docsarmscrossedA letter circulating on LinkedIn is urging sleep medicine professionals to “defer the implementation of the new [AASM] center accreditation standards until various problems can be resolved.”

The group who posted the letter takes issue with standard B-4, number 4, which states as follows:

“The sleep specialist(s) responsible for interpretation of polysomnography data, multiple sleep latency tests and maintenance of wakefulness tests and diagnoses of patients must be a sleep specialist. This requirement is defined by at least one of the following:

1. A licensed physician who is board-certified in sleep medicine by the American Board of Sleep Medicine or an individual certified in sleep medicine by either a member board of the American Board of Medical Specialties (ABMS) or a member board of the American Osteopathic Association (AOA).

2. A licensed physician who has been accepted by an ABMS or AOA approved board to sit for the examination in sleep medicine. To retain the accreditation, the examination in sleep medicine must be passed within two examination cycles. To meet this requirement, the individual must provide, in the application packet, a letter of acceptance to sit for the examination by the ABMS or board. Upon completion of the examination, the individual must provide a copy of the official notification from the ABMS or AOA board indicating final status.

3. A licensed physician who has completed a 12 month ACGME accredited fellowship in sleep medicine and is awaiting the first available opportunity to apply to an ABMS or AOA board to sit for the sleep medicine examination. To retain accreditation, the ABMS examination in sleep medicine must be passed within two examination cycles.

4. A PhD certified by the American Board of Sleep Medicine and currently interpreting sleep studies. The licensed board certified sleep medicine physician must certify accuracy by signature of all sleep study interpretations performed by a PhD.”

The group has issued the following objections in its letter:

1. Lack of representation: There was not a single ABSM boarded PhD on the accreditation task force; all members are physicians currently, as per personal communication.
2. Lack of due process: There has been no published or otherwise circulated justification for withdrawing sleep test interpretation by those PhD-ABSM who work closely with medical directors (licensed physicians not boarded in sleep medicine).
3. Possible breach of contract: The B-4 #4 sentence fundamentally and unilaterally alters responsibilities described in PhD’s ABSM certificates by specifically requiring oversight by a physician, board certified in sleep medicine.
4. Alienation of core AASM membership: The B-4 #4 sentence sends a message that rights and responsibilities of sleep professions as certified by the AASM can be easily abridged without the willing consent of affected members.
5. B-4 #4 could force those sleep labs that have a non-sleep-boarded physician medical director to close.

The group is encouraging sleep professionals concerned with standards to submit comments before December 14, 2012.