Practice Management in Audiology and Speech-Language Therapy: A Global Narrative Review of Practitioner Perspectives on Operational and Leadership Challenges

Effective practice management is essential for the delivery, accessibility, and sustainability of audiology and speech-language therapy services. However, growing evidence suggests that practitioners are often underprepared for the administrative, financial, and leadership demands of their roles.

This narrative review examines how practitioners across different countries describe their experiences with managing audiology and speech-language therapy practices. The review synthesises peer-reviewed literature that captures the challenges, strategies, and recommendations reported by clinicians working in diverse healthcare contexts.

A structured narrative review methodology, incorporating systematic search and screening procedures, was adopted. A total of 192 records were identified through database searching, of which 182 remained after duplicate removal. Following title and abstract screening, 37 full-text articles were assessed for eligibility, and 16 studies met the inclusion criteria. Sixteen peer-reviewed publications published between 2000 and April 2025 were identified through systematic database searches. Studies were included if they presented practitioner perspectives on any aspect of practice management. Thematic analysis was used to synthesise the data.

The analysis revealed nine interrelated themes: limited business and financial training; reimbursement complexities; ethical dilemmas; high workload and burnout; barriers to continuing professional development; private practice management challenges; gaps in human resource capacity; insufficient policy engagement; and the importance of interprofessional collaboration and person-centred care. Studies from high-, middle-, and low-income countries highlighted both globally shared and context-specific barriers. Practitioners emphasised the need for embedded business skills training, improved access to continued professional development (CPD), supportive regulatory environments, and clearer guidance from professional bodies.

The findings indicate that practice management challenges are systemic rather than isolated, reflecting broader gaps in health workforce preparation and policy support. The recurrence of similar themes across diverse settings highlights the need for integrated training models that combine clinical expertise with leadership, financial, and advocacy competencies to ensure sustainable and equitable service delivery.

The results of the study highlight the global need for integrated, context-sensitive preparation in practice management within health professions education and systems. This review provides actionable insights to inform reforms in training, policy, and organisational support, better equipping practitioners for sustainable, high-quality service delivery.