My answer: Actually it is a fallacy that ventolin causes no harm. We must not for get the s-isomer, which has been proven to cause inert bronchspasm. The more you take the medicine, the more you need it. It's an endless cycle.
I do see your point though. Patients do get the psychological benefit of thinking we're doing something, and the company of an RT.
Yet this has been a problem that has plagued the entire history of medicine, is that most medicine has no benefit other than psychological. Ventolin, like charms, amulets, prayers, and incantations of the primitive world, provides nothing more than the best remedy of all time: HOPE.
In other words, there are times when Ventolin has a real scientific benefit to the patients who receive it. The other 90% of patients receive nothing more than mythical benefits.
Does this "mythical benefit" and "false hope" justify the $120 it costs insurance companies for every treatment given?
Think of it this way, you give a treatment that's not needed every four hours, that's $720 a day, and $5,040 in a week. Is that price worth hope? Of course then you add all the prn treatments given in between because the patient got dyspneic on exertion to the commode, or developed an annoying wheeze, and the price only goes up even more.
Also, taking up a respiratory therapist's time giving a treatment that's not needed takes away time from someone who does need attention. This is a principle concept discussed often in economics 101 courses. It reminds me of the Broken Window Theory.
In the Broken Window Theory you have a boy walk by a sweater shop, and he tosses a rock through the glass. Some economists say this is good for the economy, because it creates a job for the glass maker. What is not seen is the effect on the sweater maker.
During the time the window is broken, the sweater keeper is not allowed to sell any of his sweaters. He therefore is out of a job until the window is fixed. He makes zero sweaters. If he sells zero sweaters, the sweater maker sells zero sweaters. Various other unseen people are also affected, such as the delivery man, and the man who sells little gadgets to support his family.
But the people don't see this aspect of the economy, all they see is what is obvious: a broken window and it being repaired. They see that the repairman is making money. They think this is good for the economy. It is, but what they don't see is that the sweater company being closed greatly effects the economy in an unseen way.
So, I guess I'm comparing useless ventolin therapy with the sweater salesman. While the patient and the physician see the breathing treatment, what they don't see is that it did no good. Regardless, studies show that 50% of patients who received a placebo also said they benefited from the patient. So this proves that the patient is unreliable.
Likewise, in a similar scenario, while the breathing treatment is being given, the patient is given lasix. While the lasix is forming pee, and thus removing fluid from the lungs, thus making it easier to breathe, it is not seen.
In this way, lasix is also like the sweater maker. Since the ventolin is seen, it is given credit. It is also like the primitive medicine man getting credit for saving the live of a patient, when the truth is that nature did the same. But since he did something, he is given credit.
Does this "mythical benefit" and "false hope" justify the $120 it costs insurance companies for every treatment given?
Think of it this way, you give a treatment that's not needed every four hours, that's $720 a day, and $5,040 in a week. Is that price worth hope? Of course then you add all the prn treatments given in between because the patient got dyspneic on exertion to the commode, or developed an annoying wheeze, and the price only goes up even more.
Also, taking up a respiratory therapist's time giving a treatment that's not needed takes away time from someone who does need attention. This is a principle concept discussed often in economics 101 courses. It reminds me of the Broken Window Theory.
In the Broken Window Theory you have a boy walk by a sweater shop, and he tosses a rock through the glass. Some economists say this is good for the economy, because it creates a job for the glass maker. What is not seen is the effect on the sweater maker.
During the time the window is broken, the sweater keeper is not allowed to sell any of his sweaters. He therefore is out of a job until the window is fixed. He makes zero sweaters. If he sells zero sweaters, the sweater maker sells zero sweaters. Various other unseen people are also affected, such as the delivery man, and the man who sells little gadgets to support his family.
But the people don't see this aspect of the economy, all they see is what is obvious: a broken window and it being repaired. They see that the repairman is making money. They think this is good for the economy. It is, but what they don't see is that the sweater company being closed greatly effects the economy in an unseen way.
So, I guess I'm comparing useless ventolin therapy with the sweater salesman. While the patient and the physician see the breathing treatment, what they don't see is that it did no good. Regardless, studies show that 50% of patients who received a placebo also said they benefited from the patient. So this proves that the patient is unreliable.
Likewise, in a similar scenario, while the breathing treatment is being given, the patient is given lasix. While the lasix is forming pee, and thus removing fluid from the lungs, thus making it easier to breathe, it is not seen.
In this way, lasix is also like the sweater maker. Since the ventolin is seen, it is given credit. It is also like the primitive medicine man getting credit for saving the live of a patient, when the truth is that nature did the same. But since he did something, he is given credit.
Also, and I'd like to see a study on this, when an RT is burned out at the end of a day due to too many frivolous therapies, it diminishes his ability to make good decisions at the end of his shift. A burned out therapist is not always at the top of his game.
This, in my opinion, may work to the detriment of good patient care. A burned out RT who is grumbling and griping at yet another useless ventolin order is probably not good for public relations either. And it's not like you can fire this RT, especially, as I've observed, this is common among all RTs. So you can't fire them all.
Now, these are simply thoughts. Although in all the years I've communicated such thoughts, I have never had anyone come up with a counter argument. Not one person has ever come up with any facts to prove that ventolin is needed for CHF, pneumonia, cancer, pleural effusion, and other lung diseases that provide asthma like symptoms.
I have had many doctors say things like, "I think that ventolin helps with heart failure." I ask this doctor, "Do you have the evidence to support this claim, or is it just a feeling?" Never has a doctor proffered any evidence. Usually they get mad as I offer my proof. They get mad at me for being honest.
Getting back to the broken window theory, as I'm giving the breathing treatment that isn't needed, what is not seen is that two rooms down is a man in the early stages of heart failure. He is the man I would be visiting if I wasn't stuck in this room. Later on he will be intubated, and and only because of that breathing treatment that was thought to do no harm.
The idea that ventolin therapy does no harm, in my opinion, is no better than treating diseases the primitive way with a medicine man dancing, rattling his shakers, beating his drums, and chanting incantations. Since this is what the sick person sees, when the patient gets better the patient will say, "The miracles of the medicine man cured my sickness."
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