Hey, fixers. I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy like the CCC, this podcast is your space to learn, engage and take action in the field of speech language pathology. We don't wait for change. We make it so let's fix SLP!
All right, you want me to open this for this week?
Sure you like my new shirt? Yours came too today.
I love your new shirt. Is that... I can't tell the color? Is it burn orange?
Yeah. It's Fix SLP orange color.
And I'm gonna get my custom color at some point.
I got the t shirt in every color.
Am I the only ones got that color?
I did order a few extra. So if you're interested in one of our new shirts, send your name, address and size to team at fix slp.com I just have a couple of each size all the way up to 2x shoot me that information, and we can talk about how you can pay me, but they're $25 plus shipping. So if you missed us selling T shirts, I have on my new burnt orange sweatshirt. It's so cozy I will now. We'll live in it for the next three months easily.
But I found that some of the patients enjoy asking me about what Fix SLP is. It actually, it's a great conversation. You'd be amazed how many cognitive activities I can bring up, sometimes discussing the ins and outs of my profession so they better understand who they're working with.
I don't know that we have much else. We have had some mini van melt downs come in. There have been some Apple reviews, but it is late here, and I I did home health today, and I don't like to document in people's homes, because it gets awkward and I'm only paid for per visit, so I have some paperwork to wrap up. It's 10. I'd like to do that. So we're going to skip those, and we're just going to go straight to our guest. And our guest is someone that has been sharing in the OT, PT, ST For Autonomy Facebook group. If you are not familiar with that group, we had their administrator, Tiffany on. I'll maybe even link it up, but you can go look for that episode if you're not familiar, but someone from that group has been sharing about some ethical dilemmas in her job. And we do think it is important to start talking about caseload caps, to start talking about contract therapy companies. It's on our agenda, things to talk about this year, and so it wasn't exactly on our agenda right now, but because it's happening now and it's relevant, we invited her on to come tell her story. So we are keeping her anonymous. We're going to call her Polly throughout this episode. That is not her real name, and we're also not disclosing where she's located, just to help protect her a little bit, because this is kind of a crazy company. So let's bring her on.
Polly, we're really glad to have you visiting with us. And I think if I go back to when I first read a little bit about your story, which we'll get into, I think it was on Tiffany Moniz group, sort of a tell all kind of whistleblower type group that's just really uncovering a lot of the workplace issues that are going on for clinicians, particularly in the skilled nursing facility. And I read Polly, some of the things that you told us, and they are concerning, and things that I have experienced before that other clinicians have, and so tell us a little bit about the setting that you're working and what's been going on. When did this change?
I've been working in my current skilled nursing setting for almost 17 years. We've had three different owners, and there's been a big change with this third owner that came on board in the spring of this year, and what we're seeing is just a lot more trying to work the system, as far as what I would consider fraud and abuse, charging for services that aren't provided or minutes that aren't provided, being pressured to provide More group and concurrent treatment, regardless of need or diagnosis, adding their codes that we didn't normally use, like sensory integration, because it's a higher reimbursement, amongst other things, just a lot more pressure on productivity, billing, having a large part B caseload, because part B is more profitable. More than part a so and it just seems like it's more what I would consider profit focused care versus patient centered care.
I want to get a little bit more information about the building. Now. we're keeping a lot of this anonymous about you know exactly where this is, and we may allude to the company, but just to get some details, what's the census in the building that you work Polly?
We have the capability of having 120.
So this is owned and operated situation where the ownership of the building and the rehab provider are the same. Correct?
Yes, correct. We've never been outsourced to a therapy company. Are you the only? SLP, there? Yes, only full time. SLP, I do have some minimal PRN support, and that that person was hired exclusively to build a Part B caseload,.
Really? That's interesting. Wow.
Yes, to come in and that way it adds more because of the profit abilities.
So how many, how many Part B patients are you carrying right now? Probably around 10. Okay, so for a building of about 100 or so that that's a that's a pretty that's pretty healthy number.
One, yeah, and there's more on the list. So when anybody comes off, we bring another on board. Ideally, this company would like us to see every part A as well. They would like us at least a minimum to do an evaluation. But we haven't done that. We've prioritized by need and by diagnosis, but ideally, the mandate is to see to see everyone, at least for an evaluation.
