EP 343: Inside a Mission-Driven Pediatric Feeding Practice

I enjoy the complexity of it and just helping people feel better. I think the biggest thing that I would recommend for someone is making sure you find the right fit for your team. I have wonderful people that work at Eats and Speaks and they each kind of just fit perfectly here.

Hi and welcome to episode 343 of the Untethered Podcast. Today we have Emily Hussey joining us. Emily is the founder of Eats and Speaks, a therapy practice based in Rockford, Illinois. With a passion for helping individuals of all ages thrive, she and her team of therapists provide speech, language, feeding and myofunctional therapy in a welcoming, wellness centered environment. Beyond clinical care, Emily is also dedicated to creating systems and resources that empower other private practice owners. She brings a unique blend of professional expertise, entrepreneurial spirit and genuine care for families into everything she does.

Welcome to the Untethered Podcast. I am your host, Holly Balkan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to.

Bring you the most up to date.

Information in the orofacial myofunctional therapy, airway tether, dural tissue and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019.

Thanks for being a loyal listener.

As we jump into today's episode, remember to listen with correct oral rest, posture, tongue up, lips closed, teeth apart, breathe through your nose. Let's get started.

Emily, welcome to the podcast.

I'm happy to be here. Thanks Hallie.

I'm excited that you're here. I feel like we've known each other for a while now and. Yeah. So it's always fun to have like a friend from online who has also been in some of our programs. But I've actually never met you in person. Right. It feels like we know each other though, like.

Yep.

It's always fun to have you on the podcast and chat and I know you specialize in speech and feeding and mayo and all that fun stuff, so we'll kind of dive into a little bit of that today. But I would love for you to share. Just I always like to ask me kind of like their origin story, like, how did you get. I feel like a lot of us go to school and like speech language is kind of like what we think we're getting into. Was that the case for you? And at what point did you like pivot into like Pediatric feeding and myo.

Yeah. So when I graduated, I started in the public school system and I worked in a variety of different placements, so general education resource, self contained classrooms. And I was there for about seven years. And I kind of had the yearning, like my last year that I. I wanted something different. I saw this consistent pattern in the schools that many of the kids were just unhealthy. Like, these kids were kids that had difficulties with speech and language concerns, sensory, behavioral things. But we'd sit at the IEP meetings and there's just this reoccurring theme that their health was also poor. And so I kind of took a deep dive probably in like 2000. Between 2016 and 2019, I did a health coaching certification that dove into, like, children's health and epidemics, the childhood epidemics that we're experiencing right now. And that kind of like, spawned me on to looking at other options. And at that point I was like, I think I just. I need to pivot. And so I quit my job and I started my own business. And I started out in the early intervention program and started kind of practicing feeding, learning more. I hopped in to feed the peeds. I think I was one of the first ones in 2020 when that launched, because, I mean, we had nothing else to do but to study pediatric feeding all day because there was nowhere to go. And so I hopped into that. And throughout the course of those years, I started to notice. Well, I very much noticed patterns in my second child, who was waking a lot at night with night terrors, bedwetting, snoring like an old man grinding her teeth every night. And so I was at a feeding course, a different feeding course in person in about 2019. And I, well, you should look into myofunctional therapy. And I'm like, I'm sorry, what is this thing that I'm talking about? And I heard about it and I went home and I just never stopped learning about it. Took an intro course and then took my method. And I haven't. I just haven't stopped since. And then as I'm learning, I was just seeing, oh my gosh, all these kiddos that I worked with in the schools when I could go back and think about why were these kids not making progress in speech sound disorder areas. And like, well, this is why. This is a big reason why. And so that has just kind of been a catalyst. My third baby, I addressed her ties when she was just about eight weeks old. So I went through that process as a parent as well. And early orthodontic expansion and airway issues with my older two. So it's been very much a labor of love for, you know, supporting other families, but also just, like, trying to dive in for my own kids to make sure they're healthy themselves.

Yeah, I feel like so many of our kids have, like, thrown us down a pathway that we never knew we were about to embark on, and here we are. We have gone far down the rabbit hole. So I guess talk to us a little bit about. You mentioned, like, your own kiddos and everything. And one thing that stood out that I love to highlight for people is the importance of supporting, like, oral health from birth and oral development. You know, it's like airway health and feeding and all the. All of the above. And so is that something that you educate on, you know, in your practice? Can you talk to us a little bit about that?

