Giants of Audiology: Interview with Barry Freeman, PhD

Welcome to this Week in Hearing and our special series ‘Giants in Audiology’ Hello, I’m Bob Traynor, your host for this episode. Today My guest is Dr. Barry Freeman, Audiology Consultants in Parkland, Florida. It’s my honor to host this episode with Dr. Freeman, a professor, a researcher, clinician, one of our first private practitioners and an industry executive, as well as the former president of the American Academy of Audiology. A person whose career has been very instrumental in, in changing the very landscape of our profession of audiology. Thanks for being with us today Barry and agreeing to go through kind of a. This is your life in audiology. Yeah, well thanks Bob for the opportunity. Son I think my mother would have been proud of that introduction, but it’s a little overwhelming to hear it. I don’t want to be on an ego trip here. Just want to share some things. Sure, yeah. Well this allows us to get to know you just a little bit, Barry. And the way we usually start with these things is I like to read the biographical sketch that someone would read to introduce you as a speaker for one of our major meetings. So here we go with that. Dr Barry Freeman is currently a semi retired audiologist living in Parkland, Florida. He earned his undergraduate degree from the Boston University School of Management. Then after military service decided to go into the profession of audiology. After completing a master’s program at Emerson College and a PhD in Michigan State, he joined the medical school faculty at Vanderbilt University and became a staff member at Bill Wilkerson Speech and hearing clinic. In 1978 he opened and maintained and audiology practice the Center for Audiology in Clarksville, Tennessee. 1997 he became the founding chair of the Audiology department at Nova Southeastern University in Fort Lauderdale, Florida. He left full time academia in 2008 to join private industry where he was senior director of Audiology and global education for Starkey Laboratories in Minneapolis. Later became vice president of business development for Z Power, a startup company manufacturing rechargeable micro batteries for hearing aids and consumer devices. Retiring in 2019, he began teaching remotely in several universities. One of what I understand now is that’s one of the major kinds of things a person is doing at this time, Barry. And your students are, are very beneficial of all the things that you have contributed to the profession. Try Bob. Thanks. So Dr. Freeman has an extensive list of publications and has lectured and taught globally and again he’s the past president of the Florida Academy of Audiology as well as the American Academy of Audiology. So where we get going here is. Let’s kind of start with some of the early years Barry and see, see how you developed into a audiologist over a period of time. Sure. I was born in Boston, Massachusetts. You’ll sometimes hear my little accent pick up some things. I, I try to manage that but sometimes that doesn’t happen very well. I was raised in the town of Newton Mass. Which is a middle class suburb. And I was fortunate enough to have parents very supportive of me throughout my early years. And I had a father who was in his own business scrap metal business and kind of entrepreneurial and he was one of the first companies that started dealing with China and Taiwan in those days and doing business overseas. And I observed that my lifelong plan was that I was going to be a tax attorney. I was going to go to the school of management, I was going to get my degree in accounting until I got to cost accounting and that kind of did me in. And then thought I was going to law school until I went into the military and came out and said I really want to work with kids. But so you know it was interesting. I’ve always used kind of the concept that about 40. There’s some literature that shows that about 48% of independent business people and entrepreneurs in this country come out of families where there was a family business. And that was the model. And and I guess to some extent my father would always say that the purpose of working was in, of the head of the family was to put food on the table for the family. He was depression age, you know, generation and it’s so it was always work, work, work. And he was a classic self employed business owner who thought that you needed to put in very long hours in order to keep that family well fed, nourished and you know, make a difference in the lives for his children as well. My mother was very supportive and she herself went on without a college degree. She went on and took classes at Wellesley College in Boston trying to enhance her own education in areas like in art history in different languages. And she was kind of a special lady because she always had food on the table for everybody and loved to cook. I don’t know if she loved to cook but she always cooked and was very supportive. I kind of find it interesting that I have two children that we’ll get to eventually probably that my daughter Kimberly is a veterinary oncologist in Portland, Oregon. And she must have followed after dad because that’s what we talk about sometimes is she decided she should have her own cancer surgery center in Portland. And so she has a cancer surgery center out in Portland, Oregon. And sometimes she has to deal with the frustrations of running that center and seeing patients and clients and everything else that goes with it. And my son said, I’m not doing any of those things. So he’s, he said I’ll never go into healthcare. I’m going to make a difference in education. Well, he’s now a healthcare actuary and works in Silicon Valley and is you know, the startup company. So I add there, Barry, that Jason did a fabulous introduction to audiologists, I think, at the Cincinnati Audiology Academy meeting. Yeah, thank you. He’s helped me certainly along the way. Even he did his undergrad at Duke. And one of his projects, believe it or not, was we were at that time trying to pass legislation to get audiologists recognized in the Federal Employee Health Benefit Program. And in one of his classes in public policy, he wrote a strategy for us which was semi adopted by our lobbyists in Washington of things that we could do to help move the legislation along. And after that time he was always able to share data with us on Medicare CMS data that doctor Ian Windmill and I have used over the years. And Jason came to one of our meetings and has presented in that area for us talking about Medicare Advantage and Medicare and and, and topics like that. So yeah, you’re always proud of your children and so especially when they’re successful like that. So but, but I move on from that. So, so, you know, after going and being raised in in the Boston area I stayed in Boston to go to go to college. Throughout my my younger years my life was around sports and school and, but sports, sports, sports. You could always find me down the playground either shooting hoops or playing baseball or playing stickball or playing tennis. And So it as, as I used to say, if I wasn’t going to Hebrew school that afternoon, I was at the playground doing something. Or possibly hiding under your desk from nuclear weapons, right? Oh yeah, well that’s, that’s an interesting story unto itself. Bob and I were talking, for those listening to this, about the fact that in the 1950s which is my generation, I missed the Baby Boom by two months. Okay. I’m a November birth in 1945, so that a baby boomer started in January of 1946. But at any rate, there was this belief that if we crawled under our desks and put our hands over our head like this, that if a nuclear bomb was dropped, we’d be safe. Of course, the absurdity of that, but that’s what happened, you know, in America. So it was. Those were the days that you know, we were threatened by, you know, those kinds of activities going on in the global level. Today of course we have to deal with kids having to confront you know, mass shootings in schools and things like that. We’re not going to delve into all of that, but certainly we’ve all had Because I am