Editor's Note

The Yin and Yang of Respiratory Care

The business of respiratory home care is often divided much like the Yin and Yang symbol — on one side, the gleaming purity of patient needs; on the other, the darkness of the bottom line. But why is it so?

Mainstream media's lynching of respiratory providers and CMS's hunt for fraud and abuse in recent months tend to make us a little ashamed that we are indeed a business. Many critics would have us believe that the desire to make a profit impedes the ability to consider the well-being of patients.

Sure, I have argued this point repeatedly. Occasionally, however, the evidence speaks for itself. This was the case when I asked readers to share their thoughts on home sleep testing in Respiratory Management's March survey. The response was overwhelming, and many of you provided additional comments beyond the multiple-choice responses.

What I read was true concern for patients. While home sleep testing has the potential to line providers' pockets by tapping another avenue of the growing sleep market, you were less concerned about profits and more concerned about clinical efficacy. Readers voiced concerns about whether or not patients could use the devices. You questioned CMS's lack of guidelines that could open up more opportunities for fraud and abuse. You worried that diagnostics outside of the sleep lab might harm patients, causing misdiagnosis or missed health complications.

Many of you asked, "Am I qualified to administer sleep tests?" You spoke out in support of training for sleep screening and voiced your faith in sleep labs and sleep physicians.

Those of you that support home sleep testing do so not simply because it could ease your own hardships but because it will create greater access for patients.

We live not in a world of black and white, but rather one with many shades of gray. Yes, respiratory providers must make a profit to stay in business, but that does not usurp the way you care for and protect your patients. Rather, the Yin and Yang of respiratory care is balancing these two forces, both of which are necessary for success.

This article originally appeared in the Respiratory Management March 2008 issue of HME Business.

About the Author

Elisha Bury is the editor of Respiratory Management.

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