Events | June 2018 Hearing Review
The AAA 2018 Convention held April 18-21 in Nashville was a breath of fresh air for the organization—even with some of the heated debate that the organization’s Board of Directors encountered as a result of not endorsing the recently introduced Patient Care Choice Act (PCCA). The 30th annual convention of the American Academy of Audiology (AAA) drew an estimated 4,400 audiologists and industry experts for four days of continuing education, getting up-to-date on new products and services, seeing old friends, and meeting new ones. This year’s convention featured over 200 sessions, seminars, grand rounds, learning modules, and exhibitor courses, as well as a busy expo hall with over 150 exhibitors. Additionally, Wednesday’s all-day Academy Research Conference (ARC) focused on “Genetics and Hearing Loss,” and Wednesday night placed a spotlight on the expo portion of the event with the “Celebrate Audiology Opening Reception.”
Thursday morning began with the AAA General Assembly which combined a celebration of the Academy’s 30 years, as well as a look forward to the challenges facing the profession. To kick things off, AAA President Jackie Clark, PhD, introduced Nashville’s new vice mayor, Sheri Weiner, AuD, who is an audiologist. Dr Weiner welcomed Academy members to Nashville, encouraged everyone in attendance to get involved in their own communities and to strive not be the “best kept secret in town.”
Looking back at the last 30 years, the 1989 AAA Program Chair Fred Bess, PhD, and the 2018 Program Chair Eileen Rall, AuD, presented a film celebrating AAA’s history, honoring its founders, and revisiting its important milestones. Drs Bess and Rall also paid tribute to Academy Founder James Jerger, PhD, who was celebrating his 90th birthday and could not attend. Another film highlighted the activities of the Academy’s sister associations, the Student Academy of Audiology (SAA), American Board of Audiology (ABA), the AAA Foundation (AAAF), and the Accreditation Commmission for Audiology Education (ACAE).
Preparing for the Age of Self-directed Care
President Clark started her address to the General Assembly by asking “How do you change a culture?” She noted that we now find ourselves in an era of self-directed healthcare, with hearing care drawing the recent attention of legislators and healthcare administrators. Affordability and accessibility are the focus both within the United States and abroad, and many consumers are experiencing success in independently determining their own needs, becoming more active partners in health diagnosis, and even treatment.
Dr Clark said that Audiology is now entering into this new chapter of self-directed and self-managed hearing and balance care. This is a chapter that some professions have navigated for quite some time, with optometry being an obvious example, having experienced a change in its distribution model with the advent of OTC/reader eyeglasses about 30 years ago.
Dr Clark admitted to using these products herself because they were easily obtainable in any drug store, affordable, and met a very simple need. She said the next chapter in Audiology will begin in 2020 when the 2017 OTC Hearing Aid Act legislation is to be enacted— and, in truth, no one really knows what the regulations will look like when finalized.
“We know that there will be a public review and response period, and proposed regulations will be heard before anything will be enacted,” said Clark. “We have been repeatedly assured by the FDA that this process won’t happen any sooner than the [3-year] timeframe laid out. Our Academy leadership and staff will continue to diligently maintain those critical communications with all of the stakeholders in our ‘next chapters’.”
She says consumers and our patients have clearly expressed their desire to self-direct this particular aspect of healthcare. “It is clear that we cannot diverge nor halt the consumers’ culture of self-directed healthcare, but we can move forward with actions that are equally if not more critical in this emerging model,” said Clark. “Now is the time to preemptively control the narrative to the world about audiology and audiologists being the experts of hearing and balance.” She says the Academy has been working closely with a PR firm to promote the value of the profession and practice of audiology with the over-arching message, “See an audiologist; Get your hearing checked.”
Another vital way of moving forward, says Clark, is by redirecting and transforming Audiology’s own professional culture to more effectively engage in the new emerging delivery model. She said that some of the Academy’s earliest founders warned that audiologists are the biggest threat to themselves. “It is time to change the dialog amongst ourselves,” said Clark. “We must be the architects of the future with that same consistent narrative to the public. We have to recognize that our past selves held over to our current culture will only conflict and will disastrously impede our future. In order for us to be transformed, we must first recognize our limitations and flaws within our current professional culture.”
Clark spoke about how some professional cultures, such as state bar associations for lawyers, have now emphasized the need for civility and respect for their own colleagues and clients by adopting new creeds. One of the major questions in these creeds is: Do we show utmost respect to our patients both inside and outside our office? Although stories about patients may be amusing and even educational, sharing them in a public forum like social media can portray the profession as uncaring, unprofessional, and disrespectful—even when the intended target audience is for professionals only, says Clark. “I’ve heard audiology friends who were very offended by [posts] indirectly mocking their child or their father or a loved one on an audiology Facebook site,” she said. “Just because you can post doesn’t mean you should.” Similarly, Clark cautioned against castigating other audiologists online or accusing them of misdeeds without knowing the full story; just because a colleague is doing something in a different manner, doesn’t necessarily make them wrong, unethical, or incompetent as a professional.
