The Audiology Labor Force series showed a stationary, or possibly decreasing, audiology workforce from 2000-2015, despite a median nominal wage increase of $2100/year over the same period (see feature image).  Does this mean that our profession lacks career appeal?  

Probably not, considering audiology’s consistently high ranking in “best jobs” lists compiled by US News and World Reports and Time Magazine in recent years.  

 

Preferred, but Not Attained

 

Figure 1. Comparison of audiology graduate program statistics for two time periods (adapted from Windmill & Freeman, 2017)

College graduates read those “best jobs” reports. Almost twice as many graduates applied to audiology doctoral programs in 2014 as in 2009 (Figure 1). Unfortunately, many didn’t get in and presumably chose an alternative career.

Windmill and Freeman’s post found that despite the doubling of the applicant pool, there was little or no growth in US doctoral programs, program capacity, enrollments, or graduates since 2009 (Figure 1).

 

Econ 202: Supply Thoughts, Given Increases in Demand

 

Audiologist Supply could be “inelastic” in economic terms, meaning the percentage change in audiologists is small or none with changes in wage. Supply becomes more inelastic in our situation due to factors such as capacity (e.g., operating at full), labor constraints (e.g., student applicants don’t meet minimum standards; not enough externship opportunities), and short term effects (e.g., capital investment, faculty slots).   Assessing those factors and calculating or deriving elasticity requires economic analyses which are left for a later post.

For today, the economic argument is based on face validity, using Figures 2a and b as examples to illustrate scenarios. In the charts, Q refers to quantity of Audiologists employed at Equilibrim, P refers to employment wage at Equilibrium.

On the face of it, increasing consumer demand for hearing services and the rising equilibrium wage support the notion that there is increasing Demand for our profession.  In the charts this is manifest by a rightward (upward) shift of  D1 to D2 in both figures, yielding expected change in Quantity of audiologists from Q1 to Q2,.  

Likewise, “best jobs” and increased demand to enter the field (doubling of graduate school applications) support the notion of increasing Supply of audiologists.  In the charts, this is manifest only in Figure 2a, with a rightward (upward) shift of S1 to S2. The result is a change in Equilibrium, from (P, Q1) to (P, Q2), shown by the horizontal axis arrow.  Whether or not wage moves depends on the influence of more available labor in the market, but the point is that the workforce grows at Equilibrium.  

Figure 2b differs, in that Demand is growing but Supply of audiologists is decreasing (S1 to S2 shifts leftward).  As described by Freeman and Windmill, this could happen due to fewer graduates entering the field; higher attrition rate through retirement and other factors; and increases in worker productivity resulting from technological innovation.  Whatever the reason, the result is a change in Equilibrium, from (P1, Qto (P2, Q), shown by the vertical axis arrow.  Wage increases because labor becomes scarce, but the point is that the workforce does not grow at Equilibrium and a shortage results.  

 

In Our Little World

 

Figure 3.  Audiologists’ Willingness to Work in 2012 (S1) and 2015 (S2);  Employers’ Willingness to Pay in 2012 (D1) and 2015 D2); Market clearing Equilibrium point in 2012 (E) and 2015 (E ).  Data from US Bureau of Labor Statistics. 

Skipping theory and checking out actual data, Figure 3 shows putative Supply (Willing to Work, WtW) and Demand (Willing to Pay, WtP) for the audiology workforce in two different years. No big surprise that our real world looks a lot like the theoretical world of Figure 2b. 

The only points of importance in Fig 3 are the two Equilibria (E1 and E2) where Demand and Supply intersect for 2012 and 2015 data, respectively. E1 and Esits directly atop each other, meaning that median wage increased but the number of those Willing to Work did not budge.  In other words, Demand for labor grew, shifting from D1 to D2 as employers’ WtP increased.  But the number of workers did not keep up. Instead, Supply shifted downward from S1 to S2 as the same number of workers stayed in the workforce, just working for a higher wage in 2015. 