I'll ask the question that jumped into my mind earlier. So since there is such a push on Part B, and you said some people may not be getting Part A services as promptly as they did a year ago. Correct is, I mean, is there at least a screening process, or is it just you're not actually laying eyes on so let me know, what does that look like?
Yes, every admission is screened, and in this building speech does the BIMS as well as a swallow screening. So yes, eyes are laid on the patient briefly. That's does not count towards productivity. That's the other issue I'm concerned with this company. There's a lot of working off the clock because there is no place to put required non direct patient time. So you only have in an eight hour day. You have 72 minutes to do all your documentation, all your screens, all your education with nursing and services, answering questions, just being stopped in the hall, retrieving, yeah, going to the bathroom, preparing, yeah, preparing, preparing for the day. Ending your day, preparing for the next day. I think that is somewhat how speech got under the radar in my building is because I was honest about my time at first, and my productivity was like, in the 60s or 70s. Because I thought there was going to be a different line item where we would put that time with our prior two companies. There was a different line item through the computer program that you could allot that time, but it didn't count towards productivity. And we didn't find out until we were, like, three months in, that there is not a separate line item and that we need to just, basically, we're told, just to, kind of, to figure it out and not work off the clock. Are those minutes tracked at all? Not with this system? No.
Polly, I I sense there's, there's stress in your voice, at least.
Yeah, yeah.
What I can tell, and that's okay, and I'm so tickled that you're visiting with us, because what I want to focus on right this moment is, you know, this pressure to pick up this part B caseload, and we all have different ideas about Part B. Actually, it's very near and dear to my heart. So there are times I think, where it is a beneficial boon for a facility, but I've seen those pressured meetings where sometimes it can be applied very heavily and strongly. And you're right, the financial incentive is there for some of the rehab companies as well. But what does that look like? What did that look like for you when that message came down? What did it sound like? Who spoke to you? And you don't have to give a name, but you can tell me, Oh, sure, then the department and what was the message? Was it written? Was it verbal? Was it a big meeting?
It was a it was a meeting. It was with our DLR, and the mandate came from the regional quality rehab. Person was in verbal. I don't recall having it specifically in writing. To be honest, it's been verbally through meetings.
The productivity, because what's the percentage you're aiming for?
It's 85% and for assistants it's 90%
These days. that's fair. That's that's better than a lot. Somebody asked me to go screen the whole building. I'll say I would be happy to do that, but it might be difficult to be 85% productive. Was it? Did anybody bring that forward?
Yes, and like I said, I put my time in, and I was reprimanded. And I believe I do have messages and teams with that reprimand. And like I said, and then from that point forward, I mean all of us, once we found that out, because it was announced in a meeting, there is nowhere to put the time with our prior company that. When everybody started kind of modifying, I can honestly say all disciplines do it on a daily basis. Like, if someone needs a wheelchair cushion at end of day or needs a wheelchair switched out, they're always like, let me go clock out and I'll come take care of that. Do people do all their education over their lunch hour? And we've all become puppets, and it's kind of like jumping, you know, we say how, how high, and that's why I'm trying to be proactive. This 2025 I want this to be the year of advocacy and the year of change, because this just can't go on and it's and it's not right, and everyone's walking on eggshells.
I'm glad we're having this conversation, because I can tell you a lot of these things have been happening, and I am glad for you in the past that you know, it sounds like there were different circumstances, but sadly, a lot of these things are becoming the norm, and it needs to be talked about, because it's often said. I've brought this up before on previous pods, people say, Yeah, we hear a lot of lot of rough things are going on in the rehab world, but I think we kind of need to peel back the onion and find those layers. Talk to me about your part a caseload right now, as far as minutes go, what you're seeing that is a sign versus what you think is appropriate for minutes on your part a patients,
Sure, all part a patients are 30 minutes, regardless of payer source. The only exception for that is med a if they have multiple diagnoses and multiple needs, such as their aphasia and dysphagia and dysarthric, if I make a play for it, I can get 40 minutes. On occasion, there's no longer time. Oh, I would like for vital stem or that. So if I do vital stem or another modality that takes longer I been doing that on my own time, or I direct them to do that as an outpatient, and we don't start it. We're also not allowed to do instrumental evaluations if they're part A, because it comes out of the daily reimbursement. We can do instrumentals on part B's because it's billed separately, and it doesn't come out of the facility funding.
