JCPSLP Vol 19 No 2 2017

pathologist; when to treat or not treat, when to stop treatment; whether to treat someone if they cannot pay; what fees to charge; what to do when you feel a colleague is not providing best practice. While this balancing of ethical principles around beneficence, non-maleficence, justice and autonomy are stated here in reference to private practice, they also relate to every area of practice. I think the most important ethical issue facing those in clinical practice concerns evidence-based practice. There are some private practitioners who see children for whom they admit they feel poorly equipped. In some cases the practitioners have not attended professional development in the area, and are providing therapy that is therefore not current best practice. The recent large increase in new graduates entering private practice also means a speech pathologist may be less likely to refuse to treat, or turn away clients for whom they may not be adequately experienced. And of course yet another issue is that it appears there are not adequate services for preschool therapy for children who stutter and so parents who may not be able to afford private treatment end up needing to pay for treatment. This can be another conflict for the practitioner – trying to achieve change with as little cost to the parents as possible, while still following best practice treatment guides. Acknowledgements With thanks to Christina Wilson, who was the Senior Advisor Professional Issues at Speech Pathology Australia at the time of this interview.

relationship in a private practice means they are free to come and go, especially if they are paying. Clearly, it is easier to retain people in trials if there is no financial cost to them. Another example of a conflict of interest is the conflict of providing an alternative treatment or testing an alternative treatment if there is a current best practice treatment. What advantages have you found to combining private practice and research? Many! Having completed a PhD, carrying on with research is a way of continuing to maximise and develop the skills I acquired through that process in my day-to-day work. I find it makes my private practice more stimulating, particularly as I have already developed my expertise in an area. It continues to add variety and diversity to my role as a speech pathologist. Importantly, it has also helped me travel and have the opportunity to present work at international and national conferences, and meet and network with other people who are passionate about the same area. This allows me to have a close and ongoing relationship and collaboration with people who have mentored me and whose work I find really fascinating. Hearing about their ideas, being a part of that community of people who are interested in the same areas as I am is something I would not get from clinical practice alone. I think it is really important for us as professionals to continue to learn. If you are not involved in what is happening in your field, even from the literature, it means you are only learning from your own experience and that, in my opinion, is very limiting. It is vital to stay abreast of new treatments and changes to treatment delivery in an area, and then apply these to clinical practice. This to me is what is intended by evidence-based practice. What do you think are the biggest ethical issues facing those in clinical practice? I think there are ethical issues whenever and where ever you are working with people and as a practising speech

Susan Block is a speech pathologist within the Department of Community & Clinical Allied Health at La Trobe University and is a Senior Member of the Speech Pathology Australia Ethics Board.

Correspondence to: Dr Susan Block La Trobe University phone: (03) 9479 1801 email: S.block@latrobe.edu.au

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JCPSLP Volume 19, Number 2 2017

Journal of Clinical Practice in Speech-Language Pathology