Next, Clark asked, Do we consistently demonstrate our professional value by improving knowledge and skills as the ultimate experts on innovation in hearing and balance assessment? She says that, for diagnosis and treatment, best practices are required every day. “Opting out of critical protocols—such as a probe-microphone measurement, advanced speech testing, and so on—are no longer acceptable for this doctorate profession,” said Clark. “We must keep current with research and literature to thoughtfully articulate important information to our patients. I vehemently disagree with our colleagues who insist that they can obtain all of their professional information from social media and see no relevance or value in reading audiology journals, or magazines, or info emails. Our general professional knowledge base is in a seemly permanent holding pattern. The profession of audiology is much larger, much greater, than this simple little gadget. We are a doctoral profession which makes a positive impact on those we serve. It’s time to stretch and push ourselves on behalf of those we serve.”
Clark also pointed to areas of education for AuD students that need attention or improvement, particularly in the subjects of public health, pharmacology, hearing loss prevention, telepractice, and patient counseling. Additionally, she says a lack of clinical contact hours has hindered the professional development of some promising students.
“So how do we change a culture?” asked Clark, harkening back to her original question. “I think that the [future of audiology are those] who unwaveringly model the utmost civility and respect to all, and operate at the very top of their scope of best practices…We have to continue to demonstrate the value that audiology brings each and every day. Bring civility back to all of our interactions. [With many changes], our Academy has brought us here today and, thankfully, as a profession we can continue to evolve. We can grow and flourish as long as we remember we will not be defined by our past, nor will our future look like our past, unless we allow it.”
AAA President-elect Lisa Christensen, AuD, reiterated Dr Clark’s points, stressing that audiologists need to kindle the flames of their passions without suppressing technical innovation or denigrating other professionals with the waters of negativity. “How we respond to these changes will show the world what an amazing profession Audiology is and how audiologists are the hearing healthcare providers that change people’s lives…I challenge each of you this year to be open to new possibilities from this Academy, [and] to be open to what you may once have considered an open threat to now becoming an opportunity. As JFK once said, ‘If one person can make a difference, then everyone should try.’ I hope that each and every one of you will join me in a positive movement forward to the next 30 years of our Academy.”
A Healthcare Futurist Looks into Audiology’s Crystal Ball
The keynote speaker for the General Assembly was Jeff Goldsmith, PhD, president of Health Futures Inc and national advisor for Navigant Healthcare, as well as an associate professor of Public Health Sciences at the University of Virginia. He is also reportedly a leading healthcare analysts, specializing in corporate strategy, analysis, healthcare policy, and converging technologies. His presentation, “Current and Emerging Trends Impacting the Field of Audiology”, mixed some bold forecasts with some rather stark statistics about the US population and healthcare environment.
Dr Goldsmith began his talk with a raft of fairly depressing facts, one of which is that there was $6.5 trillion spent on healthcare in the United States between 2014-2016, while US life expectancy declined by 3 months. Legislators have taken notice that the world’s most expensive healthcare system is not getting world-class returns on investment. In fact, Goldsmith thinks that the United States is in the fourth year of a 5-year run of declining life expectancy, with obesity, heart disease, and the opioid crisis only adding to the challenges. While Obamacare achieved the goal of adding 20 million more insured Americans, it also created a large shift away from independent providers and towards large hospital and healthcare systems that have a penchant for technocratic enthusiasm and quality matrices. Meanwhile, 28 million people still lack health insurance, about 45 million more have insurance with extremely high deductibles, and 74 million are on Medicaid—close to half the country.
Because of demographics and economics, Goldsmith predicts Medicaid will be a pivotal player for audiology in the future, “and Medicaid is a circus.” He notes that there are a host of things Medicaid does not currently cover, and Medicaid’s largest channel are “dual eligibile people”—those who are both old and poor.
Who will be audiology’s health partner in the future? Goldsmith ran through a list of likely “potential partners,” including ENT practices, primary care physicians, community health centers, hospital or integrated delivery systems, and mass merchandisers. Ultimately, he believes the answer will depend on the local market, and there will be no generic solution. However, he is bullish about the profession and the future as audiology—even given the fundamental affordability/accessibility challenge—and predicts it will continue to grow into a more integral and vital part of the healthcare landscape.
Other Great Events
AAA 2018 provided some amazing learning opportunities for Academy members, including the Judith Gravel Annual Vanderbilt Lecture presented by Charles Limb, MD; the Marion Downs Lecture in Pediatric Audiology presented by Dana Suskind, MD; panel discussions on “Current Trends in Audiology”, “The Great Debate: Is the Future of Audiology Retail or Medical?”, “Hearing Aids in Review: 2017”, as well as dozens of learning modules, grand rounds, mini-modules, industry updates, research podiums, and much more.
At its annual Honors Awards Banquet, the Academy also honored seven audiologists and industry leaders for their contributions to hearing healthcare:
- Susan Scollie, PhD, Marion Downs Award in Pediatrics;
- Laurie S. Eisenberg, PhD, Jerger Career Award for Research in Audiology;
- Ora Büerkli-Halevy, Samuel F. Lybarger Industry Award
- Jennifer E. Weber, AuD, Outstanding Educator Award
- Jamie M. Bogle, AuD, PhD, Outstanding Early-Career Audiologist Award
- Nora Stewart, MA, Humanitarian Award
- David A. Zapala, PhD, Honors of the Academy
Look for more event coverage of AAA 2018 on www.hearingreview.com.
AAA 2019 will be held in Columbus, Ohio, on March 27-30. For more information, visit www.audiology.org.