Recruitment and Retention of SLPs in Health Care
This resource is designed to help administrators, program directors, and recruiters bring speech-language pathologists (SLPs) into their workforce and retain them.
SLPs are essential professionals in health care settings. They address swallowing, communication, and cognitive-linguistic needs that influence a patient’s safety, participation in daily activities, and quality of life. The SLP’s skillset is distinct and cannot be substituted by the skillset of another professional.
Recruiting SLPs supports timely, safe, skilled care. Retaining staff helps maintain quality while reducing costs tied to turnover, recruitment, and lost productivity.
- Current Status of SLP Employment in Health Care Settings
- Benefits of Retention
- Recruitment and Retention Strategies
- Employment Considerations
Current Status of SLP Employment in Health Care Settings
Demand for SLPs continues to rise across health care settings due to demographic and health factors. The U.S. Bureau of Labor Statistics (BLS) consistently reports strong projected growth for the profession, rating it as having faster growth than average among all occupations. The most current employment projections and workforce data are available on the BLS Occupational Outlook webpage for SLPs.
ASHA collects data every 2 years from SLPs employed in health care settings. Information regarding trends in employment status (full- or part-time) and vacancies can be found in the ASHA SLP Health Care Survey.
Benefits of Retention
Retaining existing health care staff is linked to both cost savings and higher quality care compared with hiring new clinicians. Although much of the employee retention research has focused on nursing, studies show that staff turnover significantly affects organizational costs and that higher turnover is associated with lower quality care (Henderson, 2020; Shen et al., 2023).
Cost Savings
- Retention of existing staff avoids lost productivity and revenue during vacancies or orientation of new hires.
- Retention also reduces costs associated with recruiting and training new staff or relying on travel or contract therapists.
Quality Improvements
- Retention allows experienced clinicians to become more efficient, make better-informed decisions, and deliver care more effectively over time.
- Retention supports increased consistency and better compliance with policies and procedures.
- Retention also fosters leadership, strengthens team collaboration, and boosts overall team morale.
If you experience frequent turnover, you may want to consider conducting exit interviews and looking for patterns like these:
- productivity requirements that are difficult to meet
- administrative policies that limit an SLP’s clinical judgment (e.g., policies to maintain a set caseload size, policies to limit treatment times or intervals for certain payers)
- lack of administrative support
- lack of training to meet job requirements
- lack of tools to meet job requirements (e.g., assessment and treatment materials, computers)
- inadequate staffing to meet caseload needs
- lack of support by other staff of the SLP’s role and recommendations
- too much travel between patients or facilities
- too much paperwork
Even the strongest recruitment efforts would not offset the impact of high turnover on staff quality, team morale, and overall costs.
Recruitment and Retention Strategies
Recruitment Strategies
Even with strong retention, vacancies will occur. Effective recruitment strategies include the following:
- Post job openings on ASHA’s Career Portal, in The ASHA Leader, and on state association job boards; attend virtual and in-person career fairs.
- Clearly communicate hourly rates or salaries upfront, along with any additional incentives such as sign-on bonuses, relocation assistance, flexible scheduling, continuing education support, or tuition reimbursement. Transparency helps build trust with candidates, sets realistic expectations, and can reduce turnover by ensuring that every new hire understands the full value of their compensation package.
- Build relationships with graduate programs through student placements, mentorship, and guest presentations.
- Attract candidates by encouraging staff engagement in—and protecting time for—professional and community activities, such as state association meetings, research or quality improvement projects, and community education efforts.
- Leverage word-of-mouth recruitment by offering incentives to current staff for successful hires.
Retention Strategies
Keeping SLPs engaged and supported is essential for maintaining high-quality care and controlling costs. Effective retention strategies include competitive pay and benefits, supportive leadership, manageable workloads, adequate resources, access to professional development, opportunities for mentorship, and meaningful recognition—creating a workplace where staff feel valued and motivated to stay.
Learn more about effective retention strategies below.
A comprehensive benefits package is a key factor in attracting and retaining SLPs. In addition to competitive pay, attractive benefits include the following:
- Paid time off and sick leave to support work–life balance and recovery when needed
- Health, dental, vision, and other insurance options to protect employees and their families
- Retirement plans to provide long-term financial security
- Support for professional growth, including reimbursement for state licensure, specialty certifications, and association memberships
- Protected time and funding for continuing education and professional development to maintain licensure and develop new skills
Providing a well-rounded benefits package not only makes your organization more attractive to prospective staff but also improves job satisfaction and long-term retention, ultimately supporting better patient care.
Retention is strengthened when SLPs work in an environment with supportive leadership and open communication. Leaders who provide clear guidance, listen to staff concerns, and involve clinicians in decision making foster trust, respect, and professional satisfaction.
Workloads and productivity expectations that account for essential tasks—such as documentation, staff training, and team meetings—help prevent burnout and maintain morale. These practices create a culture where staff feel empowered, satisfied, and more likely to remain with the organization long term.
