The 90s Onward: Fighting the Inevitable, the Mountain Moved and Promises Not Yet Kept

crabby-audiologist-small-2Ah yes, the 90s began with many gloriously crabby audiologists and I was certainly one of them. In fact, I’d call the 90s heaven for a crabby audiologist.

At the time, I was a member of the ASHA Standards Council and the Legislative Council. I had been appointed to serve on an ASHA Ad Hoc Committee on Professional Education. As a result of crabbiness on the part of many members of that Committee, the final report consisted of a “majority” report and a “minority” report.

The majority report recommended that the professional doctorate and its unique designator, the AuD, should replace the master’s degree and restore the PhD to its original research purposes. Based on the results of a survey sent to the ASHA audiology membership, the majority recommendation included input from all segments of the profession, and was supported by every other audiology organization (AAA, ARA, ADA).

The minority report, which was signed by three members of the committee, recommended that we should move to a doctoral-level entry, but called for the continued use of a “clinical PhD” as one of the entry-level degrees, thus supporting the notion of the “robust PhD.”

Labeled ASHA Resolution LC4A-92, the majority report was debated at the 1992 ASHA convention, and what a spectacular Legislative Council meeting it was. I don’t think there had ever been anything like the events of that meeting.

Prior to the Legislative Council (LC) vote on resolutions, more than 50 audiologists spoke at the Membership Forum – 87% in favor of the resolution. At the LC meeting itself, there were audiologists lining the back of the room with placards – placards! – urging LC members to vote in favor of the resolution. But it was not to be.

Employing some finely honed skills with Roberts Rules of Order, the ASHA Executive Board paraded back and forth on stage, ensuring that Resolution 4A disappeared and was replaced by LC5-92. Passed by the Council, LC5-92 recognized the AuD as an appropriate descriptor for a professional doctoral degree in audiology, but not “the appropriate degree,” and reaffirmed support for the “clinical PhD.”

If there were any audiologists left who believed ASHA had the best interests of audiology in mind, the manipulative behavior of the ASHA Executive Board at the 1992 meeting dimmed any remaining hopes, resulting in many more crabby audiologists. Majority members of the Ad Hoc Committee persevered, and in 1993 (in fact, on my 50th birthday), the ASHA LC finally voted in favor of the original resolution.

I hung around ASHA for quite a few more years playing the “we should work for change within” game, before finally accepting the fact that no organization with 90% of its membership from another profession (one with often conflicting needs) can adequately represent audiology.

The division between speech language pathology and audiology was one problem.  The professional doctorate vs. clinical doctorate debate was reminiscent of another division that had its origins in the early ASHA predecessor organizations, where founders discussed whether allowing practitioners to be equal members would lower the standards of the organization. In my opinion, there continues to be an underlying current suggesting the professional doctorate is less worthy than the PhD.

Evidence of this attitude is also apparent in the pervasive requirement for research projects in AuD programs. No other professional doctorate requires its students to spend time in their doctoral education carrying out and defending a research project. We, of course, want practitioners who are skilled at consuming and understanding research, but I would submit that the time spent by AuD students in conducting research would be better spent in more intensive clinical study and practice.

If-you-set-out-to-be-liked-Margaret-ThatcherThere were certainly other formative events in the 90s. The tireless work of the Audiology Foundation of America and ADA to “move the mountain” was instrumental in overcoming obstacles to the requirement for the AuD.  They created momentum and made it impossible for academia to ignore reality and I am convinced that the degree requirement would not have happened without them.  But the  “entitlement” movement of the Audiology Foundation of America also stands out in my memory as a particularly divisive period. I was a member of the AFA board for several years. When AFA began to promote its notion of “entitlement” – which meant simply granting all currently practicing masters level audiologists the “title” of “doctor” and allowing them to use the AuD designator – a number of us on the AFA board vigorously dissented. The dissention was not appreciated, and in November 1995, Lucille Beck and I were unceremoniously dismissed from the board at a meeting where we were not present.

