I have had some time to reflect on my career and a million different dots needed to connect for me to stand before you at the podium this evening as this year’s recipient of the Samuel F. Lybarger Industry Award. It’s impossible to list every “dot” but there are three that played a significant supporting role in empowering me to give back to the profession of audiology in an apparently meaningful way. Interestingly, all three “dots” involve the initials “B.K.”.
When I started the graduate program at Cleveland State University, pursing a master’s degree in Audiology, there was a newly hired assistant professor in Dr. Bharti Katbamna. She was the first (and only) person who pulled me aside one day and said, “You should seriously consider pursuing a Ph.D.” That quick comment reframed my mindset over the course of a weekend and changed the trajectory of professional opportunities for which I am so grateful.
So, I decided to purse a Ph.D. at the University of Cincinnati where the universe gifted me with the second B.K. in my mentor Dr. Robert (Bob) Keith. From day one, Dr. Keith taught me to give back to the profession of audiology without expecting anything in return because “that’s what you do”. While collaborating on several HIV/AIDS research projects, he instilled my desire to educate and advocate. I remain indebted to Bob for the many lessons he taught me that made me a better audiologist and better researcher.
Finally, the third “B.K.’ is not one person but a small group of individuals I will refer to as the “band of Kemps”. Nearly 20 years ago, through an interesting sequence of event, Bob Kemp and Margy Kemp invited me to join the Oaktree Products family. They apparently saw something special in me and I most certainly saw something in them which was the commitment to give back to the profession of audiology without expecting much in return. For nearly two decades, Bob and Margy not only provided me with the flexibility, but with the resources and support to give back to the profession of audiology beyond my responsibilities to the company. And while both Bob and Margy are now retired, that commitment lives on through their sons Michael and David Kemp who are now driving the Oaktree Products bus and I hope to be along for the ride for as long as they’ll have me.
Due to recent increased EPA restrictions, many manufacturers have moved away from private label bottling their chemicals. The bad news? This has affected the very popular Audiologist’s Choice Ultrasonic Disinfectant Concentrate. After exhausting every option, this product is no longer available. The good news? Oaktree Products was able to source a comparable product called DECON-QUAT. Here is what you need to know:
ACTIVE INGREDIENTS:
Both Audiologist’s Choice Ultrasonic Disinfectant and DECON-QUAT are EPA-registered quaternary ammonium-based concentrates. The main difference is DECON-QUAT is bottled at a higher concentration of quaternary-ammonium. While an 8oz bottle of DECON-QUAT will cost more, it will make 6x more solution (16 gallons) than an 8oz bottle of Audiologist’s Choice Ultrasonic Disinfectant (2.67 gallons). At the end of the day, both end up costing essentially the same in the long run.
HOW MANY BOTTLES TO ORDER:
Depending on the capacity of your ultrasonic machine and frequency of replenishment, one (1) 8oz bottle of DECON-QUAT can last anywhere from 3- to 21-months. A good starting point is to order one 8oz bottle of DECON-QUAT per dedicated clinical office to get a sense as to how many bottles to reorder in the future. Because the concentration is higher, DECON-QUAT will last longer so order conservatively to avoid the situation where the product expires before it can be used up.
DECON-QUAT FAQs:
What is the active ingredient? This is a non-alcohol, quaternary ammonia (“quat”) based product, just like the Audiologist’s Choice Ultrasonic Disinfectant concentrate.
Is this product EPA registered? Yes. the EPA registration number is 10324-141-68959
Is this product considered a hospital-grade disinfectant? Yes. All EPA-registered disinfectants are considered hospital-grade.
How much solution does DECON yield compared to Audiologists Choice Ultrasonic? DECON yields 16 gallons of solution, Audiologists Choice yielded 2.67 gallons of solution.
How long must items soak to achieve hospital-grade disinfection (e.g. dwell time)? 10 minutes, just like the Audiologist-Choice Ultrasonic Disinfectant concentrate.
