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Inside SLP: Daily Summaries Delivered
by Megan Berg
Inside SLP is a limited series podcast that reveals how our profession came to be and why it functions the way it does. Most clinicians work inside a system they were never taught to see, shaped by decades of history, policy, economics, and unspoken assumptions. This show offers lightbulb moments that bring clarity to the structures beneath our everyday work and opens space for thoughtful, grounded understanding of the field we share.
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- Yesterday32 min
The Oregon Workaround
For the first 20 episodes of Inside SLP, we explored the history of speech-language pathology and the systems that shape our profession today. We looked at how licensure, certification, clinical training, and professional identity evolved over time, and how decisions made decades ago continue to influence clinicians, students, employers, and patients.As we begin this next chapter of the podcast, we're turning our attention to a recent controversy in Oregon that sparked questions far beyond a single state licensing board.At first glance, it looked like a debate about the CFY.But as I dug deeper, it became clear that the conversation was really about something much larger: Where clinical training happens, who is responsible for it, and what assumptions we've inherited about how new clinicians become competent practitioners.This isn't a call to action, and it isn't an attempt to tell you what to think.It's an invitation to better understand the systems we're all participating in, and to consider what role each of us plays in what comes next.We explore:The CFY, the CCC, and licensure: Why so many clinicians struggle to untangle where one system ends and another begins.The hidden training model: How the profession came to rely on employers and workplace mentorship to help complete the transition from student to clinician.The CFY lottery: Why two clinicians can have dramatically different fellowship experiences while meeting the same requirements.Beyond Oregon: How a proposed workaround to a Medicare billing problem uncovered deeper questions about training, competency, and professional responsibility.Guests:Kerry Mandulak, PhD, CCC-SLP, immediate Past President of the Oregon Speech-Language & Hearing Association (OSHA) and Professor and Chair of the Graduate Admissions Committee at Pacific University in the school of Communication Sciences and DisordersJordan Tinsley, PhD, CCC-SLP, current President of OSHA and Clinical Assistant Professor at Pacific University in the school of Communication Sciences and DisordersTeigan Beck, MS, CCC-SLP, VP of Legislative Affairs for OSHAConnect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 9, 202613 min
20: An Invitation
For twenty episodes, we’ve been examining the architecture of a profession under strain, including its history, its blind spots, and the pressures it was never designed to hold. In this final episode, we step back from diagnosis and turn toward orientation. Not a to-do list, and not a call to fix what’s broken, but an invitation to understand where we’re standing, and what it means to be a stakeholder in what comes next.We explore:The beauty of the boring: Why slow, rigorous data, like the PACT survey, matters more than outrage when systems lose touch with lived experienceNo-blame cultures: What aviation and nursing can teach us about designing systems that tolerate human error instead of punishing it.Internal architecture: How to hold professional dignity while working inside institutions that move slowly by design.The wire: Why staying present with complexity may be harder (and more generative) than choosing a side.Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 9, 202613 min
19: The Iceberg of Professional Grief
Anger can feel clarifying, but without context, it rarely leads anywhere new. In this episode, we step back from the outrage cycle to examine what’s sitting underneath it: systemic grief, misaligned training models, and the shame many clinicians carry inside a profession that was never fully built to hold them.We explore:The arsonist parable: Why chasing villains distracts from the work of rebuilding.A profession at its Flexner moment: What medicine’s shift away from the generalist model reveals about where SLP may be headed.The normalization of shame: How outdated training structures offload systemic gaps onto individual clinicians.The paradox of the nine: What becomes visible when we hold multiple professional perspectives at once.Sources:Duffy, T. P. (2011). The Flexner report―100 years later. The Yale journal of biology and medicine, 84(3), 269.
