The Future of Sleep Medicine: Questions Asked To Its Leaders, part III
Editors Note: This is the third in a series of blogs where Amy Korn Reavis, RPSGT, asks her mentors, role models, and people she admires about the field of sleep, how they got here, and what the future might hold.
Sheri Ruth, RRT, RPSGT is one of the people I had the opportunity of meeting in North Carolina. She is an amazing woman with a wealth of knowledge and organizational skills that I envy. She ran her state's conference with confidence and was able to have fun with everyone in the evening. I hope I get to see her and spend more time with her in the future.
Joe Anderson, RPSGT, RPFT, CRT-NPS, RCP, is someone I have known and admired for many years. He has been a driving force in education in sleep. He understands where the field is heading in this country and around the world. He volunteers for multiple organizations, has started a scholarship and a medical supply company to help sleep labs work together to get better pricing. He also helps people to understand the business behind the field of sleep.
How did you get into the field?
Sheri Ruth (SR): I was just graduating from college with my Associate in Respiratory Therapy. I was looking for a job in respiratory in a local hospital that I did some of my clinicals in. At that time, there were no openings, but the director of respiratory therapy pulled me aside and said, "I have a suggestion. They are building a sleep lab here, but it will be under the neurology department instead of respiratory. I understand they are seeking a respiratory therapist to operate it, so why don't you apply? It will be a foot in the door, and when we get an opening in respiratory, you can transfer to us." I followed his suggestion, but instead of transferring to respiratory therapy, I found that I loved my new career in sleep so much that I wanted to stay right where I was at.
Joe Anderson (JA): I was a neo-natal respiratory therapist and also owned my own DME company doing sleep screenings in the Caribbean.
Why did you decide to go into the leadership role?
(SR): I was one of the original founding members of CSS who sat around the board meeting table at Spartanburg Region Medical Center back in 1991. Over the years, I watched as the CSS got larger, but with its increased population came increased conflict among those leading the group. Over time, I was observing sleep professionals become discouraged with the CSS; they didn't care if they ever attended another meeting again. It concerned me that the organization that I helped create had begun to be a disappointment rather than a support system to myself and other sleep professionals. With the encouragement of several friends and colleagues, I decided it was time to take the lead and bring the CSS back to the way it was supposed to be run.
(JA): I have been an educator since 1984 and it is a passion for me. Taking the leadership role at Priority Health Education is a dream job for me and helps me further the education programs I started years ago with Sleepmate called Professional Training Services. The Sleep Professionals Association (SPA) is a pathway for sleep professionals to unite to further the profession through education and information.
What is the most important lesson that you have learned while working in the field of sleep?
(SR): That nobody can fix everybody with CPAP all of the time. There are going to be people that you just can't fix. It doesn't mean you are not a good sleep technologist. I tell new technologists that those are the patients that keep our skills sharp, the ones who challenge our skills and sometimes our creativity. Sometimes, the ones we can't fix are the ones who help shape us into becoming even better at our profession.
(JA): That every tech and every sleep center's needs are different. However, one goal is very common in our industry: improving our patients ' lives.
What is the funniest thing that has ever happened to you while working?
(SR): As I mentioned in question # 1, the sleep lab where I worked was part of the Neurology Department. This meant we had to be crossed trained in EEG technology as well. One weekend I was "on-call" for EEG. My pager went off summoning me to the hospital for an EEG. Of course all the way back to hospital I was grumbling about why the beeper had to go off just when I was in the middle of my Saturday afternoon. Upon arrival, I find that the name of my patient is Clyde Burroughs, and I was to go to his room and do the test portable instead of having him coming down to the lab, which would have been easier. So I started up to the floor with my EEG machine in tow, thinking about the name Clyde Burroughs, and asking myself where I had heard that name before. As I reached the patient room, I was greeted by a room full of people. The patient in the bed, of course, and all the others running about chattering about the NASCAR races, sporting hands-free phones, walkie-talkies, and carrying clip boards. Not really paying all the bystanders much attention, I set up the EEG machine and got behind the patient's head as I applied his lead wires. After listening to some of the dialogue between the patient and his visitors, I asked him a question just for the mere purpose of "small-talk." I said, "So, Mr. Burroughs, you must have something to do with the NASCAR races. What, do you work at the Darlington Racetrack? Or are you part of someone's pit-crew?" A look of amusement came over everyone that was in the room and the patient himself spoke up, "I am Dale Earnhart. Clyde Burroughs is just an alias. You ever heard of ‘Bonnie and Clyde?' Needless to say I was quite embarrassed. The only thing I could think to say at that moment was, "Pleased to meet you Mr. Earnhart...I guess you've figured out by now that I don't get out too much." We all laughed.
(JA): Listening to one of my patients actually saying "knock-knock" jokes in his sleep.
What do you see for the future of sleep and of sleep technicians?
(SR): Well, I feel that sleep medicine has become a payer-driven practice. Reimbursement for health care shapes so much of how we have to do things anymore. I feel that sleep diagnostics will probably shift towards the home sleep testing arena. It is more cost effective for the providers. Compliance for positive pressure therapy has been tracked at only being "fair" at best. Providers are asking themselves why they should pay out all this money when the compliance is not where it should be. At the same time, I see a shift in the field for sleep technicians on the horizon. We may not need as many nocturnal PSG techs in the future, but we will need skilled sleep technologists taking on the newly defined roles of "sleep counselors and compliance coaches. " We are looking at why patient compliance for sleep therapy is low. Is it poor quality diagnostics? Probably not. It's because our patients need a continuance of care once they walk out of the DME company with their new CPAP machine. This is where the new role of our technologist offering our patients post follow- up care, counseling, and support comes in. This is where sleep medicine in the past has been weakest, but with our realization of this fact, we can work towards overcoming our weakness and provide complete diagnostic, therapeutic, and follow-up care that our patients deserve.
(JA): Continuing education and specialization. With the almost daily changes we see in sleep technology, center ownership, licensure, and credentials I believe that the desired tech of tomorrow will be a highly specialized CLINICIAN with specialty credentials. These credentials will most likely be in Scoring, Pediatrics, and other Emerging Technologies.
See answers from AAST President Melinda Trimble RPSGT, RST, and James Krainson MD, FCCP FAASM, RPSGT, here.
Henry Johns, BS, RPSGT, CRT, CPFT, and Anglee Leviner, RPSGT, answer the questions here.
Learn more about the new clinical sleep educator certificate program from the BRPT by clicking here.