What are the mixing instructions for DECON? The instructions for use on the label indicate 0.5 oz per gallon of water
How much concentrate do I add to my ultrasonic machine? Depending on the ultrasonic machine’s capacity, anywhere from 1 to 4 capfuls of DECON concentrate (NOTE: pour DECON capfuls in ultrasonic first, then add water). Assuming a new batch of ultrasonic solution is prepared each week, an 8oz bottle of DECON-QUAT will make 20 to 80 new batches which ends up being anywhere from a 3-month to 21-month supply.
ITEM#
DESCRIPTION
CAPACITY
CAPFUL/ batch
MAX LIFE CYCLE*
B200
Bransonic
15 oz (less than 1 pint or = 0.47 quarts)
1
80 batches (18-21 months)
1780
Gemoro Sparkle Spa
1 pint (= 0.5 quarts)
1
80 batches (18 to 21 months)
CE-200A
Jeken Digital
1.5 quart
3
26-27 batches (6 months)
1785
Gemoro
1.2 quart
2
40 batches (8 months)
1787
Gemoro Heated
2.6 quart
4
20 batches (3-4 months)
*assumes new batch of solution made every week
The “mixing by capful” guide uses more concentrate than require. Is this a problem? Our “mixing by capful” guide was designed to be practical; for example, if an ultrasonic machine with a capacity of 1.5 quarts ended up needing 2.79 capfuls of concentrate, we rounded up to 3 capfuls to make it easy for the provider the make the solution.
If there is more concentrate added, the solution will be stronger but that is not a problem. EPA claims listed on product labeling outlines minimum dilutions. Mixing a solution with more concentrate than called for will kill the same microorganisms without any negative effects.
What if I don’t feel comfortable with the “mixing by capful” approach? If mixing the concentrate according to labeled instruction is preferred, the most practical approach is to mix ½ ounce of concentrate (0.5 oz) in a gallon of water and to use that solution to fill and replenish the ultrasonic machine as needed until it’s time to mix a new gallon batch.
How long will one bottle of DECON last? Depends on the capacity of your ultrasonic machine and how often you change out the solution. Assuming one new batch of solution per week, find the row that best corresponds to the capacity of the customer’s ultrasonic machine and refer to LIFECYCLE column for ballpark estimate of how long one bottle of DECON will last.
Is there an expiration date? A smaller white label with a QR code is located toward the top of the bottle. The last line has the letters “EXP”; the date following these letters indicates the expiration date which is listed as DAY-MONTH-YEAR (e.g. 01-Jun-2023).
What is the shelf-life of DECON? See expiration date on the bottle. (NOTE: it is an EPA requirement for chemicals to have expiration dates from the date of manufacture which is usually 2 years. If someone performed assay testing, it is highly likely the product would be considered effective even after the expiration date. Since assay testing is not commercially available, we cannot recommend using DECON past the expiration date).
What is the use/re-use guideline for DECON? Once mixed, the solution is good for up to 30 days, but it should be changed out if the solution appears unclear or murky. Most change the solution out weekly (or sooner as needed).
How do you dispose of the solution? The SDS sheet in section 13 indicates to dispose used solution ‘in a safe manner in accordance with local/national regulations.’ This may be as simple as pouring it down the sink with running water although different localities have different rules and a general recommendation is not available. Proceed in in accordance with local or federal regulations.
For more information or to place an order for DECON-QUAT, contact Oaktree Products toll free 800.347.1960 or via email at otp@oaktreeeproducts.com
Oaktree Products has introduced a new product within the Audiologist’s Choice flagship brand. Audiologist’s Choice Aud-Gel is a greaseless lubricant designed to make insertion of earmolds, hearing aids, custom ear plugs, hearables, and other earpieces easier. As a lubricant, Audiologist’s Choice Aud-Gel can also help create an effective seal to help reduce feedback while making instruments more comfortable to wear. The 0.5oz bottle has directions printed on the back and is sold by the each or in a countertop display of 12.
The Audiologist’s Choice brand includes key products used by audiologists every day including impression material, anti-itch cream, and ear wax removal systems. Click Audiologist’s Choice Brand for a complete list of the brand offering from Oaktree Products.
