Published April 30, 2020
The response of Governor Gretchen Whitmer to the threat of the national pandemic has garnered national attention for the state of Michigan. Time will tell whether the Governor’s response was too extreme. One unique emergency reform has been buried beneath headlines of bans on in-person purchases of seeds and gardening supplies.
This unique and promising development is the authorization of “respiratory therapist extenders”—health care personnel such as medical students, physical therapists, and emergency medical technicians who are now permitted to aid respiratory therapists and other health care professionals in operating ventilators and other related devices. At the time of this writing, Michigan is the only state in the nation to move forward with this unique reform. Although the curve is beginning to bend after weeks of social distancing, the future trajectory of the virus remains uncertain. Bold action like this unique approach will help alleviate some of this possible future strain.
States have a vast number of trained medical professionals, as well as medical students on the verge of graduation, that are more than capable of increasing access to care during this national emergency and the uncertain recovery period that awaits us. The typical reform that we have observed is bringing back retired and inactive personnel, or bringing in medical professionals from other states to treat COVID-19 patients. These reforms do not necessarily increase the state’s capacity to deal with the pandemic, and utilizing vulnerable populations to treat COVID-19 patients can have grave consequences.
States should inject flexibility to make sure that all resources are ready to aid their respiratory therapists and physicians in the treatment of COVID-19 patients. Temporary relief of supervision and credentialing requirements is a simple way for states to ease the constraints this virus is placing on their health care providers. The use of respiratory therapist extenders is an effective way to support these health care workers, while also enabling medical students, physical therapists, and emergency medical technicians to work within their education and training.
As a result of occupational licensing laws that limit the tasks that health care professionals are permitted to perform, the health care system is severely burdened by rigidity. Many physician assistants, nurses, and other health care professionals possess the training to deal with a variety of medical issues outside of their typical work load. However, scope of practice laws prevents these providers from utilizing their full skill sets.
Shortages of respiratory therapists were prevalent before the pandemic appeared. States like Maine, Massachusetts, and Texas, where a shortage of respiratory therapists is a looming concern, are perfect examples of why it’s not only crucial that we have enough ventilators and other related equipment, but also the appropriate personnel to manage these machines.
States like Michigan provide a great example of how we can expand health care provider capacity to ensure hospitals are better prepared for what potentially awaits us in the future. Bold reforms and out-of-the-box thinking are necessary to make sure that patients across the United States have access to the care that they need. And when we return to a new normal, careful consideration should be given to permanent reforms of non-physician scope of practice to give our healthcare system the flexibility to respond to fulfilling our healthcare needs.