Respiratory Therapy 2028: Visions of the Magic 8-Ball

Many people across the country celebrated the 4^th of July with fireworks, backyard barbecues and visiting family.  These acts are a celebration of the birth of a free country.  On July 4^th of 1776, our forefathers signed the Declaration of Independence which forever allowed us to become (as Frances Scott Key wrote in our national anthem); the "Land of the Free and Home of the Brave."

As we commemorate the birth of our country, it should also be noted that last year, the AARC celebrated its 60^th birthday.  Sixty years... while it may sound like a lot, in retrospect; our profession is still in its infancy when compared to professions like nursing, and medical doctors.  The time has flown by.  We've gone from inhalation technicians, chest cuirasses, and MA-1s, to where we are today; registered respiratory therapists, neonatal-pediatric specialists, and asthma educators using oscillators, closed-loop ventilators, and breath-actuated nebulizers.  We've come a long way in the last sixty years... where do you think we'll be in sixty more?

There's no doubt, our profession will continue to grow and evolve.  With new technology and the ever-changing landscape of healthcare, the profession must either adapt, or die.  While it's purely speculative, I believe in another sixty years, our profession will have changed so much that our forefathers of respiratory therapy would not even recognize it.  Anticipating what our profession will look like in 2068 would be impossible, but let me look into my Magic 8-Ball and try see if I can't identify what respiratory therapy will look like in the year 2028.

To no avail, the healthcare industry did everything it could to prepare for the sudden surge of patients (aka Baby-boomers).  Hospitals became bigger, technology continued to advance, but manpower shortages continued to plague the healthcare environment.  To combat this issue, the RT profession was forced to adapt into an even more specialized workforce.

In 2015, respiratory therapists were recognized as "professionals".  There was only one professional credential; the RRT, licensure law in 10 states required a bachelor's degree to practice, and more than 30 programs nation-wide offered a master's level education in respiratory therapy.  Healthcare moved from the hospital to the home. Now, RTs were given unsupervised responsibility to treat the patient outside the hospital, prescribe medicine and under the auspices of a physician, were given admitting privileges to hospitals. 

By 2020, CMS attacked respiratory therapy licensure laws.  Patients by the thousands missed prescribed respiratory treatments on a daily basis because of lack of human capital to deliver the care. Soon nursing assistants, other unlicensed caregivers, and EMTs were delivering bronchodilator therapy to patients on med/surg nursing floors.  Technology of MDIs and nebulizers had advanced to the point of breath-targeted aerosol delivery.  Proper administration technique became less of an issue, and anyone capable of providing the patient with the device could do so.  Aerosol delivery was viewed as more of a remedial task.  Raised to the level of a specialty practitioner or physician assistant, therapists wrote all respiratory orders for patients on nursing units. 

Clinical RTs worked exclusively in the critical care areas of the hospital caring for only the sickest of patients.  They performed bronchoscopies, line insertions and all intubations.  They also assumed complete management of ventilators. Median salaries jumped to a mind boggling $120,000/year.

By 2028, the Baby-boomer bubble had burst.  There became an overabundance of therapists, nurses and doctors.  People lost their jobs and the American economy (after 12 years of a bull market) entered into a recession not seen since 2008.  The number of practicing RTs in the United States fell below 100,000 for the first time in almost 50 years.  Only the brightest and most highly educated therapists maintained employment in the hospital and in the home.  They maintained their niche in the American Healthcare system however; with an enhanced presence in manufacturing and product development, research and disease management. 

While I may be looking at my Magic 8-Ball with blurred vision, I would welcome you to provide your visions of the future to the community.  Perhaps some may even be as far-fetched and outlandish as mine.  If enough of us respond, one of us is bound to be right!