Vol. 12 •Issue 8 • Page 54
Taking the Leap into Consulting
Creative RTs Try on New Hats
Besides scaring the living daylights out of you, a heart attack can be a great motivator.
About six years ago, respiratory therapist Jeffrey J. Belle, PhD, was in the middle of a career transition, having decided to become a smoking cessation consultant. Then came his heart attack, which was attributed to stress and, ironically enough, smoking cigars.
From that moment on, he threw himself into his new career path. Today his clients include corporations, American Indian reservations, hospitals, medical schools, durable medical equipment companies and even cruise lines. He’s on the road every other week.
“I found my passion,” said the Seattle resident, who also has gone on to earn a PhD in clinical science since the heart attack. “That gave me a real wake-up call.”
In the realm of consulting, Dr. Belle is an example of a boundary-breaking RT. Many opportunities already exist for RTs with equipment manufacturers, but therapists like Dr. Belle have searched out nontraditional forums that can benefit from RTs’ skills set, such as smoking cessation, asthma management and occupational health.
Stretching the limits of consulting isn’t just a way for RTs to earn extra money. It also could be a means for survival, given the changing state of health care.
“We have to look at ways to expand our horizons,” said Ed Robinson, RRT-NPS, RPFT, president of the Virginia Society of Respiratory Care and operations manager of respiratory care at Chesapeake General Hospital, Chesapeake, Va. “We are just a few CPT code changes away from being out of a job.”
RTs trying their hand as consultants isn’t something new, though it’s been a growing occurrence. Jacki McClure, BS, RRT, first .started consulting in the mid-1980s, working for an equipment manufacturer.
“I was a pioneer,” said McClure, now director of the national respiratory network and government relations for The MED Group, a Lubbock, Texas, company that offers consulting services for member home medical equipment companies. “Many weren’t doing it. Since then, the demand has really increased.”
Patrick Dunne, MEd, RRT, FAARC, consulted part time for 20 years before starting his own consulting business in 2001. “(The health care) industry has been steadily looking to RTs for services,” said Dunne, owner and president of Healthcare Productions Inc., a training, research and development company based in Fullerton, Calif. “The industry recognizes RTs can bring a lot of insight. That shows the profession has come of age.”
Much of Dunne’s consulting work centers around equipment companies, such as training their sales teams about respiratory products, doing marketing research for new devices, setting up testing for prototypes, and teaching customers to use new technology. He’s also contracted with home care companies to help them with billing and the accreditation process.
Equipment manufacturers re.main a great place for RTs to consult, especially considering that the struggling economy is forcing companies to outsource more and more services. In his experience, Dunne has seen many RTs start working part time for equipment companies, only to be eventually recruited for full-time positions.
“There still is a lot of opportunity out there,” he said.
Yet, experienced entrepreneurs encourage RTs to think beyond the typical consultant positions. Don’t sell yourself or your abilities short, they advise.
“Believe you can be useful,” said Carlos Ponce, CRT, president of three Aventura, Fla.-based companies that provide a range of services, from staffing to sleep tests to arterial blood gases. “Our service is needed out there. We need to believe in our profession.”
FINDING A NEED
Thinking of his native Eastern Virginia, its warm, pollen-filled air and its shipbuilding industries, Robinson sees an area that can be rough on lungs. As a result, it’s full of consulting chances for RTs as lung health lecturers to companies.
“Do your research,” he said. “See if there’s a market for your services.”
For instance, Bert Ellis, RRT, CHT, has done work for Verizon Communications. He lectures to employees about smoking cessation, asthma management, occupational health and protective gear.
These types of lecturing opportunities aren’t common, but that may be just because companies don’t realize they need them. He advises RTs to contact companies and offer to do an introductory lecture for free. Then charge the next time if you’re invited back.
“You’re kind of creating a need,” said Ellis, an operations manager of the wound healing and hyperbaric medicine center at Chesapeake General Hospital. He also does consulting for a hyperbaric chambers manufacturer.
Dr. Belle has consulted for big-name companies, such as American Airlines and Microsoft. Armed with 25 different smoking-cessation lectures, he speaks at about 40 medical schools a year, performs in-service education at hospitals and DME companies, holds clinics on American Indian reservations, and partners with state associations to organize workshops. “I’m the quarterback behind it,” he said. “I bring the players together.”
Then there’s the cruises, where for a typical seven-day trip he’ll give a lecture titled, “How to Quit Smoking in Seven Days or Less.” “They’re a captive audience,” he said.
After giving the daily two-hour presentation to passengers, Dr. Belle doesn’t lounge by the pool or play shuffleboard. Rather, he’ll retire to his cabin to try and improve his lecture. For Dr. Belle, work never ends. “My hands are full,” he said. “Respiratory has been so good to me. I sprang from my respiratory background.”