Yeah, we do. Especially because we see. We see infants. You know, I think my youngest baby I've ever seen is three days old. And we talk to parents a lot about how when kids are older that come to our practice with either speech or feeding issues, they didn't. They don't just come and have these issues that just popped up when they were seven. When you look back at their intake paperwork, you know, they were often struggling to breast or bottle feed, or they were maybe on a bottle that they just could compensate on. Maybe they even had some gross motor delays, which tells us a lot about reflexes and whatnot. So it doesn't just happen. Like, most of the time, feeding issues don't pop up when a kid just ate unless there was some traumatic medical event, I suppose. But there's a. There's a history. And so while we really stress to parents that, like, we cannot guarantee anything with any procedure or therapy, but we do see patterns. And so we talk to parents, especially when they're here. Most of our babies, depending upon the situation, are here about six to 12 weeks. And so we really spend time educating parents throughout that time so that if something were to come up when they get closer to, like, eating solids, they know exactly where to go and they know exactly who to contact right away so that we're not waiting three years with picky eating and gagging and vomiting. Instead, it's like, oh, I did this for three weeks and this didn't get better. So I called eats and speaks again, and we got right back in, and we could nip it right in the butt. And so that is something we definitely hit home to families, especially the ones that are, you Know that birth to 12 month population because there's just so much we can. Tiny bits of information that they can learn that can really change the trajectory of their kids development for certain.

No, I love that. And I think it's so incredibly important to get in there early. Like I think about when I was pregnant with my oldest, how it would have been really nice. Like I. We took these baby classes through the hospital and like there was like a breastfeeding component. Now was there actually like an ibc, TLC or anybody actually qualified to talk about this? No, we watched a video and then we went for like a tour. We did do a CPR class, so that was helpful. But aside from that, there was really no parent education on, you know, hey, you're about to give life to a human and your two big responsibilities are like, keep that baby alive by making sure they can breathe and making sure they can feed. And like as long as they're voiding and you know, peeing and pooping, everything's all good. You know, it was sort of like once the baby was here, it was like, okay, it's really important that baby, you know, has this many wet diapers and that they, you know, they have bowel movements every so often and you know, whatever that frequency was. Like I was tracking the feedings, I was tracking, but also was tracking it because one, I'm like, hi new mom, my brain's not working. And two, like I don't know what I'm doing. So if I need to actually like get some assistance, I feel like I need to log this, you know, every feed, every poop, every pee. But we were doing that because she was also an awful feeder. So there was that. Um, but I just, I'm like, I wish that there was like more parent education. Like I don't want to say standardized, but like across the board, kind of in the way that these hospitals require you to take a baby class before you give birth in their hospital. Sometimes it'd be really nice if there was some like learning for parents prior to actually having the baby.

Right. And so we don't do a ton of like prenatal visits for families necessarily, but we do have a course that we created because that's exactly it. Like we, we took all the things that we tell families when they come here that they're like, what? No one ever told us that. So that you can at least. Our goal is not to replace therapy when you need it, but our goal is to give you tiny bits of information so that when and if that does occur for you, you have a straight shot for who you're going to go. And I would say if you're a parent listening, one, you should check out our course because I'm biased, but it's, it's super helpful. But two, my biggest advice is to learn about feeding your baby before they come. You will never regret that. Whether or not you have feeding issues or not, you will never regret it. And to find providers in your area, like a lactation consultant or a speech therapist who does feeding or an occupational therapist who does feeding. Find these people before you have your baby because then you're going to know exactly where to go to. Maybe you're going to even look up reviews. Maybe they're, you're going to take a glance at their social media, have them before. Because we do have people that call kind of in a panic and we do get people in as quickly as we can. But then also we get people who maybe didn't know where to go and they sat in misery first three or four months before they find us. And then that was me.

I'm like feeding therapist mom over here.

Like, what happened? Yeah. And then they're like, oh my gosh, I didn't know this. I wish we could have come sooner. I mean, I never have a parent that's like, wow, I'm really glad you just told it to me now instead of, you know, 12 weeks ago or even when I was expecting, you know. And so our course goes through, you know, what is normal development in a baby? What are tips and tricks I can do to just support my baby's development even if I don't have concerns? And you know, what type of, what does it look like if my baby has a tongue tie or other medical based feeding concerns? Like, what can I do and who can I reach out to? It goes as far as products that we recommend for babies and maybe why some products are okay for a short period of time and why we don't want to use others. So, so it's, it's a real, like intimate, it's a short course, about an hour. So it's nothing overwhelming. And that's why we created it, just so people can have an ounce of information before they go.

