By Brian Taylor, AuD
During the recent annual meeting of the Academy of Doctors of Audiology, the keynote speaker Curtis Alcock of Audira, a British think tank for hearing, made an indelible impression on the audience. Among his thought-provoking messages (and there were many) was this: The sense of hearing and its importance to daily life, rather than the disorder of hearing loss, need to be top-of-mind for people of all ages.
Brian Taylor, AuD
The essence of Mr. Alcock’s message is that hearing is central to wellness and vitality. Hearing is a concern for all ages, not a disease confined mainly to the aged. Due to the convergence of three forces, I think, hearing care professionals are poised to assist in the care and well-being of more patients and stand to grow their businesses to boot – if (and it’s a really big ‘if’) we broaden our view of how audiology and hearing care is delivered to patients. I call this concept interventional audiology.
Let’s take a look at the three converging forces and how our industry stands to win, if we collectively embrace change.
Faster, Smarter, Cheaper Technology: A Blessing & A Curse
The very foundation of faster and smarter computer algorithms is the microchip, which continues to double in processing capacity every 18 to 24 months. An important by-product of faster, smarter and cheaper technology is the quantifiable-self movement. Smart algorithms inside smartphone apps will eventually allow patients to monitor their own hearing. They will be able to email the results to their preferred hearing care provider and discuss remediation plans. Our task is to raise public awareness so that self-monitoring your hearing with an app becomes as prevalent as self-monitoring the number of daily calories burned. For savvy individuals these apps are truly a blessing. People can now make informed decisions about the role hearing plays in daily life. But, for those professionals in our industry suffering from complacency the emergence of these types of apps is probably viewed as a curse since it spells the end of business as usual. For some it will be a painful transition as we give up some control of our testing.
Longitudinal Studies on Healthy Aging: The Secret of a Happy Life
Healthy aging is best described as the ability to maintain optimal health as we age. In other words, looking and feeling as if you are 45 even though your chronological age might be over 80. Thanks to Dr. Frank Lin and his colleagues at Johns Hopkins University we have some of the first well-designed longitudinal studies suggesting there is a systematic pathway through which hearing loss contributes to accelerated declines in the cognitive and physical functioning of older adults. This is best depicted in Figure 1 below, which is taken from Dr. Lin’s website. Through his research we are beginning to understand that hearing loss may actually accelerate some disabilities such as cognitive dysfunction and vestibular impairment. The prevalence, co-morbidity and disabling effects of hearing loss underscore the need for aggressive preventive programs to identify conditions such as hearing loss that threaten outcomes in other areas, such as quality of life, physical functioning and even earning potential.
Figure 1. There is a common etiology associated with hearing loss, cognition and social engagement. Source: www.linresearch.org
Perhaps my favorite longitudinal study related to healthy aging is the Harvard Grant Study. Since 1938 more than 200 men have been carefully studied by a group of physicians. All facets of the men’s physical, emotional, economic and psychological function have been evaluated. The researchers have found that the ability to form warm, loving relationships is the key driver of a happy life. Indirectly, we know that good hearing is a cornerstone of those warm, loving relationships. Thus, hearing care professionals need to be involved in the early stages of hearing loss identification. Better hearing is indeed better living.
The Evolution of Health Care: From Curing Infectious Disease to Preventing Chronic Conditions
The U.S healthcare system has done a fantastic job over the past 120 years of increasing the average life span of individuals, largely through the amelioration of infectious diseases as slide #4 shows. However, our current healthcare system isn’t nearly as good at curtailing the effects of chronic medical conditions. As this graph shows chronic disease rates are expected to rise over the next decade. To improve quality of outcomes and to reduce costs, we are seeing the rise of accountable care organizations. Their main task is to prevent and reduce these chronic conditions in a cost-effective manner.
Interventional audiology requires hearing healthcare professionals to change their orientation toward patient care.
Not only is hearing impairment itself a disability, and an indication for effective remediation in its own right, hearing loss also interferes with a patient’s ability to be treated for other medical conditions because it hinders an individual’s ability to engage with physicians and understand treatment advice and directives. This is an argument in favor of hearing care professionals getting involved at the early stages of the management of these chronic medical conditions. As longitudinal studies are bound to prove, not only does our early involvement improve quality of life metrics, it also reduces healthcare costs. Given that 18% of America’s gross domestic product is related to healthcare expenditures, our role in cost containment should not be ignored.
Rather than centering on the dispensing of a hearing aid/medical device, interventional audiology revolves around societal awareness of good hearing being central to a vibrant and active lifestyle.
For those over the age of 55, the disease state of hearing loss and its relationship to chronic medical conditions require the involvement of hearing care professionals. Although it is tempting to simply create some catchy new marketing slogan to capture the attention of a younger audience, our value within the larger health and wellness movement will require us to make some real changes to the way we practice. Here are three things you can do today to make your profession valued by consumers of all ages.
1) Embrace the use of apps both as a means for individuals to self-monitor their hearing and as a “starter” amplifier for those with milder losses
2) Normalize hearing loss and its association with healthy living. Recognize the critical role hearing professionals play in maintaining a vibrant lifestyle for all ages.
3) Partner with primary care physicians and accountable care organizations and become part of their preventive care teams. Early involvement in the identification of hearing loss will reduce the overall costs of care, especially for patients with multiple morbidities.
*Featured image courtesy Path to Perfect Health
Brian Taylor, AuD, is the Director of Practice Development & Clinical Affairs for Unitron. He is also the Editor of Audiology Practices for the Academy of Doctors of Audiology. He can be contacted at [email protected]
Very interesting read. I think this is what most audiologists desire, but so many are stuck in a position (like if they work for a retail chain or corporate store) where hearing technology is the primary focus. I think audiologists will also have to reconsider their opposition to apps and cheap amplifiers as starter devices to getting someone to accept hearing aids.