just staying on the topic of being of that age and I’m going to jump around a little bit for maybe what we talked about in sequence, Bob. But thinking about that, that was also a time when I was graduating high school and going, starting college, when we had things such as the Cuban Missile crisis, so we didn’t know if there would be school the next day. And we had assassinations in those days, unfortunately of JFK and RFK and MLK and So it was a very challenging time. And I think all of those things helped influence me in wanting to make a difference in the lives of others and not wanting to be an attorney, but really work with families and at that time, children, but just making a difference on the lives of people. It sounds a little corny perhaps to some people, but it really was quite an influence on my life, all of those kinds of years and experiences that we were dealing with. And so and I knew that even though I wanted to be a professional basketball player or baseball player I wasn’t going to grow much beyond 5 foot 11. And I was treasurer of a high school fraternity in high school. And we raised money and actually we became the largest contributor to cystic fibrosis in like the 1960s. It was a brand newly identified disorder. And being in Boston, we knew the physicians we knew or somebody’s in the fraternity’s father worked at the medical center or whatever. So we, we took that on as our charge. Well, the speaker was Bob Cousy, for those of who don’t remember, probably one of the greatest point guards in the history of pro basketball and the Boston Celtics. And so I met him, had the opportunity to meet him and he had. I hold my hand up and I take two of my hands and he could probably add two or three more hands and that’s how big one hand of his was. I mean, and even though he was only like 6ft or 6 foot one, it was like this is just not going to work so I better go find something else to do, because I’m not going to be making the NBA or, you know, pro baseball or anything like that. So but. But, you know, sometimes we use this. Oh, probably overuse the expression of we plan and fate. Laughs. You know, so you got to kind of move on with your life. And that’s a. That’s a life lesson. So basically then the undergraduate program was at Boston University, and it was more of a business orientation, it sounds like, which became very valuable later on. Yeah Little did I know. Yeah, little did I know. I mean, I did my degree in. Actually, the major within the school of management was international business. And so it exposed me. And I thought of this because I never was sure if I was going to end up in my father’s junkyard. And to be honest with you, and he was starting to do business overseas, as I said, and that was totally foreign to him. And so I said, oh, that sounds kind of cool. I’ll do a major in that. And so I graduated from the school of Management, and I never totally excelled at the university. And because I was struggling, I knew this isn’t what I wanted to do with my life and wasn’t quite sure what I was doing. Ive heard someone say that, well, you made the other 90% of your class successful, you know, or whatever. But I made it through. And then. But it was also the days of the Vietnam War. And so standing in line at graduation you know, normally you stand in line at graduation and you say, well, where are you going to grad school, you know, or what are you going to do? Where, what business are you going into? You know, who are you going to work for now that you’re graduating with your degree? In those days it was, where are you going to? Basic training. Didn’t matter if you were top of the class or bottom of the class. We were all pretty much going on to basic training somewhere. And so it was very different time for us. And you know, I was never a great soldier, but, you know, I. I did my six years and stayed in. I was reserves. And it gave me a chance to reassess my life and where I was going and, you know, a direction for me, which helped quite a bit. And so And. But most importantly at BU it’s where I met my lifelong partner and best friend, and that’s my wife Bobbi. And those of you that have met me at convention or other places often see Bobbi around. And she’s as much of an audiologist, even though her degree is in education than anybody. And we’ve been married for. It’ll be 56 years this year. And it seems like we only fell in love yesterday. I mean, we still enjoy each other’s company. At least I enjoy hers. And she gets a medal for putting up with me for all those years. So But anyway, we do a lot of traveling together. And she would travel with me on business trips as well. Shed go off. If I had a meeting in Amsterdam. She’d be off and visiting the city and come back and tell me what I missed. So But we often extended trips. If I was lecturing in China she would come over and in fact, our kids would come over and we would, you know, we. On our own dime. We would stay an extra couple of weeks and go visit the country. So we always took advantage of that. I have a good friend who laughs at me because he said, well, you’re really retiring. He said, how are you going to travel anymore? He said, you’ve never paid for anything. You’ve always. Always been invited places to lecture or on work or something like that. So you always had somebody paying your airfare. It doesn’t happen anymore. Well, though, it’s always where. Where do old professors get to go see the world, Barry? Except for on When you’re working in industry and things of that nature. Theres only A few of us that have had the opportunity to do that. And I Think it’s essential to. It’s one of the best educations I obtained. Certainly better than most other educations that I’ve obtained over the years. This has been a fantastic profession. And Of course I came in at an early stage. I don’t know if there was six or 800 audiologists, you know, at the time that I came in, when I was first. Yeah, exactly. And so And it obviously has grown quite a bit. It doesn’t mean the opportunities aren’t out there. It’s just you got to take advantage of that. And I say that to students and others along the way, that you just have to take advantage of the opportunities. Don’t sit in your hotel room texting all day long. Get out, meet people, talk to people. And And you know, you can make a difference and. And you can take advantage of what’s out there. So. So I understand too, Barry, that You know one of the. Another giant in audiology, Alan Feldman, was part of Your. Your movement into audiology. And then at Emerson you studied with one of the one of the most influential counseling people in audiology, David Luterman. So those had to be some pretty interesting experiences as well. Yeah. So Alan Feldman was audiologist In Syracuse, N.Y. upstate Medical center, private practice for those that don’t know him, did a lot of his early research with Dr. Zwislocki up at the labs up there. And in fact, my very first job, you said, was at Vanderbilt. It actually was at Syracuse. I made it a year at Syracuse. And my said, Bobbi said, get us out of here. This weather is horrible. And so that’s when we. We. I made about a year and a half there. Two years perhaps at most. But. But Alan was a family, a friend of the family who I would meet. My father’s sister lived in Syracuse and was his neighbor. And he would talk to me, you know, as I was hitting my teens about you know, the field of audiology. And to look it over and I wasn’t quite sure But And my sister was a speech language pathologist with a degree. She was five years older and with a degree out of Emerson. And so when I came out of the army, I went over to Emerson, and that’s when I met Dr. Luterman. And you described David as well as anybody could describe David. And he was a real especially early influence on my life. And, you know, he had me in the preschool nursery program. I can. I still have pictures of me dressed as Santa Claus for the kids, you know. And But I worked with he and his wife at that time and you know in the program, and he encouraged me to stay there, and I took classes, and it was successful. He managed to get me a