Replies to This Discussion

Permalink Reply by jesse arredondo on August 6, 2009 at 3:02pm

yes I been going through the same thing ,and more.I'll be calling my Doctor now.Thanks.

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Permalink Reply by Ron Sowell on August 6, 2009 at 4:01pm

You have just put me on my soapbox!!!! Many times this happens. Too many times. I went to a neurologistbecause I was having dizzy spells. He sent me for another sleep study - same thing! I had to make the call to get a follow up visit or else I would have probably fallen through the cracks. When I went back he had the report from the sleep study he had requestedr but he did not have the report that my machine generates daily. I had a copy in the car. He said he didn't need to see it. Needless to say, I am now going through a pulmonologist who is determined to find out why my pressures are set so high. I am to go in for another sleep study tonight (4th!) My case is a little diffferent in that I have an ASV machine due to a combination of obstructive and central sleep apnea. Central sleep apnea is due to the fact that your brain does not get the signal that it needs to your body to tell it to breathe! He said Central sleep apnea is usually an effect from another condition - and he is trying to get to the bottom of what it is! I was sent to this pulmonologist by my ENT who was the first specialist I went to about my sleep apnea. He actually READ a former sleep study I had (previous to the neurologists study) and said "You have central sleep apnea. I can't due surgery on your throat because it wouldn't help. So HE got the ball rolling initially. My pulmonlogist did a breathing test and a lung function test as well as a check on my carotid arteries. All that was ok so my next stop is cardiology for a stress test tomorrow. My general practitioner gave me Provigil too - because I told him I was tired all the time. This is the way MDs are trained. Rather than get to the bottom of the problem they just give you a fix for yours. "Got a headache? Take two aspirin mentality." The specialists have more time to do further evaluation. DOs seem to be better at it too. I have been wearing a CPAP since approximately 1998. Found out I had central sleep apnea this year!!! Not a very good record - 10 years!!!! My advice to you. Get on the internet and do your homework. Know what you are talking about when you go in. I had to learn this the hard way. No one is going to take care of me but ME! Oh, and this website is invaluable! Stay on it! Ron

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Permalink Reply by Mack D Jones, MD, SAAN on August 6, 2009 at 6:41pm

You are not going to believe this. I take that back. On this site, you have just about heard it all.

I recently met a man in his 60's who said that he had a PSG two years ago and was prescribed a CPAP machine. The machine has never been taken out of the box! It is still sitting on the shelf gathering dust. He is still paying $9.00 monthly rent on it. My OSA lecture, including some of the ghastly details, had a positive effect on him. His wife said he is now using his machine faithfully.

Another example of a broken system. Who is to blame? The 'doctor' in charge, of course. There is no patient education, no followup, no accountability. Write a prescription and I'll see you maybe in your next life or maybe not, who cares? It's just lah-dee-dah...lah-dee-dah.

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Permalink Reply by Amy on August 6, 2009 at 7:24pm

There are two issues here. I can tell you that although the doctor said the cpap was supposed to be turned up without an order for a pressure change the DME company can not change the pressure. An order that says start at this pressure and turn up two cm every week is not really acceptable because the technician has no way of monitoring how the change affects the pt andf where to stop. They can write a very specific order but the DME is not really finaicially able to send a person to visit a patient every week and evaluate them. The other part of the follow up becomes and issue with lack of communication. I always tell my pts to make an appt with thier ordering physician 4-6 weeks after they receive their machine. I also put it in writing to them. I depend on them to ccall the doctor's office and follow up. Many do not. There is not alot I can do but what I am doing and maybe trying to call 30 days after their study to follow up with them.
Remember that each person has a role and we all do our best but it is a team project between everyone and sometimes hard to coordinate.

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Permalink Reply by Jim Nadolny, BS, CRT on August 6, 2009 at 7:59pm

Dr. Jones,
What about the DME company. Billing for equiptment that is not being used, no followup? That is called insurance fraud! Many insurance companies now require compliance downloads to continue payment. What happened to this patient is tragic.

Mack D Jones, MD, SAAN said:

You are not going to believe this. I take that back. On this site, you have just about heard it all.

I recently met a man in his 60's who said that he had a PSG two years ago and was prescribed a CPAP machine. The machine has never been taken out of the box! It is still sitting on the shelf gathering dust. He is still paying $9.00 monthly rent on it. My OSA lecture, including some of the ghastly details, had a positive effect on him. His wife said he is now using his machine faithfully.

Another example of a broken system. Who is to blame? The 'doctor' in charge, of course. There is no patient education, no followup, no accountability. Write a prescription and I'll see you maybe in your next life or maybe not, who cares? It's just lah-dee-dah...lah-dee-dah.

