• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
Speechies in Business

Speechies in Business

Helping Speech Pathologists in private practice focus on what matters most: their clients

  • Home
  • About Us
  • Store
    • Practice Templates
    • NDIS Resources
    • Therapy Products
  • Cart
  • Show Search
Hide Search

KPO

Speech pathologists, therapy assistants, digital platforms, and the gig economy: some ethics and compliance issues

3 July 2018 By David Kinnane Leave a Comment

Over the last five years or so, there’s been a lot of chatter about how speech pathologists can or should outsource “non-core services” to others – e.g. to therapy assistants or software service providers – to help more clients achieve their goals for less money.

It’s going to happen, whether we like it or not.

Outsourcing is confronting. But it’s nothing new for many professions.

For example, while working for law firms and banks in the early 2000s, I watched the rise and rise of Legal Process Outsourcing (LPO). LPO is now a very big business, where law firms and companies in high cost locations like the US and the UK subcontract some of their client/legal work to other companies in the same country or (more usually) in low cost jurisdictions like India, Chile, the Philippines and Sri Lanka.

In the early days, much of the work outsourced was very low level grunt and churn work. But, as companies and clients got used to the benefits of LPO, and as the LPO providers got more experience and skills, many LPO providers started offering higher value (and higher fee) services that, for some work, threatened to replace the need for in-house lawyers and external lawyers in high cost countries altogether.

LPO is only one kind of a much larger industry called Knowledge Process Outsourcing (KPO), which can occur across borders or within them. To different degrees, KPO has affected a whole host of professions in high cost countries, including tax and accounting, marketing, medical and life science research (including clinical trials), data analysis, business intelligence, engineering and finance.

Is speech pathology work vulnerable to outsourcing?

Yes. At least some of it is.

We tend to think of speech pathology as “outsourcing resistant”. The theory goes that we offer a personal service that requires a qualified speech pathologist to interview, assess, plan, then deliver all aspects of therapy to clients in a room, face-to-face.

But is all our work outsourcing-proof?

In practice, low profit margins are probably the biggest disincentive to the large-scale KPO of speech pathology. But, over the last few years:

  • many practices have their resources and even client data “in the cloud”, often using a range of low cost subscription-based platforms to do so;
  • many small practices have started to use virtual assistants and automated (or semi-automated) platforms to handle processes like client intake and bookings;
  • clients are increasingly looking to access basic information about speech pathology needs via YouTube, blogs, social media, e-courses, or e-books;
  • many of us are assessing and treating clients via telehealth using low cost or free services like Zoom and Skype;
  • aided by mobile payment and other cloud-based systems, many of us are delivering mobile services without bricks and mortar clinics;
  • aided by increased competition in some parts of the market, clients and other service “payers” (like the NDIA) are increasingly expecting that “commoditised”, low-value services will be provided for free or at a very low price that is not worth professional time;
  • more and more SLPs are opting for (or being forced into) independent contracting work. Some – particularly Millennials – are seeking flexibility and work-life balance. Some are doing it because they want to be their own boss. Others are doing it because they can’t find stable employment;
  • digital platforms like HireUp have developed to match clients with service providers who can help them (including speech pathologists);
  • health review sites have sprung up to give consumers more transparency and information about our strengths, limitations, services (and waiting lists);
  • the evidence base has established that some conditions, like childhood apraxia of speech or hypokinetic dysarthria, require more frequent and/or intensive treatment than we’ve traditionally been able to provide one-to-one; and
  • more universities have started speech pathology programs and more adult colleges have established speech pathology assistant courses, increasing the size of the para-professional workforce with at least some knowledge of speech pathology services.

Some key ethics and compliance issues to consider when outsourcing work to a service provider or assistant

Fundamentally, what separates qualified speech pathologists from assistants like students or therapy assistants is not simply knowledge, but the wisdom about how to apply it appropriately in the best interests of our clients. Being a professional mandates that, in any outsourcing arrangement – big or small – we think carefully through issues like:

  • client confidentiality and the privacy of health records;
  • client care and costs information;
  • informed client consent;
  • “reserved speech pathology activities” that are too important to be carried out by assistants and service providers who are not speech pathologists; and
  • contractual arrangements and indemnity and other insurances to address foreseeable risks/events like data breaches and negligence.

None of this is easy – in the legal sector, lawyers have been struggling with these issues for well over a decade. And, to complicate matters, “speech pathologist” is not a protected title in some countries (like Australia), meaning that it’s sometimes very difficult to establish what “reserved speech pathology activities” might mean in a given context, outside of the rules regulating rebates and insurance payments.

What matters most is – of course – the best interests of our clients; and making sure we satisfy our legal and ethical duties to clients, the profession, and to the general public.

In outsourcing professional work to others, we cannot delegate our ethical and legal obligations to clients or the profession.

Disclaimer: This article contains our opinion on some legal and ethical matters in the field of KPO of speech pathology services. Nothing in this article constitutes legal advice.

Related articles:

  • Speech pathology graduates: should you volunteer for experience and exposure?
  • Australian speech pathologists: is it ethical to hire juniors as independent contractors?

Principal background references:

Ross, M. (2011). Legal Process Outsourcing: Ethics and Compliance. Legal Information Management, 11, 97-101.

Shuk-Ching Poon, T. (2018). Independent Workers: Growth Trends, Categories, and Employee Relations Implications in the Emerging Gig Economy, Employment Responsibility Rights Journal, (published online, 5 June 2018).

Noronha, E., D’Cruz, P., Kuruvilla, S. (2016). Globalisation of Commodification: Legal Process Outsourcing and Indian Lawyers. Journal of Contemporary Asia, 46(4), 610-640.

Image: https://tinyurl.com/yb8dpfte

Primary Sidebar

Featured Products

  • camperdown program for adults and adolescents who stutter Camperdown Program for Adults who Stutter: Practice Goal Setter $0.00 including GST
  • client questionnaire for adults Client questionnaire for adults $12.00 including GST
  • His and Hers Introduction No Prep Pack $3.00 including GST
  • Auditory Bombardment Conjunction Until cover page Auditory bombardment: Conjunctions – Until $2.99 including GST
  • Speech and Language Screener Speech and Language Screener Letter and Form $9.99 including GST
  • NDIS Incident Management and Reportable Incidents System Policy and Procedures $50.00 including GST
  • Voicemail Script Voicemail Script $1.99 including GST
  • Subject Negative ('don't') Verb Sentences $4.99 including GST

Basket

Recent Posts

  • Speech pathologists in private practice: How to sleep better
  • Child Safe Organisations: Why you need a Child Safety Code of Conduct and Policy
  • To infinity and beyond: how I learned to be optimistic about the NDIS
  • NDIS Worker Screening Policy and Risk Management Plan Template for small NDIS providers
  • New NDIS Risk Management template: another quality (but inexpensive) NDIS template for small organisations
  • Speech pathologists in private practice in Australia: defamation risk alert – don’t ignore comments on your social media posts!

  • Email
  • Facebook
  • Instagram
  • LinkedIn
  • Phone
  • Pinterest
  • YouTube

Check out our NDIS provider and health provider resources Go to Store

Speechies in Business

Copyright © 2021 · Banter Speech & Language Pty Limited t/as Speechies in Business

  • Our Terms
  • FAQs about Resources
  • Contact us