As the speech-language pathology (SLP) profession matures and evolves, there will continue to be an ongoing need for practice change. Practice change has many drivers: consumer need; an advancing evidence base; clinical innovations; financial efficiency; local service needs; population change; government policy etc. If we are to continue to have a profession with a strong identity and the capacity to make meaningful contributions to the modern education and healthcare landscape, then practice change is a necessity. To achieve practice change we must step away from long-held traditional paradigms and service delivery models. We need a workforce that is ready, committed and willing to accept change. We need organisations that are willing and open to adopt new service models, and we must have the evidence base to support these new roles and responsibilities. Making change to ensure clinicians are working to full scope or considering extended scope models (when appropriate) is actively encouraged to help achieve a more client-centred, cost-effective health service. In this discussion paper, the benefits, issues and impacts of expanding scope of practice are discussed, and ways that individual clinicians, services, training institutions, and researchers can help support the future growth of our profession are highlighted.