Advocacy in Audiology: Influencing Policy & Patient Care During Uncertain Times
Author: Angela Morris, Au.D.
Advocacy is an important aspect of any profession. It is, in many ways, what keeps the profession viable, informed, and relevant to patient and practice needs regarding economic, social, or political issues. Advocacy raises awareness, creates change, and may further an entire professional movement. This is especially critical during uncertain times when patients and providers alike are unsure about the future.
A provider’s role and ethical responsibility does not stop with patient care in the clinic. For physicians, it is clear in the American Medical Association (AMA) Code of Medical Ethics that “physicians, individually and collectively through their professional organizations and institutions, should participate in the political process as advocates for patients (or support those who do) so as to diminish financial obstacles to access health care” and that “the medical profession must work to ensure that societal decisions about the distribution of health resources safeguard the interests of all patients and promote access to health services.”1
Many other professions, such as pharmacists, believe it is the provider’s professional responsibility to be a part of advocacy efforts. The position statement on advocacy as a professional obligation by the American Society of Health-System Pharmacists (ASHP) states in the first line that “ASHP believes that all pharmacists have a professional obligation to advocate on behalf of patients and the profession.”2
When issues within the profession of audiology arise, it is imperative that audiologists as a whole advocate for their value as healthcare practitioners. Examples can be anything from payment of professional services to ensuring that patients receive proper treatment and care, to confirming that patients are being seen by the appropriately licensed providers in an ethical manner. Advocacy becomes even more critical during uncertain economic times. Policy makers at the local, state, and federal levels must be constantly reminded that our profession makes a positive difference in the lives of many of the most vulnerable members of our population. Further, it is our professional obligation to clearly communicate the scientific evidence that supports prevention and early interventions, which extend the quality of life and other health-related benefits to underserved people in their communities.
Beyond daily activities in the clinic, advocacy could be endorsing the reclassification of audiologists as limited licensed practitioners within the Medicare system. For example, policy makers must be familiar with data demonstrating that audiologists provide thorough, accurate, and cost-effective diagnostic services to persons with suspected ear pathology.3 It is the responsibility of the audiologist advocate to share scientific evidence to support advocacy initiatives, with local, state and federal legislators and agencies.
There is one additional component of advocacy--promoting the high quality of care your own practice provides members of your community. Many view these types of activities merely as marketing initiatives. Yes, some methods of advocating can be perceived as advertising or marketing, but these business tactics also represent another type of advocacy. For example, you can go to your local social, business, professional clubs in your area and talk about hearing loss, how hearing loss can affect the hearing-impaired person and their family, and advocate for regular screening. This type of advocacy could be perceived as an advertisement for your business; however, when you focus on science that indicates preventive care, such as periodic hearing screening and use of hearing protection, slows the trajectory of hearing loss, you are engaging in community advocacy that benefits all citizens.
You could also give back to the community in many ways, by doing fundraisers, helping sports teams, doing health fairs, etc. – all activities done not for the purpose of business promotion, but for the promotion of good hearing health and access for persons with hearing loss. It is all about the message. Instead of only promoting your business name on a high school ball field billboard, as an advocate you might use messaging to inform the audience, such as “Did you know hearing loss affects…” In this way, you are educating, contributing to the health and wellness of your community, and advocating for your practice and profession all in this one activity. This is the area of advocacy where you can think outside the box and see what the needs are in your community for topics related to hearing health.
Most widespread advocacy efforts for hearing health are undertaken by, or in collaboration with, professional organizations representing healthcare providers, industry stakeholders, or consumers who are impacted by hearing loss. There are at least 12 national associations representing audiologists, including the Academy of Doctors of Audiology (ADA). Every organization has its own unique agenda and objectives to consider when prioritizing advocacy efforts. It is, therefore, extremely important to research each organization and what they believe in and stand for and make sure that it is in alignment with your core values and the direction that you want your profession to go, before supporting their efforts.
In addition to joining and supporting at least one national organization, it is also extremely important for all audiologists to join their state audiology organization, if one exists. State organizations play a critical role in scope of practice and licensure issues, while the national organizations are focused on issues such as Medicare reimbursement and other federal issues.
Advocacy is your obligation as a professional, and it goes beyond simply paying annual dues to a professional organization. It warrants direct, personal involvement and often additional nominal financial investments. If you had an issue in your practice that was potentially also affecting other practices, but you had to retain an attorney to get some resolution, wouldn’t you rather share the costs with other professionals, instead of paying them all yourself? It is the same with advocacy—combining and leveraging the resources of all audiologists across the state and/or nation, makes our voice much stronger than if we all try to go it alone.
There are various ways that you can help with advocacy efforts. Of course, one of the most important ways is by contributing financially to help cover the costs of lobbyists and advocacy professionals, who specialize in legislative or regulatory issues at the state or federal level. Your annual membership dues do not typically cover these costs, at least not in totality and without these “boots on the ground” it is very difficult to advance initiatives. Unfortunately, it is estimated that 75% of audiologists do not make financial contributions to support advocacy efforts that protect their profession. As dedicated professionals, we cannot sit back and hope that others will take care of it. We all need to do our part to take responsibility for the advancement of profession we chose and the patients we serve. This is especially true during these unsettling times when COVID-19 and an economic recession threaten to upend how audiology is practiced.
Setting aside time to meet with state or federal policymakers and their staff is another way to advocate. Visiting Washington D.C. or your state government offices personally and setting up meetings with your representatives is one of the most effective ways to advocate. As a constituent, your visit means a potential vote. Your representative also recognizes that you can influence other people in their district as well. Representatives genuinely want to understand how policies affect their constituents. Their job is to make life better for their regions and if you have an issue that is a potential problem, the representative should want to try to fix it if they can.
Inviting government representatives to your practice, when they are back in their home district, is also a great way to support advocacy efforts. Representatives oftentimes like to meet with advocates as it is a good photo opportunity for them when they are getting out in the community. Most government representatives also want to provide meaningful help to the communities they serve.
Writing letters and calling legislative and regulatory offices to advocate for specific issues is another way that audiologists can help with advocacy initiatives. Most organizations have a template set up if the provider does not feel they know exactly what to say or write. Most of these activities take about two minutes to complete, but the effect this has on an issue can be substantial. The more a representative can see that an issue is affecting their constituents; the more attention and importance the issue will be given.
If you are a recent graduate or an audiologist with less than ten years of experience, you need to know that your future profession can be greatly influenced by your active involvement with an advocacy group. This involvement can take many forms of commitment including the investment of time, money, or expertise. The critical point is that to improve the standing of the audiology profession or to reach more persons with hearing loss in need of high-quality care, all audiologists must be actively engaged in advocacy efforts. We all play a role in shaping the profession in a positive way. Now is the time to make the leap.
References
- American Medical Association. AMA Code of Medical Ethics opinion 11.1.4 ((b) and (c)).
- American Society of Health-System Pharmacists. Government, Law and Regulation. Pg. 245.
- Zapala, D. J Am Acad Audiol 2010 Jun;21(6):365-79.