I'm going to ask one more question before I turn over to Jeanette, because Jeanette is over there chomping at the bit about the instrument swallow portion, but real fast before we get there, when you had your first few patients, where you're just looking at that schedule, and it's 30 minutes, 30 minutes and 30 minutes for each of these and somebody PT, OT, ST, had to say, Whoa, Mr. or Mrs. DOR, I actually am doing this modality with this person. I need them for 45 minutes or 60 when you approach that, what was said.
With the managed care, we're just that we're not reimbursed, and that they're not paying for a Cadillac they're paying for, you know, lower end vehicles. So to explain it that way, that's what we were given, that analogy that their insurance does not allow us to provide them that level of care.
This gets into all kinds of ethical pull and plays here. And yes, Polly and I'm I'm empathetic, but some other therapists are probably looking at this, saying, Why is it this way? And so we're going to talk about that. We're going to get into ir.
iYeah, I have so many things. Just the ethics of all of this is blowing my mind, because unless I've been miseducated and misinformed, they told you they're not paying for the Cadillac. But insurance is Insurance is insurance, and when they accept a patient, they are agreeing to provide the care that that patient needs, regardless of the reimbursement rate. Right? You would think there's nothing in the contract that says we permit you to give a lower standard of care or a lower quality of care, because our reimbursement rate is lower when they sign that contract and agree upon the rate they are agreeing to provide the therapy. I mean, I guess they're getting away with it, because no one's reporting them.
Well, and there is a nuance, because I think there's like, levels one, two and three with managed care, or something to that effect. And we usually, they usually agree to pay us the lowest level, which is, I think, something like 60 minutes a day. So if speech is even involved, it's already a loss. Yeah, we're probably not encouraged to pick up managed care. I mean, we do, of course, but it's, it's considered not reimbursed. Yeah, it's a quandary. And and when they do have all the disciplines, or it's an acute CVA with multiple needs, you would think we would be able to have the higher and they, and we have tried to get the next level of care, but it still is not always approved. So, so I must say, the in a sense, the managed care, there is more than one level of payment or level of care, but I don't know what that means from a service provision standpoint.
Getting beyond some of the reimbursement issues here. So I'm going to put myself in that position, and I'm going to tell you how I might have responded, and that's not. Me to say, Hey, this is what you should do. It's just a part of this discussion. So if I am six weeks into this and I have encountered what I think is I'm being hamstrung by my dor and my rehab company to provide the kind of care that I think that Mrs. Smith needs, then I can pretty much guarantee you, as soon as I find a patient that has family that's involved, I'm going to spin this thing on a head, and I'm gonna just go in there and say, Look, I would love to help your mother, but I've been told that, you know, we can't provide the Cadillac, so, gee, sorry, that's just the way it is here. And I'm gonna, I guess I'm gonna try to turn that on a head to say, Here, family, here, this is this isn't right, and you're the customer. Has anybody done that?
No, I don't think so. Because I don't, because everybody's concerned for their own job. I just feel like it's a culture of intimidation, and people are concerned about their jobs. Yeah, so no, and if we were to say that, I think the feeling would be, we, you would be reprimanded with this company, let go. Because it's not unusual to come in and have find out that somebody was let go that day or the day before, with another department. So there isn't a sense of loyalty or that we're going to be heard if we buck the system, it's you might as well look for another job, I think, is the feeling,
Okay, so I'll spin this around from the other side. Sure family comes forward and they say, gee, you know, Mom's got all these issues, and she's only being seen for 30 minutes. How do you explain that?
The usually, the DOR will will go and those cases will explain to the family that similar scenario about the insurance and how the changes in healthcare and that this is the way it is,
And that's so sad. And I could see them doing that, because there's so much unknown with families out there, because, you know, somebody gets sick, they're thrown into the maelstrom of our healthcare system. And sometimes take it for fact, and wow, I gosh, you guys are due for a state inspection. Something's gonna give here. What steps have you taken so far to try to put some justice into this? What are you doing?
