Was anyone else not allowed to talk to their sleep doctor?

[DougVK]

I see most people actually got to meet their sleep doctor and talk to them. I my self wasn't allowed too. My PCP doesn't deem it necessary for me to speak to the sleep specialist directly I think. Apparently if I had questions I am to ask my PCP who will get the answers for me.

Just wondering if anyone else was in the same boat, not being able to actually talk to a sleep specialist, about their sleep study results and such?

[SleepingUgly]

My PCP doesn't deem it necessary for me to speak to the sleep specialist directly I think.

It may be necessary for you to get another PCP!

[wolewyck]

I actually had the opposite experience. When I was first diagnosed, I actually didn't get to talk to the sleep doctor, but that was due to a combination of factors including: (a) miscommunications among the medical folks, resulting in nobody telling *me* that I should speak with one, and (b) the doctor who read my sleep study herself got sick and had to take a leave of absence. I asked my PCP all these sleep questions (which he couldn't answer), and he wondered aloud why I was even asking him-- and I said-- well, who else am I supposed to ask? At the time, I hadn't realized that there was a sleep doctor to meet...! Anyway, once we got that cleared up and he realized I had never been seen by a specialist-- but had managed to have a sleep study anyway-- he moved heaven and earth to get me an immediate appointment with one.

[jnk]

My sleep doc was excellent. Kind. Matter-of-fact. Knowledgeable. All that. But he told me nothing I wouldn't have learned here eventually by posting the results of my sleep studies in this forum.

If your PCP is willing to go to bat for you in keeping the DME in line and making sure you get what you need, he/she is all you need, as far as someone with the right letters at the end of the name.

Just my opinion.

I like it that docs are involved in the industry. But the nuts-and-bolts knowledge that the average OSA-suffering CPAP-user needs to make a success of therapy is rarely dispensed in a sleep doc's office, in my opinion. It is learned from other patients.

[redjoe]

After scheduling the diagnostic phase of my sleep study, I wanted to understand sleep apnea as well as I could, so I had been doing a lot of research, here and elsewhere. In scheduling the followup after my titration, I was told I had a choice of seeing the sleep doc or my PCP. As I had never met the sleep doc, and I like my PCP, I chose my PCP. I wish I had chosen the sleep doc. I think I could have had a better conversation, and it would have been more helpful. When I met with my PCP for the followup, it was clear to me that I already knew more than he did about SA. He was willing to go along with me, however, in my choices for machine, etc., so I was OK with it. I haven't seen my PCP since, so we'll see how things go during my next appointment. Fortunately for me, my therapy is going very well, so I don't really feel the need to see the sleep doc, and I've still never met or even talked on the phone with him.

[Janknitz]

A lot of sleep doctors don't want to talk to YOU! Why? Because that's not how they make their money.

Many sleep doctors make their money only on the sleep testing and interpretation. Insurance does not pay them to actually talk to you or make sure that you understand your OSA or that it's effective for you. These doctors are in it for the money, not for the love of sleep medicine or genuine concern for patients, so they are not going to give away their time for free. Sleep medicine is their cash cow. Their business is 100% referrrals from primary care physicians who do get paid (sort of) for patient interaction, so they expect your PCP to do all the direct patient interation and feel like they are "stealing" the referring doctor's business if they get involved with you at all.

So, it may not be your PCP who is keeping you from talking to the sleep doctor, it may be entirely the sleep doctor's approach to things.

[msradar65]

I didn't talk to or see my sleep doctor until I had some issues. Then I didn't see the doctor that read my sleep study. However the doctor I am assigned to I really like. He is straight forward, no nonsense kind of guy and he likes the fact that I have taken ownership in my therapy.

If I had not had issues I would not have ever seen him until my one year follow up.

[DougVK]

I didn't talk to or see my sleep doctor until I had some issues. Then I didn't see the doctor that read my sleep study. However the doctor I am assigned to I really like. He is straight forward, no nonsense kind of guy and he likes the fact that I have taken ownership in my therapy.

If I had not had issues I would not have ever seen him until my one year follow up.

I have no follow up for my sleep apnea.

[AndyCelt]

I spoke with a nurse practitioner, not a Dr. While I feel I was diagnosed correctly and am getting treatment, I also felt that the place I went to operated as kind of a "sleep mill" where getting you in and out (preferably with a CPAP) was the priority. I noticed that the woman who answered the phone was titled "sales associate" and they were eager to load me up with accessories.