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Permalink Reply by Dan Lyons on August 6, 2009 at 8:33pm

Rock,
My chosen profession, to which I am now retired, required me to be accountable for my each and every action, reaction and process to which I was involved. If I did not perform my position properly, each and every time, I would have been criminally prosecuted, civilly pursued, and immediately discharged. In addition, I or other members of the public could have been injured or killed.

During my career in this field, I worked very closely with medical professionals, many of whom are personal friends.

I have seen the politics to which occurs within the medical community.

I have seen good doctors, bad doctors and doctors to which I wouldn’t let treat my dog. You know what I haven’t seen, on more than one occasion, are doctors who negligently injured or killed a patient as a direct result of his/her negligence, ever do a day in jail. I have seen plenty civilly sued and loose, close their practice and move to another geographic location and start all over again, to possible inflict harm and injury to an unsuspecting person.

This same type of treatment is being displayed by some of the doctors to whom members of this board are having difficulty with.

I have also seen the same breed of doctors close their practice and go to work for the VA system. What a great way to treat the folks who gave us the ability to publicly voice our distain for this governmental attempt to socialize the US Medical industry.

As a result of the medical professionals, their organization, and their lobby, they have elevated themselves to high, to which they have isolated their egos. As a result, the have brought upon themselves the distain of their “subjects.”

As a result of their own positioning, they have lost their accountability.

There are good and bad persons in every profession. The trouble is, the medical field doesn’t provide the proper method to remove them.

Please explain to me why, they should be exempted for their negligence, and every other person in this country is not exempted. If it is fair for one why is it not fair for all, or is that just BS? Remember Lady Justice - See is wearing a blindfold.

In so far as my attempt to spread the word about Sleep Apnea and its implications, am I not? Do you have first hand knowledge that I am not spreading the word? To what level do I need to go to in order to satisfy the level to which you want?



Rock Hinkle said:

Karen i am very sorry for the way you have been treated. It is care like this that gives the rest of us a bad name. If there is anything I can do to help please let me know.

Dan once again I'll agree to make errors in judgement criminal at my work place if we can do the same at yours. Outbreaks like this do not help the problem they widen the already huge gap between the medical community and it's pts. i ask once again what you are doing to make it better? In my opinion you should take that big voice of your's and get involved with some of the many community regulatory groups that are out there. maybe become a lobbyist for the new Bill on sleep education.

The hospital and the lab i work for make very little money on pt care after paying off their overhead. Instead they invest in the community at a local and national level. This is where their profit comes from. My lab and all of us working in it are very involved in changing the system here in Indy and in D.C. Not only will i be working my normal 50 hours evaluating sleep this week, but I will also be spending my days off vollunterring at the state fair to help educate and screen for bad sleep. last week I worked 5 days and then did OSA screening at the U.S. open. What have you done to make the system better! You seem like a decent man, instead of bad mouthing the sleep community that has helped you so much, get involved pllease! make a difference.

Dan Lyons said:

“When I grow up I wanna be play doctor and study neurology. And so I can make lots of money I wanna have a sleep lab and help people who can't sleep. I will then hire people to do my work for me and pay them a pittance and when a patient complains, I can blame it on their failure.”

The unfortunate side is your story is not an uncommon one. These “sleep doctors” have figured out that can operate sleep labs and practices with a very low overhead and no oversight. While it isn’t all of the sleep physicians, there are a bunch of them out there.

You need to investigate your doctors, their credentials, their practices, and the labs to which they are sending patients.

Practices of this type need to criminal. If that would happen, they would clean up their act, quickly.

• ▶ Reply

Permalink Reply by susan mccord on September 8, 2009 at 11:19pm

I have, Karen. My neurologist didn't impress me one bit. Won't go into the specifics right now, but for instance, she held up my getting my CPAP equipment for 2 weeks after I was dx severe and told by sleep lab on a Saturday that I'd have it by the following Monday. For two weeks I tried to find out why--she was never available and long story short after 2 weeks I just got mad and started harrassing everyone involved in my "care" to that particular time. Finally narrowed it down to the fact that the neurologist had failed to turn in required paperwork to DME so they could fit me for CPAP. I had an appointment to see her, like, 6 weeks after the dx--I cancelled it and found a sleep specialist MD on my own. Unbelievable lack of concern on neuro's part and she's the one who referred me for sleep study in the first place!

Re: settings, that's another story for another day. Sufficeth to say, the entire dx/tx process was about as mis-handled as you can imagine. If it weren't for SleepGuide, I'd probably be in a loony bin by now. What a goat rodeo.....

