They were courteous, competent, and helpful from start to finish. I was most impressed by what amounted to having a concierge with me. As soon as I finished in one place, he appeared out of nowhere to take me to the next appointment. He guided me through the maze of clinics and made sure that there was no confusion about my next step in the process. In exactly 4 hours, I had x-rays, video nasopharyngoscopy (that was really cool), and visited four specialists from different disciplines.

I will probably end up using a dental appliance and a device to wear to keep me from rolling onto my back (positional therapy). The two surgical alternatives seemed excessive for my situation. I guess I’m stuck with the mask if the appliance fails.

On my drive home, I thought about my experience and how it compares to the emergency care we provide every day. For many patients, we orchestrate the acute evaluation and management of problems much more complex than sleep apnea. Trauma patients may see specialists from five or six different services and have multiple studies done in a short time. In some institutions, patients with a TIA can get a full stroke work-up including CT, MRI, carotid Doppler, echocardiogram, EKG, and blood work in an afternoon. This is great stuff, but we don’t really get credit for putting it all together so well. Patients who receive this consolidated coordination of care often lament having to “kill 5 hours” in the ED. They have no clue about how much time it would take to get all this testing done if ordered from their family doctor.