Of course, there are those of us who either are working toward, or who already are, both a medical professional and a voice teacher/singer, but there are distinctive differences in these professions that need to be remembered. I'm going to draw that line of distinction the way I see it. Why? Cause when the lines get blurred about who the true "vocal experts" are, the people who suffer the most are singers who are the most in need of guidance.
There is an epidemic in the voice-teacher community of folks who feel they have enough (cursory) scientific knowledge about the voice and vocal disorder stuff that they feel they can successfully assess and diagnose specific vocal problems in their students. And you know what, maybe a few decades ago those voice teachers did know more than the medical community. But now, this epidemic needs to be stopped. Along with the many, many singers I've known whose voice teachers "diagnosed" vocal nodules, acid reflux, etc., I myself fell into this "assumers paradise" when critiquing other's voices that didn't sound "quite right." Luckily, though, I was humbled out of it quite quickly with my therapy experiences and SLP classes without actually putting any of my assumptions onto my own students. Whew! But, although I survived without public humiliation in class or otherwise, I still felt ashamed of myself for being so presumptuous.
The truth is that the medical field has made huge advances in their knowledge of vocal and articulatory function, down to the neural organization of coordination for these functions, in the past two decades, and the advances are expected to just continue. Voice teachers and singers should know about the healthy function of the vocal system for the sake of monitoring their progress and protecting their voice from harm, but normal, healthy function is the point where medical professionals begin their understanding. They must start from normal function, because their ultimate goals are to help treat and/or cure people suffering from disorders or injury. And the level of detail needed to fully understand each and every disorder and effectively treat them is rather mind-boggling.
A very condensed look at the responsibilities of these folks is something like this (for the singer suspecting vocal difficulty):
An ENT is the guy with the medical license to actually diagnose an issue using advance technology in combination non-invasive assessment tools to determine the source of a problem. They also can perform surgery and prescribe medication, so they have some ability to treat the issue they diagnosed with those steps. They can give a general timeline of recovery for surgeries based on how invasive the procedure is and the patient's own medical history, age, etc. In order the have the ability to legally diagnose and treat disorders requires a whole lot of knowledge to diagnose and training to treat. But, if regaining vocal health requires more than just surgery and/or medical prescriptions, then the ENT needs to refer the patient to a therapist for further treatment. This is where the SLP typically comes in (at least in relation to ENT offices.)
The SLP is the person with similar medical knowledge as the ENT in regards to the systems of communication and swallowing, but they are not able to diagnose legally at all. This is because their assessment tools can show if something is wrong and can narrow down where in the body the issue is located, but they cannot say specifically what is wrong. SLPs can assess the health of a person's linguistic and communicative system, from higher processing of language all the way down to specific anatomical functions, and they are trained to treat whatever problem might be present with therapies proven to be effective. They have a professional license that they must maintain, like ENTs, in order to legally do these assessments and therapies. This makes SLPs very good compliments to ENTs who are not trained to treat with non-invasive, therapeutic methods.
A voice teacher is someone who, ideally, takes an intricate knowledge of healthy vocal function and applies that knowledge to train a person's voice to do something beyond ordinary vocal function. But, that singer's voice/communicative system only requires healthy function to train effectively. No more, no less. (Just as an Olympic gymnastic coach only needs a healthy body to train to do gynmastics.) A voice teacher does not have the full medical knowledge to either diagnose nor scientifically assess the health of a person's system. What a voice teacher can do is suspect an issue...much in the same way a mom or teacher can suspect a child has an illness based on a handful of symptoms they observe.
So what happens if you are a voice teacher and you suspect a student has a possible medical issue? You can inquire about symptomology and try to narrow down the possibilities, which can be useful in getting the student to agree to see a doctor. But all a voice teacher can really do is refer the student to an ENT, or an SLP, for a vocal assessment. An SLP assessment is usually a cheaper option, but since they can't diagnose, if the screening turns up results that are outside of normal function, then they will have to refer to the ENT for full diagnostic tests. If it turns out the student does have an issue that needs surgery and/or therapy, the student just needs to be in the hands of excellent medical professionals for a while. Once treatment is over and further assessments have determined that the student has returned to perfectly normal health, vocal training for singing can resume with the voice teacher again with the understanding that training might have to start at "square one" at first if any old compensation exists from the injury or disorder.
But, what a voice teacher should not do is try to officially diagnose the issue, try to treat the issue, or distrust the medical professionals assessment of normal, healthy function. And likewise, a singer should not seek a voice teacher for those issues. What I see happening most often is voice teachers using technical issues during singing as evidence of a problem, which may or may not be true, but this is exactly why SLPs assess vocal health from speech and measurements taken during speech. Healthy speech is some thing they have data on that they can use to compare/contrast someone's unhealthy function. Tension during singing, however, has so many possible origins that only having that to go on can only lead to assumptions that may or may not be correct. In contrast, when my voice teacher suspected my vocal injury, she wasn't only going on my technical issues during singing, she also noticed tension present when I was just speaking too...even speaking before singing at all at the beginning of a lesson. This teacher also works very closely with SLPs and ENTs, so she knows a bit more of vocal assessment than the average voice teacher.
Now, are there medical professionals who get things wrong sometimes? Of course there are! ENTs misdiagnose, miss problems altogether, and SLPs can miss some abnormality on assessments if they're only thinking about communicating for daily speaking. Also, the SLP field is a very, very broad field, so getting someone who doesn't specialize in voice might not do a whole lot of good. This is why seeking out the best, most meticulous professionals that are available to you is vital for a professional voice user. But if you're going to seek out the best, trust them too. The prevailing attitude of "They might not really know what we singers require" is not only inaccurate, it is arrogant and insulting to the medical professionals who are trying to help us. And the prevailing epidemic of voice teachers using their cursory knowledge to diagnose or treat anything is a bit like a teenager assuming they know everything and therefore don't need to listen to adults ever. Both attitudes are damaging to what I believe should be the goal: These three professions collaborating and working as a team, with responsibilities allocated to the right person at the right point in the singer's recovery, to ensure the singer's recovery is on the right track.
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