Current and future credentialing in respiratory therapy

Increasing demands by society in the United States for better, more efficient, and readily available health care have led to development of numerous categories of health practitioners. After a decade of vigorous growth, the emergence of new kinds of specialized health personnel raises questions of legal authority and quality of care. The multiplicity of health care professions often results in duplication of effort, fragmentation of services, and overlapping of job responsibilities, which contribute to ineffective regulation of health care personnel. Historically, credentialing has been the hallmark of professional accountability. All forms of credentialing are intended to provide the public with safe and effective care, but unfortunately the current system has led to ineffective regulation of health care personnel. Respect for professionalism has diminished in the public eye as consumers are questioning whether the elaborate, multiple, and costly mechanisms of current credentialing really protect society. Three types of credentialing currently in use are accreditation of institutions and educational programs, licensure of practitioners, and certification or registration of practitioners. These mechanisms of credentialing are not adequately assuring the competency of health practitioners; therefore, proposed alternatives such as institutional licensure, administrative regulation, national certification, and proficiency examinations should be explored.