“Years ago, I worked in a Ear Nose Throat (ENT) clinic where my opportunity to explain audiological results and make recommendations to the patients was limited. It occurred during the short walk down the hall from the sound booth to the exam room, where I handed the patient off to the ENT doctor. Often, the patients wanted to ask me questions about what I found out about their hearing, but I couldn’t sit down and explain it to them. This was very frustrating to me and to the patients. I know that education and counseling are time consuming and do not have billable codes, but I think we owe it to our patients to answer their questions. This was one of my incentives to go into private practice so many years ago and it is what I continue to like best about it.”
(The Audiologist, Anonymous)
How Did We Get There?
The Audiologist makes important points about focusing on the “person” rather than the “hearing loss”. To paraphrase Robyn Cox, Ph.D., a leading researcher in the field of Audiology:
It’s time Audiologists stopped asking “What hearing loss does this person have?” and start focusing on “What person has this hearing loss?”.
Perhaps one of the reasons we fail to focus on the patient rather than the hearing loss, is that we have seen such incredible advances in hearing aid technology in recent decades, making us better than ever before at effectively addressing the “acoustic” needs of our patients. Indeed, current digital signal processing has resulted in improved feedback reduction, adaptive directionality, and complex compression schemes all combined with greatly improved cosmetics.
- just over 30% of the US hearing impaired population wears hearing aids1
- of those who have purchased hearing aids, somewhere between 5 to 12% keep their hearing aids “in the drawer” or use them less than 4 hours per day2
- over 19% of hearing aids sold were returned for credit3, (although that figure includes a good number of hearing aids that were returned for other instruments which were ultimately purchased).
If hearing aids are so good, why aren’t more people purchasing, keeping, and wearing them? And among those who do purchase, why are there so many exchanges? The reasons likely include an unrealistic reliance, on the part of both clinicians and patients, on technology to solve complex communication problems that require a thorough understanding of the human dynamics associated with hearing loss.
Ida Institute: Focus on the Human Dynamics of Hearing
The Ida Institute was established in 2008 through a grant from the William and Ida Emilie Demant Foundation. The Institute is an independent, non-profit group whose goal is to help audiologists and all those who work with individuals with hearing loss to better understand “the human dynamics associated with hearing loss.” As The Audiologist alludes to in his/her lament, when one takes on the role of a patient, one begins a complex journey. The Ida Institute seeks to provide greater insight and a more holistic understanding of the complex journey of hearing loss.
Ida seeks to achieve these goals through engaging leaders, scholars, practitioners, educators and professional advocacy groups in collaborative learning experiences. It offers tools and ideas which are available and free to anyone who joins the Ida Institute. One particularly useful tool out of many which can easily help audiologists focus on better patient care is the Reflections Journal. The power of reflecting on our interactions, what went right/wrong, why we think it right/wrong, how we felt, how our patients felt, etc. can change our practices for the better, as it helps us focus on the “patient” and his or her journey. Reflection doesn’t have to take long, and can be incorporated into our days – no matter how busy.
Avoiding Unintended Consequences
The Audiologist’s personal experience illustrates the consequences of focusing the healthcare encounter on the technology rather than on the patient. Audiologists need not make the same mistake. Our profession was born in the aftermath of WWII with a strong foundation of focusing our efforts on the rehabilitation of military veterans with hearing loss.
While there will always be a place for technology in our profession, we need to find the way back to our roots. The Ida Institute has provided the map. Readers are urged to visit their site to see all that they’ve been contributing to our profession since 2008. And stayed tuned for an update on all that Ida has been up too in recent years, coming soon in this section.
1Abrams HB & Kihm J. (2015). MT9 reveals renewed encouragement as well as obstacles for consumeres with hearing loss. The Hearing Review, May 15, 2015.
2Kochkin, S. (2010). MarkeTrak VIII: The Impact of the hearing healthcare professional on hearing aid user success. The Hearing Review, April 1, 2010.
3Hearing aid sales increase by 4.8% in 2014; RICs continue market domination. The Hearing Review, Jan 20, 2015.
*featured image courtesy bahaa