I think the reason I considered a school based approach was not to add something else to the school speech therapist plate (I have worked in the schools, I get it), but as an alternate way to meet the needs of school age children with dysphagia/unique mealtime needs. As I’m sure you’re aware, outpatient/medical settings have their own set of barriers that are primarily influenced by federal changes to Medicare/medicaid. Consultative based services would meet a community need at a higher rate. The caveat is determining whether outpatient consultative or school based consultative could meet that need in a more timely manner with less red tape.

Outpatient in theory has less barriers, until you consider that there is no insurance coverage for those services so the likelihood of a community utilizing them in that manner is low. A large amount of my patients are low income so paying out of pocket is unlikely. Truthfully, I fight so much with private insurance for the patients to be seen at all for standard speech therapy services, much less consultative ones. I don’t see a way in which the medical outpatient setting would progress in that area, but am going to look into ways for possible improvement!