A Wellness Concierge? Part 2

 There's the normal chatter, networking going on as the break is ending; gotta get this session back on track. I already see a few of them flitting about at the back of the meeting room, complaining about the DISMAL number of plug-ins for their phones. The tide pools of the Convention! OK, mike works. AV works. GI tract works, after that quick lunch....here we go. Prevent, prevent, prevent....

"Hi Everyone. So many of us came back, so there must be something good going on here - right? If you are new to us today, we're continuing on with the topic of a speech-language pathologist, also serving as a WELLNESS CONCIERGE. That is, the SLP and AUD can have as a product line, education and referral services for her market that direct consumers to community wellness services. We offered in the morning session, the idea of preventative services that might help prevent cardiovascular disease (CVD). CVD, manifested as ischemic heart disease and stroke, was the #1 cause of death worldwide in 2019, according to the World Health Organization. 

 "As healthcare and education professionals, with a national scope of practice that unambiguously states, prevention is something we will do - we have a responsibility to help consumers ward off changes in their bodily function that might lead to heart disease, stroke and other cardiovascular impairments. As a body of professionals, we regardless have only scratched the surface of what prevention can do, for the people we serve. And, we have these ideas of keeping people free of CVD, but - how do we do it? 

"Let's explore each of the major incentives to help our consumers prevent CVD, with some examples of what the SLP clinician might do to help achieve each incentive - from the morning session. We're using the 2019 American College of Cardiology/American Heart Association guidelines for primary prevention, as a guide:

 " * We naturally raise the visibility of our professions, audiology AND speech-language pathology, when we are active in the broader community, interacting in collaboration with other human service workers for health (fitness trainers, dieticians, smoking cessation specialists, gardeners, etc.)"

"The SLP has incredible opportunity to grow her business, regardless of work setting, when she builds collaborations with the greater healthcare provider community.  Where an SLP may have very general knowledge of what a personal trainer, or an herbalist does, an SLP/wellness concierge can tap into a knowledge base, taken from personal research into the community's resources. That marketing research can include a review of databases, personal visits to community wellness providers, working together with the providers on community wellness events, establishing formal agreements to serve an identified customer base, and many more joint ventures. Though many potential wellness consumers may not use dedicated SLP services, an SLP/wellness concierge will have been given them direction for staying heart - healthy. 

 An operative definition at becoming an SLP/wellness concierge with emphasis on CVD prevention, might include: 

1. Do you have a grasp of the SCOPE of CVD primary prevention? Can you wrap your head around the need to balance a consumer's monitoring her risk assessment, nutrition, weight control, fitness, blood sugar control, control of fats, blood pressure, smoking risk and blood coagulation?

2. Also, wrap your head around - what can the SLP control? Risk assessment, blood sugar, fats and blood coag are 'above the pay grade'  for most of us, and would require the help of a medical laboratory.   The rest - nutrition, weight control, fitness, blood pressure and smoking risk - all have well- organized, well - entrenched behavior management networks in place, in many of our communities. 

3. Part of the work of the wellness concierge would be, then, to get consumers access to the best promotion/prevention programs. The other part is, helping create viable networks for consumers where there are none. 

' " * We grow our knowledge base for helping our consumers, when we reach from tertiary prevention (reducing the odds for disability), and secondary prevention (identifying potential impairments for bodily function) to primary prevention (reducing or eliminating exposure to risk factors for CVD)" '.

" Training to be an SLP, who does provide evaluations and treatments - how much background in health promotion and disease prevention do we really acquire in training? Unless your master's program adviser has picked out some electives for you in those domains, or your externship supervisor has directed you to offsite programs that will expose you to actual scenarios for teaching prevention strategies - it's on the job that you learn, how to offer service after the sale. For example, a demonstration vegetable garden, that consumers may or may not have had a hand in growing some product, may give up some of that product to allow tastings of vegetables produced in a kitchen. When you can help make vegetables taste good, to a consumer who may or may not have cardiovascular disease, you may have a hand in helping that person prevent further chronic disease."

"Operationalize an SLP's preparation, for a side hustle as wellness concierge:

1. Do you have any hobbies, or any interests, passions, or nagging desirous interests for your own lifestyle - that you could bring to a consumer community? If you garden, teach it. If you run, model it. If you are a devoted advocate for wellness activities, advocate it.

