At this time of the year I think about all the things that I am thankful for including the profession that has allowed me to travel around the world learning about different cultures, meeting fascinating people, and of course, the altruistic satisfaction of helping patients in need. I am also reminded, however, of the fragile nature of the global economy, politics, and the dangers that rejection of change may bring. Recent events in Audiology such as the increasing attention paid to internet hearing aid sales, the entrance into our field by electronic giants like Panasonic and insurance giants like United Health Care (UHC), as well as the FDA’s encouragement of “disruptive innovations” and the proliferation of personal sound amplifier products (PSAP) highlight some of the challenges ahead.
While some of these potential “game-changers” may fail and ultimately disappear, our profession cannot afford to idly sit by and watch the events unfold without our active involvement shaped to 1) protect our hearing impaired patients, and 2) protect our professional colleagues. Waiting for our well-intentioned, but often ineffective professional organizations to produce change and protection through legislation is not sufficient. Recent entries into this blog such as the one by Deb Abel are relevant because they point out the importance of considering unbundling as a method of either counteracting the potentially devastating effects of dispensing amplification without concurrent professional services, as may be the result of internet sales, PSAPs, and UHC-type dispensing practices, or enhancing the outcome of these delivery methods by reminding ourselves of our commitment to providing professional services.
The foundation of professional services begins with aural rehabilitation (AR) and the understanding that it is not a process that follows the fitting of hearing aids, but rather that the fitting of hearing aids is merely one component of the global concept of AR. The concept of AR incorporates education, counseling, amplification, assistive listening devices, communication strategies, group training and auditory training. Indeed, in order to prepare for the flood of incoming challenges, we must redefine ourselves by remembering our professional roots and, once again, become providers of the professional services that the impersonal delivery systems such as internet or mail order sales, cannot provide. To this end, we should ensure that every one of our hearing aid patients receives needed components of AR, which at minimum should include communication strategies and a brief, realistic list of how to deal with the first week of hearing aid use, and at best, the use of individualized programs such as the Listening and Auditory Communication Enhancement (LACE) training, currently available at Oaktree Products and soon to be available in a redesigned version online in early 2012.
Dr. Robert Sweetow is Professor in the Department of Otolaryngology and former Director of Audiology at the University of California, San Francisco. He received his PhD from Northwestern University, Masters of Arts from the University of Southern California and Bachelor of Science from the University of Iowa. Dr. Sweetow has had 25 textbook chapters and over 120 scientific articles published on tinnitus, amplification, counseling, and rehabilitation. He is a reviewer for several scientific journals, author of Counseling for Hearing Aid Fittings, and a former member of the Board of Directors of AAA. He is the developer of the interactive, adaptive computerized auditory training program called LACE (Listening and Auditory Communication Enhancement).