confused.. dr. followup?

[xiola]

So I broke my mask on friday, and called today to order a new one (no worries, i had a backup). The DME asked me if I'd been following up with Dr. X. (the dr. at the sleep lab who diagnosed and prescribed the equipment)

uh.. following up? I haven't heard from Dr. X since I walked out the door. At that time, no mention was made of a followup. I tried a while ago to get my prescription sent in to this site so i could order stuff online, but that never happened.

It was a psychologist, not my primary care Dr. who referred me (and my primary care dr didn't seem to care when I told him I'd been there.. that's another topic, I know I need a new Dr.) so basically what I'm saying is, it's been about a year and a half since I started this, and there has been no followup other than my psychologist asking if I'm still using it.

I guess I'm simply..confused. do you guys see a dr. regularly for this? Am I missing something?

[msradar65]

Nope, I don't think you are missing something. I think your healthcare team has dropped the ball. I am still pretty new to all of this. I called and spoke with my tech and let her know I was having night terrors. She suggested that I see the doctor. Well saw the sleep doc and now I have another follow up in 2 more months.

I am going to make an assumption that if I had not contacted them...that they would not be contacting me. I think they are working in if no one is complaining then there is no need for follow up.

I even took in my data and was told by the sleep doc after we talked and he found out how I was doing over all...he said he didn't even need to see the data...that was for the DME and insurance purposes.

[Janknitz]

If you are on Medicare (and some private insurances), a physician is supposed to have a face to face visit with you within the first 3 months of beginning CPAP to document compliance. Many sleep doctors skip this step by having the DME download your card to check for compliance and then they rubber stamp that you are doing fine, but never actually see you.

In addition, a lot of this works on the referral system. Your PCP (or other physician in your case) refers you for the testing, just like you would be referred for X-rays or labwork. If you have X-rays or lab work, the radiologist or the pathologist may interpret your test results but never actually see you--instead, the results are reported back to your PCP who provides the follow-up care. Or they may see you at the very beginning, but in the name of not "stealing" patients from the PCP, send you back to the PCP for your regular care.

The bottom line is that sleep doctors don't make much (if any) money on the follow-up, so unless you insist, they'd prefer not to see you again. These doctors (and I don't mean ALL sleep doctors, but specifically the ones who work this way) could care less if you are getting benefit from your therapy. They are in the sleep medicine business to make money, not to have contact with patients.

Sorry to sound so cynnical, but that's the way it works.

[BernieRay]

My pulmonologist likes to see me once a year, just as a routine checkup.

[Emilia]

Saw my sleep doc (pulmonologist) at the end of month 3..... was satisfied with what my therapy is doing and my attentiveness to the data.... said I can go a year before seeing him again.

[jerainey]

My experience re follow up was sorta the opposite. My sleep doc was associated with a hospital and had a DME in an office off his waiting room. (He told me I could use another un-related DME) His practice at the beginning was to have me download data and give me a physical about every 4 to 6 weeks. I suppose to make money from Medicare he had me take off shirt for full heart, lung, abdomen, ears, nose, throat, etc. We would look at data summary and discuss changes in machine, mask, pressures, etc. This went on for 6 months or more until I was 100% compliant with an AHI (mostly H) of 15 to 20 which he assured me was fine response to therapy. Thanks to this forum and new gear I'm doing about 2 now and feeling pretty good.

[bap40]

Never even saw a sleep doc in my case. The sleep study place was run my a doc out of state. I did the study then got the prescription and pressure. Had a DME place in same building. I ended up firing that DME and going elsewhere. No mention of a real doctor visit was ever mentioned and they folded up about a year later. Would say they jumped on the bandwagon just for the $$$ they thought they could make. I was referred by my regular doc after I discussed my symptoms with him and asked about a sleep study. No one monitors me but me. He offered me 2 places to go for the study and I knew nothing at that time about it so made the choice. Not a good one but live and learn.

[needzzzzs]

I have had two "face-to-face: teleconferences with my sleep doc since I was diagnosed back in late November. I've had several phone calls from the DME to see how I was doing in the first few weeks of therapy. I'm supposed to send my SD card to the DME for download in two months (don't need to see the doc at this time). I assume that if all is well, I won't see him again for a while.

Debbie