That's incredible. And so, so very needed. Yeah, I mean, I joke, I'm like, guess the joke was on me as a feeding therapist mom. But you know, for people listening who maybe are newer to the podcast and haven't been here for five, six years, you know, I feel like. So I, Lily, my oldest, is Tongue was tongue tied. She's now been in three rounds of expansion. She just turned 10 at this point, but really struggled to breastfeed her. And I was working with, like, the two plus crowd at that point. So my brain was like, infants. What do I do with an infant? I don't know what to do with an infant. This was 10 years ago. She very quickly threw me into learning what you do with an infant. But it took me, even as a provider in the pediatric feeding space, it took me time and energy to figure out as a new mom, that one, okay, this is not normal. Because everyone kept saying, oh, it's normal that this is happening. Oh, that's normal. And at a certain point, I was like, I'm gonna trust my gut. Like, this doesn't seem normal. She's barely getting ahead. She was never ahead of the first percentile on. On her, you know, growth, her weight for the entire first year. And she was like, 5% for, like, height, you know, and so it was like, my baby's just tiny, but also like, we are on our own growth curve, according to the pediatrician. And I went. I took her to an ibclc who was like. Put her into, like, a football hold. And, you know, that positioning. She fed well in the appointment, and then we left, and it did not work at home. And I was like, it's like when you take your car to the shop and they can't seem to figure out what that noise is, and then you leave and the noise is back. I was like. It was like taking my baby to the shop, you know, worked beautifully while we were there, and we went home, and it was a problem again. Um, but no, we struggled for 13 months with very painful breastfeeding. Like, I would have to turn my face away from her to latch because of how painful it was. And I think that's one of the. One of the reasons why, like, I created my courses. Like, I created this podcast. I created Feed the Peas. You know, it's like. Like, you're saying parents need information. I was like, clinicians need information, too. Like, I didn't know what to do with her. And I was in this space where I presumably would have greater access. Access to feeding therapists or information. And even then I was like, but I didn't. So, you know, it's. It's interesting to see it all kind of come full circle. I feel like there's more courses out there now. But when we created Feed the Peds, we were like, this doesn't exist. Like, we need something that Kind of like pulls everything all together. Let's add in the tongue tie conversation. Let's adapt mayo to these little ones, make sure they can eat, breathe, sleep, you know, succeed, thrive. But yeah, man, had I just as a parent had a sliver of information knowing, like what to expect with my infant and not just blissfully going into, you know. Well, it wasn't blissful. We were induced and it was a long. But just expecting my baby was going to latch and everything was going to work, you know, beautifully. I think I would have at least felt more like my nervous system would have been a little bit more in check.

Hopefully.

Like, I would have been like, okay, it's not going as maybe we thought it would. But also I've got tools in my tool belt. Like, I know who to seek out and where to ask for help and where to go. So I think like, like you said, like, it's just you don't know. And if you don't know who's in your area and you don't really even know who to seek out, you're kind of starting at square one. And now you're sleep deprived in your fourth trimester and it's just, it's a hot mess. And those Facebook groups do not help.

No, not, not a great way to enter a Facebook group when you're. It's 3:00am and you know, I've told a few people in the past, like, I have to stay out of the groups myself because I just, my heart is. It's so painful to watch the 75 comments that come in under this mom's post with everyone's input. And I think I honestly cannot see two. Cannot think of like two babies or even two older children that I do myofunctional therapy with that need exactly the same approach, you know, and, and so that's why having that individualized care is so important because one baby might be ready to go for a release at 8 weeks old and one baby, I would be like, no, we're not going to do that. And it's so it. All those little details can make or break things for certain. But yeah, I relate to everything you said because my first child, my best advice that I got from somebody regarding breastfeeding that was that I didn't need to take take a class that it was just, just took practice. And so our breastfeeding lasted about three months and I had like two horrible bouts of mastitis, one that landed me in the emergency room and I pumped till she was like 8 months old and I had enough breast milk to last her for the year. And we made it work, but it was not an enjoyable experience. And I think, I think that's the other aspect is like the normal and like the wait and see and all of those things. And I was actually talking to a colleague about the, you know, the whole wait and see concept in our world. And I said, I think wait and see has a time and it plays. But as long as the thing that you're waiting and seeing with is within the lens of someone who actually knows what we're waiting and looking for. So if I say, if I have a kiddo that comes in and the parents concerned about, you know, airway, but we have addressed allergies and we've addressed diet and they have some structural components with the tongue that are concerning. I'm not necessarily, I'm gonna say, well, let's wait. But in the midst of waiting, we're actually gonna do something while we're waiting. And I, between myself and the parent, we're going to partner together at that point and be like, yeah, we've waited and we've hit this mark and now we're going to pivot from what we currently are doing. But if you wait and see with another professional that is not in the lens of what you're actually concerned about, you are likely going to miss the mark. And I just think that's such an important thing. So I wouldn't maybe wait, you know, ask my family member who has heart issues for me to like wait out their cardiac issues. Because I'm a speech therapist, I don't work with the heart but for the same notion. Most times a family practice doctor or a pediatrician is not your go to person to help you wait and see because no one's seen. You might just be waiting but they're not checking back in with you on that situation. So that's something I've been talking a lot about lately because I also think that there's, you know, this notion on social media that's like it's all or nothing. Like you should never give your baby this type of pacifier, you should never use this bottle. It's like, well, sometimes we do, but our goal is to get out of those situations. You know, if a baby can't operate on a Dr. Brown's but they can operate on a mam bottle, we're working on that MAM bottle to ensure nutrition until we can optimize oral function to get off of that, you know, situation. So. But that's where you need that Clinical, you need that professional who specialize in those areas to guide you. And I don't want parents to feel like they have to make those decisions on their own.