fellowship at the Veterans Administration Outpatient Clinic in Boston. So that you know, as a good business grad school graduate, I said, you’re going to pay me while I go to school. Wow, that’s different. And so I got a. I was a VA Fellow, or whatever it was called in those days. And so that you know, I got into audiology, and I loved it. I stayed in Boston after I graduated with my master’s and worked for a few years at Tufts New England Medical Center. Those were days just to keep things in perspective, Bob. And you may appreciate this, Bobby and I did not have children. She was a teacher in the public schools making $6,000 a year. I was working as an audiologist at Tufts, making $8,000 a year. And so we, between us, we’re making $18,000. I’m sorry eight, six, $14,000 a year. And, you know, my lifelong goal was to get up to $20,000. So how far away could we be? Because then you could buy a house, which only cost about $20,000 in those days. So it’s But I knew that it was not going to be, you know, my lifelong dream to stay at that, you know, at Tufts. I wanted to move on. I still had this idea of wanting to have my own business and do my own work and perhaps get. Go on and get some additional education as well in audiology. And so it just coincidentally that the the Auditory Society was meeting. Actually, it was It was the Yeah, it was the Auditory Society. It was meeting in Boston, and I happened to meet a. A professor from Michigan State University by the name of Dan Beasley. And Dan today remains a dear friend and a mentor. And Dan at the time was one of the leading young speech scientists in the country. And he wanted me to come out and see the Michigan State program and to meet Dr. Bill Rintelmann. And for anybody listening to this in audiology, if you don’t know who Who Bill is, Bill Rintelmann was, you know, one. He was one of the original Northwestern grads, you know, trained with Jerger and that whole group that first started the profession of audiology. And so I went out there and at the time, my interests were in two areas coming out of Boston. One was in noise noise hearing loss and noise. And the other one was auditory processing disorders. Because I saw so much working At Tufts in the pediatric areas there. And Bill happened to have been. Dan was one of the leading researchers in auditory processing in his speech science work. And Bill was probably the. He and Dave Lipskin were the foremost people on hearing loss and noise. Bill did the original work on rock and roll music. He did the work on farmers and hearing loss. And so we It was a perfect fit for me. And so I could go in there and really kind of focus what I wanted to do and in fact managed to complete my PhD in three years because I was just so focused as to what I wanted to do and working with both of those individuals as my mentors there. So it was a great early start for me and a great way for me to get into the field and get ready to hit the ground running. But it wasn’t all work, was it? Barry I mean, I understand you guys had played some intramural sports and so on. We did, we did. We had a lot of fun there. The softball team at Michigan State. We played in the intramural leagues and we won the division, I seem to remember. I don’t know if people can see me or this, but I had my T shirt, which was the Malleus. We had Malleus, the Incas to stapes on the infield. And we played basketball. And this was, you know, Dr. Freeman shirt. And I. And I was commenting to my wife this morning that I can’t believe I used to fit into that shirt. But anyway but we had a lot of fun there. And we had home and home basketball games with Central Michigan University. And the folks at Central Michigan included Fred Bess and Dan Schwartz and folks like that. And so we would sometimes put a keg of beer on second base and a keg of beer on home plate. And when you made the turn, you had to, you know, drink it, drink a beer. And So I remember a story, a tale out of school is. I seem to remember we went up something like 20 to nothing in the first two innings. But we couldn’t stand anymore because we drank so much beer. But it was okay. We had a good time. And so And in fact, many of those folks ended up coming down to Tennessee. Fred Bess ended up at Vanderbilt, and Dan Beasley went to Memphis. And other folks went to the two schools. But anyway but it was a lot of work. It was a lot of fun. And I can remember when Bill picked me up early one morning because we were doing some noise studies. Out on the farmlands. Now picture this. I’m a boy out of Boston. And when I did noise studies in industry in Boston you got dressed up, you put on your tie, you put on your jacket, you went out, you know, you did your noise studies, et cetera, in the factory that was making shoes or whatever else was going on there. And so there I was waiting, and Bill kind of looked at me. They were all dressed in jeans and, you know, whatever. And he said, really? That’s what you’re wearing out here? I don’t know any different. They put me on the back of a. Of a combine. And I had to hold on to the B&K meter, the sound level meter, and do noise measurements at the air level of the farmer so we could see what they’re exposed to. And I’m hanging on for dear life. And I can remember one of the instances a deer ran across the field. And the farmer. This true story, the farmer stopped, pulled the gun off of his gun rack and started shooting at the deer. And I’m like. And the B&K meter is just going nuts, as am I. So yeah, anyway, lots of fun stories. We had a good time in a lot of that stuff. So anyway one of about 10,000 great stories of a career, you know. Yeah, those that we all have back in our heads. And it takes a little bit once in a while to jog that memory. Just like this discussion as we’re having here. When taking noise level readings and some guy getting out a shotgun and shooting something. It’s just one of those stories. It is. It’s one of those stories. Yeah. Yeah. So, yeah, so you kind of. The Vanderbilt area and, and moved on in. Yeah so. So I went to Vanderbilt, where I worked with Fred Bess in. Earl Harford was there. Now Earl was another person who was in the early years at Northwestern with Dr. Carhart and Bill Rintelmann. And Earl was the director of the Wilkerson center and of the program at that time. Fred ran the academic side. Earl ran the entire program. And then Earl left to open his own practice around 1977 or 78. And he and I became very, very dear friends, very close with he and his wife Jennifer and spent time with Earl. And Earl also moved on towards the end of his career to join Starkey and started the student program with a fellow named Jim Curran. And so Earl and I went because in my later years I spent a few years at Starkey and Earl was very influential in my life and just a real gentleman in my mind. But anyway so from there I decided when you may remember, that in those days audiologists were not permitted to fit and sell hearing aids for a profit. I think you were in practice, and I don’t know. Yeah, you couldn’t do that if you were at a VA. You could fit the hearing aid. And so I had my fitting experience from the VA but you had to basically evaluate the patient and send them off to a local hearing aid dispenser who would then fit and sell them the hearing aid, and maybe the patient would come back once in a while, you know for verification and all. Very few would ever come back, right? That’s correct. They would almost always stay with the dispenser and. And then we’re left out of the picture. Somebody What they call that at the time, they called that the triad approach. Right, right. Yeah, yeah, yeah. And so in 1978 there was a Supreme Court ruling, not specific to audiology, but to engineers, that basically said something on the idea of a professional association cannot restrict a member of. Their association from providing services, what they are trained for, what they are trained to do. And so it was carried over into audiology that ASHA had. Because there was no AAA at that time. It was just ASHA. Asha had to change their code of ethics to permit audiologists to be able to dispense