Why protocols will not eliminate useless Ventolin orders

So one of my respiratory therapist friends, of whom I will not name here even though he said I could, sent me an email a while back explaining why it is that respiratory therapist driven protocols will never result in a decrease in treatment loads.

1. There will always be the belief that if the patient is short of breath we must do something
2. People sitting in leather chairs in Washington decided that in order to meet criteria for admission a patient must have needed at least 3 treatments in ER.  It eludes them that hospitals would have physicians order them just so the hospital can be reimbursed. 
3. People sitting in leather chairs in Washington decided that in order for a patient's stay to be reimbursed for certain respiratory conditions (pneumonia, CHF, COPD) the patient must have breathing treatments ordered.  This is under the fake belief that if treatments aren't needed why keep the patient.  It eludes them that there may be other reasons for keeping the patient, nor that ventolin does nothing for non-bronchospastic lung ailments. 
4. They are convinced ventolin cures pneumonia
5. They are convinced ventolin cures heart failure
6. They are convinced ventolin enhances secretion clearance

Generally, physicians and administrators and politicians tend to ask this question when making a decision regarding respiratory therapy: "Does it feel good."  For instance, should we order treatments for pneumonia? Well, does it make me feel good.  Yes!  I feel like I'm doing something important and helping people out.  Yes! It makes the patient feel better, or at least like we are doing something useful

Generally, respiratory therapists and nurses ask the following question: "Does it do good? For instance, should we order treatments for pneumonia?  Well, does it do any good?  No! So then we recommend it not be ordered.  

We are usually trumped by too many people ask the wrong question. If ever there came a time when "Does it feel good?" is replaced by "Does it do good?", then and only then with true bronchodilator reform occur. 

Need I go on.