Wakanda's Wrld
This channel is primarily informative within the weird and wonderful world of healthcare. I discuss how to improve the wide world of healthcare along with up to date information. I love to have different guest from different walks of life within healthcare. For podcast guest inquires reach me at shanklindj@yahoo.com
Wakanda's Wrld
Breaking Silence: Confronting Diversity and Access Issues in Speech Pathology Pt 2
The countdown to healthcare's "Silver Tsunami" has begun. By 2030, every American baby boomer will be over 65, creating an unprecedented 70-80 million retiree population that will transform our healthcare system. What happens when this massive demographic meets a healthcare workforce that doesn't reflect the diversity of those it serves?
Dr. Uchi, one of the less than 1% of occupational therapists who are Black men, takes us deep into this looming crisis. Occupational therapy—that crucial but often misunderstood profession helping people regain independence after illness or injury—stands at a crossroads. Will it rise to meet historically high demand, or shrink from the challenge?
The conversation reveals how shockingly little has changed in healthcare diversity. Despite occupational therapy's founding in 1917, the first Black OT wasn't admitted to school until the 1970s. Today, only 5% of OTs are Black—the same percentage as in 2010. This representation gap isn't just a staffing issue; it directly impacts patient outcomes when people can't see themselves reflected in their care providers.
Through personal stories, we explore how cultural connections between patients and providers break down barriers to rehabilitation. One speech therapist shares a powerful moment helping an aphasic stroke patient communicate through gospel songs—demonstrating how understanding cultural context transforms care.
Dr. Uchi explains how he's using social media to make OT more accessible and appealing to younger generations and communities of color. By meeting people "in their arena" and expanding OT beyond traditional applications into areas like masculinity and mental health, he's reimagining what the profession can be.
Whether you're considering a healthcare career, concerned about the future of eldercare, or interested in healthcare equity, this conversation offers crucial insights into challenges and opportunities that will shape healthcare for decades to come. Subscribe to hear more conversations at the intersection of healthcare, diversity, and the future of patient care.
https://linktr.ee/WakandaRN
so, so okay. So I'm glad you you got, I'm glad you got the opportunity. Uh, dr uchi, welcome in. I'm glad you're here. So, um, I'm gonna go ahead and ask you a question. So what, just what is life like on the ot side?
Speaker 2:oh man, okay, well, a lot of multitasking, prime example my son here wants to get his tablet going, so sorry in advance. Um, I love occupational therapy. It's probably my favorite um healthcare profession I've ever been in. Uh, they, early on my dad told us I mean, yeah, hi, there, you are. Okay, here's the tablet, here you go. I swear, which is so funny because sensory processing, so I'm like you know, it's fun Anyways.
Speaker 2:So my dad he's Nigerian and immigrated from to the United States around 1970s and it's funny. This funny saying we have in Nigerian family households is either you can be a doctor, you can be a lawyer, you can be an engineer or a disgrace to the family. No pressure, no pressure, not at all. I was second of five to be a lawyer. You can be an engineer or a disgrace to the family. No pressure, no pressure, not at all. I was second of five, so kind of like scar from lion king, so I was like invisible. You know, disgrace to the family.
Speaker 2:They thought, oh, this guy's not going to be anything. So I told them about occupational therapy. I'll get into it and they're like, what is, is that? Keep in mind my parents are nurses. They had no idea what OT was. That's crazy to me. Okay, it was nuts, what? That's some crazy work, isn't it? Yeah? And so I told them I was going to be an occupational therapy assistant. They're like, oh, it doesn't make that much money. Then they saw it in the because my dad he does like nursing around the nursing homes, so he saw me field work, rotations, like oh, this is what ot is. I'm like you're a nurse, how do you not know what ot? Oh god, and so anyways, and then later on, because I just got so in love with it as an occupational therapy assistant, I actually uh ended up uh, going to get my doctorate in occupational therapy and so that's how I'm like, and so on my second year into being a doctor of OT.
