If you have been told by your Respiratory Therapist that you would benefit from using home oxygen, a CPAP or BiPAP machine, there are things to consider before you agree to use or purchase equipment or services:

• Ask the Respiratory Therapist how they are compensated for their work.
  
  It is a conflict of interest for a Respiratory Therapist to receive any sort of additional compensation from the company that will provide you with the respiratory therapy equipment unless they tell you in advance that this type of arrangement exists.

• Are you aware that it is your right to choose your community respiratory therapy provider?  
  
  There are many respiratory therapy and equipment providers available to you. You are not obligated to obtain equipment from the Respiratory Therapist who informs you that you would benefit from it. Your continued care with this Respiratory Therapist cannot be affected by your decision.

• Has the Respiratory Therapist told you that you may be eligible for a subsidy from a third-party?
  
  Many patients/clients are eligible for full or partial funding of their respiratory equipment from a third-party. Third-party subsidies may come from: the Assistive Devices Program/Home Oxygen Program under the Ministry of Health, Veterans Affairs, or private insurance companies. Before agreeing to purchase respiratory equipment, you may wish to find out if you qualify for any of these resources.

• Has the Respiratory Therapist suggested that you contact other providers that offer home oxygen or respiratory equipment to compare services and prices?
  
  Respiratory Therapists should be providing home oxygen and other respiratory equipment to you at the current market value. If your Respiratory Therapist does not provide you with the names of other providers, you can find a list of providers approved by the Ontario Assistive Devices Program here:
  
  Oxygen therapy providers: Home oxygen therapy | Ontario.ca
  
  Respiratory equipment providers: Respiratory equipment and supplies | Ontario.ca

Suggested questions when evaluating providers:

1. Does the provider offer all types of home oxygen systems (e.g. stationary concentrators; portable concentrators; cylinders with oxygen-conserving devices; liquid oxygen)?
   
   This is an important question as your oxygen needs may change over time and you don’t want to be restricted or find yourself having to change providers. Liquid oxygen is not available from all providers yet is sometimes the only suitable option to ensure clinical benefit.
   
   
2. How does the provider determine which oxygen system to recommend for you?
   
   Your provider’s Respiratory Therapist should perform a respiratory assessment including pulse oximetry on each system you are considering, during your normal exertion and at rest, to ensure your oxygen needs are adequately met. Lifestyle needs are important and clinical effectiveness – the oxygen meeting your physiological needs – is of paramount importance.
   
   
3. What is the provider’s after-hours response? How long will you wait for a return phone call and how long for a visit to your home if necessary?
   
   In most instances it’s reasonable to expect a return phone call within 15 minutes and an in-home visit from your provider within two hours, if necessary. Some providers have on-call teams that cover large geographical areas after regular business hours, which may make it difficult to meet your expectations. If you have the opportunity, test their after-hours phone response before making your decision by calling their phone number on a Friday or Saturday evening. This is a good test of their responsiveness and overall customer service. Ask if they will deliver supplies to you after regular business hours if needed. The person returning your call should be accommodating and able to answer your questions.
   
   
4. How will the provider assist you with travel, including by automobile?
   
   Whether for medical appointments or leisure, many patients depend on their provider to make travel easy. If travel is important to you, learn how the provider will coordinate oxygen therapy for your travel plans. Learning at the last minute your provider can’t accommodate your request can be frustrating. With pre-planning most travel can be accommodated.
   
   Some patients can be effectively treated with smaller portable concentrators or cylinders while others require a continuous flow with liquid oxygen systems. There are restrictions (government and provider) on the use of liquid oxygen in vehicles including the type of vehicle and how it’s secured. Your provider should be open and upfront about their policies around your oxygen travel needs and be able to direct you to additional resources to help in your planning.
   
   
5. Will the provider include you in your care planning?
   
   You and your family caregivers should be given the opportunity to develop your care plan and to define appropriate goals that will enable your independence and improve your quality of life. Your provider’s Respiratory Therapist should encourage and monitor your progression towards achieving these goals and schedule follow up clinical visits to support your care plan.

Effective communication, mutual respect, and trust are keys to establishing a positive relationship with your provider. Being aware of your rights and responsibilities within this relationship will help you to develop reasonable expectations regarding your care.