2. Do you need formal preparation in health promotion/disease prevention? Perhaps a University training program in public health near you, will afford you a certificate or degree in this area. Six of the top 10 public health schools, as rated by US News and World Report, are in the eastern US. One, Michigan, is Midwest, and the remaining three are West Coast. A 5/4/22 Fortune article by Meghan Malas asks, if getting a Master of Public Health degree is worth the time and expense required for the new skill set you acquire. The answer seems to be, an enthusiastic 'Yes'!

3. Self - preparation for becoming a wellness concierge/ CSD professional will largely come from independent study: for example, popular works on integrative medicine (Andrew Weil), vegetable gardening (Rodale), fitness (APTA), and blood pressure (Harvard Medical School) - they'll direct you to primary sources of research, that enhance your work with your consumers. Likewise, video and online resources on these topics make teaching and marketing of prevention services much easier. 

" * When we help the larger community access wellness information, services, and ways to sustain their desired level of function, we develop potential consumers who may be educated on accessing services, when/if the need might arise. "

"Think of concrete steps you might take, to show your market that you are ready to serve persons at any point in their health journey. 

1. Tell the market about you: get free ads posted wherever you can, whether print or digital, that describe who you are, what you offer, how easy it is to contact you, and why you are unique among providers.

2. Show the market how easy it can be, to find efficient, schedule - friendly and cost - effective wellness services, accessible to them and that can meet specific needs. 

3. Teach the market - that they have near total agency in sustaining/improving their health (in this case, cardiovascular); that consumers can share their thoughts on health status with their MD, not just waiting for the doctor to set the consumer's plan; that the teaching about staying well can become inter - generational - that the youngest in families learn from older ones, that's the way it's done."

Make history! Grow your clinical practice, by adding a skill set as a wellness concierge.

Finally, whew, it's over. Those 20 folks quickly flew outa here; many going to the airport....puts on my "ASK ME ABOUT..." button , and steps out the meeting room, just barely avoiding TRIPPING on a phone charger cord....

Not a desert, more a clearing

 I was lucky enough to trust my impulsive nature, on the day I wanted to know more about the closing of a local grocery store. Local news media had made a lot about an ALDI store, thirty years active in Westside Chicago and far from Loop prosperity, suddenly going belly up. There was consternation expressed by residents. There was outrage heard from activist groups. And most recently, the city of Chicago has proposed buying the vacated store. 

Since the neighborhood's median household income is roughly at the poverty level for a US family of three, and that just one grocery store remains to serve 17,000 residents, this seemed a serious concern. I am a speech- language pathologist who advocates for my consumers ' healthy eating; if there were a problem with consumers getting diets beneficial to their health, I would want to know what healthy solutions are out there.

Following is a podcast from the series "Curious City", produced at WBEZ radio in Chicago - wbez.org . It illustrates the issues. Thanks to reporters Linda Lutton and Asia Singleton.

https://podcasts.google.com/feed/aHR0cHM6Ly93YmV6LXJzcy5zdHJlYW1ndXlzMS5jb20vY3VyaW91cy1jaXR5L2N1cmlvdXMtY2l0eS54bWw/episode/MTA5MjU1YzAtOGZiOS0xMWVjLWJmMjItOTNlZjMwNDczZWEw?ep=14

Readers of this blog, who want to know more and be stimulated about food desert issues, should look at the 2022 book RETAIL INEQUALITY (University of California Press). The author, Kenneth Kolb, is Chair of Sociology at Furman University.  

A wellness concierge? Part One -

 He hesitated before - stepping to the microphone, his sole anchor to the convention meeting room crowd. About 20, he estimated, scattered about the chairs numbering 100....the thoughts fly, as seconds ticked by to bring the start of my presentation: is the premise just TOO CRAZY? Will they see the holes that I SEE, in the logic of the presentation? Where can I HIDE, until they just GO AWAY in confusion? Darn it, here comes the session coordinator - hearing my provenance for the presentation as a background noise, I am ready. Gotta sell this! To the mic now, and -

"HIIIII - glad you could be here, and draw on that good night's rest you got last night, for the LAST DAY 8 o'clock session! You lucky people! Here we go. You're here, I hope, to learn about what the heck a WELLNESS CONCIERGE is, and why - audiologists and speech-language pathologists should be ready to assume this role, as a next step in their careers."

