In light of the coming audiology storm, this short piece by Professor Roeser has as much relevance today as it did five years ago. One should consider this position in reference to “big box” practices as well as the rehabilitative tasks that audiology has been favorably arguing for at least the past five years.

Audiologists, beware: Today’s assistant can become your competitor tomorrow

Editor’s note: In light of the coming audiology storm, this short piece by Professor Roeser has as much relevance today as it did when it appeared at HearingHealthMatters on August 22, 2012.  One should consider this position in reference to “big box” practices as well as the rehabilitative tasks that audiology has been favorably arguing for at least the past five years.


By Ross Roeser

A growing trend in audiology practice, at least in Texas, is for audiologists to sponsor office staff for hearing aid licensure. The notion seems to be that by holding a hearing aid dispensing license the staff member will be able to carry out office duties that include a broad array of basic audiological procedures, and will be able to fit and dispense hearing aids.

When asked about the wisdom of sponsoring someone with minimal educational requirements for such licensure, audiologists invariably give the rationale that the individual will function under the “close supervision” of the licensed audiologist.

This practice is counterproductive to the desire to raise the audiology profession in the healthcare arena. It is antithetical to bringing quality audiological services to patients. And it is shirking the issue of defining and implementing programs for audiology assistants.

Hearing aid licensure laws in many states set minimal requirements. In Texas, being 18 years of age, having a high school education or its equivalent (GED), serving a 9-month apprenticeship, and passing a written and oral exam (given by other licensed dispensers) will allow an individual to become “independently” licensed to fit and dispense hearing aids. This means the individual is licensed to carry out all the audiological procedures needed to fit and dispense any and all types of hearing instruments on the market– bar none.

Most important is that, once licensed, these assistants do not have to be supervised by anyone; they can function as independent practitioners. The sponsoring audiologist might one day find his/her apprentice across the street in a competing practice vying for the same patient population!



Audiologists who sponsor hearing aid dispensers for licensure trivialize the training and skills needed for adequate hearing instrument competency. With today’s advanced technology and fitting strategies, more training and clinical experience are needed, not less.

Even more important is that once licensed the dispenser may (and will) become an independent practitioner, even if the audiologist who trained the assistant had every good intention of supervising him or her. But what happens when the audiologist is on vacation, is out sick, or when there is a satellite office that needs staffing?

What other profession promotes substandard academic requirements and limited requirements for individuals who have the potential to become independent competitors? There were only about 250 licensed Texas dispensers just a few years ago. Now the number is approaching 500 because of audiology sponsorship.

It is time to define and implement audiology assistant programs so that support staff are available—true support staff who will require mandatory supervision. Isn’t that the model virtually every other profession follows?


Ross Roeser, PhD, is Professor and Head of the Doctor of Audiology Program at the University of Texas at Dallas/Callier Center for Communication Disorders, and Executive Director Emeritus of the Callier Center. He is also Editor-in-Chief of the International Journal of Audiology, and was the founding Editor of Ear & Hearing.

feature image from Shout Awards

About Mike Metz

Mike Metz, PhD, has been a practicing audiologist for over 45 years, having taught in several university settings and, in partnership with Bob Sandlin, provided continuing education for audiology and dispensing in California. Mike owned and operated a private practice in Southern California for over 30 years. He has been professionally active in such areas as electric response testing, hearing conservation, hearing aid dispensing, and legal/ethical issues. He continues to practice in a limited manner in Irvine, California.


  1. Ross….although I understand your arguments, it seems to me that if professional audiologists cannot be separated from retail hearing aid specialists, something is seriously wrong with our teaching and training programs? Do audiologists lack such confidence in ourselves that we should be worried about our assistants taking over our jobs?

  2. CFO asks CEO, “What happens if we invest in developing our people and then they leave us?”
    CEO: “What happens if we don’t, and they stay?” ~Peter Baeklund

    Google those words and read many pages about the wisdom of excellent staff versus suppressed staff.

  3. To “AuD:”

    The reason why Engineers make more than audiologists (and the reason why they have 5-6 job offers to choose from when they graduate) is that they survived the weeding out process, because the coursework is much more difficult.

    Also, there is a lot more responsibility to the general public: When an audiologist screws up, what’s the worst that can happen, and to how many people? But, when an engineer screws up, innocent people can die, and as you can see here as just one (thankfully rare) example, lots of people can die.

  4. The “battle” between audiologists and hearing aid dispensers will be decided by the customers. If a hearing aid dispenser from our practice decides to leave and strike out on his own, shame on me for not figuring out how to keep him (if he is excellent) and more power to him if he wants have his own business. Such is our free market system.

  5. I agree Dr. Diles. A well trained hearing aid dispenser who has the characteristics you describe, adds tremendous value to a practice and to the patient, obviously.

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