Pulmonary function tests offer another consulting opportunity. One of Ponce’s companies, Quality Medical Personnel Inc., provides PFT services for research being done by the University of Miami and the U.S. Army. It also does PFT for about 500 physicians. The test is done right in their offices, the results are known quickly, and the satisfied doctors recommend him to colleagues. Ponce’s business has grown entirely by this good word-of-mouth.
His services are so popular that hospitals are losing work because of him. Hospital administrators have told him point-blank that they want him out of business. “I tell them we live in a free-enterprise system,” Ponce said. “We’re making a lot of waves down here in Florida. We’re like David and Goliath.”
AirLogix, a respiratory disease management company based in Dallas, hires RTs on a full- and part-time basis to do home visits and telephone consults with asthma and COPD patients. Part-timers only have to work a minimum of 12 hours, perfect if they already have a full-time job.
“We feel RTs are the specialists in this area,” said Julie Sizemore, RRT, MHSA, BS, the company’s vice president of clinical operations. “Nurses have a chapter in a book about pulmonary medicine, while therapists spend one or two years in school.”
The company soon will be adding 40 therapists to its workforce, and its employees report a great deal of satisfaction. “Instead of squirting medications into nebulizers, you’re using your skills to better someone’s life,” Sizemore said.
Matt Kilroy’s unorthodox career move offers an interesting option for RTs. A therapist for .25 years, Kilroy, BS, RRT, recently jumped to the other side of the fence to work full time for a health maintenance organization, a decision that’s caused many shocked looks.
Considering that nurses are hired by HMOs as consultants, RTs’ skills may be of service to HMOs as well, especially for issues like oxygen and reimbursement. “Yes, there are opportunities, but a therapist would have to actively solicit them,” Kilroy said.
Giving testimony in medical litigation cases, particularly about mechanical ventilation, can offer another lucrative consulting opportunity, Kilroy said. Typically, being an expert witness doesn’t involve testifying in court. The lawyer usually will send the RT a chart to comment on. To get this sort of work, Kilroy suggested RTs contact lawyers directly and offer their services.
For those RTs wanting to take the leap into consulting, experienced consultants advise them to start small and keep your regular job.
“You have to have some sort of salary to fall back on,” said David Gourley, RRT, BS, director of cardiopulmonary services at Chilton Memorial Hospital, Pompton Plains, N.J.
Gourley’s career has gone full circle. He worked as a therapist, then was employed at a home care company, then started his own home care consulting business, and now he’s back at a hospital. “It’s strange how things turn out,” he said. All during his tour through health care employment options, Gourley kept working per diem at a hospital to supplement his income.
Being a full-time consultant may offer many attractive benefits to an RT, such as being your own boss, Gourley said. But working for .yourself also means you have no paid vacation, must pay your own health insurance, and lack the stability of a full-time position at a hospital.
BUILD CONTRACTS AND EXPERTISE
Be upfront and keep your employer informed that you’re consulting on the side, Ellis recommended. Then, if you want to work as a full-time consultant, slowly build your list of clients until you can quit your job.
“Don’t start too big,” McClure agreed. She advised wannabe consultants to be active in local, state and national organizations. “You need to have contacts.”
You need to have expertise, too. Ellis advises RTs to take courses in any new technology that comes up. Learn about sleep apnea, outpatient testing and anything else you can think of. “My advice is to get as much experience in as many things as you can,” he said. “You can’t just get out of respiratory therapy and become a consultant. No one will want to hear what you have to say.”
With expertise will come confidence, which can be crucial, especially if you’re lecturing to a room of physicians and other smart people. “As an RT, I have to know more than the MD,” Dr. Belle said. “You have to be excellent. When I speak, you can take it to the bank.”
Being experienced and confident also will help you in pitching your services to potential clients. “Be persistent without being obnoxious,” Dr. Belle said. “You have to sell yourself. You have to show the benefits of what you do.”
The fact that so many consulting opportunities are available — or at least available if RTs can create a need for them — says a lot about respiratory therapy as a profession. It’s come a long way, Ellis said, since the days when an RT was referred to as “oxygen boy.””It’s another sign the field is growing,” he said.
But while the field may be growing, health care’s future isn’t entirely certain. As a result, consulting should be something RTs think about. “It would be ignorant for RTs to remain comfortable practicing respiratory care the way they are today,” Kilroy said. “RTs can do a lot of things. I don’t think RTs should limit themselves to strictly clinical work.”
Kilroy said clinical RTs must ask themselves an important question: “If this stopped tomorrow, what else could I do?”
John Crawford is assistant editor of ADVANCE.