The Future of Respiratory Therapy

The Future of Respiratory TherapyIt appears that 2013 will be a year of structural change for the economy and especially for those industries dependent upon unsustainable growth, such as healthcare. Furthermore, respiratory therapists may become an endangered species if deregulation is utilized as a means to consolidate health services.

Regulatory reinvention

Respiratory therapy was originally called Inhalation therapy with nurses providing the care, until it was evident that a separate profession was necessary to adequately serve the growing population of respiratory patients.

We have come a “long way baby” because technology and approaches to pulmonary medicine have evolved, requiring a dedicated and well-trained staff of respiratory professionals.

The National Alliance of Respiratory Care Professionals states that certain aspects of respiratory care should only be performed by a licensed respiratory care professional who has completed the educational requirements and passed the national board exams.

Furthermore, the Medicare Balanced Budget Refinement Act (1999) recognized that respiratory care provided by others could result in harm to the patient and increase the costs due to rehospitalization.

But the stringent rules that guide respiratory care are in danger. For example, in April 2012, the Michigan Office of Regulatory Reinvention (ORR) recommended the deregulation of 18 occupations, including respiratory care, and the elimination of the Michigan Board of Respiratory Care.

This would mean the elimination of the licensing requirement for respiratory therapists, resulting in no provisions to ensure that respiratory care providers are competent to deliver safe patient care.

Deregulation would result in no requirements for practicing respiratory care in the state of Michigan. Facilities could establish their own in-house standards and level of competencies. However, in these days of dwindling reimbursement for the underinsured or uninsured, who knows how stringent the standards would be and what would be the consequences.

Deregulation of respiratory therapy will be a tremendous set back to the profession and would require serious restructuring. If Michigan is considering these measures, can other states be far behind?

Game changer

Healthcare will radically change as Obamacare integrates into the system. I believe respiratory therapy will undergo a serious facelift from its current structure and will require therapists to become active in their professional associations’ political efforts to remain solvent. Because at the end of the day, it will be the patients that suffer the most from this restructuring.

About Mike Donnellan

I am a clinical respiratory therapist, published writer, research investigator and medical first responder with the Disaster Medical Assistance Team - CA 6 under Health and Human Services . My website,, was designed in order to network with the global health community regarding strategies and technologies to improve peoples lives. It's all about teamwork, communications and the sharing of knowledge, which I find exciting.


  1. BY Jeff Huddle says:

    I know for a fact that in Washington State, respiratory therapy is becoming a thing of the past in the Critical Access Hospitals. Every time they have a meeting more organizations share that they let their RT's go. I was on the chopping block, but finally convinced our CEO that he needed me. I told him that I wanted to stay until I retired. He agreed, them made my life miserable with my supervisors and others, who thought RT should be gone so they could have more money. I quit in April and they still do not have anymore money and continue to badmouth me. I would love to go to work where RT's are appreciated, but in Washington State, the places like that are few and far between.

  2. BY Proud to be an RRT says:

    I am a RT manager with over 40 years experience as a Leader and RT. My hospital downsized its Respiratory Department in 1996 prior to my leadership. Our hospital is a nursing lead or directed organization…where nurses provide all the RT throughout the hospital except in the critical care units where RT is still involved in patient care. Let me let you about my hospitals outcomes..Ventilator length of stay is over 10 days…why? Nursing does not want to reduce sedation why? a sedated patient is less work. Patients with asthma, and other respiratory related diseases length of stay is +5 days why? Nurses do not know how to proper administer aerosolized medications. Nurses do not understand what can be done to avoid further respiratory compromise until it is to late and the patient ends up on life support. For patients with tracheotomies it must be a scary scary place. Nurses do not want or know how to maintain airways and secretion clearance. If you need to be resuscitated.. the nurse does not even know to hook up oxygen. Don't get me wrong nurses are great and my mother was one fo 50 years. Nurses have way to much on their plate as it is…Someone needs to review the data and outcomes and determine the value of having skilled competent RT's can provide to healthcare system. I have worked very hard to change the perception of RT and take back our skill sets but unfortunately RT's don't even value themselves and demonstrate professionalism. For me I am 18 months from retirement …hope this prediction is not true.

  3. BY Lisa says:

    I believe this is just a state that is having financial difficulties and trying to save money where they can. They are also trying to deregulate Speech Pathology and Dietitians along with 15 other occupations.I work in the state of Virginia and am regulated by the Board of Medicine.Virginia Board of Medicine also regulates Radiology Technology and Occupational Therapist among others.We have never had a separate regulatory board. Maybe this could be a money saving option. I just cant see the profession disappearing when JCAHO is wanting a Respiratory Therapist on the Rapid Response Team .

  4. BY SteveO says:

    OK OK This was tried once in a hospital where i worked at years ago and was a complete failure!!! There is all kind of talk over the years about getting rid of RTs ok lets try this…lets research this and dedicate a unit without RTs ..a unit with vents and all of that…lets do it and see if it can work. A lot of talk and visions of no RT dept, but is this really gonna work. From looking around me I dont see it happening!!! and i am a progressive RT that is all for change and quality improvement and the evolution of a super profession that can do it all!! Hey I can do vents and nebs and meds and IVs and wipe a butt! I say lets take the RTs and evolve them to to that!!!! Because i think a good RT makes a kick ass great nurse!!! The USA is a unique country so lets not start harping about the smaller countries not needing a RT !!!!
    Granted we constantly have to justify or existence every day I do support the RT dept evolving to only an acute/consultant dept. Let the nurses to the nebs and MDIs and we will consult if there are any problems. The fact of the matter is NBRC and AARC has been so weak for so long and now we are playing catch up!!! but still let the govt get rid of RTs and watch a tremendous decline in quality of pt care…and watch the ins scream bloody murder!!!

  5. BY Debbie says:

    It’s a real shame what the State of Michigan is doing. It’s obvious that they don’t have a clue what value a respiratory therapist provides for their patients. I sure hope that I am never hospitalized in the critical care of a Michigan hospital on a ventilator. Nurses are great at what they do and they are far too overworked to begin learning a second career as a registered respiratory therapist. Nurses don’t learn mechanical ventilation, intubation, tracheostomy care or how to manage patients in respiratory distress with impending respiratory failure. Having a nurse set up ventilators or Bipap machines would be very dangerous. One wrongful death lawsuit could wipe out any savings the hospital might save by eliminating respiratory therapist. I sure wish that people making health care decisions would try to really educate themselves about what each profession offers before making important decisions that impact healthcare and patient safety. I’m very fearful of what the future holds for patients requiring hospitalization if things continue on this path.

  6. BY Kevin Neal RRT says:

    I have been a RRT for 27 years and now I feel threatened by Health reform, My hospital is cutting so many jobs I cant believe the patient care can be good anymore. I think the government could CARE LESS abut the care of the people and will Blame the hospitals for the cuts..

  7. BY Paula Glover says:

    They are seriously considering the same in Texas along with rad techs perfusionists … and dietitians … ;(