Reimbursements

[Meningism]

So, I've been hearing that as much as sleep medicine is one of hotter subspecialties to pursue nowadays because of lifestyle (no call, rare CPAP emergencies, etc.) but there maybe a change in medicare reimbursements in the near future. It seems as though sleep can be a lucrative field but does anyone have any what the compensation is like these days and how much they will change if there are cutbacks in reimbursements? I have an interest in the field but I'd like to have an idea of the finances as I consider fellowship possibilities.

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[TheWowEffect]

So, I've been hearing that as much as sleep medicine is one of hotter subspecialties to pursue nowadays because of lifestyle (no call, rare CPAP emergencies, etc.) but there maybe a change in medicare reimbursements in the near future. It seems as though sleep can be a lucrative field but does anyone have any what the compensation is like these days and how much they will change if there are cutbacks in reimbursements? I have an interest in the field but I'd like to have an idea of the finances as I consider fellowship possibilities.

As of now, reimbursments for sleep apnea evaluation, CPAP etc. are really good but I wouldn't bet on it staying the same for too long. It may not happen soon but there are some concerns about sleep apnea evaluation and diagnosis going the outpatient and clinical way. Right now, doing a sleep medicine fellowship solely for sleep apnea may be a wise business and career decision but I am not sure if it'll give most people a high degree of professional satisfaction long-term. Future of sleep medicine lies, imho, in insomnia and other similar disorders. May be some sleep medicine gurus, if they are frequenting this forum, can give us more insights on this.

 

[TheWowEffect]

For all those interested in this......

Proposed Decision Memo for Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)

 

[courtyard]

Hello,

I was interested to hear anyone's opinion about ENT's role in sleep medicine. My understanding is that ENT is mainly at the surgical treatment side of sleep medicine for apnea. But ENT is also eligible to apply for sleep fellowship.

Now, with exception of few places in the country where ENT person runs the sleep fellowship (Wisconsin comes to mind), majority of places are pulmo/neuro managed programs. Does that mean fellowship is mainly about diagnosis of sleep disorder? The actual surgical treatment part of sleep medicine should have been done through general ENT training right?

What do you think is practical implication for an ENT to undergo a sleep fellowship? How would you ideally design that person's practice after the training now that he can diagnose and treat?

Would it be worth specializing in sleep medicine with fellowship for the ENT doc financially, instead of just focusing on surgical treatment and rely referrals from neighbor sleep doctors?

I know there are a lot of question. Thanks for your help.

CY.

 

[neurologist]

Hello,

I was interested to hear anyone's opinion about ENT's role in sleep medicine. My understanding is that ENT is mainly at the surgical treatment side of sleep medicine for apnea. But ENT is also eligible to apply for sleep fellowship.

Now, with exception of few places in the country where ENT person runs the sleep fellowship (Wisconsin comes to mind), majority of places are pulmo/neuro managed programs. Does that mean fellowship is mainly about diagnosis of sleep disorder? The actual surgical treatment part of sleep medicine should have been done through general ENT training right?

What do you think is practical implication for an ENT to undergo a sleep fellowship? How would you ideally design that person's practice after the training now that he can diagnose and treat?

Would it be worth specializing in sleep medicine with fellowship for the ENT doc financially, instead of just focusing on surgical treatment and rely referrals from neighbor sleep doctors?

I know there are a lot of question. Thanks for your help.

CY.

If I am reading your question right, the most financially smart thing for an ENT doc to do would be do set up a sleep center and hire a sleep-board certified neurologist or pulmonologist to manage it and do most of the patient work. The ENT surgeon could then focus on what surgeons do best (surgery, I think. . . or maybe intraopererative photography . . . ) and just skim the profits.

Unless, of course, the ENT has some real die-hard interest in the technical and medical aspects of sleep med in general, in which case, sure, go do a fellowship. But doing a sleep fellowship won't make you a better ENT surgeon, it'll just make you an ENT surgeon who knows more about sleep disorders, for whatever that's worth. I can't imagine many ENTs would be excited to see half a dozen insomnia or restless leg patients every day . . .

 

[Faebinder]

Neurologist pretty much said it... I doubt an ENT would benefit from the fellowship... Heck you can argue a Pulmonologist wont benefit from it unless they want to reduce their intensive care treatments and start working with none pulmonary sleeping problems.

 

[courtyard]

If I am reading your question right, the most financially smart thing for an ENT doc to do would be do set up a sleep center and hire a sleep-board certified neurologist or pulmonologist to manage it and do most of the patient work. The ENT surgeon could then focus on what surgeons do best (surgery, I think. . . or maybe intraopererative photography . . . ) and just skim the profits.

Unless, of course, the ENT has some real die-hard interest in the technical and medical aspects of sleep med in general, in which case, sure, go do a fellowship. But doing a sleep fellowship won't make you a better ENT surgeon, it'll just make you an ENT surgeon who knows more about sleep disorders, for whatever that's worth. I can't imagine many ENTs would be excited to see half a dozen insomnia or restless leg patients every day . . .

Hello doctors,

I think there were some miscommunication from my part about the question I meant to ask you. As I am still in medical school, I wanted to get some insight as to how ENT doctors who primarily do surgical part of sleep medicine interact with sleep specialists with fellowship training to diagnose sleep medicine. How are some of the sleep clinics in communities that you know structured to coordinate between ENT doctors who have focused their practice to do OSA procedures and the fellowship-trained sleep specialists.

Thank you again for your insights.


CY.