Two Thirds of US Adults Support Prohibiting Tobacco Sales in Pharmacies

To Quote Campaign for Tobacco Free Kids on a topic that is of utmost importance for our children, here is an article on a recent CDC study on how Americans feel about making tobacco available in pharmacies.

CDC Study: Two-Thirds of U.S. Adults Support Prohibiting Tobacco Sales in Pharmacies

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids

Sep. 1 2016

WASHINGTON, D.C. – Two-thirds of U.S. adults (66.1 percent), including nearly half of current cigarette smokers, support prohibiting tobacco sales in pharmacies, according to a new study conducted by the Centers for Disease Control and Prevention and published today in theAmerican Journal of Preventive Medicine. Support for ending tobacco sales in pharmacies came from 72 percent of never smokers, 66 percent of former smokers and 47 percent of current smokers.

This study shows that most Americans recognize the fundamental conflict between pharmacies’ role in promoting health and the sale of tobacco products that kill nearly half a million Americans each year. It’s time for pharmacies and other responsible retailers to recognize this conflict as well. We again call on retailers, especially those with pharmacies such as Walmart and Walgreens, to join CVS Health in ending tobacco sales. By doing so, retailers can reduce the availability of tobacco products, send the right message to kids about the dangers of tobacco use and support tobacco users in their efforts to quit.

Their continuing failure to do so should prompt state and local governments to prohibit tobacco sales in pharmacies. According to the study, 134 municipalities in California and Massachusetts had enacted tobacco-free pharmacy laws as of January 1, 2016.

Especially during this back-to-school shopping season, we also urge parents and other consumers concerned about health to patronize retailers that don’t sell tobacco products. To help shoppers find tobacco-free retailers near them, the Campaign for Tobacco-Free Kids has created a website – –with an interactive map that pinpoints the locations of tobacco-free retailers across the country.

Despite enormous progress in reducing smoking, tobacco use remains the No. 1 preventable cause of death in the United States and costs our nation about $170 billion a year in health care expenses. By going tobacco-free, pharmacies and other retailers can play a critical role in protecting our children and saving lives.

How do you feel about this? Do you agree?


Bottom Line Health

Hello everyone and happy day! How are you today? How is your breathing? And what activities are you doing today to better yourself?

Did you know one of our members contributes to Bottom Line Health Magazine? Dawn is a contributor for health concerns regarding lung disease, and her most recent contributions had such success they are now available to everyone via Bottom Line Health Web Site.

If you have COPD, or if you know someone who does, take a moment to read it and see what you can use or share!

You can find the awesome article here:

Let us know what you think! 🙂

It’s Virtual Lobby Week!

Let your voice be heard!

Click here to show your support:

What do you need to know about HR2948 – the Medicare Telehealth Parity Act?

If enacted it will be implemented over three phases, each two years apart.

The first phase includes

  • Covering RTs as qualified telehealth providers (along with certified diabetes educators, physical therapists, occupational therapists, speech-language pathologists, and audiologists.
  • Incorporates respiratory therapists in the Medicare statute, something AARC has strived to achieve through its previous legislative initiatives.
  • Includes coverage of respiratory services, audiology services, and outpatient therapy services including PT, OT and SP.
  • Adds remote patient monitoring (RPM) for patients with COPD and heart failure and related comorbidities when provided under chronic care management.
  • Expands telehealth coverage to any Rural Health Clinic and Federally Qualified Health Clinic and metropolitan counties with populations fewer than 50,000, including use of store and forward and video conferencing.

Second phase includes

  • Adding an individual’s home as a telehealth site related to hospice care, home dialysis, eligible outpatient mental and behavioral health services, and home health services which include outpatient therapy services and durable medical equipment.
  • Expanding telehealth access to evaluate/treat acute stroke regardless of patient’s location.
  • Expanding telehealth coverage to metropolitan counties with populations of 50,000-100,000, including store-and-forward and video conferencing technologies.
  • Adding remote patient monitoring for patients with diabetes and related chronic comorbidities when provided under chronic care management.
  • Requires a report on the effectiveness of new telehealth services and providers with respect to patient satisfaction and responsiveness to needs/concerns.

Third (and final) phase includes

  • Expanding telehealth coverage to metropolitan counties with populations greater than 100,000, including store-and-forward and video conferencing technologies.
  • Adding remote patient monitoring for other chronic conditions/related chronic comorbidities specified by the Secretary when provided under chronic care management.

