Just recently, I had the opportunity to attend the 2018 South Dakota Society of Respiratory Care (SDSRC) annual meeting and educational conference in Deadwood, SD. Brian Walsh president of the AARC was able to attend our conference and shared his insights on the future of our profession. Brian also shared his insights on the need for research in our profession and how advances in technology will reshape how we perform our duties.
After listening to Brian’s initial presentation, it was clear that the AARC fully supports increasing the education level for respiratory therapists and I agree 100% with this objective. However, I disagree on how they are attempting to achieve this objective. Currently, student loan debt sits around 1.3 trillion dollars and the price of college continues to outpace the normal rate of inflation for goods and services. In the last 30 years, college has increased by 230% for public 4-year institutions after adjusting for inflation. To put this into perspective: If the inflation rate for gasoline was the same as college tuition, a gallon of gas today would cost around $11.00. Data continues to demonstrate that college enrollment continues to decline, and a four-year degree is becoming of less value than a decade ago. Because of this decline in enrollment, colleges are starting to aggressively market their services beyond high school graduates. One segment of the population that colleges are aggressively marketing are respiratory therapists who are already registered in their perspective profession. With slick marketing tactics registered respiratory therapists are being conditioned to believe…. that without the help of colleges and their centuries old traditional academic degrees, their future in their profession is dismal at best.
In today’s world information is just a click away. It is estimated that around 80% of all Americans have access to the World Wide Web and because of this, information can be easily and quickly obtained. Who could have ever imagined, that we would have access to almost all the world’s information and knowledge with a smart phone no bigger than our hand? This technology should be revolutionizing our centuries old higher educational system; however, tradition and money are preventing this revolution. By clinging onto our centuries old institutionalized educational system, we are placing a financial strain on future generations and preventing education to evolve with the changing times. The World Wide Web has become the college of the 21st century and is allowing millions to easily self-educate themselves. Prior to the World Wide Web individuals had to be physically present within the walls of academia and would travel hundreds and thousands of miles to receive knowledge. In 1920 the Harvard Library contained approximately 1,127,500 volumes and today through the World Wide Web we have access to over 130,000,000 volumes. Despite this access to a free education, we are not ready to abandon our centuries old educational system.
The future of medicine will be changing dramatically in the years to come. We as respiratory therapists will have little say on this coming change but must adapt quickly to this change and traditional academic degree programs are not the answer. What factors are going to revolutionize our current health care system in this fourth industrial revolution? (1) Advances in technology such as blockchain, 5G networks, quantum computers, AI and neural interfacing (2) Advances in genetics such as Crispr Cas 9 and tissue nanotransfection (TNT) (3) Decreasing reimbursement (4) Medical errors (5) Politics (6) Global governance (7) Religion (8) Synthetic biology (9) Nanotechnology (10) Global economics. All these factors and more will shape the future of health care and traditional institutionalized education is unable to keep pace with these changes. We as respiratory therapist must be self-motivated learners and must adapt quickly to this coming change.
I see a future where medical institutions will break free from traditional academic degrees and will use apprenticeship programs along with technology to educate health care providers of the future. With decreasing reimbursement and a coming economic recession health care institutions cannot continue to pay top dollar for traditional academic degrees. We as respiratory therapists must resist playing the traditional academic degree game and demanding higher reimbursement. We must show how we can provide value to our institutions without increasing their financial burden. We must show our institutions that we are adaptive to change, adaptive to all forms of technology and not hesitant to acquire and perform new skills. Today, millions of people are reshaping and reinventing the future of education and are providing their services for free or at substantial lower cost than traditional college. Sites such as Coursera, Khan Academy, Open Culture Online Courseo, Udemy, Academic Earth, edX, Alison, Ted-Ed, MIT OpenCourseWare etc., are all internet sites reinventing the future of education and allowing individuals a free and self-directed education.
Many involved in our current education system will see this as radical and some will even find it threatening to their existence as educators and I cannot blame them. However, our society has entered a fourth industrial revolution and this revolution has the pedal to the metal and has no intention of applying the brakes. If the AARC is to be relevant in this revolution they must become innovators and think outside the box of the traditional education model. They must demonstrate to health care institutions how respiratory therapists can decrease their financial burdens by adapting quickly to change and quickly adapting new skills. They must stay abreast of medical advancements and technologies and strategically employ the skills of respiratory therapists into these advancements. They must come alongside the respiratory therapist and develop programs to assist them to gain specific skills relevant to the quickly changing healthcare field. Finally, they must resist using traditional academic degrees to demonstrate a respiratory therapist's worth in an industrial revolution that is redefining education and employable skills. Our current educational system has served us well for many years but has changed little over the past 200 years. No matter how hard we try to cling onto our centuries old institutionalized academic system and sheepskins, the fourth industrial revolution is here and will change it whether we are ready or not.
“Intellectual freedom begins when one says with Socrates that he knows that he knows nothing, and then goes on to add: Do you know what you don’t know and therefore what you should know? If your answer is affirmative and humble, then you are your own teacher, you are making your own assignment, and you will be your own best critic. You will not need externally imposed courses, nor marks, nor diplomas, nor a nod from your boss . . . in business or in politics." ― Scott M. Buchanan