Speaker 2:Funnily enough, I did a doctor of OT in the middle of a pandemic, which is very, very, oh, my god, that is such a hands-on job. You cannot do that job. That's not a Zoom school kind of career. So I could go into a whole other rant about that, broadly speaking. Right, zoom school kind of career. So I could go into a whole other rant, broadly speaking. Right now I think OT is going through a bit of a sea change. To be honest, there is a. You know, have you heard of the silver tsunami by any chance I have not. Okay, I love this. I love explaining this to everyone. I talk to everyone about the silver tsunami coming. It's coming. It's huge, it's ominous. It's a tsunami. Batten down the hatches, baby, seriously batten them down. It's going to be wild. So baby boomers are set to be the largest retiree population in US history.
Speaker 1:Yes, Okay, I got you, I got you.
Speaker 2:I'll be right there.
Speaker 3:They're fixing the stroke out.
Speaker 1:I got you. But just for our audience who may not know, go ahead and explain yeah, I got you now maybe it was set to be its largest retiree population in us history.
Speaker 2:70 to 80 million retirees are set to cut to come into, like, basically, the retirement age. By 2030, I believe, every single baby boomer will be over the age of 65. So retirement age now, what do you think is going to have a cascading effect to that? Medicare, medicaid, social security, the alcohol industry, tobacco you know all the things that the boomers love to do. These things are going to go through some major shifts. You know, like catastrophic levels of shift.
Speaker 2:And the thing about the baby boomers I mean you know that they did what they did. Neoliberalism era was technically theirs, like they fully claimed that. But the problem is, is that the hardest thing to do as a millennial is convincing a baby boomer to do something different? It is the hardest thing? Okay, it's like pulling teeth.
Speaker 2:So, as a millennial ot, who's teaching these boomers hey, you need to exercise, you got to move your body. They're like whatever, you know, like I'll put it over here and watch fox news and cnn like they're not actually listening and because of that, their physical health is so declining right now and I saw this like when I was in home health last summer. Man. They are living in these wild situations and I'm like how are you able to navigate your home? You can barely get out of bed, like it's so scary.
Speaker 2:Uh, so putting all that together, it's like there's a increasingly massive need for OT, but because everything's so expensive, it's so hard to get more OTs in here. So one of three things is going to happen in OT world. Either we're going to become really famous really quickly there's going to be a lot more OTs that come in here, fingers and toes crossed for that one. The second one is that the ones OTs that are left, you know, who are grandfathered into this, they're probably going to get paid a crazy amount of money because they're rare, you know, to have an OT. So when you find one they're like I'll pay you top dollar to help my grandfather out that kind of thing. Or, number three, we're going to shrivel up into nothing, you know. So it's one of those three scenarios right now.
Speaker 1:So so go ahead, go ahead, go ahead it's a scary situation, but also hopeful.
Speaker 2:So that's what yeah.
Speaker 1:So it, to me, is interesting because I feel as though there's a lot of people who are gonna. There's gonna be some people that's gonna be very creative and innovative. That's gonna make a lot of money. There's because, on the nurse's side, I'm gonna go ahead and say it, because I know some people are already doing this, so this isn't a secret, ok, so I don't want to hold secrets here on this podcast like that.
Speaker 1:So on the nurse's side, right, you got people that are looking ahead in terms of this boom, this baby boomers era, that people are going to retire. They are jumping ahead. You got more people looking into getting into more assisted living. You get people who are having more adult daycare centers. You get people who are trying to look ahead because they know business is booming. There's a I mean in certain States, cnas have already become like their own administrators of their own homes, so people open up their own homes and I mean people are starting to get creative because they see what's coming.
Speaker 1:So for me, I started looking in and they are, they are, and I so, for me, on the outside, looking in, they are, they are, and, um, I don't know, I got, I got some, got some of my own thoughts too, but, but, but I'm trying to get in on this too. But I think, for for you guys, I think it's going to be a grand opportunity. I don't think you get, because there's going to be such a need that you guys are going to get paid. That's how I feel.