So I love that. And I feel like. So I haven't actually talked about this in a while, but I used to talk to parents about this a lot. The same topic. And so what we ended up doing, because we would get a lot of. Even just like with speech screenings, right? Let's wait and see. Let's give it three months. Let's give it six months. We would do a screening, and I would be recommending therapy, and the parent would be hesitant. It's like, okay, so what we ended up doing, and I actually kind of learned this from one of my mentors. And I. When I say mentor, I mentored me through grad school because it was one of my clinical advisors, but they specialized in fluency and, like, stuttering. And so they were like, wait and see is not always a great option. Like, let's watch and see. And it sounds exactly like what you're doing, right? It's more of watch and see. So you've got this clinically trained eye who is. It's almost like we're monitoring. And so it's. We're not just sending them off and going, hey, you know what? Call me back in three to six months if this is not improving. Which, listen, if that's what you're doing, by all means, like, you do you. But it's like what you're doing is, like, actively watching and monitoring. And you're like, you might not be in active therapy, or maybe we're in therapy, but we're addressing something else, and we're kind of monitoring this other thing to see down the line. Is this something we need to address? And so I feel like that's such a important topic to really, like, drill. Like, if you guys take nothing else away from today's conversation, like, that alone right there is worth its weight in gold. Because we are missing so many kids. Like, we are missing the root behind why so many things are happening. If we're just constantly focusing on, like, oh, this kid came to, you know, to me for speech. And we're just addressing the speech, and we're not going, wait a second, hold on. Yes, this is important, but why are we doing this? And kind of getting into the root cause conversation? Because I feel like that those conversations, I feel like nine times out of 10, at least in my practice, often would lead to these watch and see conversations, too, where parents maybe weren't Always, you know, totally two different things, but like, not always bought in completely into taking a certain more holistic approach. Like we'll do mayo first and then we'll start to integrate the speech into the sessions. You know, once we've got our, you know, our foundations built or, you know, I know you came to me because the baby's not feeding, but I, you know, yes, we're going to work on feeding. That's obviously important, but like, volume driven goals is not the sole goal here. We're going to monitor that. What we need to work on are like the sensory, oral, motor skills. Right? It's like building the foundational stuff. So I feel like that's like the whole watch and see thing can apply in so many different ways. But. But yeah, I love that you brought that up and I also love that you touched on like the all or nothing approach because, you know, it's like we put things. And as, as a content creator, as someone with an online business, you know, like, we put things out sometimes to be. What's the word? Like where you catch somebody's attention and you kind of, you know what I mean? There's like a word like they teach you. And I'm not somebody who teaches this stuff, so like, it's totally not coming to my brain right now, but it's almost like to like stand out amongst all the noise. Right? But I think when people do some of that, and I'm so careful sometimes too, like, as to like, what types of things that we put out and we say, because this whole, like, oh, you don't want this, you want that. This, not that. This, not that. And what we teach is similar to exactly what you said. Especially like inside Feed the Peeds. We're like, yeah, listen, like, here's the gold standard. Like, in a perfect world, it would be great if the kids were using this bottle or that pacifier, if they're using one or this utensil or this type of this or this type of that. But also like, to your point, you're like, hi, we have basic human needs here. Like, if the child comes in and they're using a, you know, maybe in our therapeutic lens, it's not the best bottle or it's not the best, you know, pacifier or utensil or whatever for oral development cup, you know, whatever. Well, we know what our goal is, but also, hi, the child needs to thrive for right now. And if we're compensating and using this other utensil tool, whatever it is, to get there like, that's okay. Like, I've, I've had so many feed the peds, you know, students or graduates even come and be like, wow, we have this kid and they're using a man bottle or they're using my man passy or they're using sippy cups or this, that the other. And we're like, okay, well, have you assessed their own oral motor skills? Do they have the ability yet to even move on to what it is you're recommending? And so I love that you highlighted that because we live in such an all or nothing world and I think we have to bring it back to reality. Like, we're dealing with humans, not robots.