I feel more empowered because this company is under investigation for other other issues in other areas. So I have been following those cases, and I've been trying to reach out through different groups and trying to get, you know, legal advice. I have contacted now three law firms. The problem is getting someone to return your call, which it is disappointing, but I've been told not to be disappointed. You know, keep trying, but I think that's hard to find who to reach out to, and kind of what, what approach to take. And I've come to Fix SLP, and the other Facebook groups that's I'm exploring at this point, trying to figure out what to do, but, but I think a lot of us stop because we try, and then if you feel like you're not getting anywhere, you just stop. And I that's what I'm concerned about, because I don't want to stop. I want to keep moving forward, and I want to help improve this, not only for myself, but for, obviously, for the patients, the families and for future generations of SLPs. I don't want this to be what's happening, and I know it's wrong. I think, I guess that's the hardest thing is. And I have tried through the I went through the company, through my current company, I went through human resources, I've gone through corporate compliance, I've talked directly now to the ed as well as my Dor, and nothing changes. So that's why I'm reaching out beyond because I do believe in following, you know, chain of command first, which I did, but now that that hasn't happened, that's why I'm reaching out. And I'm open to advice.
When I ask these things, I'm sort of thinking like the audience here. You know what? What's the what's the next step? One thing I've heard over the years is that the more evidence that you can get on paper of some of these things, because it's easy to sometimes say one thing, but it's another to sort of put it in writing, and that's tricky. I've seen rehab companies really run that Gambit, but nevertheless, it sounds like it's a case where there's got to be a patient advocacy group out there that would just be alarmed by this. Are you hearing anything from your colleagues who else is trying to pull on this rope with you?
There are several PRNs that we've talked with each other, but not formally. We have, we have, not I'm the one that's actually spearheading, but I have been told I can use their names and contacts for direct examples. I've not opened up to the other full time staff because I don't know their perspective, and I don't want to stir the pot within the building.
I want to go back to this instrumental thing, because, as you may know, I own a swallowing assessment company, so I am familiar with the need for assessments. But I also have a course on medbridge that talks about honoring patient choice and some other things. But in that. Of course, we had a very long discussion with one of the top malpractice and neglect attorneys in Ohio, and we talked a lot about where the responsibility lies and who is liable for what when it comes to dysphagia and issues of potential aspiration or or even death. And so I'm wondering, you're not allowed to have swallow studies. Again, is this documented, or is this word of -
No? Is a word of mouth? And I mean, I do have a because one, one was allowed when we first started, but then I was reprimanded because of the costs when the facility got the bill, and the Ed did not want to pay it. So it was a big, big issue, and that was to my my dor just do not we cannot go that direction moving forward. Help them get it lined up to be completed when they leave the facility. But no, I know it's wrong, it's very uncomfortable.
It's not only wrong, but it's potentially putting liability on your shoulders. And yeah, that's an even bigger issue. And so I'm wondering, are you still requesting swallow studies, or are you not even requesting them in documentation?
No, I put it in my documentation and I tell the Dor, but then it doesn't go beyond the DLR. Another issue we have in our area is that the hospitals do not do instrumental assessments on a routine basis. It's not unusual to get an admit that has not had any instrumental workup and come to us on a modified diet and thickened liquids with maybe just a 20 minute bedside in the hospital, and that's it, and that's kind of the norm in this area. And I've talked to the SLPs in the hospitals, and I am an acute care hospital. SLP, by background, so it's, it is maddening, because I would not have let those patients out the door with at least a swallow study.
