|Q&A with Bob Serianni, MS, CCC-SLP, Vice President of Clinical Services at Nyman Associates, Inc.|
|Bob Serianni is a speech-language pathologist and VP of Clinical Services at Nyman Associates, Inc. located in Fort Washington, Pennsylvania. He received a BA in speech-language pathology/audiology and an MS in speech-language pathology from Loyola University (formerly Loyola College) in Maryland. He has state licensures for Pennsylvania, New Jersey and Delaware, a teaching certificate for Pennsylvania, and is a Certified Accent Modification Instructor through the Institute of Language and Phonology. At Nyman, Bob handles a wide range of caseloads, administrative duties, and supervising graduate students and Clinical Fellows. In addition to his work in speech, Bob is an active father of four, volunteers at his children's schools and local church, coaches soccer for his community's youth athletic league, and is a Board Member for the local children's summer theater group.
Q: Who or what motivated you to become a speech-language pathologist?
A: When I first entered college, I knew I wanted to work with children. I researched the fields of education and psychology and took some introductory classes, but I found that they did not engage me as much as I wanted. My core advisor was a faculty member in the Department of Speech Pathology/Audiology who suggested I take a class in her department. I was hooked! The mix of science and education intrigued me, and I was thrilled I might be able to work with kids. It was an exciting faculty, and courses were challenging and creative. Since earning my degree, my clinical focus has changed to the adult and geriatric population in the healthcare setting; however, the passion has not changed.
Q: Can you describe the facility you work for and the services offered?
A: I work for Nyman Associates, Inc., a therapist-owned private practice that specializes in the management of Speech Pathology Departments on an out-sourced basis. We provide services throughout the Philadelphia Metropolitan area. We have approximately 30 full-time, part-time and per diem therapists, working as employees or under an independent contractor relationship. Our facilities under contract include: acute care hospitals, acute rehabilitation hospital, long-term, acute care hospitals (LTACHs), sub-acute rehabilitation facilities, home health agencies, early intervention providers and school districts.
Nyman is an ASHA-approved Continuing Education Provider. We provide ongoing education for the staff and other Speech Pathologists in our community through invited speakers, workshops and journal clubs. Nyman also provides education to nursing and para-professionals through a lecture series developed to target the needs of patients served in home health and adult day-care settings. Finally, we encourage our staff to provide outreach in the agencies where they work, to bring education to patients, families and other co-workers on formal and informal levels.
Nyman's sister company, Nyman Group, is a full-service consulting firm, providing innovative, client-focused communication tools and perspectives for leadership growth and development at all levels of a corporation. Nyman Group's consultants provide one-on-one executive coaching, as well as a wide range of professional training programs and seminars for presentation skills, sales, customer service, interpersonal skills, and leadership skills, all centered on effective communication.
Q: What's it like working at Nyman Associates, Inc.?
A: Despite my administrative role, I still see patients almost every day. When I began my career with Nyman, I requested that patient care be a part of my ongoing duties (patient care is why I chose to be a speech pathologist). In addition to my hospital caseload, I have private coaching clients.
As part of my administrative duties, I have the opportunity to supervise graduate students and Clinical Fellows. I develop our continuing education and competency programs. I oversee marketing of the company, as well as maintain relationships with current contracted agencies. I am in charge of advertising, hiring and credentialing the therapists that come on-board with Nyman. My duties also include changing the water cooler jugs and killing any bugs that might occasionally wander into the office!
Q: When and how did you start there?
A: I started at Nyman in 1998 as an Independent Contractor, seeing home health patients "after hours" from my full-time job at a local nursing home. When the Director position opened up in 2000, I applied—and was subsequently hired—for the position. At that time in my career, I was looking for a new adventure and really enjoyed the relationships I had developed working as a contractor. In 2006, when the company restructured, I was promoted to Vice President.
Q: Typically, what are your day-to-day responsibilities at Nyman?
A: I typically see patients at one of our contracted acute care hospitals in the morning. The caseload consists of adult and geriatric patients that require in-patient evaluation and treatment, as well as conducting outpatient video-fluoroscopic evaluations. Then I return to the office to tackle the duties of the day: develop CEU courses, supervise a CFY, interview a potential hire, make calls/appointments to establish new relationships with area therapists and agencies, and complete credentialing or performance reviews.
Q: What types of patients/diagnoses do you encounter most frequently?
A: In the hospital, I see a variety of patients with swallowing and/or communication disorders. Diagnoses include stroke, dementia, Parkinson's disease, head and neck cancers, among others. The hospital also has a dedicated floor with patients that are tracheostomized and ventilator dependent. There, I assess patients for communication boards/devices, assist in the vent weaning process and initiate specialized diets. Finally, I see private clients for accent modification and voice/speech disorders.
Q: Can you share any motivational stories about your profession?
A: I recently worked with a 68-year-old gentleman who was an executive with a major health insurance provider. He suffered a stroke and had a lengthy and complicated hospital course, followed by intensive inpatient rehabilitation. I saw him privately in his home for ongoing speech and language needs. One year after his stroke, he was able to return to work with a new appreciation for communication and the services speech pathologists provide.
My favorite patient is a 57-year-old grandmother with laryngeal cancer. She had had radiation treatment and several reconstructive surgeries to "preserve" her voice. She was unable to be decannulated (have her tracheostomy removed) and was told she would never eat again. I worked with her off and on for about a year and a half to improve her swallowing and speech communication. At the end of treatment, she cooked a meal to share with me as a thank you! We still speak on the phone every now and again, just to show what she's been able to maintain.
