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In response to the letter by C. Evans on the National Dysphagia Diet, I am disappointed but not surprised by her opinion. Prior to DRG's, PPS, etc., SLP services were part of standard protocols for treatment and there was no need to market or justify our services.
Today, SLP services are not part of standard protocols. We see doctors order modified diets without SLP consults, and nurses implement "swallow screens."
The real issue is the increased need to justify and market our services. Many SLPs are unaware of how to do this. They need to get copies of the Scope of Practice to every medical director and spend time chatting with each physician and charge nurse. The National Dysphagia Diet works! It offers a standardized protocol for providing appropriate textures and liquid thicknesses to patients. It provides a clear description to the people who prepare, serve, and eat these diets. I don't think that keeping people confused about diets is a way of ensuring job security.
C. Evans refers to the National Dysphagia Diet as a "blanket dysphagia diet." These are intended as guidelines and require the presence of an SLP to adjust each diet as the patient's condition changes. Future job security for SLPs does not lie in the establishment of a standardized set of terminology to describe diets, but in their ability to market their profession and to conduct themselves professionally, ethically, efficiently, and visibly!
C. Peck
Seattle, WA
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