{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/respiratory-therapists/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Respiratory Therapists", "soc_code": "29-1126", "category": "Healthcare", "us_employment": 139790, "median_annual_wage": 82280 }, "verdict": "SAFE", "risk_resistance": 78, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 15, "embodiment": 19, "liability_shield": 15, "trust_premium": 14, "judgment_accountability": 15 }, "reasoning": { "task_resistance": "Closed-loop ventilator modes (ASV, SmartCare), auto-scored polysomnography, and protocol-driven weaning have already eaten the calculation and documentation layer, but the 12-hour shift is still physically titrating PEEP at the bedside, breaking down a circuit that's rainout-flooded, bagging a desaturating patient during a turn, and performing bronchial hygiene on a post-op patient who won't cough — which is why this sits at 15 rather than in the low mixed band.", "embodiment": "Nasotracheal suctioning, mask-fitting for BiPAP on an agitated patient, radial artery puncture, hand-bagging during transport down a hallway to CT, and neonatal surfactant administration are all done with your hands on an unstable human body in a room whose conditions you don't control, which is about as embodied as clinical work gets short of surgery.", "liability_shield": "All 50 states except Alaska license respiratory care, NBRC RRT/CRT credentialing gates hiring, and your license is what's on the line if you extubate early or misread an ABG — the 15 rather than 19 reflects that you practice under physician order and institutional protocol, so the intensivist absorbs the diagnostic decision you're executing.", "trust_premium": "Home-vent families, cystic fibrosis clinic patients, and pulmonary rehab cohorts learn your name and your technique, and a COPD patient's willingness to tolerate NIV often turns on who's coaching them through the first ten minutes.", "judgment_accountability": "You decide when a weaning trial has failed before the numbers say so, whether a rising CO2 warrants escalating to intubation now or riding out one more hour of BiPAP, and how to manage an airway you can't secure — calls made in minutes at the bedside, with the physician often at the other end of a phone." }, "rationale": "The core of the job is physical: suctioning airways, managing ventilator circuits at the bedside, delivering nebulized meds, drawing and interpreting arterial blood gases, assisting intubation, and running codes. AI can already draft charting, calculate weaning parameters, flag vent alarms, and score sleep studies, but nothing automates a hands-on airway emergency in an ICU. State licensure plus RRT credentialing means a human is legally on the hook for therapy delivered under physician order.", "outlook": "Demand grows with an aging, COPD-heavy population; AI takes over the charting and vent-data monitoring layer, which likely makes each therapist cover more patients rather than replacing any of them.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "State practice acts or Joint Commission standards explicitly requiring an RRT (not an RN or tech) to verify and countersign closed-loop ventilator weaning adjustments made by algorithmic modes (e.g., Hamilton INTELLiVENT-ASV, Draeger SmartCare) before they persist; several state respiratory care boards already restrict ventilator management to licensed RTs, and CMS conditions of participation could name the credential for AI-assisted settings", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Formal RT-led protocol authority — rapid response / airway teams and ventilator liberation protocols where the RRT independently titrates and decides extubation readiness under standing order rather than per-order execution; AARC has pushed 'protocol-directed therapy' and some systems already run RT-driven weaning and RT-led ECMO specialist roles", "plausibility": "already happening", "would_add": 3 }, { "dimension": "task_resistance", "change": "Task-mix shift: if AI absorbs the routine tier (sleep study scoring, vent flowsheet charting, nebulizer round documentation, ABG trend interpretation), the residual day is airway emergencies, difficult intubations, ECMO circuit management, and neonatal transport — the judgment tier. Watch for hospitals folding scored polysomnography and charting into software while RT FTEs shift to ICU/ECMO/transport", "plausibility": "already happening", "would_add": 2 } ], "ceiling_note": "Trust premium has no realistic route: patients are intubated, sedated, or coding and do not choose or pay for their respiratory therapist; the buyer is a hospital cost center. Embodiment is already near ceiling at 19. Note that the biggest risk to this occupation is not AI substitution but staffing-ratio dilution — algorithmic vent management used to justify covering more beds per RT, which shrinks headcount without touching any dimension score." }, "adjudication": null, "employment_history": { "points": [ { "y": 2017, "emp": 128250, "wage": 59710 }, { "y": 2018, "emp": 129600, "wage": 60280 }, { "y": 2019, "emp": 132090, "wage": 61330 }, { "y": 2020, "emp": 131890, "wage": 62810 }, { "y": 2021, "emp": 133410, "wage": 61830 }, { "y": 2022, "emp": 129910, "wage": 70540 }, { "y": 2023, "emp": 129750, "wage": 77960 }, { "y": 2024, "emp": 136420, "wage": 80450 }, { "y": 2025, "emp": 139790, "wage": 82280 } ], "from": 2017, "to": 2025, "change_pct": 9, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [], "license": "https://cookedindex.com/terms" }