I Think I'm In Trouble

[jnk]

I think it is important for us to understand how many doctors view things. There are exceptions to the rule, but I believe, as has been stated, that most sleep docs view treatment questions and machine questions as something they leave to the tech/therapists.

When a doc starts getting involved in the nuts and bolts of machines, he is crossing a line and stepping on toes. Docs diagnose and prescribe. That's what they do. They don't fill the prescription and they try not to get in the tech/therapists way.

If a doc in a hospital has a question about a machine, he asks someone who is paid to know about machines, because when it involves a machine, that's a "different union," as it were.

When you have a mechanical question about fixing your car, you don't ask the showroom people, you ask the mechanic. The showroom guy may have prescribed a car for you, but he will send you to the mechanic if you want details about whether it is running properly, or how to maintain it, unless he just happens to know more than most showroom people do.

You go to a sleep doc because you feel bad. He doesn't perform the study--there are people for that. Then he prescribes a machine and maybe a pressure. But most think that therapists are paid to take care of the therapy itself. The doc sees you again for you to tell him whether or not you feel better. Anything beyond that is, in his mind, likely something for you to take up with your therapist at the DME. All the doc wants to know is that what he prescribed is working, or else he may have to prescribe something else. But he won't get his hands dirty fiddling with the application of the previous prescription unless he is exceptional in his desire and understanding.

Think about it. Unless a doc specifically prescribes full-data machines, most of his patients are being handed non-data machines by the greedy DME people anyway. So few docs expect to even see any home-machine data from their patients beyond proof of compliance.

That is my impression of it all, anyway.

jeff

[SleepyT]

I think it is important for us to understand how many doctors view things. There are exceptions to the rule, but I believe, as has been stated, that most sleep docs view treatment questions and machine questions as something they leave to the tech/therapists.

When a doc starts getting involved in the nuts and bolts of machines, he is crossing a line and stepping on toes. Docs diagnose and prescribe. That's what they do. They don't fill the prescription and they try not to get in the tech/therapists way.

If a doc in a hospital has a question about a machine, he asks someone who is paid to know about machines, because when it involves a machine, that's a "different union," as it were.

When you have a mechanical question about fixing your car, you don't ask the showroom people, you ask the mechanic. The showroom guy may have prescribed a car for you, but he will send you to the mechanic if you want details about whether it is running properly, or how to maintain it, unless he just happens to know more than most showroom people do.

You go to a sleep doc because you feel bad. He doesn't perform the study--there are people for that. Then he prescribes a machine and maybe a pressure. But most think that therapists are paid to take care of the therapy itself. The doc sees you again for you to tell him whether or not you feel better. Anything beyond that is, in his mind, likely something for you to take up with your therapist at the DME. All the doc wants to know is that what he prescribed is working, or else he may have to prescribe something else. But he won't get his hands dirty fiddling with the application of the previous prescription unless he is exceptional in his desire and understanding.

Think about it. Unless a doc specifically prescribes full-data machines, most of his patients are being handed non-data machines by the greedy DME people anyway. So few docs expect to even see any home-machine data from their patients beyond proof of compliance.

That is my impression of it all, anyway.

jeff


Jeff,
you make some valid points and it all continues to be a real education! who knew about all these intertwining relationships and territories. I suspect you are correct on all fronts. I will be curious to determine just how good my sleep doc is when I go for a follow up this fall. by then i will have my software installed...and will be knowledgeable...and it will be interesting to see how she responds to an informed patient. thanks to everyone who responded on this topic. fascinating!

T.

[rubymom]

Interesting all the different experiences.

My sleep study was in April. Nobody ever mentioned making a follow-up appointment with the sleep doctor. Just as it occurred to me that I would need to do that (about five days later), I got a call from the DME and my machine appeared. During one of about four or five visits from the RT, she asked if I'd had my data reviewed by the doctor yet. Had I not read this forum, I'd have had no idea what she was talking about. But I said no, not yet. In between the RT and I both had some contact with the doctor's office regarding my machine (needed to move to a Bi-Pap). Then I procrastinated on making an appointment. But now I have an appointment for Tuesday and nobody mentioned bringing the data. I ASSUME it's the white card sticking out of the back of my machine, but from what I've seen of it, it looks alot like the white filter that came with the machine. For all I'd know, without this forum, I could walk into the doctor's office and handy them my dirty filter.

