as to what it takes to become a certified sleep doc?
(07-07-2015 03:23 PM)Mark Douglas Wrote:  Doc FYI "cowboys" are darned hard working dependable yet independent people.
You may have watched too many Hollywood movies while you were here..

Cowboy is a common English and European expression for unqualified handworkers who do a shoddy job. Not sure how it started, although probably the association was the wearing of blue jeans by many of the less scrupulous builders running around the UK and Europe in the 1970's. Blue jeans was still not a common fashion for workers in those days (overalls or smarter work wear was far more common) and the association to blue jeans and American cowboys was probably inevitable at the time, especially given the fashion of cowboy boots that was also growing at the time. I learned my English in the UK and so I probably tend to use UK expressions. American English is, as I learned when first doing a residency there, a completely different beast. As Mr. Shaw (and often attributed to Mr. Wilde as well) once said, America and the United Kingdom are two countries divided by a common language.

On my first day in Residency in the US I described a patient's legs as "cute" meaning the shape of them in relation to each other, only to discover to my chagrin that it meant something else in the US, and since the patient was male, and I had what Americans took to be a posh British accent (I learned to speak RP) at the time it seemed to imply to some of my colleagues that I had certain proclivities that I do not have. Equally causing misunderstandings was my offer to come and knock-up one of my colleagues in the morning. The ladies took it rather hard, the men with a certain look of surprise. It took several weeks before someone set me straight on that. It took longer than that for me to get a date after all that.....


(07-07-2015 03:23 PM)Mark Douglas Wrote:  I assume you are tired and your feet hurt but far as our political problems perhaps that ought to be an Off-Topic Forum subject? For example even though you are a physician I assume you won't be voting for the Freisinnig-Demokratische Partei as they are big on personal liberties?
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Your Missus works for UBS? Three of my private accounts are with them, and my wife's uncle was a vice president of UBS for several decades. I have never had anything to complain about with them. CS, on the other hand.... (and I and my wife have several accounts at CS, too. You should never keep all your money in one place, you know)

No, I don't vote FDP, I vote EVP, even though I am not Christian - they are the only party that vaguely resembles my values at all. Parties that support bars being open 24 hours a day and people drinking themselves into alcohol poisoning are not parties that I will vote for. FDP is in favour of a 24 hour party society, just as they were stupidly in favour of free use of drugs in public that led to the debacle of Needle Park in Zurich. Their basic view is that if you want to go to hell in a hand-basket, go right ahead, and if you inconvenience other people in the process, so what? You should still have the right to do it. Not my idea of a good party to belong to.

Incidentally, I never vote along party lines for any of our four times yearly plebiscites (we remain the closest thing to a true democracy in the world, and frankly, sometimes I think it is a colossal waste of money, but I suppose it works because we still have a small enough population - it could not work in the US - too many people and too big a country) - as far as I am concerned, once they are in Parliament they have a job to do - when a proposal or law is handed back to the Swiss folk to decide, Parliament's opinion does not count, and I must again take up the decision for myself and cannot be influenced by what my or any party thinks. Their job to represent me has at that point been abrogated, so I don't let them represent me by their influence in that particular vote. But that part does belong in another section of this forum.

What I was saying wasn't intended to be political (although it crept in I am sure), but an explanation of the hard reality of any advance in medicine (and as such, on topic) - until legislation catches up, people will take advantage, and in a determinedly free market economy as you have, profiteers will be the first to have a foot in the door and legislators will be hampered by their political agendas, the influence of lobbyists and the tendency of the electorate to vote against their own interests (we have that problem here too, four times a year). Once sleep clinics become commonplace enough to be "mainstream" inevitably more regulation will come into place, but in the US that will be a long road, as the experience of plastic surgery has shown. It took decades before anything was done in any state to wean out the unqualified surgeon from the qualified, and you still have some "cowboys" practising and hurting patients. I expect the same for sleep clinics, so it does pay to really check up on the credentials of the practitioners in the sleep area before you go to them.

Remember, anyone in the US who has a general license can hang out a shingle and call himself a sleep doc and there is nothing one can do about it, so long as he doesn't put any certification letters after his name beyond M.D., but to be board certified is another matter. You can't call yourself board certified without having that certification, and the certifying body comes down pretty hard on those who do. Jail time is not unknown in such cases. (see how I brought it round to the topic again?)
(This post was last modified: 07-07-2015 05:23 PM by DocWils.)
07-07-2015 05:17 PM
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eviltim Offline

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Post: #38
RE: Curious as to what it takes to become a certified sleep doc?
As someone who suffers from multiple sleep disorders other than sleep apnea, I'm rather nonplussed with the whole thing. I eventually found a GP who runs his own sleep clinic and has gone out of his way to become very educated on these issues and whose judgment I trust, but he seems to be the exception and not the rule.
(This post was last modified: 07-07-2015 05:31 PM by eviltim.)
07-07-2015 05:30 PM
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Post: #39
RE: Curious as to what it takes to become a certified sleep doc?
DocWils, Like you, we also use the term "cowboys" in the U.S. to describe people in any occupation that tend to operate ostentatiously beyond their abilities and bring disgrace to those who are more able and well trained in the particular field. Pretty common term, not meant to refer to the true western cowboy, of which few are left to take exception.

I think the typical doctor, in any field, suffers from a lack of allowable billable time to explain all of his diagnosis in detail. As a result, you just have to find someone you can trust and place your well being in his/her hands. That's sad, but that's how it has evolved and won't likely change until ______________ (fill your own term in there).
(This post was last modified: 07-07-2015 05:46 PM by surferdude2.)
07-07-2015 05:40 PM
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zonk Offline

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Post: #40
RE: Curious as to what it takes to become a certified sleep doc?
What Does It Mean to Be a Board-Certified Sleep Specialist?
http://www.huffingtonpost.com/stanford-c...16318.html
07-07-2015 05:46 PM
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