Audiology: An Introspection

By Robert Castleton Wormus

I’m 76 years old and have been retired from Audiology for fifteen years. In retirement, I write a daily science journal, numerous social media blogs, poetry, novels, anecdotes, adventures, and prognostications about the future. It’s my avocation, and now I want to add my two cents about Audiology.  

Clinical audiology, I have no doubt, will continue to be the frontline healthcare paradigm for the identification, assessment and rehabilitation of hearing loss and balance disorders. It’s more than inevitable, it’s intuitive. The demand for clinical audiology will continue to climb as the population ages, and as current and future sophistication in electronics, technology, and fitting methodologies escalate. Clinical acumen in Audiology (psychoacoustics) and expertise in aural rehabilitation are not threatened by robotics or automation.

Of course, we’ll still have the over-the-counter gimmicks, threats, and sleazy salesmen; think of it as free advertising!

But that’s not what I want to address. Literally, the only downside of my entire career in Audiology was the overwhelming identity crisis that our field of audiology suffered – and is still suffering.

 

An Identity Crisis in Audiology?

 

As a researcher, I decided to research the identity crisis in Audiology. Using introspection, (retrospectively) I first delved into why there is an identity crisis in the first place.

What is audiology? Why did I spend an inordinate amount of my valuable clinical time defending myself, and the profession of audiology? Why was there an incessant need to describe who I am, what an audiologist does, and where we ‘fit’ into the overall healthcare delivery system? Does a teacher have to do this? A doctor, a dentist, or a rocket scientist?  Of course not – but an audiologist does.

 What I discovered from my research was interesting, provocative, and irritating.

A Google search – “what is audiology?” – revealed myopic textbook definitions of Audiology and what an audiologist does. The only definitions were those of clinical audiology and clinical audiologists.

The so-called historians of audiology obviously were:

  1. Not audiologist
  2. Not historians
  3. Had their own agendas (judging from the context).

The definitions focused more on what a medical doctor is and what an audiologist isn’t.  

This is what I want to address. The history of Audiology, as well as general information about its scope and who practices it, must be rewritten, and peer reviewed by audiologists. This will be discussed further in Part 2.

 

 

Robert Castleton Wormus got his first Master’s Degree in Special Education of the Gifted late in 1964.  He enjoyed being a ‘professional student’ for as long as the scholarships and fellowships lasted, which included an AA degree from El Camino, a BA degree in Educational methodology from CSU@LA, a certificate in Astronomy, a minor in experimental psychology, a California teaching credential in Education, Special Education,  Speech Pathology, Audiology, the directorship of the CSU@LA’s Associated Clinics, and finally three California licenses in Audiology, Speech and Language Pathology.

 

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1 Comment

  1. I look forward to part 2. As a 40+ year veteran of audiology, here are a few points to ponder about the identity crisis: 1) My friend and mentor, Dr. David Goldstein (Father of the Au.D.) explained that physicians, dentists, and optometrists first came from the streets and went into academia to show the academics what to teach students so they can survive on the streets. Most of them have been practice owners in one form or another. They have owned their professions. Audiologists, on the other hand, largely came from academia and were not familiar with the streets. Yet, they were expected to teach students how to survive on the streets. How has that worked out considering most audiologists are wage-employees, not practice owners. I have a saying, “Those who own the services that are provided own and control the profession.” 2) Masters degree programs in audiology were housed in graduate schools; hence a graduate degree. Those graduates are recognized as allied health care professionals. In health care, it is largely the “doctors” who are in charge of and oversee non-doctors. Allied health care professionals are typically not thought of as “point-of-entry” providers. 3) The Au.D. comes along. Just as the masters degree in audiology formerly was the “entry-level” degree to practice, so too is the Au.D. now the “entry-level” degree to practice. However, just as the M.D., D.D.S., D.O., O.D. degrees, the Au.D. is a professional degree, not a graduate degree. Doctors of audiology are now members of the “healing arts doctoring professions”, not allied health care professions. The Au.D. is a general practice degree, not a specialty degree. As such, our identity in health care should no longer be in crisis. We must realize and claim our rightful identities and positions in health care as the “point-of-entry primary care doctors for audio-vestibular disorders.” This is in contrast to ENTs and otologists who are educated and trained as surgical sub-specialists who provide tertiary health care to patients. It is inappropriate and fiscally irresponsible to have surgical sub-specialists providing point-of-entry health care. This similar contrast is seen between optometrists (point-of-entry primary care doctors for vision care) and ophthalmologists (surgical sub-specialists who provide tertiary health care). 4) A significant advantage that optometry and dentistry have over audiology, among others, is that these two healing arts doctoring professions have always cooperated with each other and coordinated their profession’s strategies and strategic plans between their professional schools, licensing boards, and their practicing doctors. Whereas, audiologists from different venues of the profession have always gone in umpteen different directions without a clear unified vision for audiology. This has been disastrous and is largely responsible for the profession’s stunted growth. If this cannot be resolved, this same type of conversation will be discussed 20 years from now, and non-audiologists will continue to control our beloved profession. We must come together collectively as a profession and not just as separate organizations.

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