By Michael Collins, AuD

 

My fellow hearing professionals, disruption is at our doorstep.

I doubt that most of you would have thought just a few short years ago that our industry would be turned on its head in such a short amount of time by the likes of the National Academy of Sciences (NAS), the Food and Drug Administration (FDA), the President’s Council of Advisors in Science and Technology (PCAST) and likely very soon,  the US Congress.

How many among us would have guessed that things would have moved so rapidly over the past several months that the prospect of an OTC class of hearing aids is now very real in 2017, thanks to legislation proposed by prominent US Senators, Elizabeth Warren and Chuck Grassley?

The momentum, including consumer and public sentiment, has shifted strongly against our industry as it currently operates.

 

Can You Blame the Public?

 

When it comes to hearing aids, I’m sorry to say, that in the minds of the public we’re no better than Big Pharma—taking advantage of people financially, for apparently no reason other than to get rich.

This is precisely the reason that two of the most influential US Senators are now pushing for an OTC class of hearing aids to “improve access for consumers”.

To quote American Academy of Audiology (AAA) President, Ian Windmill, Ph.D.

 

“We also suffer from an access issue. There are simply not enough audiologists positioned geographically to meet the current demand for hearing care, much less the demand expected over the next several decades. So should we be outraged with Congress or federal agencies for allowing more people to access hearing care, or should we be outraged at ourselves and our academic programs for not recognizing and responding to the demand? Moreover, do we deny individuals access to a hearable that could be a consumer electronic because they cannot easily access audiology services?”

President’s Message, Audiology Today, Jan/Feb 2017

 

Regardless of who, or what, is to blame for our current state of affairs, the reality is that we need to embrace this change that is coming at us full speed. Otherwise, we risk being left behind.

Consumers want access, plain and simple. They will find it — with or without us.

 

Expanding Access to Professional Care

 

As people who have dedicated years of their lives to improving the lives of others, whether you’re an audiologist or hearing instrument specialist, hearing professionals have a lot in common. Sadly, while our industry has been confronted with some of the biggest challenges in decades, our professional organizations have continued to bicker and put energy and resources into fighting one another in public forums and in court.

I don’t deny, as an audiologist, the legitimate concern over encroachment into our scope of practice, among other issues. However, I’ve witnessed some of the worst vitriol between professionals and organizations over the last 1-2 years than I have seen in my professional career.

It’s incredibly disheartening.

 

A Plea for Unity

 

I had written previously, back in 2015, about how encouraging it was that IHS and ADA were joining forces for the (now defunct) Unison Summit, and was feeling rather hopeful for our collective professional futures back then. However, I must admit, my extreme disappointment at where we find ourselves today.

 

Let’s resolve to make 2017 the year we honestly try to put aside our differences, for all of our sake.

 

Our industry is at a critical turning point. What happens this year could have ramifications for years to come. 

Do we want to spend the rest of this crucial time putting our energy into turf battles? I certainly don’t. Let’s all take a step back, re-focus, and instead put our energy into strategies that will put the industry on a path where everyone benefits, including the millions of consumers that need, and deserve, high quality, professional hearing care. 

 

*images courtesy mediaquaint, Flckr

 

Michael Collins, AuD is an audiologist with experience in private practice and within industry working for a major hearing aid manufacturer. Dr. Collins believes that independent hearing care practitioners can and will continue to thrive in the future, but only if they shift their focus away from just technology, and instead commit to best practices and greater personalization of the patient experience.

by Jerry L. Northern, PhD and Darrel L. Teter, PhD

geary mccandless audiologist

Geary McCandless, PhD

Audiology lost an illustrious leader from the Golden Age of Audiology (1960 – 1990) with the passing of Geary McCandless on January 4, 2017.  Those who knew him recognized his talents as a modern Renaissance man, i.e., a cultured person who is well informed, educated, and proficient in a wide range of fields.  Dr. McCandless was interested and knowledgeable in a broad variety of topics related to hearing, auditory science and beyond.His research reflected his innovative and original thinking about the challenging topics of his day.He was an outdoor enthusiast and adventurer and successful in every activity he attempted, ranging from archeology to aviation to painting beautiful southwestern landscapes in oils. 

Dr. McCandless retired from the University of Utah in 2002 as a Professor Emeritus after a distinguished career spanning over 40 years.  He received his Masters Degree in Audiology from BYU in 1956 and his PhD from Wayne State University in 1959 studying under John Gaeth.  He earned his BA and Masters degrees at Brigham Young University in 1953 and 1956 respectively.  His first position was Director, Hearing Testing and Child Study Center at the New Mexico School for the Deaf in Santa Fe. Dr. McCandless went on to hold several faculty and administrative appointments including Associate Professor at the University of Colorado Medical School; Head of Audiology, Division of Otolaryngology at University of Utah; Associate Dean and Interim Dean of the College of Health and Acting Chair, Department of Communicative Disorders at the University of Utah.

We were young doctoral students when Geary McCandless arrived in Denver in 1964 from the New Mexico School for the Deaf.  His task was to establish a hearing research laboratory at the University of Colorado Medical Center.  Dr. McCandless immediately became the local audiology guru and hearing science expert and we were absolutely in awe of his knowledge and skills.  We were excited to get to know him and learn from his experiences and interests.  He openly welcomed us into his laboratory, shared his equipment with us, advised and helped us with our dissertations, and ultimately became our life-long friend as he mentored and counseled us throughout our careers. 

