Outpatient Facility Considerations

There are unique challenges that come with working in the outpatient setting. The caseload may be more diverse in terms of clients' age and disorders, and may require developing competencies in areas such as voice disorders or pediatric speech and language disorders. In addition, good clinical documentation skills and knowledge of coding for reimbursement are essential. In this setting, the majority of services may be billed to private insurers, requiring preauthorizations, careful tracking of approved visits, and documentation of progress toward functional goals.

Note: The questions below have not been repeated in more recent surveys. This is the most current survey data regarding employment challenges and changes.

The 2007 SLP Health Care Survey asked the following question: "What are the greatest challenges you face in health care?" In rank order, respondents from outpatient settings reported the following challenges:

  1. Insufficient reimbursement (for clinical services; 66.3%)
  2. Paperwork (clinical and reimbursement; 57.4%)
  3. High productivity requirements (35.3%)
  4. Keeping current with advances in clinical information (33.4%)
  5. Unsatisfactory salary/benefits (21.3%)
  6. Not being valued by other disciplines/administration (14.7%)
  7. Managing caseloads at multiple sites (13.6%)
  8. Resources to respond to diversity within caseload (9.1%)

In 2009, respondents were asked about undesired changes they had experienced in their work environment over the previous year. This question was asked, in part, because of the challenging economic times. In rank order, respondents from outpatient facilities reported the following:

  • None of the above (40%)
  • Increase in caseload/workload/productivity (23%)
  • Reduction in salary or benefits (without changes in hours) (16%)
  • Reduction in caseload/workload/productivity (16%)
  • Reduction in work hours (11%)
  • Increase in work hours (10%)
  • Increase in the number of sites served (7%)
  • Conversion from salaries to hourly or PRN pay (3%)
  • Replacement by support personnel (2%)
  • Job loss/layoff (1%)

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