Diversification of Skills for Rural SLPs


Farming diversification and crop rotation were unfamiliar when I became an accidental country girl 12 years ago. I was raised in a bustling Chicago suburb and lived in urban areas until I transplanted to a tiny Southwestern Minnesota town.

Soon after moving, a patient who was a farmer asked “What does he grow?” and I replied “corn.” He blinked several times and said expectantly “And…?” I didn’t know what to say, because I didn’t realize farmers don’t grow just “corn”. My patient taught me a little about rotating crops to maintain healthy soil. Today, farmers not only rotate crops but grow new crops or grow crops organically to meet changing consumer demands.

Just like farmers, rural therapists need to diversify and rotate in unused skills to provide quality care.

Although many American rural areas are losing population, about 1 out of 5 people live in the country. Most specialty clinics, trauma centers, and rehabilitation facilities are in cities. Acute patients are frequently transferred to a higher level of care in a city and then return home. Quality continued care is essential to their recovery. Urban therapists can support continued quality of care by doing the following when discharging a patient to a rural area:

  • Send complete notes, evaluations and progress reports
  • Contact the rural therapist
  • Assist with resources if needed
  • Schedule follow-up visits as appropriate

For patients being seen on a outpatient basis getting to the nearest city can involve an arduous several hour trip over difficult roads. During a blizzard or at harvest time, it’s impossible! Consequently, a rural therapist needs a wide variety of skills and resources to serve a diverse group of patients.

My coworkers and I developed this list of strategies:

  • Find a mentor (many professional organizations have programs)
  • Connect to regional therapists (We have Medi-Sota in Minnesota.)
    • Join special interest groups via the American Speech Hearing Association or your state association
    • Participate in social media (Facebook groups, Pinterest, Twitter) and blogs
    • Develop a Personal Learning Network
    • Improve your web searches
    • Seek information from referring therapist
    • Partner with specialists (GI doctors, orthopedic specialists, etc.)
    • Know when to refer (especially if safety issue)

    The diverse rural population does not allow much specialization and treatment does not become repetitive. There is no opportunity to be bored! The next patient being very different from the previous patient keeps work exciting. I often complete a Clinical Swallowing Evaluation for an elderly inpatient in the morning and do language and articulation therapy with children in the afternoon.

    Maintaining skills through continuing education and networking helps rural therapists be prepared to see patients of all ages and disorders. Sometimes it is necessary to search and learn quickly. However, it’s rewarding to provide therapy in the community. Patients and families have been grateful when they can get therapy without a long trip or continue therapy with infrequent trips to a city.

    Although becoming a country girl was accidental, I have thoroughly enjoyed the challenges of treating patients with a large variety of disorders and increasing my knowledge. The variety has certainly kept me on my toes and inspired me to learn even more about speech-language pathology.

    Susan Spieker

    Susan Spieker

    Speech-Language Pathologist at Chippewa County Montevideo Hospital
    Susan is an accidental country girl, technology explorer, avid reader, and lifelong learner. She is constantly searching for evidence based practices to improve communication and lives. She has been gifted with wise supportive mentors for many years. It’s time to pay it forward.
    Susan Spieker

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  • http://www.therapistsunlimited.com/ Symen James

    A very insightful share. Thank you for this. Simply put, one must keep learning and trying new things to get better at their SLP jobs, or any kind of work for that matter.