New Directions

We live in exciting times.  Not just considering the politics all around us, but also when considering the changes that will affect what practicing audiologists might do in the future. 

If anyone has been watching the legal and ethical entanglements of many professions since Stromberg brought it to the attention of speech pathologists and audiologists in 1990[1], one can only conclude that “we have met the enemy and they are us[2]”. 

I have vowed to be more positive with the majority of the blogs I post on this site, but a little history before I turn in that new (positive) direction. The past has taught us—if we read it and took heed—that if we don’t mind our own store, someone else will mind it for us. This has happened in all sorts of professions and the results have not always been optimal for the members of that profession.


If people don’t understand or like the way things are, they sometimes get worked up enough to change what it is they don’t like. (Retirement and social security, health care, banking, government in general, and lots of other examples come to mind—recently, like hearing aids.)


Patients, Consumers Union, news publications, and the public in general got all fired up about the costs of amplification and, after enough rumblings, they all decided to do something about it.  They found many manufacturers willing to join them in their quest. And, I think, over time, meaningful good for many people will come from all these efforts.

Dennis Van Vilet’s article in the Hearing Review, Open Letter to OTC Hearing Device Regulators, on what the OTC rule makers should do with respect to the new wave of hearing appliances, is a good example of the necessity to fix things before they are broken—or before other “outside” people get involved. Even though clinicians may not appreciate others deciding professional issues, that’s the price of not taking an active role in making professional changes for ourselves, and not preparing for all possible futures.


Positive Predictions for Audiology’s Future


After considering many things involved in this on-going, new direction pledge, I think I can make some positive predictions about the future of audiology.


  • OTCs and PSAPs will get better and improve over time and use. They will be better than we at first thought. I also bet that most major manufacturers, and even the “newcomers” to our field, have thought about this and gone some distance to prepare for these new devices and markets.


  • Pricing will distribute itself over a range that will allow many more people benefit from amplification. Lots of people are reluctant to invest in amplification devices due to pricing.  All arguments to the contrary, there have been many efforts to help in this financial regard and those of us involved in providing that help can attest to that need.


  • There may be some problems with these easily available devices, but I will bet that there will be fewer than most naysayers expect. It is most often the case that the extremes of all arguments are the most vocalized but usually the worst or the best case is not what comes out in the end.


  • Time and experience will solve many of the problems that will surely arise from these new devices. People are adaptable. So is hearing—at least to some extent.


  • But, and here’s the really good new direction, Audiology will take a step backward and revisit what the field can offer to both hearing and hearing-impaired people. The field will have a chance to remake itself with regard to evaluations, participation in other hearing-related areas, and in rehabilitation. Hearing aids will not be the sole, or maybe even the largest contributor to a clinical practice. Clinicians will prove Harvey Abram’s prediction.[3]


The articles of Abrams and Van Vilet are worth reading, if not for the advice to the people who will determine the new rules, but also for the inspiration to audiologists who will have to make some changes in the way they do business, and as a lesson about the need for clinicians to tend to ALL areas of professional service.  Growth always hurts a little bit at first, but is usually worth it in the long run. 

How’s that for positive.


[1] Stromberg, C. (1990). Key legal issues in professional ethics, in reflection on ethics.  In A compilation or articles inspired by the May 1990 ASHA Ethics Colloquium.  Rockville, MD. American Speech-Language-Haring Association.

[2] Walt Kelly in his comic strip Pogo. Paraphrased from American naval officer Oliver Hazard Perry in 1813. 

[3] Abrams, H., The Last Layer is Peeled Away, accessed at on Nov. 24, 2017




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.

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Kim Cavitt

Thank you for another great read! I always enjoy your posts as I think we are on the same page!