You know, and that's why, like, I mean, we're very active on social media as well. But I cannot take posts and like, explain every possible way that tongue tie may or may not or airway may or like, it's, it's physically not possible and it probably wouldn't do anyone justice, justice if I did. And so that's why I encourage families. Like, if social media is overwhelming to you and you're not sure which direction to go, like, then you need to see, seek out that next level of individual care, whether that be a course that can dive into things a little bit more deeper and explain, or maybe it's a consultation with someone or, you know, a treatment session in person because it's just not possible for even on like, all the content that you throw out there and so many other really awesome providers and people who are doing such wonderful work. It's just not possible for us to explain every nuance to therapy. And so if you're getting only support from social media, I encourage you to reach further. Yeah, into the bucket. Because it's probably not meeting your needs and it might just be an educational piece to spur you on to something new, but it can't be the only thing.

Yeah, I kind of want to say something too that's going to ruffle some people's feathers, but because I won't say her name, but one of my friends and colleagues and I talk about this all the time. You know, people put like exercises, whether it's Maya or feeding online. And it's one thing if, like you're doing like B roll and you've got a little, you know, thing in the background and there's a kid you're doing an exercise with or they're do, you know, like, I'm not talking about that. Like, that is totally fine. That's real life. Like, all good. If you're like outright putting like exercises up to teach other people how to do these exercises on social media. I personally feel it's highly unethical because to, like, some of the points that we've made, both of us during this conversation, not no two children get the same treatment plan and no two new. No two children need the same thing, whether it's speech, feeding, language, you know, it's so to me, I feel like we are doing a major disservice by putting that out there because I think parents may then feel wrongly, wrongfully empowered in a sense to then treat their own children with the knowledge that they're getting. Whereas I feel like, you know, we should be focusing on educating and empowering our parents to understand what conversations they should be having, maybe even what goals they might be wanting to work towards. But in order to actually do the therapy, like, we need a therapeutic. You need a license, right? And so you need a state license in order to do the type of therapy that we do. That's why, like, we get medical reimbursement on super bills and some of us are in network and some of us are private pay. But like, there's a reason for all of that. Like, there are medical codes associated with the work that we do. Just like the doctors that people see. And like, you know, I don't see doctors putting their surgeries on Instagram.

These. I mean, I even, I will be honest, like even seeing providers that are putting video of tongue tie releases. I don't know, like, maybe I saw.

One of those last week and I.

Was like, I just don't know if that's the best way to be educating people. But no, I agree, because it is. There's just so much complexity to it that people don't realize it's not just, you know, because someone could be doing certain things or you show them a certain thing and it's like, okay. And they're like, look, I'm doing it. I'm like, yeah, but you're also compensating down to your diaphragm in your shoulders and your neck is this way. And then you get your tongue cave. Well, you know, like, that's not a tongue cave. We can't accept that for you. So we need to back up and move, you know, just back up a bit. No, I completely agree with you. I. I really just think people are better off having that individualized care. It's going to be more efficient and save them energy and time and chances are, money too, if they just find a good provider.

So yeah, yeah. Especially if you're not having to undo a whole lot of things that have been learned through Instagram education. Anyway, and this is not to hate on Instagram because obviously, like, we are both content creators, we do share a lot of helpful information on there, but there's a time and a place and you know. Anyways, let's talk a little bit. So you have a private practice and you've got a team and all of that fun stuff. So let's, let's pivot the conversation a little bit to private practice and you know, anything that you would want to share with anybody looking to go, like maybe just how long have you been in practice? Have you always focused on feeding in myo? I know you do speech too. Did you start with speech and language? Like, what's that look like for you?

Yeah. So I started my practice in 2019, June of 2019. And I was seen mostly birth to three at that point, driving my car around everywhere. And then I opened my brick and mortar practice March 1st of 2020. So that was quite a way to start that whole process and ended up shifting back to teletherapy for like three months and opened back up June of 2020. And I was on my own for about a year. And that's when like my year, it was like full on MYO speech. I was just diving into anything I could consume at that point in that area. And then about a year later is when I started building an admin team and other other speech therapists. And at that point it was like, if you're coming on board, you're learning about myo. So I did a lot of like hands on training with belly to belly with them, doing their evaluations and then treatment with them. And then we all jumped into myomethod at one point, probably like six months in and you know, just kind of diving into all things MYOT speech. Our practice now is mostly speech therapists. Well, is all speech therapists currently, but we are focusing on primarily speech, early language, functional communication. But then the majority of our patients are myofunctional therapy. Feeding therapy. Yeah, infant breast and bottle feeding. I'm also a certified lactation counselor and we have one other therapist on the team that is also a certified lactation counselor. So I would say that's, that's mostly what we're doing. I also do a tiny bit of adult MYO depending upon the case. And I enjoy, I enjoy that as well. I enjoy the complexity of it and just helping people feel, feel better from the adult standpoint yeah, that's pretty much what we're. We focus on here for the most part, I think. I don't know. You said if someone was coming into private practice, like, what would you recommend? I think the biggest thing that I would recommend for someone is making sure you find the right fit for your team. I have wonderful people that work at Eats and Speaks and they each kind of just fit perfectly here. And so making sure that you are really clear on what you want from the beginning, I think that can save a lot of things for people. And make sure that your, your team is sound and that it's working for both of you, I think is a big piece of advice that I have for people.