 

He Who Pays the Piper Calls the Tune

 

This is a short term situation because those “equilibria” in Figure 3 are for the audiology workforce, not the entire hearing healthcare workforce.  If there’s a Demand, Supply will get there eventually.  If short term effects and capacity constraints limit Supply of audiologists, others will be hired (and trained) to substitute and meet Demand.  

 This discussion of the audiology labor market has not taken substitutes into account.   There are already too many graphs in this post but we’ll finish with one more and take up discussion of it in a future post.  

For those who have read this post with some attention– and who are mindful of the current national social policy discussions on hearing devices and healthcare in general –there’s no need to go through the painful exercise of working through Figure 4 to arrive at the obvious conclusions.  

Figure 4.  Willingness to Work (Supply) of Audiologists (SAuD) and Hearing aid Specialists (SHAS) in 2015; Willingness to Pay (Demand) for Audiologists (DAuD) and Hearing Aid Specialists (DHAS) in 2015.  Market clearing Equilibria are E(AuD) for audiologists and EHAS) for Hearing Aid Specialists, showing that the latter are a substitute good in this market..

 

The short term will not prevail in an open market.  In our market, there are substitutes for audiologists, ready and Willing to Work.  There are employers ready and Willing to Pay, and probably willing to step in and train if that’s what it takes to eliminate the shortage in the long run.

 

Figures 2a&b adapted from econport

 

US Patent #9544700 by inventors Sunil Puria and Rodney Perkins, was awarded to EarLens Corp. on January 10, 2017.  Coming in at 22 pages and 12 illustrations (c.f., feature image),  “Optically Coupled Active Ossicular Replacement Prosthesis,” is what they call a total package.  Here’s a sample of its contents:

  • A concise anatomy course.   The patent starts with a fast-paced primer on external and middle ear anatomy that would serve most audiology graduate courses well and deserves repeating here with slight paraphrasing:
    • “The ear comprises an external ear, a middle ear and an inner ear. The external ear comprises a pinna and an ear canal and is bounded medially by an eardrum. Ear canal extends medially from pinna to eardrum. Ear canal is at least partially defined by a skin disposed along the surface of the ear canal. The eardrum comprises an annulus that extends circumferentially around a majority of the eardrum to hold the eardru in place. The middle ear is disposed between eardrum of the ear and a cochleear of the ear. The middle ear comprises the ossiles to couple the eardrum to cochlear. The ossicles comprise an incus, a malleus and a states. The malleus is connected to the eaerdrum and the stapes is connected to an oval window, with the incus disposed between the malleus and stapes … Stapes is coupled to the oval window so as to conduct sound from the middle ear to the cochlea.” 
  • A new, unpronounceable acronym for audiology: the invention is an “AORP,” or active ossicular replacement device with a “narrow cross-sectional profile.” AORPs, which are sized to a person’s middle ear, are prothestic incudes1 which connect malleus to stapes.
  • An innovative, simplified surgical procedure.  The AORP’s design enables “position(ing) in the middle ear through an incision in the eardrum…without cutting bone that defines the shape of the ear canal or the shape of the middle ear.”
  • A built-in Human Eardrum Transmission Experiment. Appearing in the small print of the patent rather than in an academic journal, readers are delighted to find a fully described experiment and resulting data to “measure transmission of infrared light through the eardrum.”

With prose this perfectly packed, be assured that the remaining pages of this patent are chock full of worthwhile reading and innovative thinking.  What a patent! 

 

The January 2017 List

 

 

Description

Patent Number

Assignee

Issued

Stimulus signal for simultaneous measurement of auditory steady state responses and psychophysical pitch discrimination

9533144

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

1/03/2017

Enhancement of reverberant speech by binary mask estimation

9538297

Board of Regents, The University of Texas System

1/03/2017

Hearing Aid Specialized as a Supplement to Lip Reading

9538295

Oticon A/S (Smorum, DK)

1/03/2017

Hearing Assistance Device Comprising an Input Transducer System

9538296

Oticon A/S (Smorum, DK)

