photoAAA President David Fabry introduces the convention’s keynote speaker, Secretary of Health and Human Services Tommy Thompson.

If Rip van Audiologist had awoke to find himself attending the 13th annual convention of the American Academy of Audiology (AAA) in San Diego this past April, he might have found it hard to believe that the event had grown from roughly 600 attendees in 1989 to more than 10 times that number in 2001. This year’s convention was attended by an estimated 7300 audiologists, students and hearing industry representatives, making it the largest meeting of audiologists in the history of the profession. The convention had the theme “Setting Sail for the Future,” and featured a keynote address from Secretary of Health and Human Services Tommy Thompson as well as a special speech from rock and roll icon Huey Lewis.

The convention floor offered more than 185 exhibitors of hearing health care products and services and had a combined 90,000 sq. ft. of exhibit space. This year’s convention also featured 100 instructional courses, 35 special sessions and a number of research poster and podium sessions that covered the gamut of hearing health care issues.

Fabry’s Message: Need for Collaboration of Efforts
Academy President David Fabry outlined the organization’s plan for improving the position of audiologists in years to come, and likened AAA’s Strategic Plan to an anchor that has the ability to keep the Academy’s ship from drifting in even the roughest seas.

photoGail Gudmundsen, AAA Convention Chair, welcomes attendees to the convention and starts off the general session.

The first goal of the plan, according to Fabry, is to increase access to third-party reimbursement by audiologists, and have audiologists recognized by the Health Care Financing Administration (HCFA) by 2005. “The next step is to call for audiologists to be placed in the ‘health diagnosis’ category rather than in the ‘therapist’ category of SOC codes within two years,” says Fabry. “Ultimately, if we prevail in this endeavor, we will achieve our goal of providing independent patient care without supervision by other health care professionals. I want to emphasize that this does not mean we won’t collaborate with other health care professionals and related professional organizations. If they share our mission, we will work with anyone. Further, we are not mandating that audiologists have to be the ‘captains’ of the hearing health care team, but we are not going to stand on the sidelines either.”

While recognizing AuD students as the “future of dispensing audiology,” Fabry also emphasized the importance and need for more PhD students. “We are at a crisis stage with regard to research and education and the number of future researchers that are now in our professional ranks. As critical as the AuD is to our clinical success in the future, it will not be possible without strong PhDs to develop and refine the research agenda. One of the objectives of the Academy’s strategic plan is to foster and support outcomes-oriented clinical research in the development of clinical researchers.”

Fabry says that there is a vital need for research that may, or may not, have immediate clinical relevance, and he pointed out the dangers of placing emphasis only on clinically applied research. He noted the imbalance and scarcity in numbers of PhD students compared with AuD students, and said that the Academy, other professional individuals and the NIDCD are developing future strategies to increase the number of audiologists engaged in research careers: “There are no easy answers to this, folks, but we must not ignore the fact that a problem exists…

“We must develop a collaborative model of mutual respect between AuDs and PhDs regarding our collective goals for audiology in the future,” says Fabry. “And this does not undermine [current] master’s students or master’s degree audiologists. We need to engage in the transition of the profession and look to the future and be inclusive. But we recognize that our future is in doctoral-level education.”

photoFormer AAA President Robert Keith (l) presents Brian Walden with the Academy’s Career Award for Research in Audiology.

Fabry outlined several other issues relating to the transformation of education in audiology. “The transition of the profession to the doctoral level is well under way,” he says. “There are now 15 AuD programs accepting students and an equivalent number in various stages of development. The challenges ahead relate to the development of accreditation standards for educational programs and for clinical programs for final-year AuD students. Further, although the issue of audiometric technicians is not identified specifically in our strategic plans, it relates directly to our educational mission. Audiologists are uniquely qualified to determine how to involve support personnel without compromising patient care, and provide the education and supervision to ensure quality of outcomes.” Fabry says a task force has been established to address this issue.

Physician hearing support programs also need to have a place on audiology’s scope of practice, according to Fabry. AAA’s “Marketing Campaign for Primary Care Physicians” program has been developed to be used as a tool for promoting physician awareness of hearing health care issues. Robert Sweetow detailed the new kit, which costs $70, and explained how it can be used to increase physician referrals.