Susan McCord

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Permalink Reply by RockRpsgt on September 9, 2009 at 12:27am

Dan I apologize for not seeing this sooner. I do not know the answer to your questions. As I have told you before I appreciate what you add to sleepguide. It seems to me that you want every little mistake made criminal. At least that is what I have read into your post. I do not see a doctor not following up anymore criminal than i see a pt ignoring a doctors orders. The difference being that it is ok for a pt to ignore a doctor, or for someone on SG to tell a pt to ignore a doctor. We have seen both on this forum. I do not see very many proffessions being held as criminals because they make mistakes. It is one thing to kill someone on an operating table. If you have been in the medical industry you would know the stress being put on sleep labs, and sleep doctors right now. They are not going to make something like this criminal. Their has to be another solution. you make it seem like it is all of us not doing our jobs. That is my opinion anyway. If I offended you in anyway I am sorry, but I was very offended by the way you had made your statements.

Dan Lyons said:

Rock,
My chosen profession, to which I am now retired, required me to be accountable for my each and every action, reaction and process to which I was involved. If I did not perform my position properly, each and every time, I would have been criminally prosecuted, civilly pursued, and immediately discharged. In addition, I or other members of the public could have been injured or killed.

During my career in this field, I worked very closely with medical professionals, many of whom are personal friends.

I have seen the politics to which occurs within the medical community.

I have seen good doctors, bad doctors and doctors to which I wouldn’t let treat my dog. You know what I haven’t seen, on more than one occasion, are doctors who negligently injured or killed a patient as a direct result of his/her negligence, ever do a day in jail. I have seen plenty civilly sued and loose, close their practice and move to another geographic location and start all over again, to possible inflict harm and injury to an unsuspecting person.

This same type of treatment is being displayed by some of the doctors to whom members of this board are having difficulty with.

I have also seen the same breed of doctors close their practice and go to work for the VA system. What a great way to treat the folks who gave us the ability to publicly voice our distain for this governmental attempt to socialize the US Medical industry.

As a result of the medical professionals, their organization, and their lobby, they have elevated themselves to high, to which they have isolated their egos. As a result, the have brought upon themselves the distain of their “subjects.”

As a result of their own positioning, they have lost their accountability.

There are good and bad persons in every profession. The trouble is, the medical field doesn’t provide the proper method to remove them.

Please explain to me why, they should be exempted for their negligence, and every other person in this country is not exempted. If it is fair for one why is it not fair for all, or is that just BS? Remember Lady Justice - See is wearing a blindfold.

In so far as my attempt to spread the word about Sleep Apnea and its implications, am I not? Do you have first hand knowledge that I am not spreading the word? To what level do I need to go to in order to satisfy the level to which you want?



Rock Hinkle said:

Karen i am very sorry for the way you have been treated. It is care like this that gives the rest of us a bad name. If there is anything I can do to help please let me know.

Dan once again I'll agree to make errors in judgement criminal at my work place if we can do the same at yours. Outbreaks like this do not help the problem they widen the already huge gap between the medical community and it's pts. i ask once again what you are doing to make it better? In my opinion you should take that big voice of your's and get involved with some of the many community regulatory groups that are out there. maybe become a lobbyist for the new Bill on sleep education.

The hospital and the lab i work for make very little money on pt care after paying off their overhead. Instead they invest in the community at a local and national level. This is where their profit comes from. My lab and all of us working in it are very involved in changing the system here in Indy and in D.C. Not only will i be working my normal 50 hours evaluating sleep this week, but I will also be spending my days off vollunterring at the state fair to help educate and screen for bad sleep. last week I worked 5 days and then did OSA screening at the U.S. open. What have you done to make the system better! You seem like a decent man, instead of bad mouthing the sleep community that has helped you so much, get involved pllease! make a difference.

Dan Lyons said:

“When I grow up I wanna be play doctor and study neurology. And so I can make lots of money I wanna have a sleep lab and help people who can't sleep. I will then hire people to do my work for me and pay them a pittance and when a patient complains, I can blame it on their failure.”

The unfortunate side is your story is not an uncommon one. These “sleep doctors” have figured out that can operate sleep labs and practices with a very low overhead and no oversight. While it isn’t all of the sleep physicians, there are a bunch of them out there.

You need to investigate your doctors, their credentials, their practices, and the labs to which they are sending patients.

Practices of this type need to criminal. If that would happen, they would clean up their act, quickly.

• ▶ Reply

Permalink Reply by RockRpsgt on September 9, 2009 at 12:35am

“When I grow up I wanna be play doctor and study neurology. And so I can make lots of money I wanna have a sleep lab and help people who can't sleep. I will then hire people to do my work for me and pay them a pittance and when a patient complains, I can blame it on their failure.”

As a result of the medical professionals, their organization, and their lobby, they have elevated themselves to high, to which they have isolated their egos. As a result, the have brought upon themselves the distain of their “subjects

Dan you forget that there are medical professionals here that want to make a difference. When you lash at them you include us.

