In this day and age of collaborative practice and evidence-based

medicine, it is imperative that a culture change occurs in medicine. Many

institutions already rely on the expertice of Respiratory Care

Practitioners and what they bring to the patient care plan, while others

remain in the medical "Dark Ages" of physician-directed manipulations

without input from other care givers, respiratory therapists in particular.

Therapist-driven protocols have been proven as key tools for patient care

expediting recovery, decreasing length-of-stay and saving health care

costs. Many studies have been done to prove the efficacy of

therapist-driven protocols and demonstrate savings in man-hours and

healthcare costs. Some remain unconvinced and this reality has had a

difficult time finding its way into many health care facilities.

How does one change the "old school" philosophy and convince those

"die hards" that therapist-driven protocols are the only really feasible

way to treat patients? Where does one start when they are faced with this

situation? As a caregiver at a teaching hospital, I try to instill these

ideas into the careplans of the physicians-in-training, so that it becomes

a routine expectation when they begin their own practices. At times, these

attempts are thwarted by the overseeing physicians, however.

We must unite to change this culture and promote our profession as

just that; a profession of clinical experts, an integral part of the

patient care, multidisciplinary team.