Secretary Thompson Provides Encouragement and Support
In his new role as Secretary of Health and Human Services, Tommy Thompson oversees, among many other departments, the FDA and the National Institutes of Health (NIH), which includes the National Institutes on Deafness and Communication Disorders (NIDCD). Prior to accepting his position this year as Secretary of HHS, Thompson served as the longest tenured governor of Wisconsin, holding that office since 1987.

Thompson spoke to the convention at the request of Dr. Thomas McDonald of the Mayo Clinic, who has helped him cope with a hearing problem. Thompson noticed a sudden loss of hearing just prior to the Wisconsin Badger’s win at the Rose Bowl in 1998. An audiologist at Mayo told Thompson he had severe hearing loss in his right ear: “I tell people my Republican ear went to hell, but my Democrat ear still works,” said Thompson (a Republican) ruefully.

Thompson, who is known for his straight-forward demeanor and home-spun talk, provided his perspectives on politics, Washington and his new position as Secretary. “I come from Elroy, a very poor rural community in Wisconsin with a population of 1500. It’s so small that you can call somebody, get a wrong number and still talk for half an hour.” He said that, following the presidential elections, he received word from President Bush’s transition team that they were considering him as a cabinet officer for education, transportation or HHS. Shortly thereafter, President Bush called to say they were considering him for transportation and HHS. Upon being asked why education was dropped from the range of possibilities, Thompson jokes that the President told him, “Well, Tommy, you talk like I do, and we can do much better than that.”

He spoke with deep respect for the scientists at NIH, and said he recently spent a day at the impressive facility. “This is where we have the world’s greatest doctors, researchers and scientists. We have the best. They work for the Dept. of Health and Human Services doing research. We’ve increased that budget by $2.8 billion this year. 75-80% of that $2.8 billion will go back to institutions in your respective states to scientists and maybe to some of you…to see how you can deliver better hearing…And I want you to know, since I have this hearing problem, there’s going to be this year a disproportionate amount of research going to sudden hearing loss.”

“Then I went out to spend a day at HCFA…And I hear the moans [from the audience]. When I was going through the confirmation [process I realized] everybody loves to hate HCFA. I mean, it’s not a partisan thing: Democrats and Independents and Socialists and Republicans and the whole gamut love to hate HCFA…As governor, I was probably one of the most frequent critics of HCFA…I was [at HCFA] after they had made $11.8 billion in mistakes. And I said, ‘How can you do that?’ and they said, ‘Well, Secretary, five years ago it was $22 billion; we’re getting better.’ I said that’s not good enough. We’ve got to eliminate those kinds of mistakes. I asked, ‘What’s going on? There has to be a reason.’

“We have some wonderful people [at HCFA]. Wonderful, dedicated public servants who want to do what is right. But what has taken place in the past years is that…Congress, when they passed a new bill or a new law, whether [it dealt with] privacy or whether it dealt with Medicare or Medicaid, they give it to HCFA but don’t give them any additional resources. And I went out there and examined it. They have a computer system that was installed in 1970. Do you know of any office in your clinics or hospitals, any insurance company, any bank…that has a computer system that was installed in 1970? Granted we’ve modernized it and upgraded it, but to have a computer system that arcane operating a division of $375 billion is absolutely an accident waiting to happen. No wonder. It’s surprising they don’t [make] more mistakes. And they don’t have a double-entry book-keeping system. Single-entry book-keeping went out in 1911.” Thompson said he recently obtained funding from OMB to change HCFA’s bookkeeping, accounting and computer systems.

In conclusion, Thompson said, “I think you’re wonderful. I think your organization does so much good. People don’t recognize there are 28 million people like me. And I didn’t recognize what a handicap it is not to be able to hear until I lost my hearing. I appreciate the dedication of your profession, and I want to be somebody that you can join with and try to improve and alleviate the hearing losses and hearing problems of 28 million Americans. The only way we can do that is through research, through better rules, better cooperation, more vision, more common sense, and the great opportunity to serve—which all of you do.”