hearing aids. And they. That was kind of the beginning of. Although there were some people that were out in independent practice in those days, this is when it really started to take off as people said, well, gosh, now that I can fit and sell hearing aids now I really can be an independent provider of services. And so I had been looking around for places to perhaps open a private practice. And I decided to stay in Clarksville, Tennessee which was a town that I saw was potentially going to be growing quite substantially over the next decade or so. So in 78 I started the practice part time and then opened it full time in 79. The town was about 50, 55,000. And when I left it was about 150,000 people 20 years later. And it was a big military town as well. It’s where Fort Campbell is based out of. So I have working relationships with the Blanchfield Army Hospital. And then since I had already I did not mention when I did my PhD, I was hired by the Lansing, Michigan public school system to open and start the first educational audiology program. So my Support for my PhD program was through the Lansing Public Schools. That’s because I had been working for several years in pediatrics at Tufts before I went back to school. So I had contracts with school districts throughout that region as well. And we were about 35, 40 miles from Nashville and opened up a practice and it became the Center for Audiology, which by the way is still still going nicely. It’s been probably 40 plus years, 45 plus years. And you know, it’s kind of built to last. And the lady I sold it to was a former student of mine and an employee of mine. And So So. So did. Did you take the last train to Clarksville? Oh, so that’s an interesting story. That is where that comes from. Because Fort Campbell was a training base for soldiers that were getting trained to head off to Vietnam where they’d get on that train and hopefully it wasn’t their last train ride. But the Monkees sang that song. Well, the opening, the story goes, at least in Clarksville, is that the opening act for the monkey in those days was a young soldier and who was stationed at Fort Campbell and his name was Jimi Hendrix. And. And so somehow they put this song together on the last train to Clarksville. And Yeah, so that was Clarksville, Tennessee, where that song comes from. Yeah. Yeah. We don’t know how true all those stories are, but they make good discussion topics, especially after you have a glass of wine or two. Oh, of course. Of course. And so So. So I stayed in Clarksville for the 20 plus years. And And And ran the practice. It was a full. I call it a full audiology practice. What I mean by that is we did everything. We didn’t just sell hearing aids. Hearing aids were just considered part of our treatment programs in those days. We had vestibular labs. We had you know, full duck. I remember the first two years, year or two I. I got in like 1980. I bought an ABR unit. ABR was just something new, you know. So you had an auditory brain stem unit. And And I get a call from the otoneurologist down in Nashville by the name of Michael Glasscock. And. And Mike calls me, says, what’s going on up there? You have now sent me 15 acoustic tumors in the last year. And I said, well, Mike, they’ve all been here. It’s just we’re now catching up with them. You know, these are patients that came in. And before that, it was more of testing in the community to see if somebody needs a hearing aid or you know, or with. Yeah whatever. And there was no. People weren’t doing impedance or reflexes or any of that stuff. And so we opened a full diagnostic center. And one of the outcomes was that we became one of the largest referral centers for acoustic neuromas to the surgeons in Nashville in those days. But keep in mind that even though the town only at the time had 50, 55,000 people, because of its location on the Kentucky border, literally five miles from the Kentucky line my office was That we had a draw area of well over 100, 120,000 people. So So it was a. It was a It was an interesting time. Interesting time. Yeah. And. And. And I understand you, you know, you were really involved in the development of the American Academy. But one of the things that was of issue for all of us at that time was that we were We were called Speech and Hearing Occupation. We were the speech and hearing. Yeah. And. And I know you have some thoughts on that. And How that all happened. So. Yeah, so. So when the AAA was founded in 1988, Dr. Jerger called me and asked if I would head up the first government affairs committee for audiology. And we put a committee together of individuals like Bob Glaser, the co author on your textbooks, good friend Craig Johnson, who’s past president of ADA, you know, rest his soul, Ian Windmill, Kathy Landau Goodman Lucille Beck from the VA. And you know, it was a pretty, pretty strong committee with a lot of diverse backgrounds coming in. And we we learned a couple of things as to why we were trying to find out why audiologists didn’t have better recognition in the healthcare system, you know, and how could we improve that? How could we get patients have direct access to who we are and what we do? And so what one of the things that we discovered to your point was, was that to find audiologists, you had to look under the letter S and you had to look under speech. And we were defined by the U.S. department of labor as the occupation basically of speech and hearing therapists or technicians or whatever the last word was. And so that there was no differentiation of that of Audiology from speech language pathology. I’m often reminded one of the past presidents, former audiology presidents of ASHA back in the 70s or whatever it was Dr. Leo Doerfler from Pittsburgh who was also a founder of the Academy, the ADA as well. In his early years, he talked about the fact that he said to equate audiologists with speech therapists because they share disorders of communication is like saying that proctologists and laryngologists are the same because they both share disorders of digestion. And so that saying has always stuck with me. You can find it online, actually, if you Google search it. Leo also, he actually was. He and Dr. Carhartt started the program at DeShawn Army Hospital in Butler, Pennsylvania. Okay. In the military. All right, so, so that’s how far back Leo goes on this. And -and by the way, as. As an aside, according to Leo, their first is a little bit of trivia. That was a trivia question years ago in the trivia bowl. Who was the first psychologist in their program with Dr. Carhartt and Dr. Dorfler at the Sean Army Base. And it was a young fellow who had just graduated with, with a psychology degree from Harvard. And his name was Timothy Leary, which is drop in dropout LSD. Timothy Leary. Well, he started, and apparently his first wife was an audiologist. But But anyway, there’s all sorts of. This is. This is a Kevin Bacon 7, 6 degrees of separation or whatever, you know. And so Yeah, lots of stories about that. And so Anyway so really there were efforts to try to get better recognition for audiology. In fact, back to Alan Feldman, when he was president, he tried to get the word audiology in the name of ASHA. He wanted hearing removed, and he wanted it to be audio. Audiology to be in the name the ASHA name instead of Speech and Hearing Association. We did that just for clarity here, Barry. Alan Feldman was president of ASHA. That’s correct. And had the. Had at least some substantial influence to possibly get that done. Yeah. Without success. But we changed our name in Tennessee. At the time, I thought it was such a good idea that we went and convinced the speech language pathologists in Tennessee that we had a. We had the Tennessee Speech Language Hearing association, or Speech and TISHA, and we changed it to TASL, which would be TASL, which was the Tennessee association of Audiology and Speech Language Pathology. So it would be like tassel. So if you were from Colorado, it would be CASL. If you were from Hawaii, it would be HASL. If you were ASHA, could change their name to ASL. But I’m not going there. Okay. Would be what it would