What Can Sleep Medicine Do?

Abstract

Free AccessDepartmentsWhat Can Sleep Medicine Do? Allan I. Pack, M.B.Ch.B., Ph.D. Allan I. Pack, M.B.Ch.B., Ph.D. Address correspondence to: Allan I. Pack, M.B.Ch.B., Ph.D., John Miclot Professor of Medicine, Director, Center for Sleep and Circadian Neurobiology, Chief, Division of Sleep Medicine, Perelman School of Medicine at the University of Pennsylvania, 125 South 31st Street, Suite 2100, Philadelphia, PA 19104(215) 746-4806(215) 746-4814 E-mail Address: [email protected] Center for Sleep and Circadian Neurobiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA Search for more papers by this author Published Online:June 15, 2013https://doi.org/10.5664/jcsm.2772Cited by:3SectionsPDF ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutINTRODUCTIONThe editorial “A Warning Shot Across the Bow: The Changing Face of Sleep Medicine”1 is a cautionary tale. It would seem that a “warning shot” is an understatement. This comes on top of another cautionary tale2 that 25% of sleep medicine fellowships did not fill up last year, i.e., before recent events. None of this should come as a surprise since the writing has been on the wall for some time (see commentary I wrote in December 20113).We should not have positioned sleep medicine as a diagnostic discipline based on one test for one diagnosis. The perception of our field nationally is that we simply make money by testing, if not over-testing. It is a perception that we need to counter by accreditation standards to avoid over-testing.Sleep medicine is a chronic care management discipline with management of many highly prevalent chronic disorders. Accreditation should be based on outcomes of care, not diagnostic criteria, as recommended by the Institute of Medicine report in 2006 (Recommendation 9.2).4The positive aspect is that as medicine moves to emphasizing patient-centered outcomes, we are in a field that has major assets: (a) highly prevalent disorders that directly affect patient lives, and (b) effective treatments that directly benefit patients. We need, however, a new vision for this field. We need new accreditation standards that help implement this vision and emphasize outcomes of care and comprehensive management of all sleep disorders, based on a team approach, not just sleep apnea. Given “dead canaries” and “warning shots,” we need change now before the next editorial is about an even more catastrophic event.DISCLOSURE STATEMENTDr. Pack has indicated no financial conflicts of interest.CITATIONPack AI. What can sleep medicine do? J Clin Sleep Med 2013;9(6):629.REFERENCES1 Quan SF, Epstein LJA warning shot across the bow: the changing face of sleep medicine. J Clin Sleep Med; 2013;9:301-2, 23585742. LinkGoogle Scholar2 Quan SFGraduate medical education in sleep medicine: did the canary just die?J Clin Sleep Med; 2013;9:101, 23372460. LinkGoogle Scholar3 Pack AISleep medicine: strategies for change. J Clin Sleep Med; 2011;7:577-9, 22171193. LinkGoogle Scholar4 Colten HR, Altevogt BMSleep disorders and sleep deprivation: an unmet public health problemWashington, DC: National Academies Press; 2006. Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited by Sleep breathing disorders: have we reached the tipping point?Suarez-Giron M, Isetta V, Masa J, Egea C, Riha R, Bonsignore M and Montserrat J ERJ Open Research, 10.1183/23120541.00172-2017, Vol. 4, No. 2, (00172-2017), Online publication date: 1-Apr-2018. Hwang D and Melius B The Affordable Care Act and the Future of Sleep Medicine Narcolepsy, 10.1007/978-3-319-23739-8_31, (417-435), . Cost Minimization Using an Artificial Neural Network Sleep Apnea Prediction Tool for Sleep StudiesTeferra R, Grant B, Mindel J, Siddiqi T, Iftikhar I, Ajaz F, Aliling J, Khan M, Hoffmann S and Magalang U Annals of the American Thoracic Society, 10.1513/AnnalsATS.201404-161OC, Vol. 11, No. 7, (1064-1074), Online publication date: 1-Sep-2014. Volume 09 • Issue 06 • June 15, 2013ISSN (print): 1550-9389ISSN (online): 1550-9397Frequency: Monthly Metrics History Submitted for publicationMay 1, 2013Accepted for publicationMay 1, 2013Published onlineJune 15, 2013 Information© 2013 American Academy of Sleep MedicinePDF download