Decline of sleep medicine

[michaelrack]

http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=28813

An editorial in the current issue of the Journal of Clinical Sleep Medicine (subscription required) reports:

64 programs offered 129 positions; 31 positions ( approx 25%) went unfilled

The editorial argues that decreased financial reimbursement as well as the limited intellectual stimulation (most patients are being evaluated for sleep-disordered breathing) may be leading to a decline into the # of people going into sleep med

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[eviorr]

http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=28813

The editorial argues that decreased financial reimbursement as well as the limited intellectual stimulation (most patients are being evaluated for sleep-disordered breathing) may be leading to a decline into the # of people going into sleep med

Actually, the article cites the misperception of limited intellectual stimulation as a factor. Many people assume that sleep medicine is nothing but sleep disordered breathing. As a sleep fellow coming from a pediatric neurology background, who is most interested in both narcolepsy and circadian disorders, I would argue (and have, to residents considering the specialty) that sleep is quite complex and intellectually fulfilling.

 

[michaelrack]

Actually, the article cites the misperception of limited intellectual stimulation as a factor. Many people assume that sleep medicine is nothing but sleep disordered breathing. As a sleep fellow coming from a pediatric neurology background, who is most interested in both narcolepsy and circadian disorders, I would argue (and have, to residents considering the specialty) that sleep is quite complex and intellectually fulfilling.

It's good that you feel this way. That's how I felt, as a fellow 10 years ago. Hopefully you will retain your excitement over the field for at least the next 10 years.

 

[Faebinder]

Read the article last week... Gotta love the title and I agree with every single statement and the meaning between the lines.

If you dont want to get disenchanted with Sleep Medicine, stop thinking of it as OSA only. The problem is that everyone focuses on SRBD because it's common, potentially fatal and most importantly, keeps the lab going money-wise. If you see 20 insomnia/circadian rhythm disorders and you dont order a study, the lab wont survive. You need the lab to properly diagnose the SRBD, PLMD and Narcolepsy. Even worse, some feel they dont need the lab altogether and believe PLMDs and Narcolepsy can just be diagnosed clinically and treated blindly.

It's a dynamic field. Go to the field for the love of the field, that's the bottom line. One fact is true.... if you dont like sleep apnea you need to get out of the field.

 

[jkhamlin]

Actually, the article cites the misperception of limited intellectual stimulation as a factor. Many people assume that sleep medicine is nothing but sleep disordered breathing. As a sleep fellow coming from a pediatric neurology background, who is most interested in both narcolepsy and circadian disorders, I would argue (and have, to residents considering the specialty) that sleep is quite complex and intellectually fulfilling.

Not only that, but current research shows that sleep disorders are at the root of many, many of today's current chronic diseases.

I have a hard time getting even other doctors to wrap their heads around sleep medicine being more than just disordered breathing. I also have a hard time getting even other doctors to understand that length of sleep does not mean quality of sleep.

I plan to do a lot of treating sleep medicine, but may never have the opportunity to do a fellowship in it. Sad if the trend is that fellowships are declining. I know there are none in my state. I'm going to try to talk my residency program into doing one, but it will be an VERY uphill battle. Like vertical.

 

[lungdocCA]

I agree. Where I practice in Central California (which is generally underserved for both Primary Care and Subspecialty Medicine) Sleep Medicine is grossly saturated with practitioners. Although I enjoy it it is hard to do more than 15% of time. I have been her for 15 years also. They need to cut the number of training programs radically as I see it.

 

[michaelrack]

They need to cut the number of training programs radically as I see it.

A majority of the doctors coming into the field in recent years grandfathered into it without doing a formal, one-year sleep fellowship. I don't think the number of sleep fellowship programs is excessive, but would be interested in seeing some numbers.

 

[sleepmeddoc]

Actually, the article cites the misperception of limited intellectual stimulation as a factor. Many people assume that sleep medicine is nothing but sleep disordered breathing. As a sleep fellow coming from a pediatric neurology background, who is most interested in both narcolepsy and circadian disorders, I would argue (and have, to residents considering the specialty) that sleep is quite complex and intellectually fulfilling.

The problem is that 90% of pts in a sleep clinic have SDB..then you see RLS...and rarely other disorders...

 

[michaelrack]

The problem is that 90% of pts in a sleep clinic have SDB..then you see RLS...and rarely other disorders...

Agree that the primary problem of most sleep clinic pts is sdb... I do see quite a bit comorbid RLS. do have some narcolepsy patients