October 15, 2011

To sleep, perchance to dream - first presentation

Yesterday morning was spent visiting several of the physicians involved in treating sleep apnea here on the island - Dr. Rach, the ENT (and my co-presenter) and Dr. Essebom, a pulmonlogist, who operates, rather will operate the only sleep lab on the island.

Besides introductions, the conversations revolved around the presentations, particularly the one last night that was to other physicians, healthcare professionals and representatives of several health insurers on the island.

One item, not originally addressed in my presentation was outlining the various diagnostic options available to treat sleep apnea. Readers know that I feel more attention needs to paid to treatment and follow-up than determining whether disease is present or not. But out of respect for Dr. Essebom I added a slide outlining the CMS decision on diagnostic options.

Arriving at the auditorium of the St Elizabeth's hospital, the only such facility on the island. The hall had the characteristics of an A.W.A.K.E. meeting with chairs arranged theater style and a side room with the display of equipment from the two DME's on the island and food.

Dr. Rach and I took turns presenting. I spoke first with an overview of the importance of sleep and the implications of sleep deprivation. Dr. Rach provided a overview of the pathophysiology of sleep apnea, complete with the sights and sounds of apneic events (much to the amusement of the audience).

I followed him with slides on treatment options and closed with a set of suggestions for next steps in a country where payors are not certain what to cover and why.

After the presentations there was a question and answer session that involve not only the presenters, but also  Dr. Essebom and several other physicians, included a newly minted oral surgeon a graduate from Howard University in DC.

Overall the presentations were well received. Will they have an impact on how the condition is addressed, only time will tell.

Me speaking with the Minister of Health
We did have a VIP attend the session - the Minister of Health for the island came to the meeting to listen and to make an announcement. The government would in two to three weeks license Dr. Essebom's sleep lab making it possible for him to bill the government health insurance program and private insurers for sleep studies.  Currently, people suspected of having sleep apnea are sent off island, at no small expense, for diagnosis and titration.

Today - presentations to the public

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