- Jan 9, 202616 min
18: What People Are Actually Arguing About
The intensity in SLP spaces right now isn’t a sign of collapse. It’s the friction of a profession that has grown faster than the structures built to support it. In this episode, we slow the noise down to examine what’s actually underneath the debates, through data, psychology, and the real set of options the field keeps circling.We explore:The preparation gap: What the 2020 Ad Hoc report acknowledges about the limits of our current training model.Displaced aggression: Why frustration so often turns inward when systems feel unreachable.The doctorate conversation: How the push for an SLPD reflects a hunger for depth, not just status.The domino effect: What changes like abolishing the CCC, unionizing, or rethinking undergraduate training would actually set in motion.Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 9, 202611 min
17: Apparently, You Can Do That
In 1968, the ASHA Convention became a moment of rupture. Not because of disorder, but because long-standing tensions were finally named. This episode examines what happened when Black clinicians challenged the limits of a profession that defined itself as “neutral,” and what that moment revealed about power, voice, and professional growth.We explore:The Denver moment: Why ASHA leadership responded to internal and external dissent with heightened security.The “birdwatcher” debate: Whether a professional association can remain technically neutral in a socially unequal world.Exit and voice in action: How the National Black Association for Speech-Language and Hearing emerged.Clinical consequences: How this advocacy reshaped the profession’s understanding of difference versus disorder.Sources:Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Williams, R., & Wolfram, W. (1977). Social dialects: Differences vs. disorders.Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 9, 202615 min
16: Optional Membership Is the Point
Many SLPs experience ASHA membership as essential to survival even when, structurally, it is designed to be optional. This episode examines why that tension exists, and what it reveals about how professions stay healthy as they grow.Rather than framing optional membership as a threat, we look at how it functions as a stabilizing feature in mature professional systems and why the fear of “splintering” often signals growth, not collapse.We explore:The rootbound analogy: How a structure built for a smaller profession can start to constrain adaptation.Exit and voice: Why meaningful participation depends on the possibility of choice.The 96% signal: What ASHA’s own internal report reveals about shared concern and institutional inertia.Sources:Hirschman, A. O. (1972). Exit, voice, and loyalty: Responses to decline in firms, organizations, and states. Harvard university press.Final Report, Ad Hoc Committee on Graduate Education for Speech-Language Pathologists, March 2020Final Report of the Ad Hoc Commiftee to Plan Next Steps to Redesign Entry-Level Educafion for Speech-Language Pathologists December 2023Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 2, 202617 min
15: Bogus, But Not Like That
How did ASHA come to link membership and certification? And what happened when that structure was challenged? In the 1970s, one SLP brought that question into federal court. While Bogus v. ASHA didn’t end with a dramatic verdict, it quietly reshaped the professional architecture we still live inside today.We explore:The tying logic: Why the court viewed the CCC as a unique form of economic influence, even when labeled “optional.The quiet settlement: How the case unfolded largely out of public view, including within ASHA’s own leadership.Member vs. certificate holder: How the center of gravity shifted from association to credential over time.The price of friction: Why the narrow gap between member and non-member options reflects institutional risk management, not indifference.Sources:Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Bogus v. American Speech & Hearing Association, 389 F. Supp. 327 (E.D. Pa. 1975).Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
- Jan 2, 202614 min
14: Before the CCC Meant Anything
In the 1940s, the idea that a private organization could define professional eligibility was so controversial it sparked accusations of communism. This episode traces the early decades of the CCC, when certification was fragile, contested, and anything but inevitable. We follow how it gradually became the central organizing force of the profession.We explore:The ivory tower era: Why ASHA’s early focus on academic legitimacy left frontline clinicians largely unsupported.The “advanced” shift: The human consequences of consolidating certification standards in pursuit of medical recognition.The dining room committees: How certification functioned before modern infrastructure and what that reveals about scale and control.The stamp effect: How the CCC came to serve as a proxy for consistency in an uneven training landscape.Sources:Malone, R. (1999). The first 75 years: An oral history of the American Speech-Language-Hearing Association. American Speech-Language-Hearing Association.Duchan, J. F., & Hewitt, L. E. (2023). How the charter members of ASHA responded to the social and political circumstances of their time. American Journal of Speech-Language Pathology, 32(3), 1037-1049.Connect:Contact Megan: therapyinsights.com/insideslpPACT Survey: pactsurvey.com
About Inside SLP
Inside SLP is a limited series podcast that reveals how our profession came to be and why it functions the way it does. Most clinicians work inside a system they were never taught to see, shaped by decades of history, policy, economics, and unspoken assumptions. This show offers lightbulb moments that bring clarity to the structures beneath our everyday work and opens space for thoughtful, grounded understanding of the field we share.
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