Point/Counterpoint Editorials |

Point: Should Board Certification in Sleep Be Required to Prescribe CPAP Therapy on the Basis of Home Sleep Testing? YesBoard Certification for CPAP? Yes

Lee K. Brown, MD, FCCP
Author and Funding Information

From the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, School of Medicine and the Program in Sleep Medicine, Health Sciences Center (Dr Brown), The University of New Mexico.

Correspondence to: Lee K. Brown, MD, FCCP, Department of Internal Medicine, School of Medicine, The University of New Mexico, 1101 Medical Arts Ave NE, Bldg #2, Albuquerque, NM 87102; e-mail: lkbrown@alum.mit.edu

Editor’s Note: This Point/Counterpoint debate was in process before the publication of the recent article by Chai-Coetzer et al which appeared in JAMA. It is referenced in the rebuttals.

Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Brown serves on the Polysomnography Practice Advisory Committee of the New Mexico Medical Board and on the New Mexico Respiratory Care Advisory Board. He currently receives no grant or commercial funding pertinent to the subject of this article. Dr Brown was a member of the American Academy of Sleep Medicine Board of Directors when “Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients” was developed and approved.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Chest. 2013;144(6):1752-1754. doi:10.1378/chest.13-1697
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Sir William Osler’s list of firsts clearly justifies his legendary status in the history of medicine: founder of the medical service at The Johns Hopkins Hospital, architect of the first specialty residency program, and the force behind bringing medical students to the bedside for hands-on clinical training.1 It is his insistence on learning medicine at the bedside combined with formal study in a particular area of clinical practice, both of which now lead to board certification, that is the model for specialty medicine. If Osler’s model is valid, certification in a given specialty should correlate with better outcomes for medical conditions relevant to that specialty, and this should hold true for the disorder under discussion: OSA. Moreover, Osler’s views would be further validated if physicians without board certification in sleep medicine measurably lack the knowledge and skills necessary for treating OSA.

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