The American Institute of Balance (AIB) is a privately held, global healthcare company specializing in the evaluation and treatment of dizziness and balance disorders in children and adults, headquartered in Tampa Bay, Florida. Founded by Richard E. Gans, PhD in 1992, the Institute is known for its innovative world-class patient care, education, and research programs. Currently, over 5,000 healthcare professionals are AIB Certified. AIB licenses, owns, or operates 100 Centers of Specialty Care clinics in 32 US states.
Throughout their 30-year history AIB has grown to be the country’s largest network of neurodiagnostic and rehabilitation balance specialists. The Institute’s mission and vision are rooted in the science and medicine of empowering clinicians to help patients with dizziness, vertigo, and balance dysfunction. It’s education programs have trained over 13,000 physical and occupational therapists and our research, diagnostic, and therapy protocols are used by leading practitioners, hospitals, and universities worldwide.
In 2018, AIB launched its Centers of Specialty Care (CSC) exclusive licensing agreement, a practice development and support program. Through this program AIB supports audiology and medical practices in the addition of vestibular neurodiagnostic testing. The business model is quite simple: utilize the AIB co-branding, on boarding, training, practices and protocols, and support to grow a business unit that ultimately will generate the practice $300,000 – $500,000 in revenue annually. Adding these services allows audiology practices to diversify themselves in markets from retail and big box providers and establish revenue streams that are independent of any hearing aid market volatility.
In addition to this diagnostic revenue, which is all based on an insurance reimbursement model, CSC practices also see an incremental increase in hearing aid dispensing numbers. By shifting practice philosophy from retail to a medical model, practitioners can elevate their brand within the medical and patient communities, which ultimately drives hearing aid sales. Centers of Specialty Care practices strongly agree this has increased physician referrals and grown their bottom line.
The CSC program is ideal for audiology practices who may be interested in offering neurodiagnostic services but are intimidated or overwhelmed by learning a new clinical skill set and business model. The CSC license offers onboarding, training, and support in all 4 key areas of a successful balance practice:
Clinical/technical/report writing
Patient acquisition and marketing
Scheduling and front office staff training
Billing and coding
The American Institute of Balance onboards and trains practices in a unique hybrid model, which pairs online virtual education with hands-on practical competency-based training. The proprietary onboarding process allows practices to be up and running in about 30-60 days. Practices continue to receive extensive support for the duration of the 5-year licensing agreement. AIB also offers an over-read program that takes away practices dependency on needing a vestibular expert in their own facility. AIB has a large network of strategic partners from our CSC program, including 100% financing for all qualified CSC clients, digital ad design, patient acquisition, and much more.
There are many misconceptions within the field regarding vestibular specialized testing including “it requires a lot of space“, “you can’t make any money on these services“, “the equipment is too expensive“, etc. however any AIB customer would tell you this is all misinformation. The criteria for AIB CSC candidacy below outline who may be a good fit.
ENT, Neurology, or Audiology practices that range from small single practitioner businesses to large hospitals or healthcare systems.
Personal, professional, and financial goals to expand practice offerings, diversity services, and grow revenue.
Belief systems and cultural buy-in to providing gold standard care to patients with vertigo, dizziness, and balance dysfunction.
90-100 square feet of space.
Strong relationships and brand recognition within the patient and medical communities.
Capacity and personnel, including clinicians, support staff, and administrative staff, to support offered services.
Dizziness is the most common complaint of individuals over the age of 65 to their primary care physicians and the third most common complaint of individuals across the lifespan. These conditions effect over 90 million Americans. With the recent advancements in vestibular testing and treatment, revenue generating opportunities, and question marks surrounding hearing aid dispensing over the next decade, there has truly never been a better time to consider the addition of neurodiagnostic vestibular testing within the audiology space. The AIB programs help practices to do well by doing good, produce excellent patient outcomes for an underserved population, differentiate your practice, and add revenue to your bottom line.
We encourage you to visit dizzy.com/csc to learn more about AIB’s Centers of Specialty Care or to complete a FREE practice analysis. Please contact AIB at csc@dizzy.com or 800.245.6442 ext. 208 to schedule a virtual call or onsite visit.
