Job Security in Sleep Medicine

A reader asks about the implications of portable home testing for OSA: Certainly some sleep labs will remain active. There are pediatrics and very sick patients that will need all night testing. I work as an RPSGT at a lab that is highly regarded and has a good reputation. What can I expect for the future? How will doctors discriminate between those patients that can use portable units at home and those that need in lab testing?

As a RPSGT, you have good job security, at least for the next 10 years. New AASM and Medicare standards (Medicare standards vary region by region) are making RPSGT's increasingly in demand.
For example in the following five states, all studies on Medicare patients must be performed by a "certified polysomnographer" by January 1 2008: Arkansas, New Mexico - Oklahoma - Missouri (Eastern) Louisiana. No one knows exactly what "certified polysomnographer" means but it almost definitely includes RPSGT's and probably also RRT's.

Due to Medicare/AASM standards, sleep studies are becoming increasingly expensive tests to perform. The AASM requirement of at least 1 tech per 2 patients, certification requirements for techs, restrictive policies on performing split-night studies, etc make sleep studies expensive. So what's their solution for high cost sleep studies? Portable home studies in which their will be no technician to replace electrodes that come loose and take care of other problems that invariably come up. Medicare and the AASM created the problem of expensive testing with all their requirements, and now their solution is a low cost, inferior test. If saving money is the goal, why not just relax the standards (maybe 1 tech for 3 patients) and lower the reimbursement a little bit. This would be a better solution, in my opinion, than widespread portable home testing.

Home testing for OSA is a complex subject, and I will be posting more about this in the coming weeks. Thanks for reading.