When it comes to you know, you said you're open to any advice every time, yes, these patients, I would be documenting every single time in your paperwork that appropriate care cannot be provided for suspected pharyngeal dysphagia without instrumentation every time. Okay, how I explain it to my students is Little Billy falls and he has pain. You're not going to send him to the hospital, and they're not going to just apply some type of treatment, like a cast without doing an x ray, because they have to know where, where the break is, if there's a break, or maybe it's a sprain, or maybe it's some other kind of injury, and so they have to know what the injury is to apply the correct treatment. And so you're doing the best you can. You're being denied this very essential and required test to know what the pathophysiology is, so you know what kind of exercise or treatment plan to apply, and without it, you could be treating the elbow when he needs the toe treated. And so I would be documenting that every time, because you don't know, you don't know what's happening in there strategies. You should never be doing a strategy that redirects the flow of the bolus without visualization that it's not harming your patient. So you know, even if you're like, Oh, you're coughing. Let's do a chin tuck, or let's do a head turn, and you don't know that the patient is safe. To protect yourself every time say it in your documentation, because there is no therapy in the dysphagia world that is a one size fits all. Throw the kitchen sink at him and see what fits. You wouldn't want your doctor putting on a cast unless he knows where the break is, same thing and so again, this isn't your fault because they're not giving it to you, but we know that we're in a building that has lawsuits going on for other reasons that isn't looking out for the best interest of their residents or their employees. And my suspicion is they won't hesitate to throw you under the bus Absolutely. Yeah, and so just make sure. One, I would make sure you have private liability insurance and two document every time when it comes to these things, because you are treating blindly. And if something were to happen, if you were to be deposed, if there was a lawsuit, an expert witness is going to look at the chart, and they're going to look for the standard of care. So. You always have to document that request, but I could see a lawyer trying to spin it on you and saying, Well, if they said, No, how did you know what treatment to apply? How did you know what to do? Why were you giving this treatment when it wasn't what the patient needed? And so some kind of statement every single time that you know you're giving therapy to help improve suspected pharyngeal dysphagia without instrumentation to diagnose the pathophysiology. Treatment may or may not be helpful, I would just be making a statement every time about not getting that instrumentation every time.
So, so in every daily note, every
Every time. Yep, I would. It's not going to hurt you. It's only going to protect you. I'm concerned in this building. I would be looking out for myself in this situation. And then my other question is, are you in a particularly rural area where there aren't a lot of jobs?
No, I'm in an urban areas.
Why don't you all just quit? Why don't you all go find jobs that are going to treat you right? Because there's a lot of things that are happening that I have a lot of concerns about, and you're clearly being abused and taken advantage of. Why don't you all just go find new jobs? Word will get out.
In my case, it's loyalty to my building and my patients. I'm not one that changes jobs, and they just came on in the spring. So I'm trying to, I guess, fix it from within, because I've just never faced anything like this, and I feel for the people I'm leaving behind if I were to go. But there are other opportunities Absolutely.
When it comes to your evaluation time, how long are you able to bill for an eval?
Far as minutes? They want us to stay 30 as far as that, because it's non I mean, I've gone up to 45 but then you can also do a treatment note that day, and you can go up to 60, okay, but I don't feel like it accounts for my time, because I keep the patients directly engaged, and we're mostly picking up the, you know, the lower level patients, and that's another because it's frustration to see p and OT. They can have them on the bike for 10 minutes or 20 minutes, and they're doing their documentation, and I have the patient, it's different, directly engaged. That is not one of my strengths. Documenting with the patient present. That's something I need to be better at, because I would much rather keep the patient involved and then document on my own time. But I know I'm not supposed to do that either. And these young therapists, they just do it. They don't know any different. Exactly, right? So it's hard to get them on board. They've never been under a different productivity expectation, but they're doing the same thing, as far as the clocking out and doing required things on their own time, though, because they're but they're just following suit because they see their colleagues and their mentors doing it. So I know we've created this ourselves. I think that's what's most frustrating. It's been a gradual and we've allowed it to happen. So that's why we have to do something. I do feel we have as a profession, and all the professions, but speech, especially, I think we've just let we've been dictated to, and we've just made our numbers work. We're good at math.
I'm going to push on that working off the clock thing, it's not appropriate. 85% productivity is really high. It is. And you really shouldn't have to do point of care documentation, which is doing your documentation with your patient. If it's not appropriate, way earlier you said, you know, if someone needs a protocol that's longer that you end up doing that on your own time. You are opening yourself up to so many issues there, because if you're giving them some kind of hour modality, are you then documenting on that whole modality, or are you only documenting on the 30 minutes that you gave them?
Documenting on the whole modality, but, but only billing what I'm allowed to bill.
What if something happens in minute 57 and you've only said that you were with that patient for 30 minutes? You're placing the liability on yourself there, even though you're doing it in the name of good. You're you're committing fraud, sort of that's a harsh word, but I think you'd be if, if you're documenting 30 minutes and you're still with that patient, providing therapy off the clock, your liability insurance is not going to cover you, probably, if something goes wrong, and neither is your building, once Again, they're putting the liability on you.
They've given you a ethical noose. And you know, it could be argued that you might be putting your head in it.
