New York first recognized the practice of respiratory therapy and respiratory therapist technician as licensed professions in 1992. Cardiopulmonary medicine, pharmaceutical treatment, and medical technology have significantly advanced since 1992, as have the academic preparation and professional standards for Respiratory Therapists. A corresponding advancement in educational requirement for licensure to a bachelor’s degree is necessary to ensure that future respiratory therapists are adequately academically prepared for this expanding role. This higher academic requirement will ensure Respiratory Therapists are able to appropriately manage patients with complex cardiac and pulmonary disorders and continue to play an active role in improving patient outcomes.
The legislation we are pursuing will improve the health, safety, and welfare of New York citizens in need of respiratory therapy services by increasing the educational standards for Respiratory Therapists (RTs) to a bachelor’s degree in keeping with best practices. Respiratory Therapists are healthcare practitioners who play an integral part in diagnosing lung and breathing disorders, consulting with physicians on treatments, assessing patients, and recommending specific changes in therapy based on their patient assessments. They are involved in analyzing data to determine levels of oxygen, carbon dioxide and other physiological parameters. Respiratory Therapists contribute heavily to managing patients placed on highly technical treatment modalities and medical devices. This includes providing a variety of advanced modes of mechanical ventilation and artificial airway devices, and actively participating in rapid response teams and emergency situations. Respiratory Therapists also provide education to patients and their families about how to best care for their cardiopulmonary disorders in both the in-patient and out-patient care setting.
- According to research data, 70% of Respiratory Care Managers, are requiring or preferring to hire new graduates with at least a BS in RT, and over 80% would prefer to hire RTs with a BS in RT over the next 5 years.2 This is significant data that overwhelmingly supports the need to move towards a bachelor’s or higher degree to practice in our profession.
- With the paradigm change in the current healthcare environment, the respiratory care profession will need to make some significant changes, which include advancing the academic standards of the profession. According to Smith, SG., Endee, LM., et al, 64% of respiratory therapists agreed that the minimum academic standard be raised to the baccalaureate degree.3 In a recent study by Danzy, J. N., Gilmore, T. W., Smith, SG., Endee, LM., & Wissing, D. increasing the academic standard to a bachelor’s degree could lead to obtaining a master’s degree in RT, which has the potential to increase salary, promote professional growth, and increase the scope of practice.4
- To be able to sustain growth in the profession, it will require 3 main issues that we identified in our study:
- Obtaining the ability to assess patients and develop a plan of care
- Receiving reimbursement for services rendered
- Obtaining the ability to write prescriptions
- Keene et al asked RTs and respiratory care educators about advanced practice respiratory therapy programs. The majority of respondents (78%) indicated that they would rather remain in their profession with advanced training and education than move on to a physician assistant program (Keene, 2015).5
- A four-year program provides respiratory care students with longer periods of clinical rotations, more exposure to complicated cardiopulmonary cases, additional training in advanced medical management and pharmaceutical treatments, and allows for the introduction of more advanced medical technology.
- In 2018 the Commission on Accreditation for Respiratory Care (CoARC) report indicated that those who were baccalaureate prepared had a great successful passing rate, at 87.6%, for the Registered Respiratory Therapist credentialing exam, compared to those who were associate degree prepared, at 78.9%.6
- In associate degree programs, there is limited amount of time to properly deliver sufficient curriculum, and there an inability of these programs to extend the time required to deliver additional curriculum for this increasing academic requirement.5 There is growing evidence that those health care professionals who are baccalaureate prepared demonstrate improved quality of patient care, which contributes to a decrease in patient mortality as compared to those who receive an associate’s degree.