Huey Lewis on Hearing Loss
Rock and roll icon Huey Lewis provided a lively and often humorous perspective on his frustrations while trying to seek a remedy for his sudden hearing loss, which occurred while duck hunting in Montana. Lewis, who is best known for his songs “The Heart of Rock and Roll” and “Stuck with You,” had experienced “two wild incidents of nausea and dizziness” before his hearing loss, both of which caused him to stay in bed until the symptoms subsided.

In a relatively short period of time, according to Lewis, he saw numerous specialists. First he saw a doctor, and after antibiotics didn’t help the hearing return, an ENT told him that he had to “get used to it” and that it could be Meniere’s Disease. Lewis says the doctor gave him a booklet about the disease that said a low-salt diet helps. “Well, give me the dizziness,” said Lewis. He managed to cope with the problem, but kept seeking solutions, which brought him into the offices of a chiropractor, an acupuncturist, a radiologist and a neurosurgeon, with no results.

Lewis’ wife suggested that he see someone at the Univ. of California-San Francisco (UCSF), and there he met audiologist Robert Sweetow, who gave him “the single most optimistic suggestion” that his hearing might come back in six months to a year. He said he went through a battery of ABR, ENG and tympanometry tests at UCSF, and described the soundbooth as looking like an “East German radio show” studio. Luckily, Lewis’ hearing did return to normal a short time ago: “I think it’s because I agreed to speak to you folks,” he says. Lewis also jokes that he would be happy to give free tickets to anyone who can “tell me what I have, because I really like salt.”

AAA Honors and Awards

A number of “Audiology’s Best” were honored at this year’s AAA convention. Former AAA President Robert Keith presented the Jerger Career Award for Research in Audiology to Brian Walden, PhD, director of the Army Audiology and Speech Center at Walter Reed Army Medical Center. Walden was instrumental in showing that noise-induced hearing loss was the most prevalent occupational health hazard to Army personnel—research which resulted in expansion of the Army Audiology Corps. He has also assisted in the development of distance-learning programs, and has conducted research in many areas, including speech perception, hearing aid fitting and selection and aural rehabilitation.

The AAA Career Award in Hearing was presented to Mark Ross, PhD, and Salah Soliman, DSc. Perhaps one of the most tireless advocates for hearing-impaired people in North America, Ross has spent almost 40 years as a practitioner and educator, and has led many initiatives, working on task forces of the FDA, Gallaudet Univ., SHHH, NTID, AG Bell and the New York League for the Hard of Hearing. As well known as Ross is in America, Soliman is considered by many to be the founder of audiology in Egypt and the Arab world. More than 95% of the audiologists in the Middle East have graduated from the program Soliman started in 1968 at Ain Shams Univ. in Cairo, according to AAA.

James Lankford, PhD, was presented with the Clinical Educator Award. Lankford was one of the first to provide supervised practicums in dispensing audiology in a university program and is now a dean at Northern Illinois Univ. This year’s Research Achievement Award was presented to Christine Yoshinaga-Itano, who authored the landmark study, “Language of Early- and Later-Identified Children with Hearing Loss” (Pediatrics, Nov. 1998). Yoshinaga-Itano has continued to provide important research on and support for universal newborn hearing screening programs.

AAA Humanitarian Awards were presented to Christine Gerhardt-Jewell and Frank Brister who have provided hearing help missions and other humanitarian aid to Mante, Mexico and Port-au-Prince, Haiti, respectively.

David Fabry presented AAA President’s Awards to Gene Bratt, Kathleen Campbell, Evelyn Cherow, Allison Grimes, George Haskell, Larry Higdon and Douglas Noffsinger who were responsible for developing the Audiology Clinical Practice Algorithms and Statement (Audiology Today, Aug. 2000). Their three-year collaborative project sought to establish target measures of audiologic assessment, hearing instrument selection and fitting, and cochlear implant procedures for audiologists in clinical practice.

AAA 2002
The 14th annual AAA convention will be held in Philadelphia on April 18-22, 2002. For more information, contact AAA, 8300 Greensboro Dr., Ste. 750, McLean, VA 22102-3611; website: www.audiology.org.