So I guess I'll find out on Tuesday whether they can read it. I wore a pulse oximeter for one night about a month or so ago (was supposed to be done within two weeks of using the CPAP but the DME dropped the ball repeatedly) and I've had no feedback on the results of that either.

Should be interesting.

[SleepyT]

rubymom,
you might want to take your machine with you as well...in case the card didn't get the download properly. wouldn't want to waste a trip. i was told to bring my machine to the appointment. the card was in a sleeve deep inside the carrying case.

t.

[fatfinger]

Komodo ,

You will find that the smarter you become with the equipment you use and your condition, the more you will demand of those folks in the white coats. Too many folks believe that the white coat (medical Professionals) have the only answers. You will have to remind them from time to time you are their boss. You control the purse strings and they can be fired for any or no reason at all. The fact they were exposed to a chapter of information that pertains to you they saw some years ago stayed the same. No one is as informed as you, to your condition. If you feel you are being brow beaten, stop that person and ask to speak to the supervisor. Explain that you will not be spoken to that way and that you are now looking for a replacement. This and other industries are driven by money not by solving problems.
Keep in mind, you are the trouble maker, if you choose to be not the one in trouble .
As to most Doctors, they are trained to read and interrupt data. They may or may not have the equipment to print the data.

[rocketdork]

I think that its unbelievable and inexcusable that a doctor would refuse to answer ANY questions. He didn't defer to others or say he didn't know, he just said that he wouldn't answer any questions, and then used the sleep study report as coercion to make sure he didn't have to.

In my mind this is a serious breach of ethics, HIPAA laws and an abuse of power.

By the time I fired him, he would have had a clear picture of my displeasure.

To me this isn't about lack of knowledge of treatment options...this is just about a bad doctor with serious God complex. I don't care if he was a sleep doctor, PCP, heart surgeon, or the only doctor in the world that knew what he knows...If I can't ask questions about my treatment, I can't learn a F***ing thing from him.

[jnk]

. . . I suspect you are correct on all fronts. . . .

Thanks, SleepyT, but you should be forewarned that I am wrong a lot!

I don't mean to defend the docs, or to put them down either. I just think we as patients have to work hard to know who and what we are dealing with in so many cases.

I hate it that so many patients get lost between the cracks, but understanding why and how it happens is part of one day solving the problem, if it is solvable. Until then, I think cpaptalk.com is the best thing going for helping patients do for themselves what those in the industry seem so unwilling to help us with.

And unless the docs and brick-and-mortar people start doing a better job, they may soon find themselves without one. Every strip mall in the nation could one day have a "sleep store" selling "anti-snoring machines" with no medical people involved at all!



jeff

[roster]

........

This what happened to me. I go to see my (ex) sleep doctor for the results of my sleep study. I have already found this forum, and have a lot of questions. He has my sleep study in his hand, I have my list of questions in my hand. He see's my list!

Without hesitation he says -"if you ask me any questions I will tear your sleep study up".

..............

Give me his name and I'll humble that boy from afar.

[mars]

Hi All

First of all I hope that Komodo ( and others) are able to learn from some of the mistakes I have made.

I hate whining, so will just say that multiple medical problems do not encourage me to pursue any of the incompetent doctors I have seen in the last couple of years.

However, I will be attending my sleep lab to see a sleep doctor about those questions, although I now know the answers to most of them. I will be telling him about Dr ##### ####, as I will all those I come into contact with over the rest of my life. If I can heal well enough from my other problems, then I may take it further. What I cannot do today, does not mean that I will not be able to do tomorrow. I learned in a self-help program many years ago that I cannot change the past, but I can sometimes change the effects of the past.