 "Disclosures: my practice does include - possibly the only wellness concierge web - based subscription platform, amidst the CSD community.  I also belong to my local Chamber of Commerce, which allows me to network with numerous peers in my business market area". 

"Here we go. A CONCIERGE can be broadly described as a person you meet, at the entrance to a building.  That person has the skill and resources to guide you through what the building, or in this case, the wellness industry has to offer. But the questions should abound: Why wellness? Why should CSD professionals take this on? Why is this added focus to our work lives so important now?"

"Ten of the top 10 causes of death in the US (NCHS, 2019), also bring significant disability into functional domains where CSD professions work. Though there has been significant reduction of mortality rates for heart disease, for example, the rate of reduction for deaths has slowed in recent years. Heart disease and its co-occurring morbidities are also striking in greater numbers,  persons of younger age; - perhaps prompted by an increased rate of obesity in young people. There is then, a moral imperative as well as a scientific clarity, for bringing wellness to the larger sphere of healthcare. Namely, us. We are part of the larger sphere, we CSD professionals".  

 

"So I am saying that audiologists and speech - language pathologists grow their clinical practices for all  ages, in a fashion that reflects the true intent of the 1988 statement of ASHA's Prevention Committee - namely, to push ahead and help our communities lessen or eliminate risk factors leasing to disability. This presentation focuses on how the wellness concierge framework, might benefit primary prevention of cardiovascular disease (CVD)."

 

"Aphasia. Vascular dementia. Cochlear hearing loss. Labyrinthitis. Auditory processing disorder. The list goes on: insults to bodily function that arise from cardiovascular system breakdowns. When Aud's and SLP's are part of the solution to reducing CVD insilts, we help accomplish many objectives:

" * We naturally raise the visibility of our professions, audiology AND speech-language pathology, when we are active in the broader community, interacting in collaboration with other human service workers for health (fitness trainers, dieticians, smoking cessation specialists, gardeners, etc.)"

" * We grow our knowledge base for helping our consumers, when we reach from tertiary prevention (reducing the odds for disability), and secondary prevention (identifying potential impairments for bodily function) to primary prevention (reducing or eliminating exposure to risk factors for CVD)". 

" * When we help the larger community access wellness information, services, and ways to sustain their desired level of function, we develop potential consumers who may be educated on accessing services, when/if the need might arise. "

"That's the rationale for becoming a wellness concierge, in capsule form. Now, how many forms will wellness concierge work take? They could include -  

" * Communication Fitness  - see the post for the 'Pretty Wonderful, Communication' blog, dated April 23, 2017"

" * Hosting events such as lectures, demonstrations, or gatherings to commemorate days, months or holidays relevant to a prevention topic (for example, October 1 is 'World Vegetarian Day')"

" * Directing curious consumers to community events that highlight a prevention topic, such as charity or fitness run/walks; chef - directed food and wine events vs. culinary school restaurant offerings; and presentations by medical vs. complementary and alternative medicine professionals; - "

" There's what we will do - now, after a short break, we'll reassemble and discuss HOW we will do each one - "

Hear Me (with inspiration taken from Lil Nas X's "Montero")

CAN YOU BELIEVE IT?

THERE YOU ARE AGAIN ON THE BOX

IVE MISSED YOU,  YOUR GOLDEN LOCKS

BUT YOU'RE THERE SELLING AGAIN

NOT HERE WHERE YOU'VE BEEN

 WHEN HERE YOU TOUCHED MY EAR

THE THRILL WAS LIKE A TICKLE

BUT I SEE YOU TOUCHING HIM NOW

PUTTING THAT TEENY PICKLE IN HIS EAR

 YOU'RE ALWAYS OUT THERE SELLING

MORE STUFF YOU'LL HEAR, YOURE ALWAYS TELLING

IN YOUR FAVORITE BAR THERE'LL BE NO MORE YELLING

BUT ALL THESE IDEAS IN MY HEAD, THEY'RE NOT JELLING!

NOW YA GOT CHEAP STUFF

OUT ON THE STREET ON MY PHONE 

YA BOUND TO MAKE A MINT WIT' DEM

YA WON'T SEE ME TELL MY PHONE: 

HEAR ME!

HEAR ME!

WHEN YOU PLUG UP SOMEONE, HEAR - I WANNA KNOW

WHERE'S THE MICROPHONE TO PUT ME BACK IN THE SHOW

YOU GONNA GIVE IT TO ALL

BUT TELL ME, WHAT'S MY GAIN?