What is telehealth, remote patient monitoring, and store and forward technology? How do they work?

  • Telehealth is an interactive audio and video telecommunications systemwhich allows real-time face-to-face communication between physicians and other health care providers and their patients located at different sites. For example, the beneficiary may be physically located in a rural health clinic or a skilled nursing facility while the physician is in his/her office suite or the hospital. The term “telemedicine” is often used interchangeably with “telehealth.”
  • Remote patient monitoring is conducted via a coordinated system that uses one or more home-based or mobile monitoring devices that automatically transmit vital sign data or other information as part of a patient’s plan of care wirelessly, or through a telecommunications connection to a server, allowing review and interpretation of that data by a health care professional.
  • Store-and-Forward Telehealth involves the acquisition and storing of clinical information (e.g. data, image, sound, video) that is then forwarded to (or retrieved by) another site for clinical evaluation (e.g., analogous to sending a picture via text message). For Medicare, this means the information would be transmitted from the originating site where the beneficiary is located to the distant site where the physician/practitioner is located for review at a later date.

These are exciting changes! What does Medicare currently cover with regards to these services?

Medicare’s currently coverage of telehealth services is limited to rural counties and health shortage areas in metropolitan fringes with the patient at a health facility (known as “originating sites). Originating sites include physician offices, hospitals, skilled nursing facilities, and rural health clinics. Practitioners who can provide telehealth services currently include physicians, nurse practitioners, physician assistants, nurse-midwives, clinical nurse specialists, clinical psychologists, clinical social workers, and registered dietitians or nutrition professionals. Only a select number of medical procedures/services are covered such as consultations, counseling services, education, patient assessments, smoking cessation and transitional care management services.

Remote patient monitoring and store-and-forward technologies are not covered under Medicare’s telehealth rules.

What is a qualified respiratory therapist?

The Act does not specify qualifications for any of the newly covered providers. Those details will be left up to local contractors to determine, and will allow those contractors (physician or facilities) to bill Medicare directly for the telehealth services furnished by RTs.

Telehealth services are an integral part of a growing healthcare system and continue to gain recognition and attention of Congress. There are several initiatives currently underway with a focus on telehealth and remote patient monitoring, and there could be more to come in future sessions. The AARC supports the expansion of telehealth and remote patient monitoring, especially advocating HR2948 because it includes coverage for RT services and allowing our profession to serve as telehealth providers. Although there has been no formal cost estimate made, the Congressional Budget Office has performed an informal analysis of telehealth and consider two main issues. The first being payment rates that would be established for telehealth services, and the second being whether telehealth services would be a substitute for other Medicare-covered services or would be used in addition to currently covered services. Cost and/or savings depend on the second issue and the specific provisions of the bills. Further study would be of benefit with results of a well-designed study examining the benefits of how these services would affect health care expenses in this patient population.

We need your support!

There are numerous reasons as to why this Act is important to our profession and why your support is needed. Such as:

Recognizing RTs as health care providers in the Medicare statute which has been a long-standing goal of the AARC.

  • Recognizing the importance of respiratory services by covering them as part of telehealth.
  • Enhancing the ability of RTs in providing a comprehensive disease management program to their patients to prevent acute exacerbations.
  • Permitting RTs to evaluate or manage patients via remote patient monitoring (RPM) as long as the patient is receiving other chronic care management services.
  • Offering a new way to deliver respiratory services that are currently not available to RTs as part of the Medicare program.
  • Expanding the location of originating sites (reaching patients who suffer from chronic respiratory disease that can be helped by respiratory therapists).
  • The bill has bipartisan support, having been introduced by Representatives Mike Thompson (D-CA), Greg Harper (R-MS), Diane Black (R-TN) and Peter Welch (D-VT).
  • AARC would not be the only organization lobbying Congress for sponsorship of the bill; we would be part of number of influential organizations whose goal is to increase the ability of Medicare patients to receive telehealth and RPM services.
  • It is the only telehealth bill that specially includes respiratory therapists and respiratory services in statutory language.
  • It provides Congress with a report that has the potential to highlight the value of RTs and other providers in how they meet the needs of their patients.

Please click on the link at the top of this page to send your letter of support for this important legislation. It will take only a moment of your time and make a world of difference to our future.


