Is the US saturated with sleep labs/centers?

[Frazier]

I've been reading up on sleep as a career path as much as possible for awhile. This forum offered me a ton of great information... it is too bad that more of the sleep specialists from around the US don't participate in the discussions -- especially since there seems to be a ton of them.

Which brings me to my question: is the united states, at this time or in the near future, already saturated with labs/centers?

I'm not overly risk-averse, in fact I like to think of myself as entrepreneurial in spirit. However, as I make use of google, and search for "city-XYZ sleep center" or "city-XYZ sleep medicine" pretty much everywhere seems to already be serviced by a free-standing center or hospital.

I expected large and mid-sized cities to be accounted for (everything 'medicine' is already saturated in our big cities); however, I found it worrisome that these were small cities and towns I was searching for.

If everywhere (i.e. locations with enough of a population to support a lab) in the US is already accounted for, the prospect of throwing down 300k+ to start a center seems unwise.

There is the alternative of: "why don't you just go and work for one of the already existing sleep centers". However, from what I read on this forum, they [for the most part] do not look to hire psych+sleep docs, and when they do --they do not pay well enough to warrant the opportunity cost of fellowship...I even remember a post on here where the individual said the sleep+psych job offers were for less than what they could make by just sticking to general psych (hence my interest in paving my own path).

I'm not looking for 400k per year; however, I would certainly want to be able to earn enough to warrant the additional year of fellowship + start up costs.

Overall: Do you feel the market is filled -- or is there still opportunity to be had?

Any insight is appreciated. Thanks.

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[michaelrack]

The way it is done now for an entrepeneurial sleep psychiatrist: Make sleep a part of your psych practice and refer pts to a sleep lab where you bill the interp fee OR add 2 sleep beds to your office space of your psych practice.

 

[Frazier]

The way it is done now for an entrepeneurial sleep psychiatrist: Make sleep a part of your psych practice and refer pts to a sleep lab where you bill the interp fee OR add 2 sleep beds to your office space of your psych practice.

Thanks for the reply, @michaelrack . Much of what I learned has come from your input across the various forums -- so I certainly appreciate your involvement on SDN over the years.

I obviously have zero experience at this point with the intricacies of referring and collecting fees.

Two last questions:

From what you have seen/heard, are hospitals usually open to such arrangements (i.e. community doc makes referral to hospital sleep lab and the community doc bills the interp fee? How does the hospital benefit -- I assume there is some sort of facility fee for them to collect?)

Also, from your experience, where would you ballpark the cost of putting together a full 2-bed set up in already-owned office space: 75k? 125k? 200k?

Thanks!

 

[vistaril]

If you are so interested in sleep to the point that you want to make it most of your practice, why don't you just do neuro for example?

 

[michaelrack]

Thanks for the reply, @michaelrack .
Also, from your experience, where would you ballpark the cost of putting together a full 2-bed set up in already-owned office space: 75k? 125k? 200k?
!

Assuming that extensive remodeling is not required, I would estimate about 75 k

 

[michaelrack]

From what you have seen/heard, are hospitals usually open to such arrangements (i.e. community doc makes referral to hospital sleep lab and the community doc bills the interp fee? How does the hospital benefit -- I assume there is some sort of facility fee for them to collect?)

Occasionally, but a lot of times there is a pulm group that has tight control over the sleep lab and will resist such an arrangement. The way the hospital would benefit is to bill the technical fee (80+%) while the interpreting doc bills the interp fee

 

[vistaril]

Boiled down: I guess my answer could be summarized with "I rather be a psychiatrist than a neurologist".

but it seems like you really want to be a sleep specialist.....and you're far more likely to have the career you want imo as a neurologist doing sleep than a psychiatrist doing sleep.

Worrying about not getting a sleep fellowship coming out of neuro is silly imo.

If you want to do sleep, pick the best route you could tolerate(neuro) to do sleep. You're going to have an uphill battle doing sleep as a psych, even if you get a fellowship(which you probably could doing psych).

 

[michaelrack]

I have heard that sleep fellowships are getting easier to obtain

 

[NRAI2001]

Where do FM trained sleep docs fit into this? I have heard of a few FM docs doing sleep fellowships.. Seems like it would be a great setup for an FM doc?

 

[Shikima]

Same concept and information that Dr. Rack has provided. Just need to find entrepreneurial opportunities which fits your specific practice model.