Speaker 2:So yeah, that makes sense. I think the unemployment rate right now is like two percent because there's so massive need. So I think, unless a medicare goes insolvent, which is going to be like 20, 35, 36, you know, like now, like I think you're probably right, we're probably going to be this is going to be massive demand. It's going to be wild times.
Speaker 1:So yeah, it's going to be wild. Watch it all transpire. Oh go ahead can.
Speaker 3:Can I share my love letter to occupational therapy real quick.
Speaker 2:Go for it.
Speaker 3:So in the Venn diagram of all allied health PT, oc and speech OT in the middle, like occupational therapy we were just talking about before you jumped on what a crap name it is because it doesn't really convey everything you do but also it would take like 50 words. They're kind of at the center, the people that get you to the functioning level that you need to be safe and to be independent and to have good quality of life, and that involves physical therapy and that involves speech therapy sometimes and other therapies and yada, yada, yada. But they are like the beating heart of allied health and yet they are the most underrepresented number. Wise, I mean, I'm not 100, I don't know if you guys are more, or we got b guys or slp is like larger, but, um, they talk about a pr problem. Every time I suggest a referral to occupational therapy to one of my patients who's like 82, they say I'm retired.
Speaker 3:I don't need that, yeah, and then I have to give the OT speech. So, like all of allied health, except for physical therapy, people get that stuff. But OT and speech like we've got a real bad PR problem. And Uchi and I did have a kind of back and forth when he was talking about like the underrepresentation in OT for people of color and like gender differences and all that stuff and I was like ha-, like, haha, we suck more, we're whiter and more girly than occupational therapy. Uh, you guys aren't half as bad as we are, but occupational therapy is like the glue of the allied health world and anybody worth their salt will immediately run to an ot with any questions. Okay, that was my love letter. Oh, heartfelt.
Speaker 2:Oh love it. So I love my ally. We're a group but we're like cousins. We kind of fight with each other every now and then, but we definitely love each other.
Speaker 3:So yeah, no one else is allowed to talk smack. We can talk smack about each other, but if anybody else needs to do it, it's not a thing yeah, yeah, it's on and pop so so I do have a couple of questions, though.
Speaker 1:Well, I have a question and then I have a a story. Uh, dr uchi, so is there? Uh, do you feel like there's enough representations of minorities within occupational therapy, and if not, then why is that?
Speaker 2:oh boy, this might. This could turn into a long podcast, I swear, okay, okay I'm gonna get comfortable.
Speaker 2:Yeah, this is a lengthy one. Uh, funnily enough, this is actually what my literature review was all about when I was in grad school was about the demographics of at. So I like have like a like intimate knowledge of this. But, uh, occupational therapy the history of it started in 1917 in the sane asylums, um. So it actually started with like night nurses and stuff like that, so white women that were trying to like basically like, hey, let's try this instead, to like help these like people in straight jackets, and it worked. That's really the craziest part about it is that occupation giving people something to do actually made them feel better and then their mental health improved. That's literally like the, the layman's term of what happened with ot, and then it turned into a whole thing. Well, think about the historical context. During 1917, this place was really, really racist, like really racist. You know, I think I heard the first film back then. That was fit like presented in the white house was birth of a nation and anyone who knows birth it's like
Speaker 3:y'all I apologize, I wasn't there, but on behalf of my people, I apologize.
Speaker 2:It's all good. They're on the team now.
Speaker 1:It's all good there's people who listen to this who have never heard of that, so it's going to be interesting I know what that is yeah it's.
Speaker 2:It's a long story short. It's a film basically warning white women that black men are going to co-embrace them. You know what I mean? It's a crazy film and they filmed this and they presented this to the white house. Given that historical context, occupational therapy was very exclusionary for a long, long, long time. I heard somewhere I think it was around 19, so 1917 is when it started. The first black ot was like, like, like made, or was it allowed into an ot school at like 1970, almost 50 years later. Okay, so it's a crazy amount of time before like black people are allowed into this.
Speaker 1:The program period not that long ago, by the way, ladies and gentlemen.
