Speech therapist profession to change? Ongoing dispute over the future of the profession

• There has been a discussion about regulating the profession of speech therapist for at least 2 years. Often, these positions are not consistent, sometimes at opposite poles - reminded Dr. Katarzyna Ita Bieńkowska
• There is no end in sight to the discussion, although the view is increasingly being emphasised that, due to the specificity and nature of the work, a separate profession of speech therapist employed in a health facility should be created.
• During the deliberations of the Parliamentary Team for Medical and Therapeutic Professions, it was proposed to include the profession of speech therapist in the Act on Certain Medical Professions

The discussion, which took place during the meeting of the Parliamentary Team for Medical and Therapeutic Professions, was prompted by a presentation on speech therapy in health care, given by Dr. Wioletta Pawlukowska from the Department of Neurology of the Pomeranian Medical University, president of the Polish Society of Clinical Speech Therapy.

- Speech therapists work in two areas. The first includes health care, in which they are employed in medical entities on employment contracts and civil law contracts. They provide health services in the field of neurology and laryngology. The second area is educational speech therapy, where they work as speech therapist teachers on the basis of the Teacher's Charter and conduct therapy with children with developmental disorders, as well as counseling and consultations - explained Wioletta Pawlukowska.

She informed that there are three proposals for regulating the profession of speech therapist. The first one comes down to recognizing speech therapist as a medical profession, similarly to a physiotherapist, which means that they could run an individual speech therapy practice and work in both health care and education.

- If, however, speech therapy were recognized as an educational profession, speech therapists working in healthcare entities would not be able to provide health services, but they could, like other speech therapists, run teaching offices - she explained and added that a new concept has recently appeared, promoted, among others, by the so-called academic community, which assumes that speech therapy is an interdisciplinary profession with a linguistic profile, and therefore does not deal with patients with, for example, dysphagia or desorption disorders.

In her opinion, the profession of a speech therapist should be recognized as one of the medical professions, which would improve the quality of education, the quality of health services provided, facilitate professional training and, above all, develop research based on scientific evidence.

- With the well-being of patients in mind, I believe that the profession of a speech therapist should be formally regulated and included in the group of medical professions, because a speech therapist is part of an interdisciplinary team and cooperates with a doctor, nurse, physiotherapist and therapist - she concluded.

She added that the profession of a speech therapist in healthcare should have a clearly defined framework of education, scope of activities and specified professional responsibility, because the activities of a speech therapist affect the health and life of the patient.

- In the interests of the well-being of patients, we propose that speech therapists be added to the Act on Certain Medical Professions – appealed Prof. Pawlukowska.

- We are open to all proposals and we see the possibility of including this profession in the act on certain medical professions, but we will have to work out the details - declared Monika Sobótka , head of the department in the Department of Medical Personnel Development of the Ministry of Health. She noted that she participates in the team meeting as an observer, not a reviewer of the submitted postulates.

Referring to Wioletta Pawlukowska’s statement, she pointed out that including speech therapists on the list of certain medical professions would mean introducing the obligation of continuing professional education, as well as bearing full professional responsibility, entry in the profession register and similar requirements.

She suggested that the consequence of introducing a professional division within the group of speech therapists would be the need to agree on and clarify the nomenclature, e.g. into clinical or medical speech therapists and speech therapists associated with education.

Dr. n. med. Katarzyna Ita Bieńkowska, assistant professor at the Maria Grzegorzewska Academy of Special Education in Warsaw, a speech therapist who works with children after cochlear implantation on a daily basis, admitted that there has been an ongoing discussion in the community about regulating the profession of speech therapist for at least 2 years.

– Often these are not consistent positions, sometimes at opposite poles. However, there is no doubt that the profession of speech therapist, neuro-speech therapist, and surdologopedist must be regulated – she emphasized.

She pointed out that the education of a speech therapist allows for the choice of various career paths.

– We need to be very careful when designating career paths so as not to close off any paths to professional development for anyone, so as not to set such high demands on young people who are just entering this profession that no one will want to become a speech therapist, and we already have problems with the medical staff – she warned.

Dr. Hab. n. med. Joanna Siuda , head of the Department of Neurology at the Medical University of Silesia in Katowice, said that she is in favor of distinguishing a clinical speech therapist within the broadly understood profession of speech therapist, i.e. a person who works or wants to link their professional activities with health care.

- For me, this is a completely different career path and different competencies than someone who is a speech therapy teacher. These two very important specializations are completely different from each other - she said.

- I agree that the regulation of the speech therapist profession is necessary - said Dr. habil. n. hum. Justyna Żulewska-Wrzosek , national consultant in the field of neurolinguistics. In her opinion, the lack of a law on the speech therapist profession currently results in great chaos in competences and unequal treatment of specialists.

- We are different in terms of the form of employment, not the profession itself. We have one profession of speech therapist, although it is performed in different sectors. Changing the place of work does not require changing the professional identity. In the current situation, only a change in the act on medical professions is necessary. We must take these conditions into account when creating the current regulations - she argued.

She emphasized that in Poland, speech therapists are educated at medical universities and at pedagogical or humanistic universities. - In both cases, graduates obtain similar substantive competences - she noted.

- However, there is a great concern in the community that if speech therapy is recognized as a medical profession and included in the Act on Other Medical Professions, medical universities may have the exclusive right to educate speech therapists, which would exclude other universities, despite their many years of experience in educating speech therapists - she added.

In her opinion, there would be a harmful division of the environment into educational and medical speech therapists. As a consequence, medical universities would prepare clinical speech therapists, while pedagogical and humanities universities would prepare speech therapists for work in education.

- Non-medical universities do not agree to such a division. When preparing regulations, we must remember the concerns of academic communities. An attempt to regulate the profession requires great prudence and therefore it would be a good idea to establish a team where discussions on these topics could be held - said Justyna Żulewska-Wrzosek.

The meeting of the Parliamentary Team for Medical and Therapeutic Professions was chaired on 6 May by Wioleta Tomczak (Third Polish Way 2050 by Szymon Hołownia – Polish People’s Party).

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