Q: Are there other areas of interest for you, either clinically or educationally, that you plan to pursue?
A: I plan on pursuing an MBA with a focus on healthcare administration in the near future. I feel that this will enhance my business knowledge and background.
Q: What are the greatest challenges you face as a speech therapist?
A: Personally, I find great challenge in balancing service delivery and keeping up with my administrative duties. Patient care receives priority and I can often get caught under a mountain of paperwork! I also feel the pull between fiscal responsibility to the agencies and the needs of our therapists. Therapists demand high salaries and benefits, which challenges Nyman to remain competitive with larger providers. Of course, with shrinking reimbursements from governmental and private insurances, our agencies struggle to stay within their own budgets. Both examples highlight a balancing act that I must walk daily.
Q: What do you like most about your job? What do you dislike most about your job?
A: I love the diversity of what I do—the day is highly unpredictable! There are always conflicts and shifting of schedules and resources, therapists' needs and agencies' wants. It "keeps me on my toes," so to speak, and the challenge is invigorating. The thing I dislike about my job is the same—never a dull moment!
Q: Are you currently involved with any research projects? Are there any projects that you would like to be involved with?
A: Recently, I was selected to participate in the American Speech-Language-Hearing Association's Leadership in Health Care Program. This yearlong program accepted 30 members, from across the country, into the inaugural class. The objective is to encourage participants to develop their leadership skills and give back to the profession through volunteer service.
Q: Do you feel that the role of speech pathologists has changed over recent years?
A: Certainly, the field of speech pathology has been enhanced over the recent years. For example, most states now regulate the profession and require specific state licensure. Areas of practice where speech pathologists play key roles have expanded, such as literacy in the field of education and dysphagia (swallowing disorders) in the medical realm.
My role as a therapist has definitely changed over the years. With my current administrative role, I have had to learn about business plans, profit/loss statements, marketing strategies, and proper hiring practices—things certainly not covered in school. I have had to attend seminars, complete independent research and sought mentorship from practitioners who started their own businesses. These additional responsibilities have broadened my skill-sets.
Q: What do you feel is of the greatest concern to speech pathologists today?
A: I share my personal insights to reflect the interests of speech pathologists as a whole. My concerns include: (1) shrinking or loss of coverage of services by health insurances, (2) lack of resources for preventative care for the aging population, (3) agencies focusing on productivity/efficiency, and (4) developing evidence-based practice patterns.
Q: What is the most rewarding part of your job?
A: I frequently tell this story to folks to explain why I like being a speech pathologist:
A few years back, I worked for a long-term acute care hospital (LTACH) in the city of Philadelphia. The focus of the hospital was weaning from tracheostomy and ventilator-dependence. Since the LTACH was based in a large teaching institution in the city, we had a caseload from across the state of Pennsylvania. I was working with a patient from the Scranton, Pennsylvania area, about three hours north of the city, who had been transferred to our unit following a lengthy hospital stay for a transplant. Her husband of 35 years had maintained a strict vigilance over her in the hospital, initially, but then had returned to their hometown because he needed to get back to work or face losing his job, and consequently, their medical benefits. He was restricted to visiting his wife only on the weekends. Apparently, this couple had been high school sweethearts and were never separated after their wedding, until this unfortunate incident. They had a nightly ritual of saying, "I love you today and even more tomorrow." Since my patient was ventilator-dependent, she was no longer able to whisper these words to her husband.
In the days that followed her rehab in the LTACH, she began to wean from the machine. I was consulted to evaluate her for different communication strategies. Eventually, she was able to produce voice with the help of a Passy-Muir Valve, a speaking valve applied to the end of her tracheostomy that allows for the return of air through the speech system. My patient tolerated the valve within the first few minutes and produced her voice with great success.
As I suspected, my patient had an instant request—to place a phone call to her husband. He was at work at the time, so we needed to get his supervisor's permission for him to accept the call. As soon as he was on the line, my patient repeated their pat phrase—something she had wanted to say and he had wanted to hear for weeks. You can imagine there was not a dry eye on the hospital unit or at the husband's work on the other end!
This is why I love being a speech pathologist—helping people regain functions they have lost through illness or injury-and return to a the quality of life they once knew.
Q: What is the most important thing you've learned over the course of your career?
A: "It is not the strongest of the species that survives, nor the most intelligent; it is the one that is most adaptable to change." This quote from Charles Darwin is what I live by—be flexible. Truthfully, I prefer "rules," but people and diseases don't follow the rules. And that is also true for the practice of speech pathology as well as my duties working as an administrator.
Q: What advice do you have for others thinking of entering the speech profession?
A: Simply, don't lose sight that these are people. We are working with someone's child or parent or sibling, and they—the patient and their loved ones—need all the support and respect we can muster.
Q: How has your job at Nyman allowed you to grow professionally?
A: I embrace our company's vision statement on a daily basis:
"To provide exceptional healthcare services, knowledge and expertise, so that individuals reach their maximum potential and providers achieve quality and performance excellence/standards."
I think my background in communication sciences has given me skills that have directly led to my success. Through artful communication, you can gain much, if not all that you seek, especially when you are working on a team. Understanding communication styles and being able to read non-verbal cues has helped me be successful with people and, therefore, be successful in business.
Q: If you could sum up your job in one word, what would it be and why?
A: Exciting—each day brings me new challenges and the opportunity to learn something new.