Speaker 2:Not that long ago thank you, thank you, um, it really is. Well, it's wild stuff. And then, on top of that, it was like 50 for about maybe a decade or two, and then I can speed up. Fast forward to now. It was in 2000 or like 2010,. One of those years, 5% of the OT population is Black. Right now, fast forward to 2025, 5% of the OT population is Black. Nothing has changed. So the reason why this is happening is because this is my speculation is that I don't believe that when we go to apply to the people of color applied to OT school, I don't think they're actually considered to be taken seriously. You know they want a certain type of like student. You know the one. You know the one I'm talking about 20s, very sheeply minded, probably a white girl, straight A's, you know, got to get that gre to 4.0 and all that. And they have no level of like sense about no offense to these people, to you know, the applicants it's more about. There's no sense of, uh, diversity in the thought process.
Speaker 1:If that makes any sense, there's a lot of it makes perfect sense to me yeah, because of that.
Speaker 2:Here's the huge fallacy with occupational therapy is that OT, out of all of the healthcare professions, is supposed to be diverse, because our whole pitch is client-centeredness, it's individualized plans to increase rehabilitation. No two people live the same. They live differently. So the whole point is you have to be able to know diverse cultures and know how they live so you can rehabilitate them back to their culture. No, so it's a wild thing.
Speaker 2:In general and I'll leave it on this last note, but I think it was as of 2023, 2024 it was like 130 000 uh occupational therapists out there. I want to say about 75 are white. Uh, five percent are black, I think seven percent are asian, six percent hispanic, two or more is about four percent. You could do the approximate and google that yourself. Indigenous is less than one percent, and then on the male versus female side, I think it's like eight percent are like women and then 20 are men. So if you do some cross-sectional, intersectional math on that five percent of 20 of 130 000, there is less than one percent that are black men in this field. So I'm a rare amongst. So I'm like, okay, let me make a social media channel and blast this on the airways. I'm going to take my shirt off, make it look sexy, like I'm going to do something to really make it splash.
Speaker 1:You know, like that's my thing, like listen, brother, with that tank top, you ain't got to take your shirt off. I'm going to say it.
Speaker 3:I'll leave some ladies for the rest of our routine, oh, shoot, oh yeah.
Speaker 2:So that's, the lack of diversity is a huge detriment to OT practice because it's limiting our ability to reach the type of people we need to reach is laying conclusion.
Speaker 3:So yeah, it's so hard this is, this is generalization but it can be so hard to convince certain patient populations you know, whatever you want to term that to seek outpatient therapy.
Speaker 3:And you know like, after some, so many people are reticent. Most of those folks are men, your older stroke folks. They don't want to acknowledge a deficit, they just want to go home and not be in the hospital anymore. And I have to wonder if part of that is what they see when they enter a clinic, which is me, and not feeling like they're at home or that I'm, how can I possibly understand them? And they're not wrong. I mean, I try my best but I haven't lived their experiences. So if they walked into a clinic and they were reticent and their wife forced them to go in and they saw Dr Uchi, maybe they would put more into that rehab effort. Maybe they'd be more amenable to kind of entering that conversation and I just I mean, I realize that we're all preaching to the choir here, but we all know that certain patient populations, whoever they are, whatever they are, they need to be able to relate to the people for agnome care.
Speaker 3:And right now, if you are, if you're black, and definitely if you're black and male you're not you're not going to see a ton of that in allied health, despite the fact that we are the most. Please, I will cut out a lung and give it to you. If you will just come to your appointments, I can help you. I swear to god, I just want you to live a good life. Let me help you. Yeah, it doesn't. It doesn't always amount to much if the person doesn't feel comfortable receiving that help from you or they just don't see themselves reflected back in their provider I was just gonna say that, um, you know there's already a lot of barriers to somebody getting taken care of.