I love that, like kind of knowing what your values are as a business owner, as a private practice, and making sure that like your team members kind of and anybody. Admin therapist, that everyone kind of fits into that. Yeah, I love that because I think it's, you know, I get a lot of therapists sometimes from other private practices into mine that go to a practice.

And they're like, oh, I was told.

I was going to get a certain type of patient. And then they gave me the complete opposite. Like, I was going to get birth to three feeding and I got like teenage language cases. It's like, not even close. And so they're miserable and then they one day leave, you know, they end up coming to me and I'm like, no, if I tell you you're getting this, like you're getting. You're getting those feeding and myo cases. Yeah. So, okay, so. And then kind of pivoting a little bit. So team, like team, outside of your actual team, do you have now also like other professionals in the area that you guys collaborate with that refer to, like, how. How's that all look?

Yeah, that has been a labor of love to just. So we have several release providers that we love and we're continuing to build that network. We have a physical therapist that we love that partners with us quite a bit who is also trained in cft. And that has been such a blessing for especially our younger ones. We have a few lactation consultants that we partner with where when myself and my colleague who also have the lactation certification, we've kind of just hit our. Our point. We're like, nope, we would love to send you to an IBCLC to make sure you're taken care of. So we have that. We work with several chiropractors in our area as well, and we've extended our network to other Ents that we know are going to support our families with potential surgery if needed, with tonsils, adenoids. We try to avoid that as much as we can, but sometimes it's just necessary for the long term health of the child. So I would say. And then just other area dentists as well that we've collaborated with. But that when you look back, I think that like after, as I'm like saying this out loud, I'm like, that's so cool to think about. Like, because I was just floating in the middle of nowhere by myself doing this myofunctional therapy and everyone thought I had a unicorn. I mean many people still do think I have a unicorn horn sticking out of the middle of my forehead, but I'm still very much on an island a little bit. But we've at least found providers that are, are either close to us or not too close to us that we feel really good partnering with. So that's been such a cool experience to have those, those people in your corner. For sure.

Yeah. I mean it can be so challenging. I feel like that's one of the biggest questions we get to like whether people are going into pediatric feeding or myo or both. It's like, where do I find those providers who get it? You know, and kind of seeking out who that is in your area or even within an hour, hour and a half of where you live sometimes is challenging. Especially if you're a like private practice owner. You've got like a small private practice. Maybe it's just you, maybe you have a small team. It's hard. It's like hard to kind of like one love on your patients, do all your work, run the practice and to be out there trying to find these other magical unicorns that will be part of your magical unicorn team.

Yep, exactly. Yeah. And it's a lot of effort and work and I think that's why I just encourage therapists and also parents. Like when you find someone like just really love on them and, and also don't forget like what you're doing because the amount of work that we have to do to find these people, we don't. Contrary to what does happen in a lot of local health systems is it's just, well, I refer to that person because they are in network or they're in our health system or I refer to that person because that's what I think this family can afford. That is not what happens in my practice and many of the practices of other speech therapists who do myofunctional therapy that I know in my area that is not how it operates. It's like, if I'm referring to you, I've likely taken my own children there and had my own personal experience, or I vetted them. I've gone and watched them do a release. So I can see. I want to look to see how does their. How do. How do they. How are they treated? You know, when they're there, what is the bedside manner looking like? How can I help facilitate that process even better for my patients? So we do our best to try and vet people, and we're not perfect. We're never. It's not like we're going to get it perfect every single time. But I do know that when we have issues with providers and we don't feel like our families are being taken care of, well, we are happy to step away from that relationship. And that's not an issue for us. So.

