This November, Respiratory Therapy will have been regulated in Ontario for 20 years. In that time, as well as all the years before the CRTO came into being, we have witnessed tremendous growth in our profession.  The most dramatic changes have occurred in the acute care setting, where RTs are now performing procedures and fulfilling roles that weren’t even conceived of 20 years ago.  We know that medical advances will continue, with every reason to believe that the RT role in acute care will evolve along with them.  There are many other ways RTs can make significant differences in the lives of their patients, however most opportunities to grow as a profession now exist outside the walls of a hospital.

Demographic and financial realities will cause a dramatic shift in how health care services are delivered in this province over the next several years. One of the principal goals in the Ministry of Health and Long Term Care’s (MOHLTC) Ontario’s Action Plan for Health Care is to find cost effective ways to provide timely and high quality health care closer to home. The “Right Care, Right Time, Right Place” initiative is aimed at expanding practitioners’ scope of practice so that patients can receive the care they need in the place they choose.  As patients with increasing complex respiratory needs are being discharged from hospitals, RTs are being asked to apply a broader range of acute care skills in a community setting. This presents a unique opportunity for RTs to use their specialized knowledge and have a tremendous impact by fulfilling a very real need.  But for many of us, it will require a significant shift in how we practice individually, as well as how we see ourselves as a profession collectively.

Traditionally we’ve tended to view respiratory therapy as technology-focused and acute care-centred. However, as the population ages and more Family Health Teams (FHTs), community-based specialty clinics and long-term care facilities require RT services, we must be willing to work and (to borrow from Apple’s advertising slogan…) “think differently”. For some RTs already out in practice, it may mean learning a new skill…or dusting off an old one.  For new grads, it means considering a much broader range of practice setting options than ever before.  For example, the trach we previously changed in the ICU will now, more than likely, be changed in the person’s home. 

No matter where we work – or how long we have been working – RTs need to be ready for what may be the biggest evolution in our profession yet.