Beyond Best Practice: Why Individualized Care Matters in Speech Pathology

Is best practice always best? In their insightful book, Your Medical Mind, Dr. Jerome Groopman and Dr. Pamela Hartzband challenge the notion of rigid adherence to "best practice" in medical care. There are two main points underlying this challenge…

The Evolution of Care

Medical knowledge is constantly evolving, and what might be considered best practice today could be outdated tomorrow. Think of it like your smartphone. If you're like me, you're constantly being bombarded with updates, features, and new and improved apps. Oh, and that cutting-edge technology you purchased just a few years ago? Is now bordering on obsolete. Just like you probably wouldn't want to use a ten-year-old phone, you wouldn't want to rely on outdated speech pathology knowledge either. The problem is that best practices and universally accepted standards don't always update as quickly as research, knowledge, and technology, which may challenge the status quo.

Patient-Centered Care

The second thing to consider here is the need to focus on individualized care. It's important to recognize that what works for one patient might not work for another. Best practices and standards of care, by definition, apply to everyone. However, this cookie-cutter approach rarely works in healthcare. This is because no two people are alike. Literally, every single person on this planet has a different chemical makeup. Even identical twins. In this way, treating a patient is like tailoring a suit: You wouldn't expect a single suit size to fit everyone perfectly. Similarly, dysphagia treatment needs to be customized to each patient's unique needs, abilities, and values.

For The SLP

These concepts resonate deeply with my experience as an SLP. Our field often grapples with gray areas, conflicting research findings, and the ever-changing landscape of evidence-based practice.

Think about it: What aspect of speech pathology ISN'T evolving? Is there any single practice in our field that boasts universally agreed-upon, black-and-white research results? From swallowing techniques to language interventions, we're constantly refining our approaches based on new evidence and individual patient needs. And this is the way it should be.

The truth is, our field is messy. We often navigate a dearth of research inside a swamp of conflicting information. While best practice seems like a nice solution, it can be like forcing a square peg into a round hole. Attempting to artificially "clean up" this complexity by forcing rigid adherence to a simplified, one-size-fits-all version of "best practice" does a disservice to ourselves and our patients.

Patients don't want THE right answer; they want the answer that's right for THEM. They deserve individualized care that considers their specific circumstances.

So, how do we embrace this ambiguity? How do we navigate the uncertainty inherent in our profession? Here are a few things to consider:

• Stay curious: Seek new knowledge, challenge existing assumptions, and remain open to different perspectives.

• Embrace critical thinking: Don't mindlessly follow trends. Evaluate research critically, consider its limitations, and apply it thoughtfully to individual cases.

• Prioritize patient-centered care: Involve patients in decision-making, respect their preferences, and tailor interventions to their needs.

• Cultivate a growth mindset: View our field and the lack of research-based guidelines as an exciting adventure to find what works best. See the challenges we face as opportunities for learning and growth. Don't be afraid to admit when you don't have all the answers. A little secret that few will admit: Nobody has all the answers.

It's best to see speech pathology less like baking and more like cooking. A recipe might provide a basic framework, but you often need to adjust ingredients and cooking times based on the specific dish, your experience, and your preferences. Similarly, dysphagia interventions need to be adapted to each patient's responses and goals.

By acknowledging the enigma and embracing the unknown, we open ourselves up to a world of possibilities. We create space for learning, growth, and discovery. We empower ourselves to provide truly individualized, evidence-based care that meets the unique needs of each person we serve.

What are your thoughts on "best practice" in speech-language pathology? Share your experiences and insights in the comments below! Have a friend that may like this? Share it!