- Becker et al indicated that patient care may be improved by raising the minimum educational standard of RTs from associate prepared to baccalaureate and beyond.7
- According to a paper issued by the AARC, respiratory therapists working in critical care are expected to participate on rapid response teams. However, only 65% of associated degrees’ programs provide this teaching skill in their curriculums and only 42% of these programs teach skills to integrate evidence-base medicine.8
For respiratory therapists to provide quality care, be an actively-involved member of the healthcare professional team, be able to make decisions founded on data-driven evidence, and provide care in various healthcare settings, it will be essential for them to be skilled in critical thinking and problem solving, in order to provide optimal patient care in this ever-changing advancement in medicine and medical technology.8 This increase in clinical skills and competence will require a greater academic standard to meet these requirements, providing respiratory therapists with the autonomy to optimally treat patients with cardiopulmonary pathologies and to play an expanded role in disease management3 and ultimately, improving patient outcomes.
References
- United States Department of Labor, U. S. Bureau of Labor Statistics, Occupational Employment Handbook, Respiratory Therapists, Summary and Job Outlook,
https://www.bls.gov/ooh/healthcare/respiratory-therapists.htm#tab-1 - Varekojis, SM, et al, 2018. Respiratory Therapy Department Directors’ Preferences Regarding the Educational Background of New Graduates Staff Respiratory Therapists. Respiratory Care Educational Annual, Vol. 27, Fall 2018, 16 – 21.
- Smith SG, Endee LM, Benz Scott LA, Linden PL., “The Future of Respiratory Care: Results of a New York State Survey of Respiratory Therapists,” Respiratory Care, March 2017 62(3):279-287.
- Danzy, J. N., Gilmore, T. W., Smith, S. G., Endee, L. M., & Wissing, D. R. (2022). A Pre-Pandemic Evaluation of the State of Staffing and Future of the Respiratory Care Profession: Perceptions of Louisiana Respiratory Therapists. Respiratory Care. October 2022 Vol. 67 No. 10, pages: 1254 – 1263
- Keene, S., McHenry, K. L., Byington, R. L., & Washam, M. (2015). Respiratory therapists as physician extenders: perceptions of practitioners and educators. Respiratory Care Education Annual.
- AARC Issue Paper, Entry to Respiratory Therapy Practice 2030, www.aarc.org
- Becker, E. A., & Nguyen, X. T. (2014). The current impact of entry-level associate and baccalaureate degree education on the diversity of respiratory therapists. Respiratory Care, 59(12), 1817-1824.
- AARC Paper Support for Transitioning from Associate to Baccalaureate Degrees in Respiratory Therapy, https://www.aarc.org/wp-content/uploads/2016/01/Transitioning_AS_BS_2016.pdf
New York State Society for Respiratory Care Ad Hoc Committee for the Advancement of The Respiratory Care Profession in NYS
Co-Chair: Stephen G. Smith, MPA, RT, RRT, FAARC: Clinical Associate Professor (Ret.), Past Chair: New York State Education Department Respiratory Therapy Licensure Board, Vice President and Executive Board Member: New York State Society for Respiratory Care, Respiratory Therapist Clinical Liaison to the Long Island State Veterans Home, Stony Brook University
Co-Chair: Felix Khusid, BS, RT, RRT-ACCS, NPS, RPFT, FAARC, FCCM, FCCP, ATSF: Administrative Director for Respiratory Therapy and Pulmonary Physiology Center, New York – Presbyterian – Brooklyn Methodist Hospital, President of New York Downstate Association for Respiratory Therapists (NYDART), Co-Chair: NYSSRC Ad Hoc Committee for the Academic Advancement of the Respiratory Care Profession in New York State
Lisa M. Endee, MPH, RRT-SDS, RPSGT, FAARC: Clinical Associate Professor, Specialty in Sleep Diagnostics and Therapeutics, Respiratory Care Program and Polysomnography Specialty Option School of Health Professions, Stony Brook University, SHP Drowsy Driving Prevention Program, American Association for Sleep Technologists (AAST) Director at Large
Katherine Herlihy, Esq: Attorney at Whiteman, Osterman and Hanna, LLP, Legal Advisor to the New York State Society for Respiratory Care
Brandi Ewing, MSRC, RRT, RRT-ACCS-NPS, AE-C: President of the New York State Society for Respiratory Care, Regional Director of Respiratory Services, St. Joseph’s Health and St. Peter’s Health Partners