A Prolific Career

Geary published more than 90 articles and 40 book chapters and presented hundreds of invited lectures.   Dr.McCandless was one of the most popular speakers on the national and international circuit of auditory-related meetings during his 40 year career.  He was a perpetual faculty member of numerous scientific and professional programs including 30 years of participation in the Colorado Audiology-Otology Conference (popularly known as “the audiology ski meeting”), 20 years as a speaker in the International Hearing Aid Seminar held annually in San Diego and directed by Robert Sandlin, and two decades on the program of the infamous Jackson Hole Rendezvous, hosted by Michael Marion.  His clinical and research reports were both educational and entertaining while reflecting his innovative and original thinking about the challenging topics of his day.  Through his professional years he often served as a consultant to industry, helping them develop and evaluate new products including hearing aids, cochlear implants, and a wide assortment of audiometric equipment. 

During the early and mid-1960s, Dr. McCandless was among the first to investigate the utilization of computerized cortical evoked responses as a clinical procedure.  Working with an early hand-made signal averaging-computer (about the size of a small suitcase) his initial research projects were with slow latency evoked responses. He pioneered research in 1964 on the use auditory evoked potentials in children (especially use of “late waves”) and helped to develop the computerized instrumentation to record these potentials for auditory diagnosis.  His publications provided the groundwork for standardization of testing protocols in use today in terms of best electrode placement, effects of frequency and stimulus variations and presentation, sedation, in the technique known then as electroencephalographic audiometry, later to be known as evoked response audiometry (ERA).  He also conducted research which helped establish normative standards for acoustic immittance measurements and its application in diagnosing middle ear disease.  Geary was especially interested in hearing aid research and was responsible (along with Paul Lyragaard) for developing the POGO prescriptive method for hearing aid fitting.  His research on the Symbion Ineraid Cochlear Implant helped to demonstrate the benefits of multi-channel implants over single channel devices.

Dr. McCandless is perhaps best recognized for his research and publications with hearing aids and amplification.  He was among the first to advocate “open ear molds” to reduce sound pressure at the tympanic membrane through large vents, thereby reducing potential noise induced hearing loss.  Geary, along with Paul Lyragaard, developed the widely used prescriptive method for hearing aid fitting known as POGO (Prescription of Gain and Output). He developed a widely used, user-gain-based hearing aid fitting protocol and suggested using the onset of the stapedius reflex to set the output limit of hearing aids fitted to infants and young children.  He served as a consultant to numerous hearing aid companies throughout his career.He recommended and tested the fitting algorithms for Songbird, the world’s first disposable hearing aid, along with the fitting selector used by dispensers to select the appropriate response and gain levels for the device.

But the extensive McCandless contributions and research interests in audiology went way beyond hearing aids.  He published reports on tympanometry and acoustic reflex measurements and their use in hearing aid evaluations, newborn and infant hearing testing including studies of the maturation of the stapedial reflex response, screening for otitis media in Native Americans of the Wind River area in Wyoming, auditory dysfunction in patients with facial paralysis, a descriptive report of the temporal bones in dinosaurs, and several studies involving cochlear implants. His research on the Symbion Ineraid Cochlear Implant helped to demonstrate the benefits of multi-channel implants over single channel devices.

Dr. McCandless had strong commitments to the professional issues of his time.  He served on a variety of editorial boards, served as President (1977-78) and Executive Board Member of American Auditory Society, and received many honors during his career.  He was a Fellow of ASHA and AAA, a recipient of the Outstanding Faculty Scholar award at University of Utah, and the Frank R. Kleffner Clinical Career Award from ASHA.  He served as a consultant to government agencies and participated as a committee member of many state, national and international initiatives.

An Amazing Person

But as much as we admired his audiology career, he astounded us with his outdoor activities. He set a high standard for living beyond the sound room, and we considered ourselves fortunate to accompany him on many of his outdoor adventures.  There was literally nothing he could not do — or fix or repair.    

In his retirement, along with his wife, Marsha (also a noted audiologist), they lived a full life in St. George, UT, complete with their extensive blended family of 7children, 14 grandchildren and 7 great-grandchildren.  An exceptional athlete, Geary ran in 25 marathons and qualified and ran in the Boston Marathon; he was a fabulous skier on both snow and water, yethe was always willing to slow down and coach those of us less skillful. Geary and Marsha loved the southwest and explored every corner of each state hiking and/or riding mountain bikes, dirt bikes or motorcycles.  As a licensed pilot, he owned and flew his own planes to remote locations, where they would disembark and bike or hike to high points and difficult summits or they would take the day to play the local golf course. They kayaked the caves of the Channel Islands and rafted the Colorado River through the Grand Canyon. Geary and Marsha spent much of their time boating at Lake Powell and spent many summers boating in the San Juan Islands of the Northwest US.  In their later years, they traveled the world extensively visiting more than 60 countries.

Dr. McCandless was an exemplary clinician, teacher, mentor, scientist, researcher and all-around good guy.  He influenced the lives of many of us in Colorado and Utah by serving on our thesis and dissertation committees, and as a personal friend.  Many of his students have continued in their careers to become leaders in the national audiology community.  His legacy will live on through the many colleagues he influenced.  A prolific contributor to the world of audiology, he truly lived his life as a Renaissance man.