There are very few areas of medicine where you have the opportunity to look at so many different parameters at the same time. Or if the patient is referred to us, we can often coordinate his or her pulmonary care with the appropriate clinic. The same thing it has done to everyone else - made life more complicated. In San Francisco we have had to add a second office person to handle authorizations and related phone calls. And with reduced reimbursement, we find it increasingly hard to provide pro bono treatment.
Preliminary talks are under way to collaborate and perhaps integrate services.
This is an opportunity to benefit from the merger and consolidate the only two accredited sleep labs in San Francisco. When I started, there was no sleep medicine. We were intrigued with the observation that some patient symptoms became worse during sleep, and that led to the notion that the controls of the vital functions are different during awakeness and during the two different states of sleep. If a patient is examined only while awake, we found that we couldn't diagnose sleep-specific conditions. As a psychiatrist in a VA hospital, I treated many Vietnam veterans with recurring nightmares.