December 2016 Newsletter



Consultants in Dysphagia Evaluation and Management

817-514-MBS1 or 1-888-514-MBS1

Clinical Café Newsletter

By: Ronda Polansky M.S. CCC-SLP




DiagnosTEX will be running vans January 2-5 after New Years!  We wish everyone a blessed New Year! Look forward to working with you again in 2017!


2017 DiagnosTEX Dysphagia Calendars are distributed! Thank you for all the great feedback! So much fun to see how much anticipation there is for them each year.


New Years Resolutions Statistics – Do you have one?

Type of Resolutions (Percent above 100% because of multiple resolutions) Data

Self-Improvement or education related resolutions = 47%

Weight related resolutions = 38%

Money related resolutions = 34%

Relationship related resolutions = 31%


IMPORTANT NOTICE – Medicare Patients that do not have secondary insurance

Starting in January, all patients who do not have secondary insurance and have Medicare only, will be required to pay their deductible to DiagnosTEX prior to the scheduled study. If you have any questions, please call and speak to the DiagnosTEX billing staff. As with any visit to a doctor’s office, deductibles must be met at the beginning of each calendar year. Please help us educate all your patients when you are scheduling for an MBSS.


Upcoming CEU’s in 2017 –

Deciphering Dysphagia with Ampcare ESP – January 27, 2017 in Plano Texas.

This will be hosted by Neurologix, our SLP, Kelly Murray’s new company. Come out for 8 entertaining CEU’s and see her new place!!


A new disclosure added to our medical record – Media utilization, HIPAA, and legal exposure

Please be aware that unauthorized use of any information or content in the provided report or DVD may constitute a HIPAA violation or other legal issue if names, descriptive information or identifying information directly or indirectly are used on social media, blogs etc. Depending on the state or jurisdiction, some boards have specific laws that address the healthcare practitioner’s inappropriate use of social media. Other boards may use existing laws and will investigate complaints on the grounds of:

  • Unprofessional conduct
  • Unethical conduct
  • Moral turpitude
  • Mismanagement of patient records
  • Revealing a privileged communication
  • Breach of confidentiality
  • Slander

There can be other consequences as well, such as the violation of state or federal laws that could result in civil or criminal penalties, including fines or even jail time. Some of these laws might include state privacy laws, laws related to confidentiality of health records, or criminal laws related to harassment. Case law could also create tort liability such as invasion of privacy, intentional infliction of emotional distress, or possibly libel as well as slander. First and foremost, breaches of patient privacy or confidentiality are the most egregious errors that healthcare professional can make when posting on social media, including blogs. It is important to distinguish the concepts of confidentiality and privacy (Cronquist & Spector, 2011). These are related, but decidedly distinct, concepts. Any patient information gained during the course of patient care must be safeguarded. This information may only be shared with other members of the health care team for health related purposes. Confidential information must only be shared with the patient’s informed consent, when disclosure is legally required, or when a failure to disclose results in significant harm. Breaches of patient confidentiality or privacy are serious and can be intentional or unintentional. Healthcare professionals may breach confidentiality or privacy in a variety of ways, including with information they post via social media/blogs. Inappropriate use of social media can adversely affect team-based care (Cronquist & Spector, 2011).  Online posts about co-workers or contracted services, even if posted from home during non-work hours, may constitute lateral violence. These actions are now receiving greater attention as more is learned about the impact on patient safety and quality clinical outcomes. Such activity causes concern for current and future employers and regulators because of the patient-safety ramifications. Think before you type.


Dysphagia Tidbit – Exacerbation of Progressive Neurological Disease Symptoms during Dysphagia Treatment

With any progressive neuro disease there is a potential of exacerbating symptoms if we over-exert the patient during treatment (PT/OT and ST).  Progressive Neurological disease include: Parkinsons, Multiple Sclerosis, Mysathenia Gravis, ALS, Post-polio,etc.  It is the clinician’s responsibility to determine treatment appropriateness and tolerance on patient to patient basis. Never overgeneralize your clinical decisions based on a diagnosis alone. There are varying degrees and stages of these diseases.  It is the clinician’s responsibility to evaluate tolerance of each and every patient and to watch/monitor O2 sats and BP during treatment. If patient is stable and nothing is changing during treatment, continue. If you do not evaluate on case by case basis you do the patient a disservice.  You must also consider the type of exercises that you are doing regarding the speed and rate as well as consistency of rest breaks. For example, a traditional Shaker is much more fatiguing of an exercise due to weight of the head.   During any type of dysphagia treatment place a cold towel around their neck to keep body temperature down, use a cold spoon, sit near AC ( away from windows or heat generating device).  Train on energy conservation. It is our responsibility to give every patient the same opportunity and not judge their tolerance level until evaluated. Exacerbation of symptoms is temporary and is resolved with rest, allow the patient the most optimal opportunities to improve or maintain their muscle function.

Think about other therapies such as PT. Completing repetitive sit to stand is much more fatiguing than swallowing.  No one ever says after a party or a big dinner, “I cannot swallow one more thing, my swallow is tired and hurts.  Maybe our stomachs but not our swallow. We already swallow 720x a day, 7 days a week, including our saliva. Swallowing uses only about 30% of our muscle function.

If you ever have any questions or concerns on treatment or treatment recommendations please call us. We would be happy to discuss them with you, that is what we do! If it is about a particular patient, we have access to all details, including the report and video so we have the whole picture!


In addition, Ampcare is open to discussing any question regarding treatment with NMES, we are all just a phone call or email away! We are all passionate about seeing success for the patient, and we want to work with you to achieve that success!