Occult sleep-disordered breathing in stable congestive heart failure. Takasaki Y., Orr D., Popkin J., et al. Effect of nasal continuous positive airway pressure on sleep apnea in congestive heart failure. M.D. While 57 years ago Charlie was probably just trying to defend his and his brother Will's outrageous concept of the group practice of medicine, the idea that a specialist needs to work closely with other providers of medical care to benefit the patient is just as applicable today as it was then. Indeed, as increasingly powerful payers dictate the management of care, it may be more important than ever for the referring physician and the specialist to work together for the cost-efficient care of the patient.
Sleep medicine is a new area of specialty medical practice.
Also, there are experts in sleep medicine who have not taken the ABSM examination. Board certification does not guarantee competence, or physician and patient satisfaction, but it is a logical starting point in selecting a specialist. Regardless of parent discipline, a sleep medicine specialist should be highly knowledgeable and competent in the diagnosis and management of all sleep disorders. A pulmonologist need not be an expert in epilepsy, but if she or he is also a sleep disorders expert, then the recognition of sleep-related seizures and the place of seizures in the differential diagnosis of abnormal nocturnal behavior in sleep is required. Most psychiatrists do not need to know about the control of breathing during sleep, but the psychiatrist who is also a sleep specialist certainly does.