I love Rooster's post and image. The doll has been named. In fact, I invite anybody who wants to (with Roosters permission) to give their own name to the doll. Maybe start a doll thread.

So my best wishes to Komodo, and my thanks as well for the support I have been given.

cheers

Mars

[BlackSpinner]

I love Rooster's post and image. The doll has been named. In fact, I invite anybody who wants to (with Roosters permission) to give their own name to the doll. Maybe start a doll thread.

I make dolls like that and also the reverse because I figured if you can make dolls that do negative things to people you can make them to do positive things. So I mostly make healing dolls these days.

Make a doll and paste a photo of your self on it - you can do the traditional thing and put in nail clippings and bits of hair too. Then do what inspires you that is the positive equivalent of sticking pins in. Add crystals, herbs, and religious symbols where it hurts, put the doll in a nice environment, surround it with candles and positive images of the end results you want - what ever works for you. Spend a few minutes a day looking at it and breathing deeply or meditating or in prayer.

The problem with the stick the pins in type of dolls is that you waste your energy on them and you sort of create a bond between you and the person you dislike.

if you you want to see my dolls Http://www.lena-arts.ca

[Komodo]

I'M BACK FROM MY DOCTOR! ........and OMG!!!!!!!!!!!!!!!!!!!!!!!!

HE should be paying ME instead of the other way around!

You HAD to be there to see the expressions on his face when I started in with my questions.....priceless!

Since he didn't have any data from my DME, I brought my daily log. When he saw it, his eyes went wide in amazement, first, then the frown came! He asked me how I got the data, and I told him I went into the clinitian menu. He told me I wasn't supposed to go in there!!!! Things kinda went downhill from there! He looks at my data and says it looks like I'm doing pretty good, my AHI averages <8.0. I tell him, it should be <5.0. He says:" Yeah, that's right, but where are you getting your info from?" I tell him about our little forum here! He is NOT happy! I ask him a few simple, intelligent, questions, that he "briskly" answers in as few words as possible. He agrees with ME, that I should raise my pressure from 14 to 16. He tellls me he'll have my DME come out and do the change, I tell him, don't bother, I can do it myself. THAT was the straw that broke the camel's back! He says:"I guess you really don't need me." hands me my paperwork and says:"Make an apointment for next year on your way out." and walks out of the room!!!!!

NOW... what should I make of this? Have I become so well educated from this forum that I really don't NEED a doctor, and be happy?
~OR~
Should I be f'ing p*ssed off at the treatment I received, and go looking for a different doctor???

I choose the latter!


When I've read posts from some of you other folks about the horrible way your doctors have treated you, I couldn't believe it. Until now! WHAT IS WRONG WITH THESE DOCTORS!!!!!!

[klockemy]

What sleep doctor? Never met him. He dictated the results of my sleep study and that is the entire extent of his interaction with me. My PCP did my prescription and I found any answers I needed right here.

Same here, nothing from the original sleep doc. I can't even tell by the name if 'they' are a he or she. I go to my neurologist that is specialised in sleep medicine also, so I use her to monitor my progress.

[BlackSpinner]

NOW... what should I make of this? Have I become so well educated from this forum that I really don't NEED a doctor, and be happy?
~OR~
Should I be f'ing p*ssed off at the treatment I received, and go looking for a different doctor???

Thoroughly pissed I would say. You showed him up but afterall you don't have a degree in medicine - you just learned how to make your therapy work, just like my mother learned how to check her blood sugar and figure out her injections, that didn't make her a doctor either.
Look for a new doctor who will work with you and is happy to have intelligent successful patients. Report the other one to the medical board.

[carbonman]

I tell him, don't bother, I can do it myself. THAT was the straw that broke the camel's back! He says:"I guess you really don't need me." hands me my paperwork and says:"Make an apointment for next year on your way out." and walks out of the room!!!!!

I think he is the one that needs to seek some professional help.

Way to go.
Your actions are exactly what is going to drive the change that we need.

[SleepyT]

Go, Komodo! Go, Komodo! Go! Go! Go! You did us proud!