Oxygen therapy is one of the most misunderstood treatments in pulmonary medicine. This misunderstanding extends beyond the patient population.  It also includes many physicians who fail to realize that oxygen is a medication, a drug, just like any pill that a patient may take. 

Oxygen needs to be prescribed in an accurate way, i.e. how much to take and how long to use it. Compounding these misunderstandings is the way in which oxygen is reimbursed by insurances including, and most often, Medicare.   Insurances treat oxygen therapy as a commodity dispensed to the patient rather than a drug.  Oxygen is the only therapy that has been shown to improve survival in patients with low oxygen level, but only if ordered and monitored in the proper way.

The need for oxygen can be determined easily using a finger probe called a pulse oximeter.  This device can actually be purchased in many pharmacies for around $50.  The oxygen prescription must take into account the activity level of the patient, and what happens to the oxygen level, not just at rest, but with various activities.  Most oxygen prescriptions are based on resting levels, and should include increases for activities.  Unfortunately, these types of detailed prescriptions are usually not given.  Insurance companies often balk at variations in prescription orders or changes in those orders. The proper oxygen delivery system needs to be selected and monitored.  The proper oxygen prescription is more complex than most patients and physicians may think