Update on the Advanced Practice Respiratory Therapist

According to a report issued by the Association of American Medical Colleges in March of last year, physician demand in the U.S. is expected to grow faster than supply over the coming decades, leading to a physician shortage of up to 86,000 by 2036.

Who will take up the slack for these missing physicians? A recent poll conducted by the Medical Group Management Association found that 63% of medical groups planned to add new advanced practice provider roles in 2024 alone, suggesting that advanced practice providers are a big part of the answer.

Physician’s assistants and nurse practitioners make up the lion’s share of advanced practice providers today, but the AARC, NBRC, and CoARC have been working to ensure an Advanced Practice Respiratory Therapist (APRT) is part of the mix as well.

Where does the APRT stand today? We asked three members of the AARC’s Advanced Practice Respiratory Therapists Advancement Committee to give us an update.

Co-chairs Bill Croft, EdD, PhD, RRT, FAARC, and David Vines, PhD, RRT, FAARC, FCCP, and Member Sarah Varekojis, PhD, RRT, RRT-ACCS, FAARC, a professor and director of clinical education at Ohio State University, which houses the only APRT program in the U.S., offered these insights:

Why is it important for the respiratory care profession to support the development of an Advanced Practice Respiratory Therapist?

Bill Croft: Unlike nurse practitioners and physician assistants, APRTs have focused training in respiratory care. Their education, which includes a master’s degree and 1,000 hours of clinical training, equips them with specialized skills to diagnose and treat respiratory diseases. This specific expertise makes APRTs invaluable in managing complex cardiopulmonary conditions.

Sarah Varekojis: RTs who choose to pursue becoming an APRT will be able to make a significant impact on the lives of many patients we interact with regularly by improving access to health care and patient outcomes.

Where are we today with the development of educational programs for the APRT and what is the AARC doing to promote the formation of more programs?

David Vines: The AARC Advanced RT Fund is a significant step forward in supporting the development of new APRT programs and helping states pursue APRT licensure. Kudos to our professional association for creating this fund. 

Bill Croft: There are at least five more colleges and universities expressing the desire to explore the APRT program. The AARC APRT Committee is monitoring and supporting their progress.

How have the graduates of the Ohio State program been putting their new APRT degrees to work for the good of the profession and its patients?

Sarah Varekojis: Two of the OSU program graduates are currently working at the Baltimore Veterans Affairs Medical Center as APRTs. They have excellent support from both the respiratory therapy department and the medical staff, and they are making a difference in the care they provide to patients. 

Other APRT program graduates have leveraged their master’s degrees to pursue leadership roles in respiratory therapy as managers and clinical educators, as well as in other areas of health care administration. And several graduates have moved into expanded clinical roles such as transport or organ procurement. Regardless of where they are currently working, all of the graduates are excited about their futures as APRTs.

Are there any other new developments on the APRT front that you can share with us?

David Vines: The NBRC is developing an end-of-program competence examination for APRT programs accredited by COARC. A job analysis was conducted, and the NBRC developed a content outline. The results of the job analysis have recently been published in CHEST.

Sarah Varekojis: CoARC has received an inquiry about submitting a Letter of Intent (LOI) for an APRT program, and we expect to receive an LOI submission in 2025. We have also heard that the VA is continuing to explore expanding employment of APRTs in other medical centers across the country.

What can RTs do to support the continued development of the APRT?

Sarah Varekojis: All RTs can help move our profession forward by supporting APRT licensure legislation in their state; educating colleagues, physician leadership, nursing leadership, and health care administration about the APRT; and appreciating all the work the AARC is doing to create clinical career advancement opportunities for RTs.

Bill Croft: The advancement of APRT legislation will add a highly specialized advanced practice provider to the workforce, improving care for the most vulnerable patient population. However, each state needs to review its data sets to establish the need in its own state. The introduction of the APRT role into legislation represents a significant advancement in respiratory care, addressing critical gaps in health care access and providing specialized expertise in the management of respiratory diseases.

Learn more about the APRT here.