Healthcare in a rural area is tough. I've been through 2 doctors in the last year and currently can't get assigned to one, no one is taking new patients, so I am working with a very nice nurse practicioner. Would love to communicate with a physician who doesn't glaze over when I start asking OSA questions. What qualification or specialty should I look for?

Many (most?) "sleep doctors" come under the category of pulmonologists.

May we ask where you live?

Den

As I understand it, any doctor can write one a prescription for an xPAP. However, the sleep specialists are usually pulmonologists, neurologists, or ENT's (ear, nose and throat physicans who are also called otolaryngologists). Not all of those specialists are experts in sleep disorders; they would have to sub-specialize.

In my experience, the more specialized the doctor, the better their knowledge of your condition. I have the most common, but still rare, bleeding disorder. The board-certified hematologist nearest to my home orders blood tests that mean NOTHING, according to my super-specialist an hour and a half away. I stay on his patient list so that I will be treated locally in case of an emergency. I know he will contact my super-specialist and follow whatever her treatment recommendations may be.


The county medical society (for the county in which you live) should have a list of specialties, which may be even more specific than the yellow pages groupings. Some of the best doctors are not listed in the yellow pages, in my experience.


You may wish to do a search of your area on the internet or to call the physician referral service from the closest hospital. Believe it or not, one of my best docs was a referral by the hospital service. The service even asked me what I was looking for in a doctor!

I hope that you can find a highly qualified and competent sleep specialist with whom to work; personalities that mesh can be VERY important in a doctor/patient relationship.

Any of you medical professionals out there with other ideas: please add on to this!

All the best to you.

If my pulminologist sleep doc is any example, this category of sleep doc is woefully inadequate in examination and analysis of the airway and possible anomalies of same. Mine never even looked up my nose or down my throat. In fact, he never even touched me.

My vote would be for finding a good ENT doc who knows about OSA.

I live near a big city (Cincinnat) and I have yet to find a sleep Dr. who cares or who wants to help. I quite going to my sleep Dr. after I went in just for an office visit to ask questions that I had written down and I wanted to discuss my problems trying to find a mask that works (his sleep center only carried one full face mask to use during the sleep study) but after two or three questions he said we have to do the daytime sleep test or he would have to inform the Ohio BMV that I was non compliant in my treatment this would result in the revoking of my commercial drivers license. I have not returned to his office or returned their calls. I went to a ENT recently because I could hardly breath through my nose and did the septoplasty and turbinectomies surgery and I can now breath through my nose much better but it never helped my apnea so now he wants to go into my throat (I forget the surgery name) but I am not going to do it.
So if I never find the magic mask that works or find a Dr. that cares I will just live with the apnea.

Gosh -- reading these posts makes me feel even luckier than I already felt in finding such a good pulmonologist/sleep doctor. (See my thread "A Good Doctor Story for a change!!") I sincerely recommend you all keep trying until you find one. It can make a big difference having that kind of knowledgeable and caring doctor in your corner. Good luck.

Hello Mouthbreather,

With all due respect to my fellow Cpapers and definitely with the idea that many of us have different opinions.

My opinion only:

1. Even if you are in a rural area, try your utmost to locate a physician who is Board Certified in Sleep Medicine. Then find a second Board certified Sleep Disorders Specialist and get a second opinion.

After you get a second opinion post again here, remember we are not Physicians.

2. The American Academy of Sleep Medicine [ASSM] is a start.

3. Google "AASM", THEN FOLLOW LINKS TO YOUR STATE and Board Certified
in Sleep Medicine or Board Certified in Sleep Disorders; I am not sure of the exact term.

4. Get your friends to use the internet to find someone Board Certified in Sleep Medicine

5. Ask for a definition of a sleep doctor on this forum again.

6. In the spirit of cooperation and maybe I am having a really bad day; I thought the people on this forum would have a more precise answer.