About the Authors:
Dr. Joseph Sakumura is Director of Clinical Innovations at The American Institute of Balance (AIB). He received the Doctor of Audiology (AuD) degree from the University of Kansas Medical Center and completed his residency training at AIB. His primary interests are in the diagnosis and rehabilitation of balance disorders in a broad range of patients, children to adult. Dr. Sakumura is also a faculty member with the Institute and assists AIB’s Partners in Balance affiliates with practice development and in the application of new and emerging technologies.
Gina Lorenzetti is Director of Marketing at The American Institute of Balance (AIB) where she is responsible for strategic and operational management of activities related to marketing and communications. She received the Bachelor of Science (BS) degree in Marketing and the Bachelor of Arts (BA) degree in Public Relations, Advertising, and Applied Communication from Central Connecticut State University. Founded in 1992, AIB is internationally recognized as a leader in patient care, research and professional education in the evaluation and treatment of vestibular and equilibrium disorders.
The popular Welch Allyn MacroView head has been redesigned, offering a more compact head with improved features than the original. The next-generation LED MacroView Basic offers a larger viewing area (3x instead of 2x) and 5x magnification. The extended focal length provides a focus-free design, so the head no longer comes equipped with a manual focus adjustment wheel. The integrated LED bulb is guaranteed for 7 years, eliminating the need for replacement bulbs. For brighter views, use the Welch Allyn LumiView Clear disposable4.25mm or 2.75mm specula. All Welch Allyn 3.5 power handles and other original MacroView accessories remain compatible with the MacroView Basic head.
Interested in converting the MacroView head into a smartphone video otoscope? Check out the Welch Allyn MacroView Plus. Images may be captured and shared for consultation when using the MacroView Plus otoscope head and the Welch Allyn iExaminer SmartBracket (sold separately) paired with a smartphone and the iExaminer Pro App.
For more information on the MacroView Basic, MacroView Plus or the new Welch Allyn Diagnostic head, contact Oaktree Products at 800.347.1960 and ask for customer service. You can also email Oaktree Products at otp@oaktreeproducts.com.
The CDC recently updated their consumer webpage (January 14, 2022 updates) to reflect new mask recommendations to prevent transmission of SARS-CoV-2. This update received a lot of press although it targets consumers and remains separate from mask guidance for healthcare personnel. Based on the most recent interim guidance for healthcare personnel issued by the Centers for Disease Control & Prevention (CDC) on September 10, 2021, the current mask options for audiologists employed in healthcare settings are as follows:
NIOSH-approved N95 or equivalent respirator during aerosol-generating procedures (AGPs);
Respirator approved under standards in other countries similar to NIOSH-approved N95 masks during non-AGPs; OR
a well-fitting facemask.1
While the referenced document does not specifically address what constitutes a “well-fitting facemask”, a report issued by MMWR on February 10, 2021 emphasized that the effectiveness of both cloth and medical procedure masks “can be improved by ensuring that they are well fitted to the contours of the face to prevent leakage of air around the mask‘s edges”.2 While both cloth and medical procedure masks were mentioned in this MMWR report, the more recent CDC interim guidance specifically designates cloth masks for community use and not appropriate for use by healthcare personnel.1
Another critical point outlined in the CDC’s September 2021 interim guidance document is the call for consideration for using NIOSH-approved N95 or equivalent respirators in clinical situations where multiple factors posing an increased risk of disease transmission may co-exist (e.g. unvaccinated patient, unable to wear mask, providing services in a poorly ventilated area).1 This recommendation is very applicable to the audiology setting and something every clinical practice should taken into account when assessing current infection control protocols.
Footnote:Recognizing that the use of solid face masks may not be possible or appropriate when interacting with individuals with hearing and speech disorders, using a transparent mask is recommended.3
Final footnote: In early April, 2021, the CDC announced it was no longer necessary for health care facilities to implement NIOSH-approved crisis capacity strategies.4-6 In the presence of increase availability and stabilized supply of NIOSH-approved respirators, the CDC recommended promptly resuming conventional use and disposal practices.
