Home oxygen pioneer becomes a beneficiary

Wednesday, June 30, 2004

Pulmonologist Thomas Petty, MD, is known in medical circles as the “father of home oxygen” because he has advocated and prescribed its use for nearly 40 years. Now, in an ironic twist of fate, he is on the other side of the cannula as a home oxygen patient himself.
Tom Petty

Petty, 71, is on portable liquid oxygen as he recuperates from a stubborn infection he contracted during heart valve surgery last year. Though he is optimistic about eventually getting off oxygen, “it won’t ruin my life if I don’t,” he said.

Oxygen has been an interest of Petty’s for almost half a century. It began for him in 1955, when as a medical student he spent a month at the top of Mount Evans in Colorado to study high altitude’s impact on physiology.

“That experience taught me about how fundamental oxygen is to life - it has everything to do with living,” he said.

Petty received his medical degree in 1958 from the University of Colorado and from there began exploring the restorative properties of oxygen. That led to the development of the seminal Nocturnal Oxygen Therapy Trial in 1965, which found that ambulatory oxygen, when administered for at least 12 hours, improved a patient’s survival rate compared with stationary oxygen.

“I was taught in med school that nothing could be done for COPD and emphysema patients, but I never believed it,” Petty said. “Fortuitously, I received the first liquid oxygen prototypes in ‘65, and those systems were actually very similar to those in use today. It came as no surprise to me that they dramatically improved quality of life.”

Although he’s a pioneer in the field, Petty, who served as head of pulmonology at the University of Colorado from 1971 to 1985, says the true patriarch of ambulatory oxygen is famed New York cardiologist Alvan Barach.

“I am a disciple of his – I got turned on by his knowledge,” Petty said of Barach, who died in 1977. “He was an iconoclast and a charlatan who happened to be right.”

Through the years, Petty has continued to study the physical and psychological benefits of ambulatory oxygen and has become one of its biggest proponents. He has persistently lobbied for modality-specific Medicare reimbursement that allows all home oxygen patients to be equipped with portable systems.

“Ambulatory oxygen is a medical necessity, not a luxury,” Petty said. “By delivering more oxygen to tissues, ambulation improves muscle tone, increases blood circulation and restores heart, lung and brain function.”

Yet with Petty’s activism comes a sharp critique of respiratory providers. In his view, home medical equipment companies aren’t doing enough to promote ambulatory oxygen systems because it isn’t financially advantageous for them to do so.

“I don’t like to bad mouth suppliers, but they are a problem,” Petty said. “They are putting patients on stationary systems and discouraging them from choosing portable units, saying that Medicare won’t cover them. I know it makes people mad, but I’m being bluntly truthful about the way it is.”

Bob Fary, a prominent spokesman for the respiratory supply industry, has had occasion to verbally joust with Petty on his stance regarding providers and concedes that his argument has a certain degree of merit. At the same time, providers are tangled in a web of sticky reimbursement policies, he said.

“I don’t disagree with some of the points Dr. Petty makes, but I also understand why providers do what they do,” said Fary, vice president of sales for Santa Barbara, Calif.-based Inogen. “All reimbursement is being reduced across the board and there is tremendous pressure to have the most efficient and effective system for home oxygen.”

Even if the HME industry recoils from Petty’s views, providers should respect his influence on respiratory therapy’s evolution, Fary said.

“Tom Petty is a national treasure – he is a tireless advocate for patients with lung disease and oxygen dependent patients,” he said. “People have survived and thrived because of him.”

Despite his fragile health, Petty continues to work as a consultant and writer on respiratory issues. He has a book due out soon called “Adventures of an Oxyphile,” a 100-page manual for oxygen patients that describes personal experiences of oxygen users, including Petty.

“I’ve written many articles and chapters for scientific journals over the years, but I never thought I’d be writing for patients until I became one myself,” he said. “Because I am a consumer, I’ve become a beneficiary of my own technology. It has given me a valuable understanding.”