7. Pulmonologists, ENT's are probably not good enough unless they are also Board Certified in Sleep Medicine /Sleep Disorders. Even then, expect the unexpected and good luck.


I wish my answers were better.

Hello again Mouthbreather

from someone else's post.

I believe Diplomate and Board Certified Mean approximately the same thing.

would go here and find a board certified one:


>>>>>> http://www.absm.org <<<<<<<<<<<<<<<



Click on Diplomats link on the left, then your state, then your city, it will give you a list docs in your area.

Good Luck

SOMEWHERE on the web a couple of weeks ago I was at one of the sleep association web sites and there was an explantion given about the differences between a sleep CLINIC and a sleep LAB or maybe one of the terms was sleep CENTER. I failed to bookmark the site and now I'd like to find it but I'm not finding it even thru a google search. Maybe I'm not defining my search parameters well enough. Does anyone know the URL to that explanation of the difference??

I remember one type pretty much concentrated on the OSA, pulmonary aspects whilst the other type specialized in evaluation and detecting ALL forms of sleep disorders.

Anonymous wrote:Hello again Mouthbreather

from someone else's post.

I believe Diplomate and Board Certified Mean approximately the same thing.

would go here and find a board certified one:

>>>>>> http://www.absm.org <<<<<<<<<<<<<<<

Click on Diplomats link on the left, then your state, then your city, it will give you a list docs in your area.

Good Luck

I found that my NEUROLOGIST WAS LISTED there, but my PULMONARY Dr. who is associated with a sleep lab IS NOT!!
This is also evidenced by conversations with each!

You may also want to check somehow on RESPIRATORY THERAPISTS - although nor MDs, they may lead you to a good one.

More good luck!!

Link to an Explanation of Board Certified vs. Diplomate in Medical Specialties

It was difficult enough just finding an MD, but NOW there is even more to consider in looking for a sleep specialist. Here are a few selected sentences from the above article:

"Board certification can be quite confusing to the general public..."

"Major specialty certifying boards are not educational institutions. Certificates issued by these boards do not confer degrees. Certification does not grant legal qualifications, hospital privileges, medical licensure, the right to prescribe medications, or the competence to perform procedures. Board certification is not a requirement to practice a specialty."

"Board certification simply means that the physician has completed the requirements set forth by the specialty board. This generally includes graduation from an approved medical school, completion of a residency program accredited by the Accreditation Council on Graduate Medical Education (ACGME) in that field, and completion of comprehensive written and oral examinations in that field.

A physician who has successfully completed the requirements set forth by the board may be granted a certificate and is known as a diplomate of the board."

"In the past, lifetime board certification was granted. However, during the last 10 years, most boards have changed in this regard." "To recertify in a specialty, the physician must take another examination, generally a written examination."

Please note that the bold emphasis was added by me! I hope this helps to clear up the difference between the board-certified physician and the diplomate physician. The article states several times that these certifications are not the ONLY criteria for which one should look in finding a good physician/specialist.

THANKS, BIRDSHELL!

I went to http://www.absm.org to see if I could get a better sleep Dr. and there he was my sleep Dr. who could care less about me. Oh well if anyone has any recommendations for a sleep Dr. in the Cincinnati area please PM me.

I'd bet that Columbus has excellent resources. Would you be willing to drive there for your preliminary tests?
I lived in Dayton for 9 years, and know that Columbus has MANY great hospitals.
...just a thought, as my husband & I have driven from Harrisburg area to Philadelphia for his PD treatment for months, until finally getting connected with one nearby at the Hershey Medical Center.

GO REDS!!!

Fantastic info, thanks! Looking forward to tracking down the "A Good Doctor Story for a change!!" chat linda b. Also appreciated the http://www.absm.org
link, alas all the diplomats are about 2 hours away, but that is probably what it will take to pursue. I drive 1/5 hours seeking dermatology care, so par for the course. I'm "North of the Notches" in NH. Scenic beauty is worth the trade off though. Thanks again for your knowledgeable replies.