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i was told by the nurse practioner for the doctor who reads all the test results and makes the diagnosis even though he never sees the patient

"Someone" from the sleep center called to schedule a titration.
"Someone" from the sleep center called to ask where to fax my prescription.
Tech? clerk? I don't know. I had been reading here so I didn't worry about it much.

I guess it's what I have come to expect from the medical community.

There are a couple different ways to look at the question. Obviously, everyone has to receive their diagnosis from a doctor. However, some people never actually see a sleep doctor. It's a fair bet many sleep doctors would rather have it that way. For them, it's more efficient to have the office clerks and sleep techs do all the leg work. When the sleep doc isn't being a neurologist or a cardiologist or a pulmonologist, they'll put in a little time to verify scores. They don't want to see you because to them the $200 to $300 they might make on that office visit isn't worth their time and effort when they could be making more from an office visit with someone from their 'real' specialty. It's all -- once again -- about time and money. It's easier just to verify scores. Why even deal with the patient? Sleep-deprived patients are messy and emotional.

So they don't. We're pushed through a system by people who know the system and don't care enough to explain the system. Some of us never really get a solid picture until we come to a forum like cpaptalk.

In all cases after each of my sleep studies were done, after a couple weeks, I got a call from the sleep lab confirming the doctor's diagnosis. Some sleep labs will not recommend specific DME's but only give a list of local and national DME's. But some sleep docs are tied at the hip to specific DME's and give the job of calling the patient to the DME - again about time and money. Their sleep lab isn't weighed down having to explain anything. Foist it all in the DME's lap. In any case, the sleep doctor's office would rather fax or email your prescription directly to the DME than give it to you in your hands -- again because it's more 'efficient'.

I specifically asked on each occasion for an office visit with the sleep doc before and after each sleep lab so I could get questions answered. Most people apparently don't for some reason.

EDIT: The above may seem a harsh estimation, but darn it, sometimes I feel like that's what's going on. I know not all sleep labs and sleep doctors are not like this.

I'm glad to see that it's usually the doc who is giving the diagnosis. It *should* be! Thanks, everyone who has taken the poll (or who will).

Debbie

needzzzzs wrote:I'm asking this question because a friend of mine was just told yesterday that he had it by the DME. I realized that that's how I learned about my diagnosis, from a phone call from the DME, not my primary care physician, who ordered the test. My friend was so confused, he barely understood what was wrong. Thought the machine he was getting was for oxygen therapy. All he was told was that he didn't breathe enough. He's a university professor, so not unintelligent, but I think that the way he was notified was terrible. I work in the medical field (as a librarian) and already knew some basic info about sleep apnea (at least what it was, and the major modalities of treatment), yet I think in both cases that the physician should have been the one to contact us and give us the diagnosis.

That's why I'm curious about how *you* all found out. Was my friend's and my experience the exception, or the rule?

Debbie

I answered "Other Healthcare Provider" because I pretty much diagnosed myself, and I am a healthcare provider...as a paramedic. I knew I would need an official diagnosis for CPAP to be covered by my insurance. So I went to my PCP and told her I think I have SA and needed a referral for a sleep study. Did the sleep study and told them I am pretty sure I have it, and sure enough I was correct. They did the titration the next week and faxed the script to the medical supply place my insurance uses, and had it in 2 days...paid in full by insurance.

I told my doc I thought I had sleep apnea. He looked at the pulse oximetry trace I provided and agreed. I told him I thought it was mostly central but neither he nor the sleep lab tech believed me. The sleep lab tech told me what the diagnosis would be and that indeed it was mostly CSA, but a sleep doctor interpreted the sleep studies and made the actual diagnosis.

DreamDiver wrote:Obviously, everyone has to receive their diagnosis from a doctor.

Well, not "everyone"

Going back one page...
viewtopic.php?p=583705#p583705

I asked my primary care doctor at Kaiser in Hilo if he could order a sleep study for me as I thought I might have sleep apnea. I was sent to the Sleep Lab in Honolulu for my sleep study.

I answered "Other Healthcare Provider". The Dr (PHD) at the sleep lab told me. Test was scheduled by my ENT because I hinted that I thought I might have OSA. After a few questions, he thought it would be a good idea to verify BEFORE doing septoplasty and sinus surgery, and then do the surgery BEFORE titration if in fact I did have OSA. Initial study was in July, Surgery in August, Titration at the end of October, and XPAP in early November of '08.

Doc that signed my RX was an ENT on a panel at the sleep lab. Luckily, he is also in the same group as my ENT - otherwise there would have been an insurance fiasco!

Have not seen any of the doc's since.

I picked my physician on the poll, but it was actually my neurologist - although it was pretty obvious to me during my sleep study as the tech woke me up to fit me with a CPAP as she said I was "having breathing difficulties".
For me the actual diagnosis was really just a formality.

Cheers,
xena

My wife made the diagnosis and instructed me to talk to my PCP about it. He sent me to a Sleep Doctor and he confirmed the initial diagnosis.

Dennis

rested gal wrote:

DreamDiver wrote:Obviously, everyone has to receive their diagnosis from a doctor.

Well, not "everyone"

Going back one page...
viewtopic.php?p=583705#p583705

That is an inspiring read. You really went after it once you decided you had a problem.

Mr Bill wrote:

rested gal wrote:

DreamDiver wrote:Obviously, everyone has to receive their diagnosis from a doctor.

Well, not "everyone"

Going back one page...
viewtopic.php?p=583705#p583705

That is an inspiring read. You really went after it once you decided you had a problem.

Also the links from that page to RG's titration at NotMuffy's. I sleep gladly corrected!

I am really surprised by all the people who were notified over the phone that they had what is basically a chronic and life threatening illness. When i was writing software for a doctors clinic and finding out how their business worked in Nova Scotia one of the things I was told was that they were not allowed to give results of any test over the phone, especially not any "negative" results like that. I know my doctor here in Quebec will have her nurse call and make an appointment if there is anything on my tests she is concerned about but nobody will discuss my results over the phone.

My girlfriend at the time (my wife now). She told me that shouldn't couldn't sleep with my bouts of not breathing ("I'd lay there waiting for you to breathe again."). She works for a physician's group that does bariatric and general surgery, and they refer everyone out whose going to have lapband/sleeve/etc surgery to sleep lab before hand. She had one of her docs refer me, I did a split night study and by the next Friday I had my APAP. The sleep doc did go over the results with me, and I've had a fine relationship with the DME.