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AdvoCATing for Instrumentals: Don’t be afraid to brag!

Updated: Dec 19, 2022

So you FINALLY get approval for that instrumental, despite the DON suggesting you just try pudding thick liquids (PLEASE don’t do this), despite the Admin telling you that the last SLP hardly ever needed an instrumental (Well that explains why half the building is on honey/puree), and despite the patient telling you that they swallow fine (even though they are coughing like crazy after every meal and you keep finding half dissolved pills in their mouth). And low and behold….. the MBS shows a massive Zenker’s diverticulum that wouldn’t have been helped by pudding thick liquids (again, please NO) or four weeks of therapy.

What’s next, after making the appropriate referrals? Go to Facebook to let all your peeps know? Do a private self-congratulatory high five with yourself in your car? Consider… letting all the haters know you were RIGHT! In general, SLPs are not the best at self-promotion. (How else do we get stuck with popsicle sticks while PT gets a $10,000 treadmill?) However, if your goal is to truly advocate for the best in patient care, you need to show your clout and value to those that matter.

It’s worth the few minutes of slight awkwardness with the Admin to say “Oh hey!! Mr. Jones? That we got that MBS on? Thank GOODNESS we did that-we could have really missed the mark on him. And with something like that, there’s just no way to know without X-ray vision! Haha! Whew!” or “Just a quick follow up on Mrs. Smith-the FEES showed partial right sided vocal fold paralysis - wild, right? So so thankful we caught that!”. You don’t have to come right out and say “Hey I was right! We DID need that MBS! Maybe next time you won’t be so stingy, amiright?”, but if you keep reporting back to them, they’ll get the message.

MBS Envision would love to be part of your advocacy team. If you are battling for instrumental assessments and would like some advice or references for evidence based practice please reach out to me at

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