take to get that done in those kind of. Yeah, yeah, I know. But anyway, so what we learned when we had this committee for AAA, the Government Affairs Committee, there were several things we learned. Of course, we learned that to become a profession, you should have a degree that is a unifying degree. At the time, there were 25, 26 different designators. A master’s in speech, a master’s in Communication disorders, an MS an MA and the list goes on and on. And we wanted EdD, ScD, all different things as well. Yeah. Lots of letters. Yeah. And then, so one of the efforts was to try to move forward to have the AuD recognized as the unifying degree designated for the profession of audiology. Second, we realized that professions are recognized by state licensure. You know, you go to a licensed physician, you go to a licensed dentist, whatever, and they define the scope of practice. And they define the. They grant you the legal right to practice in your state. So we put a program together to try to get licensure in every state of this country, which we now have. Okay. But it was a long haul. It was 20 years for that. Colorado was one of the last ones in 1996, I think. That’s right. That’s right. I remember those days. Thats correct. Yeah. We also learned that the U.S. department of labor, which creates these, what are called occupational codes that’s the group that recognized audiology as speech. Speech and hearing. The profession of speech and hearing. It said, like, 80% of us work in the public schools, providing therapy to children and so forth. So we petitioned to have our own occupational code for audiology. And the person taking the lead on that at the time was Carol Flexer, who was also going to be stepping in to be president of the academy’s board of directors in around 1995. So we petitioned to do that. And she and Craig Johnson were very, very influential in getting those kinds of changes made. And we got our own occupational code for audiology. That’s when the Department of Labor started collecting data on us, on who we are and what we do and which has become very positive for the profession. And so we tried to come up with a strategic plan for the government affairs to get better recognition. Realizing that there were steps along the way. We knew at the end we wanted Medicare, we wanted the VA to have better recognition for their audiologists in the system. And Dr. Beck was, was amazing at you know, moving the VA forward where the vet. Where the veterans now have access to the audiologist in the VA system. And so once it was like a domino effect as you started to do that. Of course, we’re still struggling with the Medicare issue. There’s. I got a note yesterday, you know, from AAA saying we still are trying to pass this thing. And so but, you know, steps have been made along the way. Whereas other than Medicare, audiologists do have access to a lot of. To their patients and can bill directly for the services they provide to those patients. One of the things that happened was we decided we would. There was a lot of talk in those days about with the Clinton’s administration, with health care reform before you got into the current health care reform. And in those days the Clinton administration was looking at what was called the Federal Employee Health Benefit Program as a model for their health care reform. In other words, all employees within the federal government have certain services. And what the government was looking at is maybe we can just create a program like the FEHBP program, Federal Employee Health Benefit Program for everybody in the country, okay, and have better access to healthcare which did not happen directly that way, as we know today. In hindsight, however we discovered as audiologists in our committee that audiology had no recognition in the federal employee health care plan that they didn’t know who we are, what we do. If I saw here I was in Clarksville with federal employees all over the place because of the army base and all of the associated companies and things like that that were around there supporting the military. And none of those folks had access to audiology services. It was a pay out of pocket kind of situation. Unless you got some type of like a workers comp case or Something. And so Coincidentally so I was asked. I was president of the Academy in 1996, and I was asked to come to a committee, a congressional committee, to talk about how audiology would fit into the health care system and especially the Federal Employee Health Benefit Program. We introduced legislation to have audiologists recognized by the Federal Employee Health Benefit Program. Now the Federal Employee Health Benefit Program, without belaboring this whole thing is really made up of all the private insurance companies who provide services to federal employees. If you’re a postal worker, if you’re. Whatever the case may be, it could be Humana, it could be Blue Cross, it could be Aetna, it could be anybody. And so we. So I was invited to a congressional committee where I presented a lot of data that had been collected at the VA at Vanderbilt in private sector that we had published, talking about the cost benefits for patients to have direct access to audiologists. And just. Just to be clear, Barry, this is the first time that anybody in the government had really paid any attention to the profession. And it was because of the work that your committee did and then later moving into the presidency, you know, here’s my chance. I’m going to make my active. My. We get active on this thing and make sure that this happens. So we’re. We’re now invited to a legislative committee which is like, wow, we finally have a seat at the table here. And How cool is that? Yeah, well, probably one of the most significant things we did is we hired the first lobbyist ever hired just for the profession of audiology actually had lobbyists, but they were speech and hearing. Even though one of their lobbyists, Steve White, was an audiologist, but still had to represent audio, still had to represent speech and hearing and in the discipline of communication disorders. And so this is the first time we had a lobbying team. And so that’s in part how we got. But we laid the groundwork by doing a lot of these research studies to look at cost benefit studies if patients, instead of if they had direct access to us, what the savings would be, etc. So coincidentally after my testimony I was invited by one of our lobbyists to go to a function that evening with Tom Daschle, who was the Senate Majority Leader at the time, and he was out of South Dakota. And Tim Johnson was running for Congress at that time out of South Dakota. So they invited me to go to a small, open House to meet these people because they said in South Dakota that the numbers will probably be in a relatively small. Maybe 50, 100 people will be there as compared to the hundreds and hundreds that will typically come. And, you know, lobbyists that show up at these things. Well, we’re there, and you’re shaking hands, and you’re meeting, and I’m being introduced, and all of a sudden, Marshall Mats, our lobbyist, comes over to me and says, the president’s coming. And I said, what? And he said, president Clinton has decided to cross the street from the White House and come here and to meet these folks. And he said, they’re going to be putting a rope up. And he described it. He said, get up to the front and introduce yourself to him. When he comes by, be up at the rope seat and shake his hand. So I’m rehearsing in my own mind. And so as the president came down, he’s a very engaging. He was very engaging person, President Clinton. And so when he would come by, he would always talk to people. Oh, I read that. That book you recommended. Oh, thanks. Yeah. Oh, yeah, we’re taking care of that for you. How’s the kids? And he come down and he comes to me. He doesn’t know me from anything, and I shake and I shake his hand and I introduce myself. First, I needed to use the word audiologist, so I said, I’m an audiologist. And I had to use Tennessee, where I was practicing at the time, because Al Gore’s vice president. And we knew Vice