Doctors

Over the last two decades singing teachers have worked to be able to understand medical terminology, vocal health, medical treatment of singers with illnesses, and of what happens in surgery. We have educated ourselves about ailments like reflux and learned how allergies effect the vocal folds and sinuses. We have looked at photos of throats and vocal folds and we have become familiar with anatomy and physiology of the throat and neck.

In return, some doctors have learned about singing. A few. A little.

Very few doctors, however, come to voice conferences unless they are invited as guest speakers. Even at the Voice Foundation Symposium: Care of the Professional Voice, which was started by a doctor and is currently run by a doctor, almost no doctors attend the sessions presented by teachers of singing or speech.

Why should this be a problem?

I attend medical conferences (I’m an invited guest). The presentations are done by doctors sometimes with the assistance of Speech Language Pathologists. The singing teachers are few and can comment but not too many do.

Here is an example of what I heard at one conference a while back.

The young doctor, from Florida, had a man present to him in his office with the complaint of his voice not being strong enough. He was a minister and he found he could not do his sermons effectively because his voice was too weak. The doctor decided to do some surgery on his throat to “tighten up” (my words) his vocal folds so they could close more firmly. The surgery was successful and the man ended up feeling like his voice was “better”.

Why had the doctor not thought to send the man to a speech teacher or a singing teacher? Why would his only resort have been surgery? Doesn’t that seem like using a shovel to kill a fly?

No other doctor in the room made the suggestion that some kind of training would have done the same, or an even better, job. Not one of the SLPs said a word. I didn’t speak up. (It wasn’t like I could have said anything as a comment when I was just a guest.) Still, I thought it was very interesting to note that the doctor seemed pleased enough with his treatment outcome to present it to his colleagues in New York City. I am sure he was absolutely clueless that any kind of applied intervention would have helped or even that it was in existence.

Medical school doesn’t teach young ENTs about singing or the teaching thereof. It does not inform them what experienced teachers can do for a voice, or even what singing training (based on function) can do to help both speech and song. The ENTs in training do not have an opportunity to develop awareness of what can be done for an injured voice either through non-medical, non-surgical intervention.

Here’s another case, also presented by a young doctor, this time from NY City.

His patient was a young vocalist who was performing R&B but also teaching and working in a non-music job. She had vocal fold problems, reflux and other issues. She had therapy, but because she was paying out of pocket, not a lot of it, and she kept using her voice while she was trying to heal and re-train it, which is never optimal. She had several surgical interventions from this doctor but never really got better. Her problems would go away but then return. He felt there was nothing else he could do for her as a surgeon and was despairing of her ever returning to normal, thinking she would not be able to sing professionally again.

One of the other “senior” (well-known) singing teachers in the room did speak up. He said that expert teachers of singing work often with “ruined” voices (or ones that are badly damaged and not likely to return to normal function) and help the performers do a very decent job working professionally in whatever style they choose to sing. The other teachers in the room seconded that opinion. The MD seemed surprised and doubtful. I felt sorry for the singer. Perhaps if she had had less surgery and more training she would have avoided all the trauma that even simple surgery causes.

Why would it be that an otolaryngologist would not seek out information about singing teachers who work with professional rock singers or gospel singers or any CCM singer and find out what, exactly, they do so they can help their patients get appropriate care? Even if we assume they have the patient’s well-being upper most in their mind, how can the doctors understand what is possible if they don’t go find out? It would take some motivation to do so and, believe me, there is far less motivation on the medical side of the fence to find out about singing teachers and what we have to offer than there is on the pedagogical side of the fence to learn about medicine.

We hold doctors in a place of esteem in our society. We do not necessarily have that same kind of respect for any other profession. While things are different than they were decades ago in that they are slightly less formal than they used to be, we still tend to think of doctors as having a certain kind of power or authority that can be intimidating. There’s nothing wrong with this, necessarily, but if it gives them the impression that they do not have anything to learn from the other related professions, it can be a problem. The evidence is strong that it is this attitude that prevails. If it were not so, then all the voice or singing related conferences would have lots of voice specialists in attendance (as audience, not presenters), and all the medical conferences would have singing teachers presenting information about how they work with all kinds of vocal issues in singers or professional speakers.

I don’t like the imbalance. I would be happier if those of us who teach singing and have decades of experience working with singers of all levels in all areas of the profession would be given a level platform on which to interact with their medical colleagues. I don’t see this happening any time soon. Perhaps it is because the medical profession is still largely dominated by men. (I can think of only four female ENTS in NYC but I know at least a dozen men). Perhaps it is because the motivation just isn’t there without a financial incentive. By that I mean, if not knowing about singing teachers would make a doctor look less skilled or less than knowledgeable about vocal health and therefore make him less competitive in the medical marketplace, then maybe there would be incentive to become informed. This, sadly, is absolutely not the case. Therefore, the only reason an MD might want to learn about singing or the teaching of singing is personal. Some have but most have not. It won’t change until and unless singing teachers can find a way to raise their visibility or one of the teachers is able to write or publish about this particular issue in the journals doctors read.

What do you think? Is this something that can be changed?

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2 thoughts on “Doctors”

  1. It would take a lot to change this attitude. The best thing we can do as singing teachers is establish a criteria of training, knowledge and professional standards that teachers would have to be certified in. All doctors have the same basic training and all ENTs have the same specialized training. I can see how it would be hard for them to take seriously a profession where anyone who’s had some voice lessons or sung for a season with City Opera can hang out a shingle and call themselves a voice teacher. The onus is on us first.

    That said, it would behoove the people at these medical conferences to acknowledge the level of interest and knowledge apparent in the voice teachers who self-select to be at those kinds of events.

  2. Such a great article which The young doctor, from Florida, had a man present to him in his office with the complaint of his voice not being strong enough. In which The doctor decided to do some surgery on his throat to tighten up my word his vocal folds so they could close more firmly. Thanks for sharing this article.

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