Yeah, yeah, no, it is. It is so critical. And that's one of the things that I tell people all the time. I'm like, you gotta figure out who these people are. Like, you're just. You don't want to just blindly refer somewhere because somebody said, oh, they're good, or, oh, they're a network. Oh, they're. You know, because that's typically how things work in our medical system. But, yeah, I always tell people, I'm like, if you can go as a patient or take your child as a patient, if it's a pediatric provider, and see, like you said, kind of like, what's the office? Like, how do they treat you as a patient? Like, how do they treat you as a patient when they don't know who you are? Because that's gonna be very different than if they know you're a referring provider. Right? So being able to, like, go in and, like, have that actual experience before referring anybody there when possible. Like, I'm like, that is the most powerful thing you can. Can probably do as a referral source. And then being like, you know, when you're there, like, oh, hey, by the way, you know, I do this, and I would love to refer patients to you, and, oh, that's a whole different. You know, then it's like the conversation usually changes and, you know, they light up because you're offering to send them business. But were they like that before. Before you offered to send them business? Were they like, like you said, bedside manner matters. Like, that is one of the number one things where we've got some providers that are really wonderful in, like, the D.C. metro area near my Practice there's. And we have to. Because we don't have a ton of ents, we sometimes have to say, hey, this ent is actually really great. The bedside manner is a little wonky. You know, I'm just gonna put that out there. Grin and bear. If you can grin and bear it like, and you, you understand, you go in knowing that I think it'll be a good experience otherwise, like, unfortunately we have to have that conversation. But I, because we've had so many parents come with this one ENT in particular, particular who's part of a practice and there's more than one ENT there and they'll say like, you know what? So and so seemed great. But like the bedside manner, like major turn off, like, don't want to go back. And I'm like, oh, okay. Well that's problematic now, isn't it? You know, so, yeah, it helps if.

You can prepare them and give them like, they know what they're doing. They're going to take really good care of you. But they're not going to be warm and fuzzy.

Yeah, they're not going to be warm and fuzzy. You're going to wonder why they work with pediatrics and you might want to run screaming out the room. Promise they're not going to do anything horrible, but they're just not, you know, it's probably not going to feel like super great like it is when you come here.

Yeah, man.

I tell you, I tell you. Are there any other, like, challenges not necessarily related to like providers, but just like challenges that you want to share? I mean, you were, you were sharing last week about some challenges as a private practice owner with one trying to get reimbursement from Blue Cross and to their dropping your rate for reimbursement without any notice. I mean, that included. But in addition to that, like other challenges that you would share with others?

Yeah, I mean, I think my biggest challenge right now is finding qualified providers who want to join our team. That's our, our bottleneck right now is helping people understand this world of feeding in MYO and tots and you know, just like overall wellness based approaches to even traditional therapies. And so I think that, and I've actually talked with my team quite a bit about. We, we love having graduate students and we often have, we have them often. And I would say one of our biggest challenges is, you know, as a niche specialized practice is most graduate students could never just walk in the door and, and treat and do a job without having belly to belly, like support at least in my practice, I would never allow that. And so I think that is one thing that I do wish that a higher education would put a stronger emphasis on, on preparing these students earlier so that, you know, yes, we can come out and we can take trainings, you know, like feed the peds, which is so wonderful. But I do feel like we're just within our field. Just. It's a tremendous disservice that these kids, these students are not that it's not even required to take a pediatric feeding course. And maybe it is now, but most of our students now are not coming in with pediatric feeding knowledge or don't even know what myofunctional therapy is. They don't even. They've never even heard of it. And I just think about the amount of kids that could get so much better support if even they had an ounce of information about it. So I say that is one of our challenges. Obviously, you noted, like, we went several weeks without any payment from insurance, and we also had our reimbursement rates cut. And so I've been in contact with people at my state organization, at ASHA, and at my Illinois, Illinois Department of Insurance to file complaints, because I think that's just another thing that if you are a parent listening, like, that's just something to consider that if you have no one in your area who's accepted, accepts insurance, or maybe the provider that you want to go to only accepts, like, one insurance, it's not because we want to make your lives hard. It's because it's not possible a lot of the times. And so we don't have. I don't have productivity for my team. They work their butts off anyways. And we. We do our best. But I do think there will get to be to a point where practices like mine will not be able to accept insurance. It just won't be something that we'll be able to offer to families. So in. In the midst of all that, one way we're trying to combat these challenges, just continually develop programming for families. So I encourage you, if you're not already following along on our Instagram or you can visit our website, we will be having more resources for parents and hopefully professionals in the near future just to give you guys more guidance, even if you're not near us, so that, you know, I think the process, when I think back of what I want for families that walk through our door or what I want for families that find us online, I want you to be able to walk through a developmental issue with your child or a medical issue with your child with just like peace and I. And that's why we want to continue to create resources so that you can be guided and know like, okay, this is my next step. I don't have to freak out about it. And also know that sometimes, like, just because we can do something doesn't mean we should do it. Just because your kid looks like their tongue is a little tight or their palate looks narrow, just because you, you can do it doesn't necessarily mean you should it. It just depends on what your life, where your life is taking you. And so to combat all the challenges within private practice, like we're just trying to develop resources for parents and professionals that can make your life a little bit easier while we continue to, to serve others. So yeah, I think that's great.