So, Pneumonia Set In…

I have had an interesting week this past week. I got this nagging cough that wouldn’t go away. It kept getting worse and worse… So, I went headed to the Dr. That’s right… pneumonia, it was. While I was struggling, achy, and all the good stuff that goes with it, I was struggling to breathe, but not TOO bad, at least not yet. The real trouble came when I went home.

I left the office and headed toward home to rest before getting my prescriptions filled. I was tired. And achy. Did I mention achy? Well, while I was there, laying on my heating pad popping Ibuprofen 800s and trying to gather the energy to run to the pharmacy, my wheezing worsened. And worsened. Pretty soon a simple breath resembled the sound of that freight train I heard enter the sugar factory earlier in the week. So, I decided that whether I felt energetic enough to get up and go to the pharmacy or not, I needed to.

Stepping outside didn’t help. Have you read the news about Utah’s latest inversion and our air quality? It’s worth mentioning. It’s HORRIBLE! It is this mucky, thick, brown-tinged air that belongs nowhere it could possibly be inhaled by anything. It’s bad, really bad. Worst in the nation, I believe I just read. Needless to say, inhaling that toxicity did nothing but worsen my ability to breathe. About halfway to the pharmacy I noticed my face started to feel numb along with the end of my nose. Nervous at this thought, I pulled out my oximeter and placed it on my finger. Waiting for it to calibrate my heart rate and oxygen levels jumped around a bit, only to settle on what is a HORRIBLE reading for me…  heart rate of 107, SpO2 of 69. I told my husband to drive faster. I needed that inhaler in a bad way. Let’s just say I ended up on oxygen, obviously, with a nebulizer (to be used every four hours) and a good dose of antibiotics.

Long story short, I’m feeling better, finally. Days later. I will return my oxygen tomorrow, I will soon return to my own “normal” energy levels, and all will be well, I’m sure, but in the meantime it was sobering to feel so short of breath and have to use all my accessory muscles to do so. I thought of you, all of you. And I was reminded of the strength and power you all have within you and of that strength, evident in the eyes of those who have it. Look in your own mirror each morning. Look for that power. It’s there, beneath the doubts. It’s there. You have it and you are an inspiration to the world! Thank you for sharing it with us.

Happy Breathing!

To Do or Not To Do – Antibiotics – That is the Question…

So you have a cough. So it’s productive. More productive than usual, maybe. You wonder – should I go to the doc? Or should I wait it out? You weigh your options, and make your decision, but as you analyze things keep this in mind.

New evidence may show that “jumping” to antibiotics may prove ineffective, and withholding antibiotics may not even show negatively in outcomes. The key lies in the color – of the mucus, that is. So, before you ask for antibiotics, ask yourself… What color is your mucus? What do you know about that color – What does it mean? And if we may throw one more question out there, what do you know about the antibiotics you’re prescribed?

So what exactly do those colors mean? They should indicate the following:

clear or white, normal amount (for you) of production – healthy
slightly yellow – immune system is fighting an upper respiratory infection (sinusitis)
dark yellow – indicates the immune system is effectively fighting a lower respiratory system infection.
green – bacterial infection in lower respiratory system
brown – usually associated with smoking. If color becomes a darker brown it is advisable to cut back on amount of smoking.
Blood – sometimes present in bronchitis. People sometimes get scared when they see blood, and if it is a large amount visiting your physician is advisable.
Once you are familiar with your “rainbow”, and somewhat familiar with what you may need, we can tackle the next item, which is…

Are you aware that excessive use of antibiotics, over time, has proven to create a species of “superbugs”? Antibiotic overuse has been shown to significantly increase the resistance those “buggers” have against medication designed to kill them. This, in turn, has shown an increase in overall medical costs AND the possibility, or risk, of drug related adverse events. Importance lies in the discriminate use of antibiotics in patients with COPD who are suffering from exacerbations. It is necessary to improve overall outcomes and protect future health.

So when should you use an antibiotic? Antibiotics are not used to treat viral infections, they are used to treat bacterial infections. Which antibiotic you get, if prescribed, will depend upon what type of bacteria your infection is made of. Different antibiotics target different types of bacteria.

So… to do or not to do antibiotics. Ultimately it is between you and your provider. Be a little hesitant and very cautious, but be diligent and attentive. Be aware of the color of your mucus as it changes, so you can help your physician help you. Because as we now know – color is everything.

Dawn L Fielding, RCP, AE-C