Yeah, you have to stop treating at 30 minutes. All of you do. No one should be treating off the clock, especially. But then, like you said, by doing the paperwork after you're creating this call. Culture where it is okay, like this is just what we do now, and just sort of like we push into Asha and we say, for as long as we keep our CCC, so we can take students, Asha is never going to change this requirement, because this is how they fund their ledger. Same thing. There's never going to be change with contract therapy companies, privately owned companies, in house companies, they're all equally as slimy. They are never going to change for as long as we all continue to do this, you got a bill for your time that you are spending in the building, and that means your productivity is going to go down. Are they letting people go for low productivity?
We've been reprimanded, like I said, early on, when it was when we were billing, or when I was billing, the honest time, and then we just all made the numbers work after that to be but that's being completely honest.
Yeah, y'all have to stop. And what I would start doing is a time audit. So keep a notebook with you. I gave therapy from this time to this time. I wrote documentation for this seven minutes after, then I went to the bathroom, then I went to find Mr. Jones, who wasn't there. Then I had to talk to so and so nurse, because she stopped me in the hall about someone who's not even on my caseload. And I know this is like extra work. But again, this is all stuff that's going to protect you, because then if you get let go for low productivity, you can sue them if you're showing a pattern of what's happening during your day, and that they were basically forcing you to work off the clock, and that if you weren't working off the clock, you couldn't meet the expectation of the day. Your case is in that notebook, time, stamped, dated. It's what's going to protect you if something happens. Because, remember, they're not protecting you. They're they're putting so much liability on all of you. It's It's outrageous. They're forcing you to make decisions that aren't great ones, but there's no good answers here. There's no good answer. You're kind of damned if you do, damned if you don't. You have to protect yourself, and if you get let go, there's other jobs. If something happens to a patient while you're treating off the clock, that's going to be harder to find another job. So you need to start changing all of you, not just you, personally. And again, this is it's this isn't me attacking you. This is like, really encouraging you to think about these things because they've put you in a bad position. In exchange, you need to look out for you. You have a family and a career and a life, and at the end of the day, this is just a job. This is just a job we as speech therapists are really good at making, SLP, our whole life and our whole personality, but you are more than this job and letting it potentially ruin your life because they're money grubbing and they're putting the liability and responsibility on you guys, is crazy, so you, in return, have to protect yourself in every single way possible. And treating off the clock is not a good idea.
You know, and I think the thing I would say earlier to go back to a point there is a huge number of SLPs that have walked away from their job because it was frustrated. They just gave up. They were in these situations like, the hell with this, I'm gonna go get, you know, work somewhere else, and that's unfortunate, because, you know, we're losing great people. However, for every 100 of those that I've heard about are known. I really don't know of anybody that's actually gotten fired because they didn't make productivity. And so it's kind of a bluff that has been put out there and facilitated time and time again. And I get it because I work for a rehab company that if you weren't, I mean, down to the minute, they would call you the sons of bitches, would call you the next day and say, Why did you clock out one minute late? But at the end of the day, no one was really ever fired. They got threatened. They got reprimanded. You know, it was all sorts of little head games that were played, and that's the thing. And it's not just us telling you to do this, but it's sort of like this culture that's out there, and we're talking to an audience right now that we have to start pushing back, and our colleagues have to start pushing back. People talk about unionization. Well, it kind of starts with a lot of people saying, You know what? Go, you know, go fly a kite, and there's a line and we get it. You know, reimbursements have been difficult. Over the last 15 to 20 years. It's been very flat. So companies are trying to figure out other ways to be creative. But at the end of the day, who's suffering the most the patience and so, yeah, I, I can't tell you enough, and everybody else out there, you gotta start calling their bluff and just saying, Hey, this is a bunch of crap. We're gonna do our jobs, and if that's a problem, well, yeah, we can all, I guess, get dismissed if that's what you feel is necessary.
Well, as far as, like, the. Time study by doing that on a daily basis and having that then do you take it to someone after so many days
You're keeping it as you're keeping it as, I think, protection for yourself? Oh, I see, yeah, it's your own log book. Because if, if you know, and it's hard, because there are a lot of Right to Work states where they can get any reason for letting you go, but it's going to be something where, if I've got a if there's a therapy department out there, and let's say you and you know, the COTA and the PTA are all in on this together, and you're like, Yeah, we're blogs on this, and we're all three gonna, you know, start doing things kind of like they should be done ethically, how we were trained to do them, to protect ourselves as well. And if two out of three, or all three of you are let go at the same time, and you all have good paperwork, and this was why you were let go, that could be a good case, even in a right to work state. Okay, it's certainly good news. I mean, as far as am I a journalist, I might recover it.
