I’m sure you’ve heard by now about the Department of Education reclassifying certain degrees as nonprofessional, thus excluding them from qualifying for sufficient federal student loans. This list may not be exhaustive at this point, as we remain unsure of the final impact of these changes, but here it is as of now:
- Nursing (MSN, DNP, NP, Nurse, Midwife, CRNA)
- Physician Assistant (PA)
- Rehabilitative Therapists (PT, OT, SLP)
- Audiologist (AuD)
- Counseling and therapy fields
- Public Health (MPH, DRPH)
- Education (All Specialties/Master’s degrees)
- Social Work (BSW, MSW)
- IT, Cybersecurity, Engineering
- Business (MBA, Accounting)
- Arts & Architecture
Whoever is seeking a degree on this list will suffer from stricter caps on the amount of money they will be allowed to borrow to obtain their education. This means that while many will seek out these programs and likely start them with the help of federal loan money, they may not be able to complete their programs when the money runs out. This money is not a handout– it’s a loan they’d have to pay back with interest– and yet they will still be denied further loan amounts as a result of these new classifications.
You likely have seen these lists already, but I’m writing this because I want to talk about why it really bothers me.
I’m a Speech-Language Pathologist, and have been for 16 years. My profession requires a four year bachelor’s degree followed by a two-year master’s. I was able to obtain my graduate degree for roughly $40,000 total, which was actually quite a good price even for 2009, the year I graduated. Ironically, that is the amount at which federal loans will be capped ($20,500 per year) when these changes go into effect.
The government knows full well you will not be able to get this same degree for that amount in 2026, which will thus eliminate those who cannot afford it from the pool of people who would have otherwise been future SLPs. In my class of twenty-five students at UNC Chapel Hill, three were men. This field continues to be dominated by women today, as do the ever-so-slightly more balanced Occupational Therapy and Physical Therapy disciplines. One could claim that many of the professions on the list above are similar in demographics, leading any sane person to wonder why they were targeted specifically.
Let’s rewind for a minute to the Covid19 global pandemic.
Insufficient PPE in April 2020, but we were smiling behind our masks.
We were called heroes. I work in a skilled nursing facility with rehab services, also known as a nursing home. Many of those buildings, often called SNFs (”sniffs”) for short, admit patients for short term rehabilitation services as well as for long term care. Physical, Occupational, and Speech therapists make up the rehab teams there, helping to get elderly patients stronger so they can return home safer and more independent after injuries and hospital stays.
We got hit hard with the virus in 2020, with many deaths of vulnerable patients occurring faster than we could even get them back to the hospital. We worked through the worst of it, through the shortage of PPE, and would return back after quarantining when the virus got us sick at work. At first, we were paid for our quarantine time off if we caught Covid and we were granted hazard pay for the exposure. The hazard pay didn’t count for being in the building in general, but only for the specific minutes that were spent in Covid-infected rooms, but it was something. We were applauded once nursing homes were finally given the attention (and PPE) they deserved.
Then, the “Healthcare Hero” moniker faded. Therapists (PT, OT, SLP) were even volunteering to take CNA and housekeeping shifts to help out the other departments in shortage when our hours were cut. We are full-time employees, but we aren’t guaranteed eight hours a day. After our caseloads are seen, we are expected to clock out. With the virus closing buildings to new admissions to stop the spread, our census would drop, therefore dropping our caseloads and, thus, our hours. Therapists were working shortened hours for weeks or even months at a time. Things got dicey between coworkers as those with seniority claimed they were due their hours before newcomers. Buildings that honored such seniority ended up furloughing or even laying off therapists, a profession we were told would “always be in demand.” Some had to seek other employment because they simply couldn’t wait around for caseloads to build back up as their bills continued.
I say all this to highlight how both extremely essential our profession can be as rehab therapists, and how dispensable we were already made to feel during a time when we were helping our buildings stay afloat. Rehab therapists are some of the most caring and dedicated people I have ever witnessed. I don’t say that to diminish nurses, CNAs, PAs, or any other field, I just know what I see daily, and they consistently go above and beyond their scopes of practice to help their residents succeed and get their lives back.
This perceived demotion of our field to “non-professional” seems par for the course in terms of not being appreciated. Speech Therapy is already the “red-headed stepchild” of the therapy world as it is; I’m kind of surprised we even made the list instead of being forgotten altogether.
Alas, I understand that my title hasn’t been stripped, my Master’s degree still counts, and my day-to-day life as an SLP isn’t imminently changing.
What is yet to be seen are the ripple effects this will have on the field in years to come. We can only speculate, but it’s reasonable to say that lower income folks will have a tougher time getting these degrees going forward, and this will likely disproportionately impact minorities. This will mean less diverse representation in these fields, further gaps between the rich and the poor, and less ability for those from low-income backgrounds to pull themselves out of their circumstances (their bootstraps are being cut, if you will).
The healthcare fields implicated here are full of altruistic folks who want to make a difference. They are often people who grew up with nurses in their families, or were those who benefited from one of these services in some way and were thus inspired to go into that profession themselves. These are people who truly care about others, and they may be stripped of the chance to be of service in the way they dream of because they’re denied the privilege of overpaying for their education.
I see what the other side is trying to say. Tuition costs have skyrocketed, and this strategy is claiming to fight back on those hikes so colleges and universities will lower prices. I have yet to see concrete ways in which eliminating federal loan funding will achieve lower tuition costs, though. Why couldn’t the government have gone the other route, to find ways to enforce or facilitate lower tuition instead of cutting the students off directly? This hasn’t been explained to the American people, and we are rightfully concerned.
What does this mean for the future of educators and healthcare workers? These fields are already experiencing shortages, which have led to high caseloads and classroom sizes. Therapists, teachers, social workers, and other healthcare professionals are overworked and burnt out as it is. I am interested to see what this does to program sizes in the years to come, and the demographics of such programs.
Are we going to suddenly see more white male SLPs because that’s who can afford these degrees? Or will we simply see a decline in program participants, with fewer new grads emerging each year, thus fewer people served? Will we not be able to replace these professional roles as fast as people are retiring? Will people get burned out even faster and leave the profession, like they did en masse during the pandemic? Will Medicare and Medicaid continue to cover these services, and who will get cut first? What will be the future of these professions be? People have told me for the last sixteen years, “you’ll always have a job.” Is that true, and will it even be a job I want anymore?
I am exhausted and kind of fed up working in conventional healthcare as it is. It’s not the patients- I love my population. It’s everything else. We are used to yearly Medicare changes, added paperwork, and insurance companies denying coverage to our patients in need. We really don’t need anything else making it harder to do our jobs effectively. I feel for our student clinicians from the local university. Every one of them is smart and caring and eager to join this field.
I hope they don’t get as jaded as I feel right now.
I apologize for not being more hopeful, but I’m trying to find the light in this one and I’m failing.
xo, Amy