1/03/2017

Method and Device for Analyzing Hearing Aid Settings

9538294

Sivantos Pte.Ltd.(Singapore, SG)

1/03/2017

Implantable Sound Sensor for Hearing Prostheses

9533143

Cochlear Ltd. (Macquarie University, NSW, AU)

1/03/2017

Hearing Aid

D775737

GN Resound A/S (Ballerup, DK)

1/03/2017

Audio System for Audio Streaming and Associated Method

9538284

GN Resound A/S (Ballerup, DK)

1/03/2017

Attenuating Tip for Hearing Aid

9538298

Zounds Hearing Inc. (Tempe, AZ)

1/03/2017

Systems and methods for facilitating apical electrode stimulation by an electro-acoustic stimulation system

9533146

Advanced Bionics AG (Staefa, CH)

1/03/2017

Dynamic compliance voltage management for an implantable stimulator

9539430

Advanced Bionics AG (Staefa, CH)

1/10/2017

Hearing Aid

D776282

GN Resound A/S (Ballerup, DK)

1/10/2017

Wireless Streaming to Hearing Assistance Devices

9544699

Starkey Laboratories, Inc. (Eden Prairie, MN)

1/10/2017

Device for Recharging Hearing Aid Batteries Using USB Dongle

9543778

Starkey Laboratories, Inc. (Eden Prairie, MN)

1/10/2017

Electronic Device Including Automatic Gain Adjustment for Hearing Aid Compatibility

9544406

BlackBerry Ltd. (Waterloo, Ontario, CA)

1/10/2017

Contact Hearing System with Wearable Communication Apparatus

9544675

EarLens Corp. (Menlo Park, CA)

1/10/2017

Optically coupled active ossicular replacement prosthesis

9544700

EarLens Corp. (Menlo Park, CA)

1/10/2017

Signal enhancement using wireless streaming

9544698

Oticon A/S (Smorum, DK)

1/10/2017

Removable auditory prosthesis interface

D776281

Cochlear Ltd. (Macquarie University, NSW, AU)

1/10/2017

Wirelessly Powered Audio Devices

9544683

WiTricity Corp. (Watertown, MA)

1/10/2017

Mobile terminal and method of pairing mobile terminal with hearing apparatus

9549240

Samsung Electronics Co., Ltd. (Suwon-si, KR)

1/17/2017

Portable terminal for controlling hearing aid and method therefor

9549264

Samsung Electronics Co., Ltd. (Suwon-si, KR)

1/17/2017

Magnet arrangement for bone conduction hearing implant

9549267

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

1/17/2017

Triphasic pulses to reduce undesirable side-effects in cochlear implants

9545516

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

1/17/2017

Fixation system for an implantable medical device

9545522

Cochlear Ltd. (Macquarie University, NSW, AU)

1/17/2017

Method and hearing device for tuning a hearing aid from recorded data

9549268

Sivantos Pte.Ltd.(Singapore, SG)

1/17/2017

Method of controlling a hearing instrument

9549266

Sonova AG (Staefa, CH)

1/17/2017

Adaptive piezoelectric array for bone conduction receiver in wearable computers

9547175

Google, Inc. (Mountain View, CA)

1/17/2017

Processing of audio signals for a tinnitus therapy

9549269

Sonormed GbmH (Hamburg, DE)

1/17/2017

Methods and systems for enhancing pitch associated with an audio signal presented to a cochlear implant patient

9549265

Advanced Bionics AG (Staefa, CH)

1/24/2017

BTE hearing aid having a balanced antenna

9554219

GN Resound A/S (Ballerup, DK)

1/24/2017

Programming systems for eliciting evoked responses in a cochlear implant patient and performing predetermined actions in accordance with the evoked responses

9550061

Advanced Bionics AG (Staefa, CH)

1/24/2017

Implantable fluid delivery apparatus and implantable electrode

9550051

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

1/24/2017

Compressor architecture for avoidance of cross-modulation in remote microphones

9554217

Starkey Laboratories, Inc. (Eden Prairie, MN)