The one, one problem I have, I think, is because I am the one that's the outspoken one in the department, and that I don't have anyone to join me, I think I would build be more confident had I if I had other support. So I'm but I'm willing to stick my head out there and can do more this. As I said, this year, I've decided I'm going to stop this, so I will do what I need to do, but it is hard when you're the only one. And I just want to say that to other colleagues out there, I think that's where we're at. I think we know, but it's hard to be the one to stick your head out. And I do appreciate to be empowered to try to do things different on puzzles. How we got to this point.
It is how we got to this point. And that's why we're losing a lot of people. That's why a lot of things are suffering, and so I'm, I'm glad we kind of touched on these today. We could certainly go a lot longer, keep fighting the good fight. My heart goes out to you and your patience, because it doesn't feel sustainable.
No, I agree. Yeah, yeah. I still have so many things to say. So thank you for being brave enough to come on and kind of start this conversation, share these stories. I don't think we have super good answers, super good advice, other than just protecting yourself with the time log, with your documentation of what you do and don't have for what you need to do. And one more thing I might suggest before we go, because I think this can be applicable to many people listening, is that if you do start some sort of relationship with the family or the care partners from home, they can always file complaints with their ombudsman. So you know, in these swallowing cases, family is upset because patient comes on thick and liquid, you can just quietly tell them my hands are kind of tied right now. One way you could make this happen is starting a case with the ombudsman. They're here to protect you, and please just keep my name out of it. You can say that it's, it's our understanding that the speech pathologist has requested it, and we want to know why it's not happening. That's, that's one way you could go, as well as pulling in the ombudsman through the family, if possible. So anyway,
Yeah, you have to find the joy. You have to be able to, you know, look at yourself in the mirror and know that you've done the best for your patients, because these shyistas, they'll move on, but you know, you gotta watch out for you.
Yeah, yeah. All right. Polly, thanks so much for coming on. Thank you.
Bye.
I don't know. I just no one else talks about these things in public. So, you know, there's going to be a lot of people like her out there that are just drowning, and they need to, they need to know, that's the thing that's fun about Tiffany. She's like, Yeah, no one ever gets fired over productivity and she's kind of right. So
I yeah, I agree with her, yeah, one thing I did tell her before we before she signed off completely that I want everybody else to know she had said something about she didn't know if we'd ever done an episode with folks who are maintaining that high productivity standard and how they're going about doing that. And I did tell her, we will probably never put content or an episode out about that, because we are here to encourage you to stand up for yourself. Yeah, we're not gonna, we're not gonna promote engaging in that type of activity, because it's not okay you're it's not okay that you're being forced to do those things. It's not okay that you're trying to find ways to comply. And so we're just not going to promote it. Our stance is always going to be do a time audit and don't do it.
Yeah. Just like trying, like, we had an episode telling everybody how to look like an Instagram model. You know, that's just like, really, you know, that's not really not quite realistic.
You know what it would be like? It would be like us putting content out, telling you how to manage your 100 student caseload cap.
Yeah, yeah, that's good.
Burn!
Burn on baby. Burn on.
Alright. Preston?
Jeanette.
It's been a week.
Okay, you did good.
How do we want to wrap this up? I gotta say, Thanks for fixing it somewhere.
Jeanette, you know, there's just nobody I'd rather be talking with at 10pm at night when it comes to SLP. So you know, we're just keep doing it. You're wiping either tears of pain or joy. I can't tell.
No. Okay, Preston, let's get out of here. I'm tired. I love fix SLP, but not at 10 o'clock at night. Okay, all right, everybody. We'll see you next week. Thanks for fixing it.
You want to tell the listeners what that stands for. Are we keeping that
We are not recording (beep) right now.
We are, yes, we are. Where's this is our this is our outro. This is our after she's
Uh-uh. Nuh-uh. You do that and I'm gone. You will never I will ghost you. I will ghost you.