JCPSLP Vol 17 No 1 2015_lores

Diversity in practice

Diversifying student placements Understanding barriers to and benefits of placements in speech pathology private practice Carl Sokkar and Lindy McAllister

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

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

KEYWORDS BARRIERS BENEFITS PRIVATE PRACTICE SPEECH PATHOLOGY STUDENT PLACEMENTS

Carl Sokkar (top) and Lindy McAllister

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JCPSLP Volume 17, Number 1 2015

www.speechpathologyaustralia.org.au