The Millennium – Crabby Audiologists Learning the Alphabet

By Angela Loavenbruck, EdD
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The start of the 21st century saw  the  American Academy of Audiology (AAA) maturing as an organization with clearer insight into the challenges ahead for audiology. Brad Stach, one of the founders of AAA and a past President, was quoted as saying that the original meeting of those 32 audiologists in 1988 was first and foremost about autonomy. The contribution of an obscure government classification system to our autonomy struggle was first noticed by Barry Freeman and spotlighted by Carole Flexer during her presidency in the mid-90’s. It took almost 15 years to get us our rightful place in the alphabet.

The SOC (Standard Occupational Codes) were created by the US Department of Labor. They categorize and classify every profession and list them in a publication called the Occupation Handbook. Each profession has a corresponding SOC code which is used to gather data about the various professions. Freeman noticed that there was no SOC code for audiology – in the eyes of the government, we did not exist as a profession. Since both the government and private entities like insurance companies used the SOC codes as a starting place when identifying and gathering data about various professions, not having a code made us invisible.

Becoming Visible

Audiology decides it's time to stand out from the crowd.
Audiology decides it’s time to stand out from the crowd. Image courtesy MainStMarketing

Why was there no SOC classification for audiology? Prior to AAA, audiology was solely represented by ASHA. Speech language pathology and audiology were treated as one profession and therefore you had to look under speech language pathology to find audiology. In addition, since we were viewed as an adjunct part of speech language pathology, the SOC codes listed us under the category of “Therapists”, along with speech therapists, recreational therapists, occupational therapists and physical therapists, none of which were independent professions and all of whom worked at the direction of physicians.

It became clear that we could not be recognized as an independent profession providing both diagnostic and therapeutic treatment measures until we removed ourselves from the speech pathology category.

Here’s where we had to start getting really crabby with a lot of people. In her presidential address in Salt Lake City (1995), Flexer discussed the SOC. She presented research that identified very different personality traits of individuals who chose to be audiologists compared to those who chose to be speech pathologists. The personality characteristics of audiologists put us into the diagnosing and treating category while those of speech pathologists were more aligned with the therapy category. As Flexer noted, audiology was grossly miscategorized and virtually invisible in the eyes of government and private organizations important to our ability to perform our work roles effectively. It was no wonder that the word “audiologist” did not immediately come to mind when hearing health care was discussed.

AAA Questions Wisdom of Classification

Audiologists new it was time for a change, but ASHA wouldn't budge. Image courtesy Elements Partnership
Audiologists knew it was time for a change, but ASHA wouldn’t budge. Image courtesy Elements Partnership

Flexer and Freeman, representing AAA, went to ASHA and explained that audiology needed to be more appropriately classified. And ASHA of course saw the wisdom of our plan and said “of course we will do this with you as a joint effort for the good of the audiology profession.”

If you believe that, the crabby audiologist has a number of useless items you may wish to buy.

ASHA did what it always does – said no and claimed that audiology was better off staying under their jurisdiction, wrongly classified as therapists, because after all we benefited somehow by being represented by 80,000 SLP’s.

AAA then did what it had to do. They began meeting with the Department of Labor and the Bureau of Statistics in a multi-stage process to reclassify audiology as a Diagnosing and Treating Profession.

Because our degree designators at the time were MA or PhD, we could not join the other professions in that category. All of them had practitioner degrees with designators like MD or DO. Until the AuD became a reality, and our own intrinsic view of ourselves changed, we could not accomplish the goal of changing extrinsic views of our profession. The process was also complicated by the Department of Labor’s schedule for reviewing the codes. It took countless visits to legislators, letters to various agencies and the dedicated work of our wonderful lobbyists (Olson, Frank and Weeda), AAA staff and our volunteer leaders. We initially scored a partial victory by creating a separate category for Audiology under the Therapist heading.

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The Reflexive No

Amazingly, it wasn’t until 2010 that Audiology was correctly classified as a totally separate occupation category in the major group labeled Healthcare Practitioners and Technical Occupations.

All those wonderful crabby audiologists finally succeeded. In fact, speech language pathologists were also more accurately categorized and therefore benefited from the persistence of all of those crabby audiologists. As with all of the far-reaching aspirations of our profession, it’s interesting to wonder how much faster we could have all reached our goals if ASHA tried saying Yes early on, instead of the usual reflexive No in the face of much-needed change.

 

Image Credits: Dr. Grant Loavenbruck, MainStMarketingElements Partnership and Boujiemack.com