President's Message: Our Time to Shine

Author: Angela Morris, Au.D.

Things are changing fast for the profession of Audiology, and I feel it’s finally our time to shine. When our membership decided to fight the fight for the Audiology Patient Choice Act, we knew that the process would be long and hard— and that has certainly been the case. I believe that this year, however, is our year!! Your ADA board along with many amazing members have lobbied hard to get our bill introduced again, and we did it with a renewed energy and excitement. ADA, as an organization, has gained a newfound respect in Washington D.C., not only with legislators and committees, but also with federal agencies.

ADA’s supportive stance on the Over the Counter Hearing Aid Act has shown our government that Audiology is not a self-serving profession, but that we want what is best for the patient first, including the opportunity to go directly to the best care—and that is from Audiologists. We have made no bones about the fact that Audiologists play the most important role in the successful outcomes of our patients in all aspects of hearing health, including the fitting of an amplification device, no matter where the device comes from.

The Audiology Patient Choice Act, H.R. 2276, could not be in a better position. With the recommendations from the PCAST and NASEM reports, the direct access component of the bill has been given more credence. With the premise of the OTC bill being more access for hearing impaired, and the fact that the sponsors of this bill want it to be successful, ensuring that Medicare patients have access to Audiology, and all the services we are licensed to provide, is a natural fit.

We are showing legislators one by one that patients will not be successful with OTC products if they don’t have access to proper care and management from an Audiologist. As we see more and more sponsors sign on to the Audiology Patient Choice Act, we know our message is getting through.

Is there opposition to H.R. 2276? Absolutely! There is opposition from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), the ENT organization. However, we also have letters from ENTs, who actually work with us every day, that state that this legislation is the right way to go. Again, with the reports from independent bodies, including the Food & Drug Administration, who voluntarily stopped enforcing the medical evaluation requirement, because it has, “little to no clinical benefit, the argument about patient “safety” as it relates to direct access to audiologists is really a moot point.

OTC hearing aids have been a hot topic lately, and many people wonder why ADA has taken the position it has. I want to share with you, the reasons why I personally have supported the Over the Counter Hearing Aid Act, and why I approve ADA endorsing the legislation.

  1. Audiology has not, and cannot adequately serve the hearing impaired population—and over the past 30 years, we have not been able to improve hearing aid adoptions rates using the current model. There are people who live in areas where the closest Audiologist is three hours or more away. Do I think those folks should just go without any help at all for their hearing loss? The answer is no. There are many people that came to my practice who were not ready, nor did they need a traditional hearing aid. If I could give them something that was a few hundred bucks that would help a mild loss, then that is what I would do. I would rather be the one providing those products myself, of course, then sending them out my door to go find something online themselves. Then, when their hearing loss gets worse, which usually it does, they will be established patients who were completely satisfied that I have given them good information that allowed them to make an informed decision—a decision that was in their best interests, regardless of the immediate impact to my “sales” numbers. The marketing opportunities for Audiologists who add OTC products to their mix will be phenomenal. Increased cash flow potential is also an exciting thought if you are a practice owner.
  2. The next reason is related to the first. I want to see Congress open the marketplace and make prices more competitive so we as independent Audiologists can compete better in our markets. I do not fear that people would choose to go to an online source or buy from OTC somewhere else, if I am competitive on pricing for the hearing aid, and prove my worth for my services. I believe we should be charging transparently for our services. If we bundle, it gives no value to our services, and contrary to many beliefs, our time and abilities are very valuable. The fact that the OTC bill has recommended the removal of the medical waiver is exactly what our members have been asking for, for years. It no longer provides a mechanism to funnel patients away from audiologists. We want autonomy to see our patients, not only because we know we are fully capable of determining if a medical referral to a physician is necessary, but mainly for their convenience.
I have heard some say that ADA only supports OTC hearing aids, because it was going to happen anyway. While not exactly true, I will say that yes, we all agreed that this was going to happen. My position is that I would rather come up with ideas for our members, and try to get the most benefit for our members in this political climate as I can.

The board of ADA is committed to our members and to the advancement of practitioner excellence, high ethical standards, professional autonomy and sound business practices in the provision of quality audiologic care. Support of the OTC Hearing Aid Act is support for all of these principles. I want the profession of Audiology to flourish. It is my passion and it is why I have put so much time into working with the board of ADA.

Will practices need to change how they do business in an OTC environment? Definitely... But change can be good and fruitful. Change is the best remedy for stagnation. ADA has great members with great passion and dedication to our profession. If you have personally reviewed all of the evidence, and you still feel like there is no validity in supporting the OTC Hearing Aid Act, then I respect your informed decision. I only ask that you will give me the same consideration (I can assure you I have read and witnessed first-hand every detail).

Audiology is not the only health care profession that is changing to become more consumer driven. You can buy braces online with no orthodontist, download physical therapy exercises with no physical therapist, and by reading glasses at any drugstore with no optometrist.

Let’s face it, the real fear isn’t that the patient won’t be safe, it’s that our profession won’t, and that we will become obsolete. The fact is, there is no amount of lobbying or complaining that will prevent that from happening if we don’t adjust with the times.

What will we do when scientists discover a pharmaceutical formula that will eliminate hearing loss? Will we oppose that too, or will we be among the providers that prescribe it?