Rebuttal From Dr Gay

Abstract

We debate the value of sleep-board certification necessity to prescribe CPAP in the diagnosis and treatment of straightforward OSA. As stated by the Centers for Medicare & Medicaid Services (CMS) and supported by the American Academy of Sleep Medicine (AASM) guidelines as a standard of care, “Treatment of moderate to severe OSA with CPAP must be based on a prior diagnosis of OSA established using an acceptable method,” 2 Kushida CA Littner MR Hirshkowitz M American Academy of Sleep Medicine et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep. 2006; 29: 375-380 Crossref PubMed Scopus (566) Google Scholar but no statements were made regarding the prescribing physician's board certification. Dr Brown's 3 Brown LK Point: should board certification in sleep be required to prescribe CPAP therapy on the basis of home sleep testing? Yes. Chest. 2013; 144: 1752-1754 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar contention that “physicians without board certification in sleep medicine measurably lack the knowledge and skills necessary for treating OSA” is not the appropriate conclusion. Point: Should Board Certification in Sleep Be Required to Prescribe CPAP Therapy on the Basis of Home Sleep Testing? YesCHESTVol. 144Issue 6PreviewHe who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all. Full-Text PDF Counterpoint: Should Board Certification in Sleep Be Required to Prescribe CPAP Therapy on the Basis of Home Sleep Testing? NoCHESTVol. 144Issue 6PreviewComparative effectiveness and least costly alternative diagnostics and therapies have become powerful mantras within Centers for Medicare & Medicaid Services (CMS) policies. These concepts played a role in the decisions by CMS to eventually provide reimbursement for home sleep testing (HST). This was based on supportive evidence proving that spending the higher cost of in-laboratory polysomnography (PSG) produced the same outcome; therefore, Medicare supported the least costly alternative of HST. Full-Text PDF Rebuttal From Dr BrownCHESTVol. 144Issue 6PreviewPrice is what you pay. Value is what you get. Full-Text PDF