One of my areas of expertise within sleep medicine is behavioral sleep medicine. Most of the behavioral sleep medicine experts in the U.S. are psychologists. I am one of a few in Washington State with an M.D. background.
Practicing behavioral sleep medicine was not something I set out to do. During my fellowship I found it frustrating to refer so many patients away, rather than caring for them myself. After begging Dr. Rachel Manber (a world renowned insomnia doc at Stanford) to train me, she finally agreed and I was able to sit for both boards at the end of my fellowship.
Behavioral sleep medicine is very time intensive requiring longer visits, more frequent visits, and extensive documentation. I tell my patients to expect to see me 4-6 times before seeing results. The treatment requires tenacity and patience from the patient and the doctor. And trust.
Having the extra bandwidth to spend more time, focus, and reflection on these cases has been extremely gratifying. It has brought me back to the intrinsic reasons I wanted to become a physician – to be of meaningful use to my fellow humans. I’m once again aware of how the relationship I have with my patient is by itself therapeutic. So often in my career as a neurologist I have felt despair at the technology and cures not yet available and I have underestimated the importance of this critical and poignant role. A privileged role indeed.
How has the pandemic shaped your role at work?