Rock Hinkle said:

Dan I apologize for not seeing this sooner. I do not know the answer to your questions. As I have told you before I appreciate what you add to sleepguide. It seems to me that you want every little mistake made criminal. At least that is what I have read into your post. I do not see a doctor not following up anymore criminal than i see a pt ignoring a doctors orders. The difference being that it is ok for a pt to ignore a doctor, or for someone on SG to tell a pt to ignore a doctor. We have seen both on this forum. I do not see very many proffessions being held as criminals because they make mistakes. It is one thing to kill someone on an operating table. If you have been in the medical industry you would know the stress being put on sleep labs, and sleep doctors right now. They are not going to make something like this criminal. Their has to be another solution. you make it seem like it is all of us not doing our jobs. That is my opinion anyway. If I offended you in anyway I am sorry, but I was very offended by the way you had made your statements.

Dan Lyons said:

Rock,
My chosen profession, to which I am now retired, required me to be accountable for my each and every action, reaction and process to which I was involved. If I did not perform my position properly, each and every time, I would have been criminally prosecuted, civilly pursued, and immediately discharged. In addition, I or other members of the public could have been injured or killed.

During my career in this field, I worked very closely with medical professionals, many of whom are personal friends.

I have seen the politics to which occurs within the medical community.

I have seen good doctors, bad doctors and doctors to which I wouldn’t let treat my dog. You know what I haven’t seen, on more than one occasion, are doctors who negligently injured or killed a patient as a direct result of his/her negligence, ever do a day in jail. I have seen plenty civilly sued and loose, close their practice and move to another geographic location and start all over again, to possible inflict harm and injury to an unsuspecting person.

This same type of treatment is being displayed by some of the doctors to whom members of this board are having difficulty with.

I have also seen the same breed of doctors close their practice and go to work for the VA system. What a great way to treat the folks who gave us the ability to publicly voice our distain for this governmental attempt to socialize the US Medical industry.

As a result of the medical professionals, their organization, and their lobby, they have elevated themselves to high, to which they have isolated their egos. As a result, the have brought upon themselves the distain of their “subjects.”

As a result of their own positioning, they have lost their accountability.

There are good and bad persons in every profession. The trouble is, the medical field doesn’t provide the proper method to remove them.

Please explain to me why, they should be exempted for their negligence, and every other person in this country is not exempted. If it is fair for one why is it not fair for all, or is that just BS? Remember Lady Justice - See is wearing a blindfold.

In so far as my attempt to spread the word about Sleep Apnea and its implications, am I not? Do you have first hand knowledge that I am not spreading the word? To what level do I need to go to in order to satisfy the level to which you want?



Rock Hinkle said:

Karen i am very sorry for the way you have been treated. It is care like this that gives the rest of us a bad name. If there is anything I can do to help please let me know.

Dan once again I'll agree to make errors in judgement criminal at my work place if we can do the same at yours. Outbreaks like this do not help the problem they widen the already huge gap between the medical community and it's pts. i ask once again what you are doing to make it better? In my opinion you should take that big voice of your's and get involved with some of the many community regulatory groups that are out there. maybe become a lobbyist for the new Bill on sleep education.

The hospital and the lab i work for make very little money on pt care after paying off their overhead. Instead they invest in the community at a local and national level. This is where their profit comes from. My lab and all of us working in it are very involved in changing the system here in Indy and in D.C. Not only will i be working my normal 50 hours evaluating sleep this week, but I will also be spending my days off vollunterring at the state fair to help educate and screen for bad sleep. last week I worked 5 days and then did OSA screening at the U.S. open. What have you done to make the system better! You seem like a decent man, instead of bad mouthing the sleep community that has helped you so much, get involved pllease! make a difference.

Dan Lyons said:

“When I grow up I wanna be play doctor and study neurology. And so I can make lots of money I wanna have a sleep lab and help people who can't sleep. I will then hire people to do my work for me and pay them a pittance and when a patient complains, I can blame it on their failure.”

The unfortunate side is your story is not an uncommon one. These “sleep doctors” have figured out that can operate sleep labs and practices with a very low overhead and no oversight. While it isn’t all of the sleep physicians, there are a bunch of them out there.

You need to investigate your doctors, their credentials, their practices, and the labs to which they are sending patients.

Practices of this type need to criminal. If that would happen, they would clean up their act, quickly.

• ▶ Reply

Permalink Reply by Mary J on September 9, 2009 at 11:48pm

Karen - Thank you for sharing this story. This was "an education" as I read thru the posts. I am so grateful that people are willing to share, contribute, debate, question and all learn together. This is a great community forum and I'm learning so much. This is a fantastic opportunity for all of us to learn and grow by reading the comments from the other XPAP users, pracitioners and doctors.

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