Brooks JT, Beezhold DH, Noti JD, et al. (2021). Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure. MMWR , 70:254–257. DOI: http://dx.doi.org/10.15585/mmwr.mm7007e1
NOTE: The information is based on current CDC recommendations which are supported by evidence and science. It is critical for audiologists to follow state, county, and local mandates, including the direction provided by the public health department of your individual state. Be sure you know how contact the health department of your individual state and stay connected with them along with other state, county and local authorities to keep informed about COVID-19 in your community.
Looking for a meaningful gift for an AuD student you may be supervising? Take advantage of this special Luxamed offer from Oaktree Products while supplies last….because once stock is gone, the offer is gone.
The Florida Combined Otolaryngology Meeting (FCOM) will take place in an inclusive hybrid format, both in-person at the Ritz-Carlton, Naples, and as a virtual event online, November 5-7, 2021. FCOM will provide all participants the opportunity to learn, connect and forge positive professional relationships with peers from throughout the U.S. and across the globe. Session tracks including Ear, Nose & Throat, Medical Audiology, Otology – Medical Audiology, Advanced Practice Provider, and Business. With more than 120 unique sessions for attendees to choose from, the conference offers something for everyone with registration starting as low as $59 (virtual)!!
Who Should Attend?
The FCOM is a combined meeting that includes the Florida Society of Otolaryngology Head & Neck Surgery, Florida Society of Facial Plastics & Reconstructive Surgery, Network of Florida Otolaryngologists, and Network of Medical Audiology Professionals. The meeting features world-renowned otolaryngologists, plastic surgeons, medical audiologist, advanced practice providers and industry leaders presenting on what they consider the most pressing, innovative and newly emerging issues, techniques and tools within their disciplines today. All interested healthcare professionals involved in ENT are encouraged to register for this event including but not limited to audiologists, audiology assistants, physicians, physician assistants, nurse practitioners, administrators, and students.
Sample of Medical Audiology Session Tracks:
Pre-Convention Seminars
Diagnosis & Non-Surgical Treatment of Vestibular Disorders in ENT.Richard Gans, PhD, Joseph Sakumura, AuD, Kim Rutherford, PT, DSc
Cognitive Screen Essentials: Elements of Patient Care & Practice Success. Jill Davis, AuD, Abigail Sweeney, AuD, Lori Adams, AuD
Panel: Future of Audiology – How Medicine & Technology will Impact Care. Moderator: Dave Fabry, PhD. Panelists: Bill Facteau, Paul Harkness, Camille Dunn, PhD, Stephan Huhn, MD, Richard Gans, PhD
Brain Changes in Age-Related Hearing Loss: Effects of Early Intervention with Hearing Aids. Anu Sharma, PhD
Other audiology-focused topics include radiology, decision-making considerations in surgical and non-surgical management of conductive hearing loss, tinnitus, cochlear implant team care models, Medicare expansion Earlens, 3D ear scanning and more. Click AGENDA to see the full conference program and SPEAKERS to see diverse line-up of presenters across all session tracks.
Patricia Ramos, AuD, co-founder and president of the Network of Medical Audiology Professionals, is very excited about the expanded scope and relevancy of this year’s FCOM, expecting more than 1,500 attendees from all over the world. “The national and international draw of this meeting continues to grow, largely because it brings together the right mix of related specialties in an area of medicine that is best served by collaborative, coordinated, patient-centered care and we attract an audience who knows that,”said Ramos. “FCOM will include a strong focus on the very partnerships needed to provide the best outcomes for patients.“
How To Register
To register for FCOM, visit FCOMnow.com/register. To learn the ins-and-outs of this year’s conference, click MEETING FORMAT for a review of session formats that include onsite only, LIVE broadcast, Premier, Premier+, and On-Demand. Check out the FAQ’s for more information about the conference. Follow @FCOMNOW on Facebook, Instagram, and LinkedIn, and under the hashtag #FCOM and #FCOM2021.
