After many years of working in clinical administration in a rehabilitation hospital setting, this author is now employed as a medical reviewer for a large HMO for those seeking access to their speech-language benefits. After being in this role for the last 18 months, I have a variety of clinical concerns related to the supervision of Clinical Fellows working alone in long-term care (LTC) settings. The issues related to the impact of limited available supervision in this setting have emerged. These concerns focus on the following areas:

Some suggestions to compensate for reduced direct supervision and daily colleague contact are offered. It is the hope of this author that this article can result in a dialogue between caregivers and employers within these settings.