Respiratory therapist vs. pulmonologist: understanding who does what in respiratory care

A pulmonologist is a physician who has completed medical school, internal medicine residency, and a pulmonology fellowship, and is the specialist who diagnoses respiratory conditions, orders and interprets diagnostic tests, and makes treatment decisions including prescribing medications and oxygen therapy. A respiratory therapist (RT) holds a specialized allied-health credential focused on the practical delivery and management of respiratory treatments — setting up and adjusting oxygen equipment, administering nebulizer treatments, managing ventilators, and teaching patients device technique.

In practice, both roles work together throughout a patient's respiratory care: a pulmonologist determines that a patient needs supplemental oxygen and at what flow rate, while a respiratory therapist is often the person who actually sets up the equipment, troubleshoots device issues, and provides the hands-on education on using it correctly — a distinction that matters when deciding who to call for what kind of question.

For day-to-day equipment questions — how to clean a concentrator, what an alarm code means, how to adjust for altitude during travel — a respiratory therapist is typically the more directly useful and more available resource. For questions about whether your prescribed flow rate should change, new symptoms, or medication adjustments, that decision sits with the pulmonologist.