Monday, May 11, 2015

Build Your Caseload with New Referrals

How do you handle a dramatic change in your caseload?  Do you:

A.   panic, then have an emotional breakdown
B.   start looking for another job
C.   spend your extra time shopping at the mall
D.   consider a change of careers
E.   roll up your sleeves and do something about it

One of the agencies I contract with has slowly but surely stopped sending referrals over the last few months. At first, I was okay with it and took the, "Good. Now I can go on vacation during Spring Break" attitude. But, almost 2 months later, it's much more of a concern than it was back in March. My caseload has dwindled from about 20 visits each week to only 2 visits scheduled for this week. Yikes! 

I found myself asking, "Why isn't the phone ringing? I'm going to be unemployed next week if I don't get some new patients. What am I going to do?" I contemplated my options and then used the process of elimination to help me find the best answer. 

Option C- ELIMINATED.  I learned years ago that shopping is a bad idea. Even though there is more time for picking out new shoes to coordinate with your new outfit, you are spending money.  When there is less work,  that also means that there is less money. Now, I was in remedial math until 8th grade (seriously, I'm not kidding), but I have figured out that the money coming in needs to be more than the money going out. Using the old test taking strategy of eliminating the obviously wrong choice first, I moved on.

Option D- ELIMINATED. I've invested 21 years of my life working as an SLP, and changing course right now would be an even worse idea than going to the mall. Better keep going down the list.

Option A- ELIMINATED. The thought of getting all worked up and crying just seemed like it would not be worth the effort. Besides, people would certainly think twice about sending new referrals to the  teary-eyed therapist who was struggling to keep it together. Tears pouring out of my eyes are not going to result in new referrals, so, I'll keep going.

Option B- ELIMINATED...for now. I haven't had to look for a job in years and I really don't want to start now. The entire HR process you have to go through as a new hire for most companies is long.  It typically involves watching a bunch of boring videos about HIPPA requirements (again), demonstrating your ability to follow Universal Precautions (again), taking tests to prove you really do understand blood borne pathogens (again), updating the resume (again) and worst of all, peeing in a cup. Yuck! Who really wants to do all of that stuff...again? Right now, not me.

Option E- this is the only option that has not already been eliminated, so, I'm going to roll up my sleeves and do something about this pesky problem of mine.  Here goes!

After commiserating with my OT and PT friends, I made a few phone calls to talk to the bosses and the CEO. The common response was, "We're just not getting the referrals we used to." Hmmm- that can only mean one thing: someone is not doing their job! I'm not going to sit around waiting for someone else to do something about this situation, I'm going to get involved. 

I know exactly what to do...remind everyone how important Speech Therapy is!  After all, it is Better Hearing and Speech Month,and the timing could not be more appropriate. Now, how will I spread the news?

I remembered a handout I created before I did a presentation at the Corpus Christi Parkinson's Support Group not too long ago. I pulled up the document, made a few small adjustments for my new audience and printed it on some bright paper. 

I've been known to pop in to speak to agency staff during weekly case conference meetings, and that's my plan again.  Watch out nurses, here I come!

Making a Referral to a Speech-Language Pathologist

Common Diagnoses:  Referral to an SLP is usually justified with any of the following medical diagnoses:                                                                                                
  • ·        Stroke, TIA
  • ·        Parkinson’s Disease
  • ·        Alzheimer’s and Related Dementias
  • ·        Altered Mental Status
  • ·        Dysphagia
  • ·        Cancer of the Head or Neck
  • ·        Head Injury
  • ·        Amyotrophic Lateral Sclerosis
  • ·        Pneumonia
  • ·        Head Injury (Closed Head Injury, Traumatic Brain Injury)

Dysphagia:  70% of geriatric patients are experiencing difficulty swallowing
  • ·        History of aspiration or aspiration pneumonia
  • ·        Alternative feeding methods are being/ have been used
  • ·        Weight loss: gradual or sudden, usually unexpected
  • ·        Poor appetite
  • ·        Altered diet:  changes to solids or liquids
  • ·        Pneumonia- usually in the lower lobes
  • ·        Dehydration
  • ·        Malnutrition
  • ·        Nutritional supplementation required (Ensure, Boost)
  • ·        Difficulty swallowing medications
  •          Coughing, choking

  • ·        Promotes continuity of care
  • ·        Provides cost effective treatment
  • ·        Enables functional activities in a functional setting
  • ·        Diminishes social isolation
  • ·        Maintains quality of life
  • ·        Allows for medical acuity and frailty at home

You don't have to be a marketing expert to get your point across, just put on a big smile, pass these handouts around the room and let the enthusiasm you have for your job pour out of you. 

By the way, if anyone is interested in the complete, extended version of this document, contact me and I will be happy to share.

Over the years, I have found that information like this, given to the right people, can really make a difference in the amount of referrals you get. You are providing information and raising awareness, all at once- so efficient! 

Whether you're a speech language pathologist or not, the moral of the story still the same:  take responsibility, take charge and stop waiting for someone else to do the job. 

This week, consider situations that could be improved based on the actions YOU take. 

Post a comment to share your success story- I would love to hear from you!  In the meantime, don't forget to continue the celebration of Better Hearing and Speech Month.


Hope it's a great week....thanks for reading!

If it is to be, it is up to me.  William H. Johnsen