JCPSLP Vol 17 No 1 2015_lores

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Diversity in practice
JCPSLP Volume 17, Number 1 2015 37
KEYWORDS
BARRIERS
BENEFITS
PRIVATE
PRACTICE
SPEECH
PATHOLOGY
STUDENT
PLACEMENTS
Carl Sokkar
(top) and Lindy
McAllister
Diversifying student
placements
Understanding barriers to and benefits of placements in
speech pathology private practice
Carl Sokkar and Lindy McAllister
funding for privately provided allied health services through
initiatives such as Chronic Disease Management (formally
known as Enhanced Primary Care), Better Start for Children
with Disability (Better Start), the Helping Children with
Autism Package, and more recently the National Disability
Insurance Scheme has meant that clients with chronic
illness and disability can better afford to seek services
outside the public health sector. The shrinking public
sector with restricted and decreased service provision
(SPA, 2014), with consequent reduced opportunities for
public employment, has led to reciprocal growth in private
practice.
The growth in the private sector has also been in
response to an ever-increasing demand for speech
pathology services, which the public sector cannot meet.
These demands are a result of an ageing population and
associated increase in chronic disease, improved survival
rates of premature and chronically ill infants, an increase in
the detection of communication and swallowing disorders,
and a rise in public awareness of early intervention
(Health Workforce Australia [HWA], 2013; SPA, 2014).
Compounding this trend has been a desire among speech
pathologists for increased autonomy, caseload diversity,
and better remuneration (Lambier, 2002).
A similar trend of a growing private sector has been
reported across other health professions (Green, Baskind,
Mustian, Reed & Taylor, 2007; Sloggett, Kim & Cameron,
2003). However, unlike some health professions such as
physiotherapy, dietetics, and radiation science, where
private practices routinely provide clinical education
placements, few student placements are provided by
private practices in speech pathology. To illustrate, in
the speech pathology undergraduate and graduate
entry degrees at the University of Sydney in 2013,
3% of paediatric student placements and 0% of adult
placements were provided by private practices. Despite the
considerable shift of speech pathologists from the public to
private sector, the majority of clinical education placements
continue to be provided by traditional sites such as
hospitals, community health centres, disability services, and
other publicly funded institutions.
There are a number of reasons why student placement
sites may need to diversify to include speech pathology
private practice. With the rise in private practice, employers
need to ensure that new graduates are work-ready for this
sector. Traditionally, new graduates sought public sector
experience first before entering the private sector. The
recent SPA senate inquiry submission (SPA, 2014) reports
Private practice is a rapidly growing
employment sector in speech pathology in
Australia. However, very few student
placements occur in private practice settings.
To ensure graduates are prepared to work in
this employment sector, the clinical
placements offered to students must
diversify. This article reports the results of a
project undertaken to explore the barriers
and benefits associated with speech
pathology students undertaking placements
in private practice settings. Two groups of
private practitioners were interviewed: those
who had supervised students in a private
practice setting and those who had not. The
semi-structured interviews were used to
explore the participants’ perceptions of the
role of private practice in student education,
challenges and barriers to student
placements, the benefits that might result
from the placements, and satisfaction among
those who had supervised students.
Participants also discussed professional
issues including reimbursement from health
funds, legal issues, and the need to structure
placements in ways that would enable them
to manage workload, protect income, and
meet university requirements.
The importance of private practice
There has been significant growth in private practice in
speech pathology over the last decade, with a sharp rise in
the last 2–3 years (Speech Pathology Australia, 2014). In
2002, 23% of practising members of Speech Pathology
Australia (SPA) were working in private practice as their
primary speech pathology position (Lambier, 2002). By
2013, this figure rose to 50% (SPA, 2014), indicating that
between 3250 and 3500 speech pathologists are now
working in private practice in Australia as their primary
position.
The rapid growth of the private practice sector can be
attributed to a number of factors and trends. Government