Following that vote, two other members of the board (Ian Windmill and Bob Glaser) resigned. In my opinion the entitlement activities of AFA damaged the move to the AuD at a very sensitive time. Ultimately AFA dropped its pursuit of entitlement and lent its support to the development of distance AuD programs, which allowed practicing masters’s level audiologists to obtain the AuD degree without leaving their practices. Assisted enormously by a grant awarded jointly by the Army, Navy, Air Force and Veterans Administration, distance education programs were instrumental in the development and launching of these programs for government audiologists, and eventually any practicing audiologists who wanted to upgrade their educational credentials.

Still other important events in the 90s involved AAA’s growing sophistication and effectiveness in the political arena. In 1994, the fledgling organization hired the firm of Olsson, Frank and Weeda to represent audiology in Washington. Marshall Matz and other attorneys on that staff were instrumental in introducing and shepherding legislation that, among other things, changed the definition of “audiologist” in Medicare and Medicaid law and expanded the direct access of federal employees to audiology services. I continue to wish that this firm still represented us in our efforts toward direct access. Remember too that managed care reared its many heads in the 90s – certainly an event that changed audiology practice in ways good and not so good.

So much to be crabby about – so little time….

Image Credit: Dr. Grant Loavenbruck and SMS Quotes


5 Comments

  1. I was one of those crabby audiologists as well. In the 1970s David Goldstein had infected Bob Hinkle and I with the concept of a professional doctorate and, of course, of audiology standing as a separate profession. At the same time we were working toward licensure and Bob and I were involved in getting licensure passed in Indiana – when it passed, Bob and I were among the first to be licensed even though we were still at Purdue. When I was teach at ASU, I was first VP and the President of the Arizona Speech and Hearing Association, and we were working toward licensure there. In the meantime, we succeeded in getting the Arizona examination for hearing aid dispensers changed and a cadre of audiologists because licensed to dispense hearing aids. ASHA was not a friend or alley at the time. I was on the ASHA hearing aid committee working hard to get the code of ethics changed so audiologists could dispense, making very little progress when all of a sudden ASHA changed the code of ethics once the EC realized that a Department of Justice suit was just around the corner for restraint of trade. I was a Northern Illinois University when we became the first university clinical training program to actively dispense hearing aids and we hired two more clinical supervisors just to handle the related tasks. ASHA was still not pleased, but ADA gave us an award. While I was not in favor of the AuD as a degree, title it did hold more attraction than a clinical versus a true Ph.D. I disagreed with David Goldstein on grandfathering those with masters into the AuD and was happy to see major universities set up distance learning programs to provide a bridge between the masters and the AuD.Later I was involved in some of the coursework for the distance-learing AuD programs.

    I stayed with ASHA through all of those years, including when I was in the private sector making and marketing audiometric equipment and sound rooms and later hearing aids as the initial manager of Starkey Texas.. When I joined the federal government as a researcher and found that ASHA had dropped the ball and that incoming audiologists, clinical or research, could not have have relocation expenses paid, I pulled out my other credentials and was hired as a physical scientist with paid relocation. I bid ASHA adieu.

    ASHA has never supported audiologists the way they supported the other profession and I think that when the organization changed its name to the American Speech-Language and Hearing Association, it became clear that audiologists were last in line. So, I love your recall of the 1990’s,but the issue predates that and goes to 1970’s as well with ASHA’s restriction on hearing aid dispensing and initial opposition to licensure.

    1. Hello John, ASHA’s lack of support certainly did predate the 90’s – please take a look back at my earlier blogs on Hearing Health Matters about the 60’s, 70’s and 80’s for historical discussions of those decades…. it’s been a consistent theme. Angela

  2. Ironically, I sat next to you on the way to an ASHA convention way back in 1990 I believe–Love what you wrote and proud to say I was one of those crabby audiologists as well;)

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