YOU GONNA MAKE IT LOUD, BUT CAN I STAND THE PAIN?

I WANNA WEAR YOUR LATEST MODEL

WISH I COULD BOTTLE WHAT YOU SELL

I CANT WAIT TIL WE HAVE A DATE FOR FITTING

AND YOU'RE SITTING

NEAR ME, PUT MY CRAVING IN MY SHELL. 

 I CAN GET YOUR STUFF CHEAP NOW

WEAR IT EVERYWHERE I WANT NOW

DON'T NEEDTA SEE A DOC NOW

MAYBE I KNOW HOW, NOW

  

HEAR ME!

WHEN YOU PLUG UP SOMEONE, HEAR - I WANNA KNOW

WHERE'S THE MICROPHONE TO PUT ME BACK IN THE SHOW

YOU GONNA GIVE IT TO ALL

BUT TELL ME, WHAT'S MY GAIN?

YOU GONNA MAKE IT LOUD, BUT CAN I STAND THE PAIN?

....leaves,collar of pea coat pulled up to withstand the cool air....

WHAT'CHA GOT NOW?
WHAT"CHA GOT?

WHERE YOU AT?

WHERE....?

Monetizing Prevention: SLP's have a new product line

In the final analysis, what is the value to CSD professionals of primary prevention activities? How can clinicians accommodate primary prevention fully into their clinical practices? What are the payoffs for making primary prevention a viable product line, within your speech-language pathology or audiology practice? How will your market share be affected by your new product lines? How will the professions evolve as a result?

For myself, I needed to answer some questions about how any new product line (in this case, primary prevention) can be successful, to determine if primary prevention can be a successful adjunct to evaluation and treatment. I needed to know:

* what exactly is this prevention product?

Education activities designed to help consumers lower, or avoid risks for communication and swallowing disorders

* can I easily explain this to other people?

We can help keep you well for expressing yourself, and to eat and drink. 

* how can I make the abstract idea, a concrete entity?

Identify, assemble and present activities, selected to help consumers at risk maintain wellness.

* is anyone else doing this?

(Readers? You can help answer this. Thanks.)

* if so, what are the forces that make their products marketable?

High interest 1:1, small group and large group educational events, targeted to consumers' identified needs.

* what is my market area, my niche?

(Fill in the blank, readers)

* does my market area want this?

Observe the activity near you at fitness centers, weight loss nutrition programs, smoking cessation programs, farmers' markets, etc. 

* how do I find out if my market area wants this?

Ask your consumers and friends on your digital social networks, if they are curious about how to stay well and avoid cardiovascular disease, cancer, diabetes, etc. 

* how do I market this?

Use all communication channels that touch your desired market, and make it easy for consumers to reach you and HIRE you.

* what distinguishes me from other practitioners in this area?

CSD professionals can link their educational activities to clinical interventions, as consumers request services

* do I have the credentials for this work?

Speech - language pathologists and audiologists can pursue independent study and coursework in health promotion 

* what will be successful outcomes of primary prevention work?

Consumers demonstrate increased knowledge in risk reduction strategies for communication and swallowing disorders

* HOW WILL I GET PAID?

Readers? Those activities not funded by grants and other external supports , might require a fee for service, to justify the time and costs incurred to teach consumers, who may never buy your clinical services. 

Those of you who have a primary prevention product - how do you do it?

 

 

The zealot tree

Trapping evil spirits....I like ice cream. I really do like ice cream. One story from our family lore that I frequently tell new consumers, is that I learned the actual value of a batch of ice cream - when I had to make it. Now that I regularly make batches of communication starter, the story seems as fresh as that hot summer day.

In the early 1960's, the ice cream technology available at my house was the wooden bucket fitted w/ hand crank. My Mom made it a very simple transaction for me: you help make it, you get to help eat it! The result of what seemed like three hours (I swear!) of hard relentless churning of that peach bit + creme anglais, was that we had fluffy - and slightly saline - peach ice cream for our hot summer party. I had churned away the evil spirits of lassitude, powered by the desire for a cool summer treat. My left arm also grew back, within two weeks.

