What is SLP "productivity" and how is it measured?

Productivity is a measure of how much time you spend billing patients/clients over the course of your workday. It’s a way for your employer to ensure that you are working as efficiently as possible because, at the end of the day, they are running a business. The best jobs seem to allow for a good balance of staying busy while allowing you the time to provide ethical and quality care.

We informally interviewed some SLPs working with adults across different medical settings and now have asked lots of employers about the productivity standards they report. Every single clinician we spoke to reported working really hard. This wasn’t surprising to us. What was surprising was that some interviewees were meeting their productivity requirement consistently, some did a lot of the time, and some were not even close. This demonstrates how productivity standards can vary widely across jobs and settings. It can be hard to figure out exactly what your prospective job’s productivity requirement really means in practice. This can have a significant impact on what that job will be like.

There are different ways employers measure your productivity. Some examples:

• A percentage (time spent billing patients/total time in your work day)

  • If your productivity is 80% and you work an 8 hour day, you must spend 6 hours and 24 minutes billing patients.

     

• A certain number of patients you are expected to see per day

  • In an 8 hour shift, you must bill 8 patients.

     

• Number of “units” you must bill with instrumentals, evals, and treats weighed differently based on how much time they take

  • For example, in a 10 hour shift, you must bill at least 16.5 units. Speech/language treatments are 1.5 units, dysphagia treatments are 1.2 units, any evaluation is 2 units, and instrumentals are 2.5 units. You can do any combination of these during your day.

     

• A point system which is similar to units but is common in home health positions
  • Similar to the “unit” system above, different types of visits (e.g. evaluations, treatments, etc.)  are assigned a certain number of points and you have a daily or weekly goal. The job might require 30 points a week for example and you must arrange your schedule to average 6 points a day.

From our discussions, we came up with some red flags (🚩) and green flags (✅) for you to consider when applying for your next job:

✅ The employer has a productivity requirement of somewhere between 60–80%. This range seems to be the sweet spot providing ethical and quality care, sustaining this ability long term and maintaining job satisfaction. Of course, we don’t have an exact number for this. But according to our interviews, higher than this is challenging, especially for newer clinicians. Lower than this may be too good to be true.

🚩 The employer does not assist you in building your schedule. Ask what the waiting list is like in an outpatient job, or how much time is typically spent finding new patients that qualify for therapy (this can be common in SNF positions). Your productivity and pay can take a hit if you don’t have access to patients needing to be seen and it is your responsibility to find them!

✅ The employer has a clear cancellation policy. For outpatient/private practice positions, a productivity standard on the higher end might be fine if the practice reports a low cancellation rate. Consider asking if the practice has policies in place to discharge clients that routinely cancel without notice.

🚩 The employer does not recognize that new employees, especially new grads, will need more time at the beginning. You shouldn’t be expected to meet your full productivity goal while also navigating a new building, a documentation system, and remembering where the bathroom is. Ask how soon after your start date will you be expected to bill at full capacity. This is especially important if you are paid per visit and must build your own client schedule (by evaluating and adding patients).

✅ The employer understands that some things take longer than others. An instrumental study is going to take longer than an aphasia treatment. A “quick” treatment session might turn into a long family meeting. Ideally this would be reflected in your productivity calculation. Ask if different types of encounters are weighted differently than others. This should be true if the employer has a “unit” or “points” system to track your productivity.

🚩 The employer does not have any support in place for helping you meet your productivity goal. Meeting with you to discuss your low productivity without proposing solutions isn’t going to help you be more efficient. Strategically organizing your schedule by location, providing you with a laptop or iPad for point of service documentation, and having the supplies you’ll need accessible and available might save you time, but you’ll likely need support from above to assist you. Ask what strategies they suggest for maximizing your billing time. If you are facing lots of cancellations, does the practice have administration staff that can help you fill these slots?

✅ The employer recognizes that there are essential parts of the job that cannot be billed. These include: coordinating with different departments, updating the team, making sure orders are accurate, doing in-services, going to rounds, gathering supplies, prepping for sessions, driving to the next client, and even walking from place to place. It’s reasonable to need time to do these things and not have it count against you. Ask if there is a way to report “non-productive” time so you can clearly demonstrate how hard you are working. Recognize that for some positions, this “non-productive” (but very important) time is not paid at the same rate as client facing time, too!

🚩 The employer has the same productivity requirement for SLP as it does for physical and occupational therapy. You are probably not going to be able to see as many patients as a PT or OT in a day based on the nature of our job. Many of our codes are procedural rather than timed which means a swallow evaluation can take 15 minutes or 45 minutes. This can make a big difference over the course of your day in a positive or negative way. Ask how SLP productivity requirements differ from other disciplines.

We want to hear from you. Anything you would add to the productivity discussion or any advice you would share with a job seeker based on your experience in the field?