Speaker 1:There's so many barriers. I mean just. I mean just thinking about just the hospital setting in general. I mean think about it, especially if you don't have any idea. So you have the, you know you don't have the knowledge, right, so you're nervous, and then so you know you may have the hospital delirium, right, not knowing everything is. And then you know you got to take care of, you know you have nurses and doctors and you have all these people, all these, all this, all this people of the team that has to take care of you, right? But I don't.
Speaker 1:I think what's underestimated and I'm not, I mean, of course, I'm going to be preaching to the choir is the fact that if you see somebody that either looks like you or talks like you, to break down those barriers, you know what I'm saying To break down those barriers, because you need that representation, you need it. And I think people think like, oh, you know, just because they went to school or just because you know, maybe they have the knowledge or the experience, all that is great. We would love to trust people as they come in Right, but at the same time it helps to have somebody who looks like you, it does Like you. Create that, that bond, you create that, that that patient trust. It just helps. And then, when it comes to healthcare, especially in the journey of recovery or therapy or just regular treatment, I mean you need to break down as many barriers as you can so these people can get the help that they, that they need.
Speaker 3:So it's just, absolutely, absolutely.
Speaker 3:I had an acute stroke patient that I was seeing in the hospital and it was, you know, an older African-American woman who was completely aphasic, like couldn't know communication at all, and I kind of read the room Everybody was wearing like a shirt that had like a gospel quote on it or had a cross on and I told you my background is in music but I also have a like, a minor in ethnomusicology and that is basically the study of, like you know, it's history through music and my focus was on the African-American experience in the United States and what that influence was which, yes, all the things influence all the things.
Speaker 3:all of our music is a little bit stolen, surprise um and so I was working with this woman, I decided to do a little bit of melodic intonation therapy and because I wasn't able to kind of pull up from a hat a ton of spirituals, just based on how I read the room, this woman, I'm telling you she was singing her name. She was singing whole phrases to me and it was just miraculous and amazing, oh wow. But the look of surprise on the other spaces. I could tell it wasn't about her being able to communicate when she'd been so like unable, it was who is this white chick and how does she know that song?
Speaker 3:and I get it and and if I hadn't been like kind of so persistent, she probably would. They probably would have just kind of ushered me out, but like it shouldn't be that much effort they should feel comfortable in their own skin, and it shouldn't be such a uh.
Speaker 3:I don't know. I mean, you know what I'm saying. Everybody who watches your channel probably knows what I'm saying. It's not that I don't want to ever work, but plenty of white females are going to stroke out in the future and I can take care of them. In the meantime, there is a huge amount of population that deserves to see themselves reflected in their care providers. I'm not going to get choked up.
Speaker 1:I said I wasn't going to get choked up but it's pretty criminal.
Speaker 3:It's pretty criminal and just horrifying how that representation isn't there and it's just like how many people could have gone so much farther in their rehab from whatever it was If they had had Nucci, if they had Okonda.
Speaker 1:So I want to ask either one of y'all can answer questions or I can take turns answering this one how can the PR get better? How can we get people to become more occupational therapists uh, that people of color or people are diversity, or how can we get people more into uh speech pathology? Like, how can we do better on the PR? Like what? What are you guys thoughts?
Speaker 2:on that, he's got a whole tree to buckle up. Okay, go for it. An OT to be appealing and fun and exciting and bubbly. And the thing that we we the way that's, that's how I feel about occupational therapy is that it's so much more than just dressing and toileting and, you know, transfers and stuff. There's so many different niches in OT practice that makes occupational therapy so much more dynamic and unique and absolutely like a blast to do. So. I'm trying to, I'm trying to use ot in other ways that no one's ever thought of like. One of the things I want to do is tackle, like youth, mental, mental health. You know how to do that. Well, I want to ot masculinity. How do you ot masculinity? Okay, everyone talks about toxic masculinity, blah, blah. Well, why do that and make it like healthy masculinity? That's me, my occupational therapy brain to show people that it's okay to be a man but also be kind and caring and to be wanting, attuned to your emotions. You don't say you don yeah yeah.
