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Judge Nap wrote:

49er wrote:

Judge Nap wrote:

49er
Unfortunately, it is very hard to find a suitable doctor. It seems about 10 years ago, it was possible to schedule a brief paid visit with at least a primary care doctor to see if there was a potential match. But unfortunately, that seems to no longer be possible.

Maybe it depends on where you live? Within two miles of my home is a great medical complex and within a 25-mile radius the choices of facilities and doctors are remarkable. Very pleased with the selection.

Hi,

Are you saying you were able to prescreen doctors as I outlined in my post?

As an FYI, I live in a large metropolitan area but based on conversations I have had with people, that doesn't seem to make a difference in satisfaction with doctors.

49er

Isn't this automatic? Every person I have ever heard of visiting a doctor for the first time could walk out and move on to the next doctor if he did not like what he observed. You don't have to let them touch you, although the nurse will probably weigh you, measure your height, take your blood pressure and pulse. For most people this is a $25 or $50 copay and locally self-pay is typically $76.

Good point except I don't have health insurance. Self pay for the last sleep doctor initially was around $200 which was collected before the visit.

But sometimes, it is very hard to tell on the first visit what a doctor is really like.

49er

Always tired wrote:I think an excellent question to ask any prospective sleep doc is -- do you have sleep apnea?
Mine does and it makes a big difference.

Great point.

Interestingly, Dr. Krakow has apnea and I would have no qualms about seeing him if I was in a position to.

49er

But sometimes, it is very hard to tell on the first visit what a doctor is really like.

49er

I was a little worried about you when you said you wanted to do this. Glad to learn you know better.

If you have one trusted doctor, ask him for a recommendation. Also ask your social circle. Don't rule a doc out based on one bad review and don't rule a doc in based on one good review. Get a variety of opinions.

Always tired wrote:I think an excellent question to ask any prospective sleep doc is -- do you have sleep apnea?
Mine does and it makes a big difference.

I got lucky. My doctor also has sleep apnea, so he totally understands adjusting to the machine. And he can offer real advice with problems adjusting to treatment. One of his receptionists also has sleep apnea. She asked how I liked my Quattro FX as she was considering it.

I think it helps if you can talk to others who like their doctor. I got lucky as my GP referred me to my sleep doctor. She used to have her office in the same city and has since moved. She knew that this sleep doctor would be closer to where I live than the ones that are closer to where she is now.

Since my mom disliked her old sleep doctor and saw how well my treatment was going, she did a trial with my machine for a couple nights and then went to my doctor. She is doing better now.

My preference is a neurologist for my sleep dr. I have multiple problems, so a neurologist was just natural for me, but I have friends & family who first went to ENT's or pulomonologist and I think these drs each see OSA & other sleep disorders from their perspectives. The ENT is looking for blockages & the pulmo is looking for lung deficiency. Each looks from their own perspective, but I think the perspective of a neuro is broader reaching that the ENT or pulmo.

Just my opinion.
Jen

My choice would be to see (from the very start) a Neurologist with Sleep Apnea who has a specialty in Sleep Disorders.

IMHO (& this is just my opinion), those who get a Sleep Study done via their GP or someone else who will just sub it out to a real Sleep Doctor just have too many Drs in the mix.

My initial Sleep Doctor when I had my Sleep Study done 14 years ago WAS a neurologist with Sleep Apnea & had a specialty in Sleep Disorders. He was also associated with the Hospital where the Sleep Study was done & they did almost 100% of all of the Sleep Studies in the City.

Only problem was that he did NOT believe in APAPs (auto CPAPs) even though he used a CPAP himself. Plus, his preference was for Respironics.

He died soon after I got my 2nd CPAP & was replaced by 2 YaHoos.
I avoid going back like the plague, but when I do, I always deal with the Nurse Practitioner who was hired by the initial Sleep Doctor a couple of years after I was diagnosed.

That practice is just now "accepting" that patients may want APAPs & ResMed ones to boot. That is why I was able to get a prescription for my current ResMed S9 AutoSet that I purchased in January 2012.

But, in reality, they still think that a straight Respirionics CPAP is still best & all they really need to know is the # of hours you are using it every night.

If they need to know anything else, they believe that a full Sleep Study is the only way to get it.

Unfortunately the technology has progressed much faster than what the Sleep Doctors & DME providers have been able to (or willing to) keep up with.

In theory, a sleep trained neurologist should do as well as a sleep trained pulmonologist with all primary sleep disorders. If I had the need for medications, including sleep aids, antidepressants (as either sleep aids or for other reasons), and/or wake promoting agents beyond Provigil/Nuvigil, my first choice would be a really good sleep-trained psychiatrist.

My sleep doctor is a pulmonologist, which is great for me because of my asthma and COPD (I've never smoked). She is also the director of the sleep lab and is very knowledgeable.

I think you should base your decison on the other aspects of your health, and whether you treat them. For instance if you have breathing issues, you should see a pulmonologist, foggy thinking/depression/other brain issues a neurologist and nose issues an ENT. No one size fits all docs.

I like Kasey Li. He asked if I had more questions and I stopped to think for 25 seconds. He waited.

1041 wrote:I like Kasey Li. He asked if I had more questions and I stopped to think for 25 seconds. He waited.

Kasey Li is not a sleep doc. He's a surgeon.

That is a pathetic commentary on our expectations of doctors if we're impressed by them waiting a whole 25 seconds for us to get our thoughts together!