There's, it's so needed. And to your point, like, that's why I never took insurance, because I was like, it's either going to be me who is not who. I don't have the time to chase after insurance companies and make sure we're getting paid and you know, or I'm going to go hire a biller who. I have a biller already. I have an admin, right. I'm going to have to pay somebody like basically a whole salary just to chase down money. You know, at the end of the day, when I looked at like my profit margins and the ability to keep my practice open for it to even make sense for me to run this business, I was like, it, it doesn't make sense. Like you either have to, at least in my area, in the D.C. metro area, the way that I looked at it was you either have to have a large facility with a ton of therapists and it has to be volume driven where. And I'm not downplaying all these facilities because some of them are, you know, some of them have really great therapists, but sometimes it's a 30 minute session, in and out, as many sessions as a day as you can possibly fit in because we got to keep the lights on. And I was like, I don't want that. I don't want that for me, I don't want that for the kid. It feels that we get maybe 15 minutes of solid therapy in, in a 30 minute session. Whereas like in my, you know, 50 minute sessions are really 45 minutes because 5 minutes we save for documentation. At the end, in 45 minutes, I can do a whole lot with a kid. We can address speech, we can address feeding, you know, or we can do speech and mayo or, you know, whatever we're doing. I was like, we can dive in a bit deeper because it also takes children time to warm up and to get into a session. And I'm like, you're already five plus minutes in by the time you start actually getting something out of the kid that is therapeutic, you know, intervention type of stuff. Right. And it's not just like, let's play this game, and, you know, sure. Can some people sit down and get a kid to interact faster and everything? Okay, maybe, yeah. But, you know, I like to go. I like to keep the nervous system in check. And so for me, I was like, I feel like that requires a certain type of therapy, and that is not something that is conducive to, you know, that model. On the flip side, it's like, if we were getting higher, reimbursement, raise from insurance, then, yes, I probably could have made it work. But I was like, that, you know, would require a brick and mortar and a bigger team. And like, you, I started out, you know, more younger. It was birth to five for me, but I was in the car driving around, doing the things.

Right.

Then we kind of pivoted to bringing on a team of therapists to help with the caseload and to kind of grow the practice. But all that to say, I mean, I. I'm in awe of what you do and what you've created and the fact that you're hot. You know, I feel awful that you have to go and chase insurance. And, like, you know, I saw how much time and effort you were putting in last week just from, like, you going to social media to be like, hey, hi. Maybe somebody will pay attention to me here, because it's not just making a phone call. It's actually getting somebody to listen to you. Yeah, those company in the. Or, you know, the insurance company, which is crazy.

The quickest response that I got from someone was messaging their Facebook.

Isn't that wild?

And I. And I mean, I still just got an. It was not. It was not helpful, but they did actually respond to me, and it did not look like a bot or AI. It did look like an actual human. And so, yeah, I mean, it's just. It's such a wild thing. And I think the challenge of, like, navigating, okay, how much time am I gonna. Effort am I gonna put into this to try to even just earn what I did before? Because when I spoke with someone at Isha and Asha, they both encouraged me to band together with. All of the other speech therapists are in my area to try to bring numbers. Spoiler alert. I am the only one doing this therapy in my area. I'm surrounded by large medical systems. There isn't my closest colleagues who I consider dear friends, they're all in the suburbs of Chicago and they didn't get touched with their rates. So it's kind of hard to just drum up all these numbers when there's literally no one else doing this. So, yeah, so it's, it's this delicate band balance of making sure, you know, my team is taken care of, making sure that our patients are taken care of, that we're doing whatever we can to stay open, but also, you know, just being of service to people and even, you know, other therapists and moms and, and which is why we're excited to continue to develop resources online for, for people to support in ways that we can't maybe if you're not in our area.

So. Well, I, I'm wishing you all, all the luck. I'm rooting for you. But man, that is so frustrating to hear that others that are in the suburbs of Chicago didn't have their rates touched. But you, who you're the only person actually providing it in your area, that's where they knock the rates down. Like, but that's got to be illegal. I don't know, I'm just going to go out on a limb and say like that sounds crazy, but I'm sure they found some loophole. But hopefully those rates go back up for your sake, your patient's sake, and the ability for you to keep offering.

An insurance based service.

But thank you Emily so much for joining me today. Everybody go and check out her website, eatsandspeaks.com and follow her on social media on Instagram. We are on Facebook too, right? Is it also.

Yeah, they're both. Yep, it's Eats and speaks therapy.

Awesome.

Awesome. Thank you, Haley.

Quick disclaimer. All information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, Airway and feeding related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources and all I offer@halliebulcan.com or pop over to Hollybulcan on Instagram to get all the latest updates.