President Gore from my work in Tennessee. And he says, oh, nice to meet you. And he goes on. Next thing I know, he’s walking back, and he comes back to me, and he said, did you say you’re an audiologist from Tennessee? And I said, yes, sir, I did. And he said, well, I just had my hearing test, that I had a physical this week, and they told me I have a hearing loss from this noise, you know, the music that I play, and that I need hearing aids. So I reach in my pocket and I had my testimony. I said, well, sir, you should know that your insurance will not cover you or the services that are provided to you, because I was up here on the Hill today testifying. And I explained. And he took the testimony, put his pocket. I figured when Hillary did the laundry next Tuesday, you know, it would be thrown away. But anyway the next thing I know is, you know, I was excited. I called my mother and, you know, all that stuff. And. Yeah. And so next thing I know, I get back to my office, and my secretary comes in. I’m seeing patients. And she said, the White House is on the phone. And I go, what? She. I said, seriously? She says, no, I think it’s serious. And I thought it was like Ian or Gene Brad or Bob Glaser or somebody, you know, spoofing me. So I think something Glazer would do, actually. Exactly. Yeah So I I pick up the phone, and Ira Messenger was the head of the Healthcare Reform Task Force, and was. Either he or somebody from his office was calling and saying, the president read over your testimony and wants to get this done. And I’m like, okay. And said, we need a meeting in Washington. I want your lobbying team here at the White House. So I immediately called Marshall up and our lobbyist, and they went over to the White House, and it was agreed. It’s a time that Congress would talk to one another, sorry to say. And our senator from Tennessee at the time was Fred Thompson, who was in Law and Order, and, you know, he was the prosecutor in law and order. And. But also he ran for president on the Republican ticket, a conservative Republican. And then on the Democratic side, we had Tom Harkins, I think from Colorado. No. Was he Colorado? He wasn’t Colorado. I think it was in this area somewhere. Well Tom Harkins was the author of the American Disabilities act and also had a brother who was severely hearing impaired. And so those two got together and managed with colleagues to get our legislation passed. So audiologists became recognized in the federal Employee Health Benefit Program, and boom, it was like a domino’s effect because you had like 12, 14 different private insurance companies like Blue Cross, UnitedHealthcare, etc, all say, well, we got to do this. So let’s just put them into all of our insurance plans. And so we managed to get recognition in the healthcare system. And in fact, the next year they added in. We didn’t even ask for it, but they added in hearing aid benefits. So we had that covered during that period of time. It was very exciting. It was very exciting for audiology, it was exciting for the profession, and that’s what it’s all about. Yeah. Well, yeah. And those of us in the trenches at that time, we could actually tell there was really stuff happening which we’d been waiting for all of our careers. Sure. So it was great to see that. And. And now after this monumental experience that you. You had with the committee as well as president meeting the. The. you moved on to Nova Southeastern University. I was very involved in trying to get the profession to transition to the unifying degree, especially since the Government Affairs Committee and we realized that we really needed a single unifying degree designator. And and I was called by the folks at Nova Southeastern and asked if I would head up a plan to implement an AuD program at NOVA on campus. And I wasn’t quite sure that. I mean, I had a very successful practice going in Clarksville, but I have someone positioned to buy it. My wife, Bobbi said, let’s do it. Kids are off at college. They’re out of the house. Why not? So I actually kept my practice. I kept my office building. I kept my home in Clarksville because I wasn’t sure it was a good move. But, you know, about a month in, I realized that this was going to be exciting times. I always considered myself. And it’s a little. Maybe it sounds egocentric, but I’ve always considered myself a builder. That I realized in my professional career, I love to take things and build them up I built my practice. One of the early audiologists. I built the. No, I helped build the Nova program with a good team. You know, I built whatever. And so we. We did a lot of good work through AAA and the Academy. And so so it was a, it was a nice challenge. It was different to go back to academia. And so we built that out and we built a program in Fort Lauderdale and I also opened a program in London and for audiologists there. And I think that’s still in existence. And so we had students from around the world who were earning their AuD degrees through the Nova Southeastern program is very, very exciting. I stayed there. Programs now that do that. But this was the very first of its kind and set up a model for places like Salus and some of the other institutions that have come across with these international AuD degrees. Yeah, yeah. And And the international community was. While the practitioners, the audiologists were in the trenches, were excited about it, the university folks weren’t exactly excited about it. I remember someone saying to me, standing in line with a glass of wine a very British gentleman who is at one of the major institutions. Yeah. And who said, who said to me, Barry. He said, he went and he flicked his finger on my shoulder and he said, I thought you were a flea and would just disappear. I said, but that didn’t quite work out. He said we had to change all of our programs because you know, the community wanted some more education than what we were offering here in the UK and in Europe. So it was fun time. And I stayed at Nova and then I was called by Starkey and they were introducing some new technology. They wanted to build out their education programs. And they also reached out to Jerry Northern and Dave Fabry. And we went in there and Jerry was looking at pediatric programs for them. Dave has continued to stay with them in many areas. And my responsibility, we’re building education teams that could be around the globe. And So I stayed with Starkey for a few years and and when I was leaving, Mr. Austin, the owner called me and said, why don’t you stay on? Because I just made a commitment to give away a million hearing aids through the Clinton Global Initiative. This was in 2010. And I need help. We need to make these, we need to make this program sustainable. So I said, if Bobbi can travel with us while we’re traveling. He said, sure, because she has an education background and she was great in terms of working with families and things like that. And so so we did that for about a year and then I burned out. It was a lot of travel. I mean one week you’re in Haiti, the next week you’re in Or somewhere. Yeah, exactly. And so we were in Ethiopia, we were in Israel, on the west bank, we were on everywhere you can think of. So Philippines. And so it was exciting but I really got worn down and said I think I’m retiring. And so I did, I stepped down and I started my own little company and did a couple of projects, did some consulting and then I was called by Z Power who, which was a company in, based in Camarillo, California outside of LA that was a spin off of NASA that had come up with a. The battery that was used in the Mercury and Apollo space missions was a rechargeable battery using what’s called the silver zinc technology chemistry instead of lithium ion. So non flammable obviously if you want to put them in nuclear subs or up in space. So Z Power was successful in shrinking it down to the size of a number 10 battery if you wanted. And had great capacity and it was rechargeable. And we just really did not have much in the way of rechargeable batteries on the commercial market. There were a couple of companies that had nickel metal hydride batteries