Advocating for Better Care Experiences in many work settings help a traveling SLP stand up for her patients. First Person/Last Page
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First Person/Last Page  |   January 01, 2016
Advocating for Better Care
Author Notes
  • Julia Kuhn, MS, CCC-SLP, has been a traveling clinician since 2010. She specializes in adult neurogenic rehabilitation and has worked in acute care, inpatient rehab, long-term acute care, sub-acute care, long-term care and independent living facilities. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders (Dysphagia). kuhn.julia@gmail.com
    Julia Kuhn, MS, CCC-SLP, has been a traveling clinician since 2010. She specializes in adult neurogenic rehabilitation and has worked in acute care, inpatient rehab, long-term acute care, sub-acute care, long-term care and independent living facilities. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders (Dysphagia). kuhn.julia@gmail.com×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Special Populations / Cultural & Linguistic Diversity / Older Adults & Aging / Healthcare Settings / Practice Management / Attention, Memory & Executive Functions / First Person/Last Page
First Person/Last Page   |   January 01, 2016
Advocating for Better Care
The ASHA Leader, January 2016, Vol. 21, 72. doi:10.1044/leader.FPLP.21012016.72
The ASHA Leader, January 2016, Vol. 21, 72. doi:10.1044/leader.FPLP.21012016.72
I started my journey as a traveling speech-language pathologist because I wanted to see the country and have the flexibility to take extended trips around the world. As I packed my car and headed cross-country, I could not have anticipated the professional experiences and learning opportunities that lay ahead. My goals have evolved over the years working as a traveling clinician in the adult setting, from just travel to self-growth and education. I have gained new knowledge and experiences that have helped me grow into a confident, independent, patient-centered clinician.
As a new traveler and a novice clinician, I faced barriers to providing patient-centered care during my initial contracts in skilled nursing facilities. I was continually facing myths regarding patient care and reimbursements. At one facility I was told that I could see patients only for a minimal amount of time because of Medicare reimbursements. Conversely, supervisors at another facility requested I see patients for extended treatment sessions for the same reason. I was working for managers who dictated treatment duration based on reimbursement, not need, and held me to unreachable productivity expectations.
Instead of succumbing to mounting pressure, I learned to navigate the industry and distinguish the facts from myths. I researched Medicare policy, honed my clinical skills and pushed for treatment to meet my patients’ needs. In doing so, I became a better clinician and advocate for my patients—and also a stronger voice for myself and for my co-workers.

I became selective about where I would work, found myself interviewing facilities much more than they were interviewing me, and turning down jobs that I suspected would compromise my boundaries.

I soon understood the importance of setting boundaries and having the integrity to stand behind them. I developed the ability to walk into any new facility and be able to handle my caseload. I earned the respect of those around me as making critical decisions became more natural and less intimidating. I developed a strong network of clinicians who provide one another with education and support. I became selective about where I would work, found myself interviewing facilities much more than they were interviewing me, and turning down jobs that I suspected would compromise my boundaries.
I feel fortunate to have had these experiences, which have helped shift my priorities from exploring new locations to making an impact in my workplace. I have encountered people, places, cultures and ideas that have pushed me outside of my comfort zone, forced me to grow and molded me into the clinician that I am today. I look forward to the next steps on my journey and the new places and people along the way.
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January 2016
Volume 21, Issue 1