George Barnes MS CCC SLP

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Rochelle Park, NJ
George Barnes MS CCC SLP

Med SLP specialist in MBSS, trach/vent, and aspiration pneumonia management. Mobile FEES provider. Making Swallowing Simpler

📍Greater NYC 🍎

04/23/2026

It is incredibly frustrating to pour your expertise into a patient assessment, only to have your diet recommendations questioned and ignored.

But could the onus be on us?

You shouldn’t have to fight tooth and nail for professional respect.

The secret to commanding authority and ensuring patient safety isn’t just knowing more—it’s standardizing your approach.

When we use objective, standardized data, we wield research as a sword.

We cut through the noise, clearly justify our recommendations, and ensure the interdisciplinary team listens.

Want to learn how to do it?

Comment “SLP” for this week’s article, which lays out some of the best tests to easily incorporate into your clinical practice TODAY.

04/22/2026

What surprised YOU this week? 👇

04/21/2026

According to a 2010 study by Groves-Wright, Boyce, and Kelchner, clinicians accurately identified a wet vocal quality from audio samples only 6% of the time.

What’s worse, interrater reliability was poor, meaning clinicians couldn’t even agree on which voices actually sounded wet.

When I first read that number, I was floored.

As medical SLPs, we are making life-altering decisions every single day.

Yet, when we rely on subjective labels like a “wet vocal quality” or “poor” tongue strength, our treatment plan essentially becomes a series of guesses.

The answer?

Objective, measurable metrics.

Abandon subjectivity and embrace standardization.

It’s the only way to keep our practice credible, reproducible, and effectively targeting the right deficits.

Want to learn how to do it? Comment “SLP” below for this week’s article.

04/17/2026

False!

Residue is not a physiological impairment in itself...

But it may be a sign of one.

The key is figuring out which physiological impairment might be causing the residue.

Remember, our job goes beyond identifying aspiration and residue.

These are signs of an underlying issue.

They are the effect.

We still need to find the cause...

Want to learn how you can be more effective during MBSS?

Comment “SLP” to check out this week’s article!

Happy reading :)

04/15/2026

What surprised YOU today? 👇

04/14/2026

For years, SLPs have been taught that if barium “coats” the throat after a swallow, it’s a sign of physiological weakness.

But here’s the problem: if you’re using standard GI barium instead of Varibar®, you’re likely looking at a false positive.

Standard barium sulfate (the kind used for stomach X-rays) is designed to be mucoadhesive.

Its entire purpose is to stick to the lining of the esophagus and stomach so the radiologist can see the anatomy.

Varibar®, however, was specifically engineered for swallowing studies.

It is designed to mimic the flow of real food and liquid without sticking to the mucosal lining.

When you use standard barium, the “residue” you see in the valleculae or pyriform sinuses might just be the product’s chemistry, not the patient’s physiology.

This leads to:

📉 Over-diagnosis of impairment.

🍔 Unnecessary diet restrictions that rob patients of real food.

❌ Inaccurate baseline data for rehabilitation.

That’s the sticky truth!

Want to learn more about how you can UP your MBSS game?

Check out this week’s article. Comment “SLP for full access.

Thank you to Jo Puntil, MS, CCC-SLP, and Angela Menlove, MS, CCC-SLP, BCS-S, for their exceptional course on this subject, which served as the inspiration for this piece.

04/13/2026

CMS has fundamentally changed how healthcare is funded...

And they have their eyes on your MBSS practice.

In the era of Value-Based Care, it’s no longer about the volume of tests you perform; it’s about the value and outcomes you provide.

You wouldn’t pay a mechanic to “fix” your car and accept it back with a missing tire, would you?

Show me the numbers...

Medicare is increasingly looking for these 4 clinical red flags that trigger audits and denials:

🚩 Subjective Reporting: Using non-standardized terminology instead of validated scales.

🚩 Non-Reproducible Results: Lacking a consistent protocol that another clinician could replicate.

🚩 Siloed Information: Failing to communicate clear, actionable data across the continuum of care.

🚩 Missing Physiology: Formulating a care plan based on “aspiration” rather than the underlying physiological impairment.

Find out how you can transform your MBSS process in this week’s article.

Comment “SLP” for full access.

And thank you to Jo Puntil, MS, CCC-SLP, and Angela Menlove, MS, CCC-SLP, BCS-S. Their exceptional Medbridge course on this subject served as the inspiration for this piece, and I am grateful for their review and approval of the final text.

04/09/2026

Lungs aren’t sterile...

And a little bit of aspiration might actually be a good, healthy, normal thing.

We’ve been trained to treat the lungs like two fragile, sterile sacks that can’t handle a single drop of liquid, right?

But research shows that even healthy individuals experience microaspiration, especially during sleep.

Just like muscles need the stress of weightlifting to grow, the lungs may need a routine, minimal challenge to stay sharp.

In this context, maybe NPO could cause more harm than good?

Learn more in this week’s article written with Dr. James Coyle. Comment “SLP” for the full piece.

04/08/2026

Have one of your own? Share it with us 👇

Thanks for reading 🙏

04/07/2026

The answer: False

SLP’s thicken liquids more than any other intervention.

But they can actually be more dangerous to the lungs when aspirated.

This week’s article is ALL about changing the way we think about dysphagia management.

And thanks to Dr. Coyle, who helped edit it, it’s one of my most popular articles.

In other words, you don’t want to miss this one.

Comment “SLP” for the full article.

04/02/2026

My advice? Walk slowly out of that room without making any unexpected movements or gestures.

But seriously. Can you blame them? 👇

04/01/2026

Answer? B, C, and D

Here’s the thing...

If your patient is breathing more than 24 times a minute at rest, they already have tachypnea (rapid breathing).

See, we often obsess over tongue strength or laryngeal elevation.

But if the respiratory system is faltering, it drags the swallow down with it every single time.

Healthy adults follow a precise rhythm:

Inhale -> Exhale -> Swallow -> Exhale.

That post-swallow exhale is crucial for keeping the lungs clear.

But when tachypnea hits, that rhythm breaks...

The patient may inhale immediately after the swallow—sucking pharyngeal residue straight into the lungs.

The risk obviously increases the higher it is, but once we get into the 30s and 40s, that’s when the REAL concern starts.

Find out my recs for patients with tachypnea. Comment “SLP” for this week’s full article.

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96 Parkway
Rochelle Park, NJ
07662

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https://www.feesibleswallowsolutions.com/

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