RE: Do I need to see a specialist?
Being one of those guys in white coats (actually I never wear one, much to the consternation of my staff and my superiors, but I always hated it as I do the current fashion of wearing scrubs even if you are not in surgery or in a messy procedure - there is no reason on earth to put on whites unless you need to do something that you need to protect your cloths from or to lend you an air of authority that I really don't need at my age - I've always hated uniforms - I'd probably show up to work in tie-dies, cut off chinos and sandals if I could), I know a lot about how little one speciality knows about another - our training gives us a very good overview of each region of medicine, but it takes years of practice and experience to understand the nuances of many these branches of medicine, and few GPs have enough training to accurately prescribe the right machine and pressure settings for a CPAP. It ain't rocket science, believe me, but it does take experience and knowledge and a good "feel" for what works in each given situation.
That said, the basics can usually be easily understood by a trained physician pretty quickly, because we already have the ground understanding of the subject and know how to read and understand the technical jargon involved, but any GP worth their salt, if they didn't send you to a specialist, would check with one anyway to be sure of the script. We have a lot of quid pro quo in our business, and I certainly benefit from consulting with my colleagues, as do most docs I know. How much sleep specialist consult with one another is something I couldn't say, but it certainly has raised my curiosity, so I may ask around. The problem here in my country on that score is that there are practically no accredited sleep specialists in private practice at all - most work through the hospitals here so there is bound to be a lot of cross consulting, as hospital environments encourage that if only because of proximity. So if that is also true in the US I cannot say.
I would suspect that private practice might encourage a more insular attitude to some sleep specialists, as it does DMEs in the US (here we only have the LungenLega and the hospitals themselves to distribute the devices, and the LL is spectacularly helpful and kind, but they are in the business of being activists for public awareness and treatment of lung problems and government sponsored, to boot, but not OF the government - they remain a private organisation), but I should hope that most are open to questions from their patients. The one thing to remember is that they are very busy people, have seen it all a few thousand times, so make quick judgements a lot, and because they are not in a "caring" branch of the profession, in the sense that they don't deal with nasty and scary areas (to them, at least), bedside manners tend to be, well, let's say, less well developed. Hand holding is not going to be their thing. And that is one of the big reasons for this forum. But they still know their stuff and should, if not over-busy or burned out or having a bad day, give you good advice and good treatment. They don't do this for the big money - there isn't big money in sleep research. But at least it ain't a messy gig. And trust me, there are branches of medicine where you gotta love mess, 'coz there's lots of it.
(This post was last modified: 11-02-2013 06:32 AM by DocWils.)