San Blas

For those of you considering a career as a medical SLP, run! Health care can't afford any more waste. This career is mostly unskilled, unnecessary, and can be downright miserable. I've been working as a hospital SLP for several years in the inpatient/outpatient settings and feel like a fraud. The only times I feel skilled are when using my knowledge of brain anatomy to predict what deficits a brain injury patient will have, when diagnosing aphasia types, or during cranial nerve examinations to predict if someone is silently aspirating. This will not be how the majority of your time is spent. I probably use these skills about 10% of the time, if that. In the inpatient rehab setting, which is supposed to be a step up from the SNF setting in terms of quality of patients, most of my time is spent justifying why not to pick someone up for cognitive treatment because so many patients who get referred to speech are inappropriate. This makes for a hostile work environment with nurses and therapists outside of your field who constantly try to override your clinical judgment. You will not feel like a professional, you will feel like a worker bee being pushed around by your boss to meet the required minutes and to please the often ignorant and unrealistic family members who want mom, dad, or spouse to receive cognitive therapy regardless of the cause of cognitive changes and the prognosis for improvement. This means you will "rehabilitate" patients with: 1) severe dementia 2) patients in their 90s who of course are confused, don't want cognitive therapy, and just want to spend the remainder of their lives in peace 3) terminal cancer patients who are very near death 4) psychiatric patients whose cognition will never respond to behavioral techniques and will never be normal again 5) chronic stroke patients who haven't improved in years 6) patients with so many complicated co-morbidities, they don't stand a chance of benefiting from the simple, commonsense advice we offer Most of the day you will feel like you're pulling teeth to fill an hour session or you'll feel like you're doing nothing that the nursing assistant couldn't do for 1/3 of the cost. Oftentimes, even appropriate patients - acute brain injury/stroke patients - are unmotivated or again have so many co-morbidities that no healthcare treatment other than medications - and that's a longshot - can help. Treatments themselves feel like guesswork and expensive conversations that you're billing insurance for. And there's no fooling anyone who has commonsense that doing crosswords and word searches is seriously going to increase a person's safety and independence at home. This job does not do what it's intended to do - cut healthcare costs in the long run in the aging and disabled populations by reducing the burden of care. You'll see far too many frequent flyers to ever believe that. Instead, this job offers false hope to the sick and their families so the greedy healthcare industry can continue to flourish and we can continue to pay more in Medicare taxes and our health insurance premiums. Stay away from this profession!