SLP retention improves when clinicians have the tools and support needed to work effectively. This includes the following resources and equipment:
- up-to-date assessment and treatment materials
- reliable technology, such as computers and documentation systems
- sufficient support staff
- adequate clinical staffing to manage caseloads
- access to functional space and equipment for patient care
Insufficient or outdated resources can hinder care, reduce job satisfaction, and contribute to staff turnover.
Providing access to mentorship and professional development supports SLPs in both clinical and professional growth, thus reducing burnout and turnover. Early career professionals benefit from guidance by more experienced colleagues, whereas seasoned clinicians value opportunities to refine their skills and broaden their expertise.
Strategies for effective mentorship and professional development include the following:
- on-site or traveling mentors to provide consistent guidance and support
- peer mentorship accessible by phone or email for timely problem solving and professional advice
- cross-training to support staff transitioning into new settings, populations, or specialized clinical areas
- continuing education opportunities such as conferences, webinars, and in-service training to maintain competency and stay current with best practices
Financial support and protected time for mentorship and professional development can improve clinical competence and strengthen staff satisfaction, benefiting both the SLP and the patients they serve.
Supervising students is a role that benefits clinicians and the facility by promoting skill development, strengthening connections with universities, and introducing future SLPs to your organization. Although supervision can be challenging due to travel and caseload logistics, its success depends on close collaboration between the supervising SLP and administrative staff to support the student’s learning experience.
Management research has shown that companies that provide higher levels of recognition have lower voluntary turnover than companies with poor recognition cultures (Bersin, 2012). Individuals value different forms of recognition, but recognition may include the following practices:
- public acknowledgment of accomplishments
- inclusion in systems-level decisions that impact clinical care delivery and workflow
- leadership roles on clinical or administrative teams
- support for pursuing advanced competencies or certifications
- flexible scheduling
- support for transportation or parking costs
- financial bonuses or extra leave
Employment Considerations
Understanding licensure, certification, supervision requirements, and competency expectations helps employers support safe, compliant, and high-quality speech-language pathology services. The sections below outline considerations when hiring and supervising SLPs, clinical fellows, and students as well as expectations for ongoing clinical competency.
State Licensure
SLPs are licensed health professionals, and each state sets its own rules for who can practice under what conditions.
- For SLPs who work in-person, employers need to understand the licensure requirements for the state in which the clinician delivers the service.
- For SLPs who work in telepractice, employers need to understand the licensure requirements for both the state from which the SLP provides services and the state where the client is located at the time of service.
State speech-language pathology practice regulations vary widely. Some state regulations outline specific requirements for procedures like endotracheal suctioning or endoscopy. Other states establish supervision expectations for provisional licensees and assistants. Staying current with these state regulations helps ensure compliance. For more information on state-specific guidelines, see ASHA’s State and Territory Information and Audiology and Speech-Language Pathology Interstate Compact resources.
Certificate of Clinical Competence
SLPs may hold a Certificate of Clinical Competence (CCC) from ASHA. This credential means that clinicians have voluntarily met rigorous academic and professional standards, typically going beyond the minimum requirements for state licensure.
For more information about the CCC, visit ASHA’s webpage, General Information About ASHA Certification.
Clinical Fellows
In some states, individuals who have completed their master’s degree and passed the PRAXIS® exam may meet state requirements to be licensed on a provisional basis and may be hired to work in health care settings as clinical fellows with required supervision.
When deciding whether to bring on clinical fellows, employers should
- consider adopting the requirements mandated by the state regulatory agency or the state licensing board when determining how to license their clinical fellows and
- confirm whether their payers credential those providers who are licensed on a provisional basis.
For more information about clinical fellows, visit ASHA’s webpage, A Guide to the ASHA Clinical Fellowship Experience.
Students
Students who are pursuing a graduate degree in speech-language pathology complete externships as part of their program requirements. These experiences provide valuable hands-on training across diverse clinical settings. Supervision requirements can vary by health care setting and payer, and supervising SLPs benefit from having dedicated time that is specifically slated for mentoring and supervising students.
For more information, see ASHA’s resource, Supervision of Graduate Students: Billing and Payment Compliance.
Clinical Competencies
In addition to meeting licensure and certification requirements, many health care facilities verify competencies of SLPs in specific practice areas or for specific procedures. Formal competency assessments—including documentation of competency—can vary depending on facility and state guidelines. Written competency plans can help meet documentation standards for facility reviews or surveys (e.g., by The Joint Commission or by state departments of health).
SLPs who have not achieved competency in specific treatment areas (e.g., swallowing disorders, laryngectomy rehabilitation, tracheostomy and ventilator management) or procedures (e.g., performing and interpreting videofluoroscopic swallow studies [VFSS] or flexible endoscopic evaluations of swallowing [FEES] often need to complete continuing education, mentorship, and supervised practice before practicing independently in these areas. Offering professional development opportunities and protected time to complete these learning activities helps SLPs build needed competencies, meet their facility’s expectations, and strengthen their ability to assess, treat, and respond to patients’ clinical needs, while also supporting job satisfaction.
ASHA’s Health Care Services Team in Speech-Language Pathology is available to answer questions and help you troubleshoot recruitment and retention challenges at your facility. Email healthservices@asha.org and let us know how we can help.
