Do Productivity Standards Impact Clinical Decision Making for Speech-Language Pathologists?

Purpose: An increasing number of medical speech-language pathologists (SLPs) must comply with productivity standards in clinical settings. Studies in related fields have demonstrated a positive correlation between productivity and unethical behaviors. We aimed to identify common practices in productivity measurement in the field of speech-language pathology and to examine relationships between productivity standards, clinical care, and ethical behaviors. Method: We disseminated a survey to currently practicing SLPs via social media, e-mails to speech-language pathology departments at large medical centers, and American Speech-Language-Hearing Association Special Interest Group discussion boards. Thirty-one questions probed demographics, productivity requirements, and perspectives on clinical care issues. Descriptive statistics summarized survey data. Spearman's rho correlations and odds ratios examined relationships between productivity, demographics, and unethical behaviors. Results: One hundred seventy-one participants met inclusion criteria and completed the survey (response rate = 83.0%). One hundred fifty-two participants (88.9%) had a formal productivity goal, and 50.3% ( n = 84) denied feeling pressure to engage in unethical workplace behaviors. The average number of reported unethical behaviors was 3.3 ± 2.35. The number of unethical behaviors reported was weakly associated with having an expected productivity percentage, having a difficult/inappropriate productivity goal, and having productivity standards that negatively influence clinical decision making ( p < .05). In contrast, the number of unethical behaviors reported decreased as years in clinical practice, participation in productivity goal setting, and organizational emphasis on ethics and evidence-based practice increased ( p < .05). Conclusions: Preliminary findings reveal relationships between productivity standards and perceived negative impacts on patient care and ethical decision making. Results highlight the need for future research to facilitate the development of industry standards to support clinicians and, thereby, improve patient outcomes and reduce health care costs. Supplemental Material: https://doi.org/10.23641/asha.31253272