et cetera out there. So my task was vice president of business development was to go to the hearing industry and try to show proof of concept and to show that this is something that the public wants and that we could build. Build a product for them. And so at, by 2018 we probably had around 70 to 80% of the global hearing hearing aid market. Absolutely And then, and then Bose came to us and wanted millions of batteries for some new products that they were developing as well. And so we really grew very quickly and probably too quickly in hindsight. I announced I was retiring in April of 2019, right after AAA. We were supposed to go public, but unfortunately it was not sustainable. And I’m not going to go into the details of that, but I had resigned the year before. I gave them my retirement date and I stuck to it. Of course I thought we’d be going public the week after my retirement and I was vested but millionaire. At the same time. Right, that’s it. And so yeah, we plan and God laughs, remember? That’s right, exactly. So anyway, but anyway, so in the meantime, and I don’t know how far we want to go into this, I continue to stay very active in certain areas of my research interests. And that’s when I was talking to my son about this as the healthcare actuary and especially Dr. Ian Windmill. And my son Jason came to me with all this data. He said, do you want to look at this stuff? And I started looking at it. I called Ian up, who I’ve done some publications with over the years, and I said ian, I got all this data here, I don’t know what to do with it. And it was So so we really started to look at two things. We started by looking at the demographics of the profession was probably the first thing that we did. And when we started to look at the demographics of the profession, we there were some models that were coming out of Washington from the Department of Health and Human Services on human medicine. And this was probably around 2010, 29, 2010, 2011 that were showing that it may have even been earlier than that, but that were showing that there was going to be a shortage of physicians in the United States. So we’re looking at those models and remember this is at a time that audiology is starting to transition to the doctoral degree. 2006 or 7 was when programs really started to make the push. And so we said let’s start taking a look at if we apply the human medicine models to audiology and can we do some projections of how many people will be attritioning out of the profession, will be leaving the profession and how many will be staying in the profession and how many will be graduating from academic programs. And so, and Bob, if we need to take a break or stop or we gotta end anytime soon, just let me know. I’ll wrap this up shortly. I know we’ve been going about an hour here. Well, we’re doing fine. This is all great information to log for that talks about how things have happened in our profession here, Barry. And with your position sitting at the table here giving us this implication. There’s, there’s a famous slide that I use all the time in class. Which is, which is the one with all the blue bars on it. Yeah. I think most professors and, and every once in a while you’ll see that slide come up in various talks. Sure. This is fundamental stuff that you and Ian put together. You and Ian and Jason put together. So so let’s continue with the discussion. So, so one of the things we realized is that the attrition rate out of audiology was pretty high. It was higher than you might. This was still at a master. A lot of the people still working were master’s degrees. They hadn’t gotten back to their doctorate or anything. And so we saw attrition rates running over 40%. That means within first five years of graduating with a master’s degree, 40, 40% were leaving the field. And it was like, wow, and what are we doing to replace those people? And at the same time we looked at projections coming out of the government of how many people were going to be seeking audiology services by aging or pediatrics or anything like that in healthcare. And so there was this huge gap between those seeking services and those providing services. And it was one of those eye opening things that if we don’t do something about this, then somebody else is going to step in and take over our scope of practice. And where’s audiology going to be in the future? And so we put this together and we published it and it’s another one of those articles that became very well known. I see today that Amyn Amlani and Victor Bray at Salus are using that data and updating it. And we’ve had conference calls with the me and I to talk about, you know, what, what our experiences were in putting together this data because unfortunately the academic programs have not responded. And so you still have this gap between the patients aren’t going away anytime soon. I always tell students the best thing about audiology is you’re not going to run out of patients anytime in the near future. Almost like morticians in many respects. Yeah. Okay. Yeah. Okay. Thanks. Anyway, so we really either have to get very efficient in the way we do things or we have to just think about what we’re doing and what we’re offering in the healthcare system. And so So that’s how some of that data started to come together. It’s still a concern. We still see that a lot of that we’d like to see. You know, Dr. Jerger’s original vision was like, what, 10, 15 programs graduating, you know a lot of graduates every single year, and each one with 100 students or so. Instead, you still have an average of around six or seven graduates per program in the United States. You’ll have salas, you’ll have Nova, you’ll have Pacific. That’ll graduate 20, 25. That means you’ve got other universities because it’s an average graduating 2 and 3. And it’s like, I don’t know how they do it. So. But that’s the politics of of academia that I was happy to get out of, of course. Yeah. So if But when I went to nova, I said, well, I know that my program can’t exist unless I have 15 to 20 students. That was my budget number. And I didn’t have a. We were the first program in the United States to not have an associated speech program. When it started, it was part of communication Sciences. And I petitioned to move Audiology to separate it from speech and move to the medical school because speech, most of their graduates went to the public schools and they wanted to stay in the school of education. So we petitioned to move to the medical school. And because I saw a lot of synergies with geriatric medicine and optometry and human medicine and even PT and OT And at the time, speech didn’t want to move. So so I knew that I needed to have. In fact, Ashton went crazy at that time because they had. They had to accredit two programs from a single university, and that was foreign to them. But that’s another story. But anyway so it’s still a concern. That’s why Victor and Amyn, who do great research in these areas are still looking at this. And why there’s still an effort to get academic programs. The answer is not to grow the number of programs, which is what really this response has been. It said, well, let’s add more programs that only have five students. And so as compared to having, you know, programs with you know, 30, 40, 50 students or something like that. But that’s something you and I would sit down at a. AAA meeting over a beer and we can have our discussion about, but not here, but two. Or three beers actually. Yeah, more than that. Yeah. So the listeners, you know, to this. Hey. Have to understand that some of this is out of our control and they need to go to their alumni institutions and say, what are you doing to our profession? If you can’t graduate enough people, what’s going to happen to our profession if we can’t meet the needs of all the people that, you know, we’re supposed to be serving here? Thats my political speech for the day, but so then I’m going to, I’m going to move on before you start getting me bogged down on that. Well, the deal too here is that that’s another generation of fabulous people having good careers to help facilitate some of those