The MDTP course for SLPs

Relief that I finally found a way to do swallowing therapy that makes so much damn sense for our patients.

And not just living in larynx land, but actually stepping back and treating the patient as a whole, and improving their quality of life in a multitude of ways.

I’ve been thinking a lot lately about why I got in the to this field, how we ended up here, and most importantly, how we treat our patients.

I got in to this field to help people re-learn how to swallow. Sports, fitness, and food have always been my passions in life, and I leaned toward PT or OT early on in college, but once I found a field that combined exercise science, the satisfaction surrounding food, and helping others, I thought for sure I found my calling.

And then I remember being told to sit at lunch with Bruce for 50 minutes, remind him not to talk while he eats, all while completely removing the social aspect of his meal because I had to sit and stare at him, therefore he didn’t feel comfortable carrying on with his normal lunch time banter with the fellas.

This was definitely not what I signed up for.

Nor did he.

All of my colleagues went to lunch together every day, and I couldn’t partake in that social activity because I was busy ruining Bruce’s social time doing “speech therapy” aka watching him eat.

I remember I finally took a stand and told my boss that I wasn’t going to sit at lunch anymore but instead we were going to do exercises after his meal to improve his swallowing muscles.

He said but that’s what SLPs do, and I said not this one anymore.

I remember feeling so defiant that I was going against the grain of our profession, yet I knew enough about muscle physiology from an entire life of playing sports and taking some exercise science classes that there was no way we were going to improve Bruce’s swallow without exercises.

So that was really the springboard that led me to really digging in to the research to learn why we are doing what we are doing.

Fast forward to this past year, and realizing our field still has such a long way to go in understanding muscle physiology. I started the podcast as a way to get this information out there, and it’s working, but from the sounds of the Washington Post article, we still have such a long way to go to convince our colleagues that we are in fact rehab specialists, and not people watchers.

And I’ve always believed that actions speak louder than words, so as much as we can preach and rebut that article, the fact of the matter is that so many SLPs will be sitting in the dining room tomorrow, watching their patients eat, thickening their liquids, and trying to carry on a personable conversation because we don’t want to just be the weirdos sitting there staring.

As Dr. Carnaby was presenting yesterday, I had the most gigantic epiphany. I don’t talk much about my personal life, but dear lord she punched me in my gut.

I have a 2 year old son with special needs that receives therapy every day. He had one particular therapist that was just the nicest, sweetest woman ever, but she just came in and coddled him.

She would chat with us, chat with him, not push him very hard, just very gentle and sweet. And that’s all good and all for a babysitter, but this is a therapist that is supposed to be pushing my son, that early intervention is paying for, and is responsible for instilling motor learning in his still developing brain to hopefully help him learn to walk someday.

I remember finally reaching my breaking point as the missed milestones just kept adding up and passing by. What we’re doing isn’t working for him.

Sure, she’s the sweetest lady ever, but he has a few other therapists that push him very hard, and we’ve seen consistent progress, and I needed that all around.

So I made the tough call to replace her, and as much as I felt horrible and she was devastated, nice doesn’t make my son walk. He needs someone to push him and push him hard.

And that’s exactly what Dr. Carnaby stressed yesterday. She’s not there to be their friend or social worker, she’s there to be the rehab specialist and push the patient to rehab the swallow.

We are so concerned with “establishing rapport” and “making them like us.” They will like us if we set the tone that we are here to work and improve their swallow, you don’t need 5 sessions of super maple syrupy sweet talk to set that tone.

And that’s why I replaced my son’s therapist, and if you aren’t working hard for your patients, quitting the small talk and distractions, and doing good exercises with your patients, then I hope this is a wake up call that we are all replaceable.

Medicare/insurance isn’t afraid to deny payment, or cut off therapy.

Our physician colleagues aren’t afraid to write damning articles about us.

Why are we so afraid of cutting the chord and just getting down to business?

I know someone posted a few week backs about swallowing therapy being boring and redundant, and I admitted that I could totally see that happening, but yesterday changed that all for me.

If you are making your patients swallow and swallow hard, repeatedly, they are working so hard at a task that can improve so much of their quality of life, they more than likely are so focused on improving their swallow so they can chug a beer with their buds, that they really are not focused on it being “boring.”

I hope everyone is able to take this course some time soon. I know they are working on expanding the course offering, so without giving away the entire protocol, I hope my take home points strike a chord with you to start doing aggressive rehab with your patients this week.

I can guarantee that they would rather that than learn about your third cousins new puppy that has doggy dysphagia — although intriguing, it’s not doing jack squat to improve their swallow or quality of life.

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