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Saturday, September 5, 2009

Bronchodilator Reform: Part II

After I wrote about Bronchodilator Reform as a quest post at Respiratory Therapy 101 last February, I decided this post needed a follow up. And thus is what inspired the following post:

Bronchodilator Reform: Part II
By Rick Frea: February 25, 2009 @RespiratoryTherapy101

So we are in a healthcare crisis caused mainly by skyrocketing healthcare costs. Perhaps one of the culprits of this crisis is something RTs have been vying against for years — bronchodilator abuse. Shockingly, few have listened to our cries for reform. Perhaps, however, money will talk.

While important officials often go to hospitals looking for procedures and therapies that are no longer needed in order to save money, never do they set their beedy eyes on the respiratory therapy department where millions of dollars are wasted every year on frivolous treatments.

While Ventolin breathing treatments may not be the only cause of rising healthcare costs, they are a major contributing factor. In a pithy manner I will explain.

By now you know Ventolin is ordered by many doctors for all annoying lung sounds, and many patients who are short of breath regardless of the cause. That is what they do despite the fact Ventolin is ONLY indicated for shortness of breath due to bronchospasm.

Now you might be asking: what do useless breathing treatments have to do with the healthcare crisis. Well, consider the following.

Where I work treatments cost $84 a pop. I estimate (on the conservative side) that 80% of Ventolin treatments ordered are not indicated and thus are non-beneficial to the patient. You can see, Houston, that we have a problem.

You do the math. Say the average hospital gives 40 breathing treatments during one 12 hour shift. That’s a total daily profit just from Ventolin treatments of $3,360. So you can be certain here we will not have hospital adminstrators on our side in our battle for bronchodilator reform.

But, when you consider who is paying the cost, officials might want to be aware that (80% of $3,360) $2,688 each day is going to this one non-indicated procedure. Multiply that by 365 and you gett $981, 820 wasted on Ventolin Abuse at just one hospital.

Multiply that by all the rest of the hospitals in the U.S. and that’s a lot of wasted money. Plus, mind you, I’m being conservative. The actual amount of money wasted on Ventolin therapies is more likely much higher.

Yet, still, when important officials go to hospitals demanding cuts in un-needed procedures, rarely ever do beedy eyes peer into the RT department.


Anonymous said...

If 80% of treatments are unindicated then aren't 80% of RT staff unneeded??

I know that is simplifying things but even at best estimations for ICU and ER staffing my guess would be an RT staff of 60% less than what is there now.....

As a second year RT student.....I would say it's time for RT's to step up and justify their existance.........

Rick Frea said...

That's a theory some hold on to.

However, here's something to think of: If getting rid of un-needed breathing treatments resulted in no need for RTs, then why do hospitals that have RT driven protocols continue to thrive?

Any thoughts anyone?

Anonymous said...

I am not an RT and I am just now looking into going into the profession. So my outlook on this may be very naive. Maybe, if 80% of your day was not spent on unneeded treatments then you could concentrate on needed protocol. From what I have read, a high percentage of people are admitted to the hospital for SOB. If these people were treated correctly by an RT then the RT's job would still be secure and maybe the RT would be seen more as a professional in some hospital settings. I have read that the scope of being an RT is more than just the lungs. It is the whole respiratory system that includes the heart. This opens up a whole other need for the RT. Personally, I see the future need of the RT growing. The medical industry, though slowly, is starting to recognize the vital need for RTs that go beyond breathing treatments. I think this is why that hospitals that have protocols for their RTs still have a high need for their RTs they just veiw them as more than someone who comes to do a breathing treatment. I'm hoping they veiw their RTs as having another prospective about the patient's condition and seen as a professional with valuable information to add.


Rick Frea said...

You appear to be correct in your assessment. I think there definitely is a need for RTs, and I have a post coming up regarding that for RT Care Week. I also think there has been much progress, and that this is a good profession. Also you have to consider the hospital you work for. I work at a small town hospital that tends to stay behind the times. I know for a fact there are many hospitals that better utilize their RTs. As with any profession, where you choose to work is a major factor is worker satisfaction.