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Curious as to what it takes to become a certified sleep doc?
#51
RE: Curious as to what it takes to become a certified sleep doc?
Love Seth Hazlit, although I'm currently reading the books having watched the entire series.

Quote: I see no problem with them doing the same in speciality areas.

PAs are pretty common in specialties in my area. I think they are great provided they are well trained and follow up with answers. I see an oncology PA every other visit, instead of the doctor. Regular and both specialty opthamologists have PAs do all the prelim stuff before I see the doc. I even saw a PA, at first, in the ER, when I had an infected animal bite. Neurology only uses PAs to take histories or as a contact for follow-up questions. I saw the Sleep center PA when I went to get my script after the titration, but I was frustrated because she referred me to the internet (to sites I cannot access as a non-medical professional) to get answers regarding cpap and glaucoma. So, hit or miss.

My late Dad saw a cardiology PA as far back as 2000. There seem to be more PAs in this specialty than any other with the possible exception of Ophthamology.

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#52
Good Doc/Bad Doc
Watch out on the good doc/bad doc dichotomy.

Sometimes the doc you like, who takes time to explain, etc. is really not that competent, and is getting by on personality.

Other times, the ahole doc who has delusions of grandeur and is gruff with the patients actually does know his stuff.

Get the free OSCAR CPAP software here.
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If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#53
RE: Good Doc/Bad Doc
(07-09-2015, 07:18 AM)archangle Wrote: Watch out on the good doc/bad doc dichotomy.

Sometimes the doc you like, who takes time to explain, etc. is really not that competent, and is getting by on personality.

Other times, the ahole doc who has delusions of grandeur and is gruff with the patients actually does know his stuff.

I could care less if a doctor personally cares about me, but do hope that he/she cares in the general sense.

If you refer to those docs who are a*ho*les, I'd prefer a fictional 'Dr. Gregory House' to one whose main attribute is compassion with less of a dx and treatment skill set.



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#54
RE: Curious as to what it takes to become a certified sleep doc?
I can't speak for other docs out there, but I doubt I got to my level or responsibility without a certain degree of competence (heavens knows I have been one of the worst at playing office politics, so that ain't it). It is passing rare to see department heads who are duffers, if only because they would be eaten alive by their underlings. Although the medicine done in Dr. House was often unrealistic, and the process certainly was, I have seen my share of colleagues who were just as abrasive and self destructive as he was. A lot of them weren't very good physicians, either, and drug addled ones never are, no matter how good their brains may be when they are off drugs, and that is actually the most unrealistic aspect of Gregory House (also, it would not tolerated - he would have lost his license fast, no appeal). No matter how good a diagnostician he may have been when not on medication, on medication his thinking processes and judgement ability are severely constrained.

I try to listen to my patients, which may come across as compassionate, not because I necessarily care about them, but because it helps me to build a complete diagnostic picture - you would be surprised what clues come to light if you take time to listen that can save you very expensive and time consuming wrong alleys if you don't listen. That is why taking a thorough history is drummed into us in med school - it is the basis of how we can arrive at a diagnosis. I have heard from my patients that I am, as you Americans say, "crusty"(schroff) or "gruff"(ruppig, brüsk) but kind, my nurses complain that I can be a pain in the amount of detail I expect, and my juniors call me a martinet sometimes (to be fair, I only come down hard on them when they engage in lazy thinking) and I hesitate to guess what else behind my back (the nurses are more straightforward - if I am being a d*ck, they tell me to my face). But my wife and my (very few) friends like me. And usually I get to the bottom of the problem with any patient and when possible, fix them. And I like that. It is also what I like about this forum - it stimulates lateral thinking in me and exposes me to a range of complaints and solutions that I can bring into my daily practice. And more and more I am seeing how sleep influences some of the cases I see. It is an eye opener. For that I am very grateful to you all.
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#55
RE: Curious as to what it takes to become a certified sleep doc?
(07-08-2015, 04:22 AM)DocWils Wrote: ...

30 patients a week? Paradise!...

My point was not that he saw few patients; it was that he still worked a 70-hour week caring for 30 patients a week while docs today see seven or eight times that many (and probably also work long hours). The only thing paradisiacal about him seeing 30 patients a week was that he was allowed to spend however much time he thought was necessary to get them the care that they needed.

But even if Ronald Reagan was railing about the evils of socialized medicine to him in 1960, Dad continued in his profession for another 35 years.
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#56
RE: Curious as to what it takes to become a certified sleep doc?
Good on yer Dad! I bet he was good physician, too. Certainly dedicated. Well done, that man.
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#57
RE: Curious as to what it takes to become a certified sleep doc?
I think maybe the important part is that I think of him every time I read one of your posts.
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#58
RE: Curious as to what it takes to become a certified sleep doc?
(07-14-2015, 02:00 PM)TyroneShoes Wrote: I think maybe the important part is that I think of him every time I read one of your posts.


High praise indeed!

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#59
RE: Curious as to what it takes to become a certified sleep doc?
(07-14-2015, 01:39 PM)DocWils Wrote: Good on yer Dad! I bet he was good physician, too. Certainly dedicated. Well done, that man.

Docs who do a thorough history and are great problem solvers are still out there even if an endangered species. Dr B takes as much time as he - or I - need and for that I am grateful. First visit was about 45 minutes. Smile He recently told me he would do his job for free he loves it so much.

Doc Wils I'll take a crusty old Charles W. Kingsfield Jr. who is at the top of his game anytime over a personable yet ineffective "nice" person any day.

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#60
RE: Curious as to what it takes to become a certified sleep doc?
(07-14-2015, 02:00 PM)TyroneShoes Wrote: I think maybe the important part is that I think of him every time I read one of your posts.

Tyrone, I am deeply flattered by that. I honestly am at a loss for words. Thank you, that was a very kind thing to say.
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