1/24/2017

Bone-sealed audio device having insertion part with adhesive and phase-changing material

9554216

Oticon A/S (Smorum, DK)

1/24/2017

Configurable hearing instrument

9560458

Oticon A/S (Smorum, DK)

1/24/2017

Holding unit for a vibration transmitter and a vibration transmission system using it

9554224

Oticon Medical A/S (Smorum, DK)

1/24/2017

Apparatus and method for processing multi-channel audio signal using space information

9552820

Samsung Electronics Co., Ltd. (Suwon-si, KR)

1/24/2017

Method and apparatus for processing audio signal

9554227

Samsung Electronics Co., Ltd. (Suwon-si, KR)

1/24/2017

Post-filter common-gain determination

9553557

Cochlear Ltd. (Macquarie University, NSW, AU)

1/24/2017

Automatic sound optimizer

9554218

Cochlear Ltd. (Macquarie University, NSW, AU)

1/24/2017

Systems and methods for remotely tuning hearing devices

9553984

Audigence, Inc,; Cochlear Ltd. (Macquarie University, NSW, AU); University of Florida Research Foundation, Inc.

1/24/2017

Electromechanical transducer with mechanical advantage

9554222

Cochlear Ltd. (Macquarie University, NSW, AU)

1/24/2017

Devices for enhancing transmissions of stimuli in auditory prostheses

9554223

Cochlear Ltd. (Macquarie University, NSW, AU)

1/24/2017

Devices for enhancing transmissions of stimuli in auditory prostheses

9554223

Cochlear Ltd. (Macquarie University, NSW, AU)

1/31/2017

Automatic sound optimizer

9554218

Cochlear Ltd. (Macquarie University, NSW, AU)

1/31/2017

Systems and methods for remotely tuning hearing devices

9553984

Cochlear Ltd. (Macquarie University, NSW, AU)

1/31/2017

Post-filter common-gain determination

9553557

Cochlear Ltd. (Macquarie University, NSW, AU)

1/31/2017

Calibration method for cochlear system and hearing system applying calibration mapping

9555243

Oticon Medical A/S (Smorum, DK)

1/31/2017

Configurable hearing instrument

9560458

Oticon Medical A/S (Smorum, DK)

1/31/2017

Interface circuit for a hearing aid and method

9557755

GN Resound A/S (Ballerup, DK)

1/31/2017

Antenna with shielding apparatus and manufacturing method

9559409

Sivantos Pte.Ltd.(Singapore, SG)

1/31/2017

Analog/digital audio converter and a method thereof

9557959

Samsung Electronics Co., Ltd. (Suwon-si, KR)

1/31/2017

Connectorized cochlear implant systems and methods

9555242

Advanced Bionics AG (Staefa, CH)

1/31/2017

Digital automatic gain control

9559653

K/S HIMPP (Lynge, DK)

1/31/2017

Conversation assistance system

9560451

Bose Corp. (Framingham, MA)

1/31/2017

Hearing aid and method of detecting vibration

9560456

Panasonic Intellectual Property Management Co., Ltd. (Osaka, JP)

1/31/2017

 

Editor’s note:  The Patent Series is updated monthly now, and every two months in the past.  Click links for patents approved in December 2016,  November 2016,  October 2016Sept 2016,  Jul/Aug 2016,  May/Jun 2016Mar/Apr 2016Jan/Feb 2016,  Nov/Dec 2015, Sept/Oct 2015,  Jul/Aug 2015, May/Jun 2015,  Mar/Apr 2015Jan/Feb 2015,  Nov/Dec 2014,  Sep/Oct 2014,  July/Aug 2014,  May/Jun 2014,  Mar/Apr 2014,  Jan/Feb 2014Nov/Dec 2013September/October 2013Jul/Aug 2013May/Jun 2013Mar/Apr 2013Jan/Feb 2013Nov/Dec 2012

 

Footnote

1Yes, incudes is the plural of incus. More than one stapedius or malleus is stapedii and mallei, respectively.  Did we learn this in school?