Now, the joy of a thick, frozen bite of ice cream is dulled by political backlash directed at an ice cream company. This company leads its business model with its own social values; it has chosen to restrict its product to a country, whose policy is antithetical to these values. Refer to:

https://www.jordantimes.com/opinion/james-j-zogby/lessons-ben-jerrys-boycott

I like Israel. I really like Israel. One ice cream company is not bringing down the state of Israel. State governments in the US, who see themselves as the guardian of Israel's legitimacy within the country, have swung the battle - axe of politics down on this company. It's ludicrous, and almost pathetic that Israel supporters fear an ice cream company. Rather than freeze up Israel's management of its internal affairs, the company shared its moral vision to illuminate the moral shortcomings of the nation. 

The political strike against the ice cream company embodies an act of zealotry. As the late Arkansas journalist Paul Greenberg put it, a zealot either agrees with you too strongly, or disagrees with you strongly. 

Some writers, like Reza Aslan, say Jesus was a zealot. Other writers like Eric Hoffer might point to the example of an Obama voter, becoming a Trump voter in the next cycle, as the zealot's mark. Not strictly is the intensity of a person's devotion considered, but also how the focus on the devotion blinds the zealot to the full measure of that devotion. What could possibly be wrong with trying to punish Ben and Jerry's parent company, for B&J supporting a people they see as oppressed? 

I really like people, like Bronowski, who have strong opinions. Whether they force me to work to eat, defend my favorite dessert, or justify a clinical judgement - I do enjoy the arguments. These days, I see a lot of zealotry, in the forms of inflexibility, in the field of CSD. It could be coming from the training a clinician receives in pre-service education, or through subsequent continuing education. It also can bleed through from some social - political movements that occupy your mind, but that are tangential to this CSD gig you've secured. It could even be as simple as letting the pressures of real life get in the way, by getting entrenched in clinical 'ruts', doing the same activities with persons carrying similar diagnoses. A clinician who participates in research studies, may surmise that the protocol is always the thing. Everything.

However you delineate the actions of persons on the train of a clinical/research movement; - when every case becomes a strict research protocol, without back - channel communication that can be crucial to the consumer moving towards her desired outcomes, it's zealotry. We are selling a service, albeit a professional service, and it seems sensible to deliver the service the consumer bought.

Zealotry = evil spirits? Only in the sense that your perceptions, your judgement can be clouded by adherence to a narrow frame of reference (dogma, allegiance to mentor/leader), that has political as well as scientific implications to your effective practice.

I really like the bottle tree. It reminds me of how important it is, to trap and stow away things that don't belong - things that can prevent you from safe passage on your clinical journey.

The new professional comes a'calling

I recently started, after a break of almost twenty years, the mentoring of two new SLP professionals. Recently, I committed to consider a third - yikes! Mind you, I've mentored a few dozen new SLP's at all levels of their career development, since taking this career path: shadows of a clinician during the undergraduate years; interns in a medical setting, prior to their receiving the master's degree; and lecturing to graduate students about aspects of the 'hidden curriculum' - that is, what actually happens during the SLP's clinical workday. 

 The Clinical Fellow is approaching that very imposing finish line, in the marathon race to our professional credentials. Over the weeks, months and years of classroom study and clinical training, an SLP student in the classroom injects her didactic learning into clinical learning. With necessary clinical training in the University clinic setting and selected practica done, the intern then spends the better part of a term in a community's clinical setting, where theory first meets the workday road. Following that, the newly hired CF will show how independently they can apply their knowledge, to serve their consumers and the support systems. 

And - the C's are only the MINIMUM qualifications for clinical practice. Training never ends!

 

 

When I first took on mentoring of young SLP's, the time interval overlaid that for the emergence for mitigation/prevention of serial harassment in the workplace. I had to deal with my perception of being a member of a significant minority in the field, who is also perceived by some as being a significant source of these problems in the workplace. It is what it is. It's a healthier and more productive workplace nowadays, and the forces of 'quid pro quo',  'hostile working environment'  and appropriate workplace banter can go bidirectional.  Anyone now completing their master's degree, and who has not yet internalized the lessons of serial harassment, will not make it as a CF. Parenthetical? It only shows that relating to your peers, is one lesson learned within the seminar called "Communication".

A CF remains psychically connected to her training program, and that's a good thing - because the idealism instilled by that discipline of class, clinic and practica, can easily carry over to her first paid workplace. The job of a mentor? Helping the CF sustain that idealism and enthusiasm, when her workplace tends to blunt or temper the role SLP may take in serving consumers. The CF is the local expert for her scope of practice, and makes her workplace more and more glad of that through the experience.