Speaker 2:So I'm trying to use it like that. I'm trying to OT like how can we solve the systemic issues with like policy and the fact that we have a horrible work-life balance and the billionaires are stealing all our money? Okay, well, as an occupational therapist, this is what I do Boom, boom, boom, boom, boom. So like I talk about how an OT would do this for fixing the policy in public health. What's another thing?
Speaker 2:I think really talking about OT as a lifestyle, because it really is. It's a lifestyle, it's not necessarily just a career. That has been really helpful and, honestly, this is one of my biggest pushes. That's why I'm on TikTok so much. I'm not really on. I mean, I have some Instagram posts I do every now and then, but I feel like talking to the youth especially, we have to talk to them in their arena, versus like, oh, come to my seminar in like you know this upper echelon tier place that they'll never achieve loan debt out the wazoo. So I'm like, let me get down to your level, let me code switch this so you know what I'm talking about, instead of like talking about occupational apartheid and occupational marginalization like no one's gonna know what that means.
Speaker 2:So you have to break it down to that level. Um, I like to make it sexy and fun because I've learned, research shows if you're looking at something visually appealing, you're more likely to retain the information, so it hooks them in. And then I feed them the carrots. So the desserts feed the carrots. That's what I've been doing, so that's that's on my side of things. Um, I recognize my privilege as a, you know, muscular black man, but you know, I'm also like I'm a black man or like I do something that's a huge part of it.
Speaker 3:Everyone's always saying why aren't there more black male role models? Well, it's because we haven't given them. There was no um accessible platform, like unless you can afford to mount a two thousand dollar a ticket or whatever seminar, what are you going to do? Stand on the street corner and like scream out your platform and you know tiktok social media for all of its, you know, downside, has been a great equalizer um the black male role models are out there we just haven't given them access to the people that need to hear their message, um.
Speaker 3:and so that's why I'm so grateful for you, uchi and wakanda um, because because now we can all see you and everybody gets to listen to you and learn from you, as opposed to me, who I'm just gonna shut up, so I need to absorb more.
Speaker 1:So I feel like we're going to have to do a part two. I already told Carolina, so normally I try to keep my stuff about 30 minutes. But hey, sometimes if it's really good, it's really good. I just may break it down to a part one, part two, and then we may have to come out here and do another, like a part three or whatever.
Speaker 1:I'll step out and let the two of y'all handsome men, do your thing well watch that for there you go I'll pay for that well, well, I'm, I'm gonna say, uh, we can all be involved, we're all handsome or good looking to somebody in the world, so that's that's what I'm gonna say. To that I'm gonna say that we're good looking to somebody in the world, but, but so, but anyway, anyway. So where can people find you guys? Where can people find you guys? You guys have provided great information. We've only barely touched the surface of a lot of stuff, but where can people find you guys?
Speaker 2:oh man, I am on tiktok, I'm on instagram. It's linked to my facebook, but no one goes there because it's like but um, um, which is funnily enough. So yeah, instagram, facebook I have a red note, but I barely do that too. I got a YouTube as well. I'll hook up Dr Uchi, the Swole OT, super easy to find.
Speaker 3:Luckily he said it. He said it, he said.
Speaker 2:Swole OT. There's not many Uchindu Iwanyaus in the world, so it works out. It's easy to find TikTok's, my main driver right now. And yeah, just follow me along. Some of it's a little bit OT related, some of it's educational thirst traps, some of it's fitness, some of it's just me talking about myself and how my journey as a person has transpired. It's a nice little entertainment area. So, yeah, that's the place to check me out. All right, what about you, caroline?
Speaker 3:You can find me on this podcast with you right now, because I'm not really a presence.
Speaker 1:I'm not really a TikTok creator.
Speaker 3:But who knows, I got to figure out. I got to read my hospital rules about social media a little bit Okay.
Speaker 1:I jump in the deep end.
Speaker 3:But, for the most part, you can see me commenting on your videos and youtube videos okay, okay, all right.
Speaker 1:So thank you all for joining in with your wakandar end and then so until next time, guys. Thank you guys for stopping by thank you yeah.