[ChrisT]

I needed a quick appt. to get my sleep study due to severe sleep apnea and the doctors at the sleep study group only were available a month out so I saw a nurse practitioner. The one I saw did not seem very knowledgeable and I was getting into trouble due to what I consdered inadequate therapy. She ignored my questions and bushed off my concerns and I felt I was being run through a sleep mill. When I asked for an appt. with one of the doctors there I was told by the nurse practitioner that I could only see one if both he and she agreed. It was evident this was not going to be allowed to happen. A nurse friend told me that sometimes the way the nurse practitioner is reimbursed she gets docked if patients then consult with the doctors. Whatever the reason I thought it in my best interest health wise to change sleep study groups. I did just that and got a pulmonologist in another city, actually another state, who not only answers my questions but listens to my concerns and I feel like my treatment is much more appropriate and have faith we will successfully find solutions. The pressures the nurse practitioner had me on were 1/2 of what I am on now and CPAP rather then BIPAP which she refused to consider or talk about. Listen to your gut feelings. Switch groups if you need to.

I do not want to imply that nurse practitioners or PA's cannot do this job as I have known plenty who could step into this position and with the right training and do phenomenally. This was just one person in a practice that I suspect was more interested in money then pateints.

ChrisT
Auto BIPAP Respironics, Chin Strap, Fish-Paskel nasal mask

[DougVK]

I have been thinking about chaning PCP, he is a good doctor but there some things I wish he did that he doesn't. He doesn't seem to know he patients name without looking at a chart. He also doens't seem to know what medical issues they have had, without a chart. I would understand for patients who he sees once a year or less, but for people who he sees multiple time a year, he could rememebr who I am.

[Bandnuts]

I've been hit with the same as Janknitz (note below). It's like a patient mill. I was sleep tested and provided a machine (by the one and only company they will work with). The machine did not correct my issues (CPAP as provided when VPAP was needed) and when I called the DR to discuss 30 AHI on CPAP he would not talk with me.

He had his sleep center set up a new sleep study saying it was required to verify the central events and confirm the need for VPAP. So, I did the second study and the issues were confirmed (duh), and a new type machine ordered. Once the second prescription was issued, I called his office to discuss ongoing treatment (my case was pretty bad) and I was told I could not talk with him over the phone, I needed an appointment. However, he was so booked with other people and sleep study work that he was unable to see me for at least 90 days, maybe sometime in August. Since this happened in April and I had already paid him for 2 separate sleep studies in a month, I considered it a polite "drop dead".

It's the DRs that take on way more than they can handle and remove the actual patients needs from their job description that account for these issues. When I was in my 20s, one of my very close friends was a very successful AND very good MD. He would tell me all the time that.... Doctors aren't smarter than you, they're just educated different. He would go on to explain that if I ever had medical problems, I needed to learn the details of those problems on my own, so I would be better equipped to address them as a partner with the DR. I'd forgotten those words until this year as issues related to my heart and sleep were identified...

Thanks for letting me vent...

A lot of sleep doctors don't want to talk to YOU! Why? Because that's not how they make their money.

Many sleep doctors make their money only on the sleep testing and interpretation. Insurance does not pay them to actually talk to you or make sure that you understand your OSA or that it's effective for you. These doctors are in it for the money, not for the love of sleep medicine or genuine concern for patients, so they are not going to give away their time for free. Sleep medicine is their cash cow. Their business is 100% referrrals from primary care physicians who do get paid (sort of) for patient interaction, so they expect your PCP to do all the direct patient interation and feel like they are "stealing" the referring doctor's business if they get involved with you at all.

So, it may not be your PCP who is keeping you from talking to the sleep doctor, it may be entirely the sleep doctor's approach to things.

[Janknitz]

Doctors have huge caseloads these days. I'd much rather have a doctor double check the chart for who I am and what I'm there for than to make a mistake.

In the days before electronics, many doctor's offices had file bins on the outside of each exam room. This allowed the doctor to peek at the chart and see who you are and what your medical history is before stepping in to see you. That's starting to disappear with electronic records, but it was nice to have the doctor walk in knowing something, even if he had to look it up seconds before entering the room.

[cowlypso]

I saw my sleep doctor before my sleep study, and then they weren't going to let me see or talk to her again until I'd been on CPAP for 3 months. But I learned that if you pitch a big enough fit, they cave. I got in to see the doctor the next week, got the direct phone number for her PA, and the doctor just called me today on the phone to follow up.

[jmcanzo]

I see my sleep doctor and his PA at least once a week... and they both know me by name. I guess that is what happens when you work in the same building and support the sleep centers computers... LOL I had to laugh one day when the PA saw me in the hall and said she was really tired cause she did not sleep well the night before.......
Just today one of the RT's in the hospital that I have talked to ran into me, she was seeing a sales rep today and was going to see if she could get me a new mask or nose pillow type mask... I have not heard back from her yet..