Innovation. It is the Hallmark of respiratory care as a profession, and will continue to be our singular saving grace. In order to position ourselves for success in the new industry of wellness we must embrace change, be willing to let go of long protected turf, demonstrate our value and redefine ourselves, our work and even our profession. Because of our innate innovative approach we are well suited to the task. We must continue to dominate our own field of expertise and simultaneously take and/or break new ground. Let me just throw out some ideas within the acute care setting: COPD case management, dialysis, echocardiogram technician, IV/line technician, cardiopulmonary bypass, cardiopulmonary rehab. Some of these are really way outside of the box! Yet, as respiratory therapists we are uniquely qualified in all areas cardiopulmonary and renal. We can demonstrate our expertise and value in these areas while providing real cost savings for our respective institutions. Beyond the walls of the hospital we can position ourselves at the front line against hospital readmission by defining and implementing best practice solutions for pulmonary patient follow up, evaluation and care. More importantly through support of current legislative efforts (S 343/HR 1077 and HR 941) we must see a return of the respiratory therapist to the home care setting and expand our skills to other outpatient arenas.