kinds of things. Barry. And so so as we, as we move forward here what’s the coolest audiology moment to date for someone who’s been around, around and probably around and around the profession of audiology for a very long. Long time. Yeah. Well, you know, obviously meeting President Clinton was pretty cool. That was. And And speaking before members of congressional committee is pretty cool. Yeah. And as well as Department of Education and Accreditation agencies and things like that. But I have to tell you personally that I still remember giving my presidential address before. Before about 4,000 people and Fort Lauderdale for AAA. My father was there, my uncle was there. And And that was pretty special moment for me. But I gotta tell you. And it happened twice this week. Okay. Actually, I’m having breakfast this week. I’ll tell you. What I mean is I watched the success of so many students and colleagues, people that, you know, great leaders. I’m not a great leader, but people that are in those positions, if the people around you are successful, then you can kind of feel successful. And I love staying in touch with my former students and seeing how well they’re doing. I’m having breakfast with one on Sunday morning. He’s driving through. He said, we gotta talk. I gotta tell you what’s going on. I got a call last week from another one who’s looking at his practice and what he wants to do. And I see these former students and, you know, now that I live here and I’m retired and wearing my own hearing aids, and I go up to my former students. I have an article coming out next month with former students and young, younger colleagues on the future of audiology. Audiology Today asked me to write an article on the future. And I said, well, my future is pickleball, tennis, working on my golf game. I said, but let’s put an article together on the future of audiology with, you know, people that really. It really matters to. So we have something with younger colleagues. Nothing is better than to see the success of those folks that you that you have worked with and. Or your. Especially your students. And fortunately, I’ve been fortunate enough, as have you to have a lot of these success stories of people around us. And you’re going, wait a minute. How did they do that? Why didn’t I think of that? Yeah. Really? Yeah, exactly. So Well, as you talk about the future of audiology, my understanding one of the things you’re looking at is AI and robots and something that we talked about called co-bots and things like that. Cobots before collaborative robots. They work in collaboration. That’s what they’re calling them, I think in Japan or South Korea or something is cobots. How do you see that developing, Barry? Yeah, well I think that there’s a lot of technology coming out that will enhance the profession. I think in terms of providing rehab services for people with fall related injuries with diagnosis management, treatment programs. We already see a little bit of AI going into hearing aids and products like that. Yeah I do think that if, if we don’t have enough audiologists then why not we have assistance. But why couldn’t we have some type of system, robot or otherwise that helps out with regards to whether it’s cleaning the room or cleaning to. I don’t know what it would look like cleaning, you know, cleaning your equipment or welcoming the patient in and handing them an iPad or having an iPad mounted on a robot that rolls out to the patient and have them sign the HIPAA forms or fill out their, their case history. That’s there. And so you know, there are so many, you know, it’s, it’s as much as you want to think about, you know, that, you know that you can think about in these areas. And I’m hearing there’s a lot of new stuff coming out in the area and you’ve got your textbooks on practice management areas. Im sure we can look at that and come up with some tools, techniques, strategies, et cetera to make practices more efficient and effective. At your practice door. If a robot know, greeted people and had handed them a thing and said please build this out or something like that would that practice look like they were the coolest thing in the world or what? Talk about differentiating your practice from everybody else. And you know what? And I think it’s going to be common, commonplace over time. Yeah, yeah. I think that audiologists have to think, you know, one of the things and that, that Ian and I published was we started to look at using my son. The data my son got was to look at and then we’ll wrap this up. But look at what audiologists are doing in their practices. And you talked about the blue bars earlier. The slide that’s looking at comorbidities. Medicare is tracking comorbidities that is 16 different comorbidities that patients that see audiologists that Medicare is tracking, CMS is tracking. We may not be tracking it. They’re tracking the number of people with cardiac disorders you know, anything you can think of and they’re tracking it. And these are things we ought to be doing. And that one of the things that we found in looking at the actual numbers is the average audiology practice uses one to two CPT codes per, per patient on average. And that means they’re bringing people in, they’re probably doing some form of a pure tone evaluation or comprehensive. And and nothing else. They’re not Even, you know, 20, 30% of the time, they’re not even doing a tympanogram is being built. We have all that data nationally and it’s like what are we, how are we going to differentiate? How are we doing? How are we going to provide the best health care to our patients if we may not know what’s going on? You know, I opened this talk by talking about all the oto, all the all the acoustic neuromas that we found. I mean it was just standard in my day when I came out, when you came out we couldn’t fit hearing aids. So it wasn’t. The product, wasn’t the center of our universe. And I know your current co author Brian Taylor and I have done talk after talk on this area. Stop making the product the center of your universe and start looking at the patient. And those practices that are going to continue to be successful are going to be providing a full scope of audiology services, not just the pure tone, to see if the person needs a hearing aid. And, and then if they don’t send them on their way, I can’t imagine what they’re missing. Well the, the, and we see that in forensics, in the forensic world all the time people will come in, they say do I? Well they have, they say well we have normal hearing. Well you have normal hearing for, for word recognition, you have normal hearing for pure tones, but what about those high frequency pure tones? What about the speech and noise testing? What about a whole host of things where we can’t continue to do an 80 some year old evaluation and call that done? We have a whole lot of other things to do. And, and this has been just a fabulous discussion Barry. And it’s been great to to, for me to learn from you as well as both of us possibly to learn from each other to some degree. And the the the deal here is that this kind of records some things for future generations to hopefully build upon and take their practice and maybe set it up with robots and cobots and some AI things may be the next generation. So, so, so basically thank you for for being with us and thank all of you out there for tuning in to This Week in Hearing and this episode of Giants in Audiology. Today, my guest has been Dr. Barry Freeman, professor, researcher, clinician, private practitioner, industry executive, and the former president of the American Academy of Audiology. And likely one of the few audiologists to ever meet and actually have words, interactive words with a president of the United States and a true giant in audiology. Again, thanks for your fabulous contributions to our profession, Barry, as the profession is definitely better because of those people who have built a lot of things for the next generation to build upon. And those of you who are watching, be with me next time when we get to know another giant in audiology. Thanks, Bob, so much for the opportunity.