Your Story (June 2015)

Dr. Joseph Montano is Chief of Audiology and Speech Language Pathology at New York Presbyterian Hospital-Weill Cornell Medical Center. He received his M.A. degree from New York University, his Ed.D. in Audiology from Teacher's College Columbia University, and is certified in Audiology (CCC-A) through the American Speech Language Hearing Association (ASHA). He serves on the New York State Licensure Board and is a member of the ASHA Legislative Council.

Prior to coming to Weill Cornell, Dr. Montano was an Associate Professor at Long Island University/C.W. Post, and for 17 years was Director of the Department of Communication Disorders at Manhattan Eye, Ear, and Throat Hospital. Dr. Montano's clinical expertise is audiologic rehabilitation with particular interest in adjustment to adult onset hearing loss, hearing assistive technology systems and hearing aids. Although he is not owner of his practice, he brings an ownership mentality to it. This is especially apparent in his expertise in aural rehabilitation and counseling. His story has some valuable lessons for any audiologist aspiring to offer stand-alone rehab programs.

AP: Tell us about your medical center and what makes it unique?

JM: Weill Cornell Medical College is the academic affiliate of New York Presbyterian Cornell Medical Center. Our Audiology practice is housed across the street from the Hospital and is part of the faculty practice of Cornell. We serve a patient population characteristic of New York City’s diversity of cultures, socio-economic classes and ethnic backgrounds. Our program offers a full spectrum of audiology services ranging from hearing, balance and tinnitus assessment to rehabilitative services such as hearing aids, cochlear implants, auditory training/speechreading and communication groups. We strive to provide person-centered care for all interactions. In 2013, circumstances presented the opportunity to move again and this time to create our own space as the new home was just an empty shell. Since 1993, we had built the reputation as a Centre of Excellence, as the ‘drive-to destination’ for hearing care if you sought out the best. The latest move though presented a whole new opportunity where I could allow the designer side of my character to flourish.

I appreciate good design but have never seen a practice that puts as much effort into the environment as it does to the clinical side of things. Our clients hopefully embark on a life-changing, long-term journey with us, and I wanted to create an immersive experience that they could interact with.

AP: Describe a typical day or week in your practice. (how busy are you and what type of cases are you likely to encounter)

JM: Our audiology practice is fast paced and exciting. We have a staff of nine audiologists and seventeen otolaryngologists. The work environment is second to none. The relationship between physicians and audiologists is one of mutual respect with the audiologists the primary managers of all non-medical aspects of hearing rehabilitation. Schedules are planned and filled and of course, as in many practices, the need for flexibility is critical. Each day we are faced with patient add-ons from the physicians, hearing aid patient walk-ins, and emergency cases. In addition to the out-patient services, we are also responsible for any in-patient hearing evaluations and ototoxic treatment screenings. Somehow, with all the hustle and bustle, we find the time to provide quality care to our patients.

AP: What are some of the services or approaches you and your staff use that stand out from other audiology clinics?

JM: My practice, within our department, is primarily rehabilitative and consists of hearing counseling, amplification fitting and patient management. My approach to hearing aids is rather basic, the instrument is only a tool in the rehabilitative process. I take a counseling approach to the hearing aid fitting process and spend much less time talking about hearing aids and more time exploring the impact of the hearing loss and listening to the patient story. Self-assessment is performed face-to-face and items are discussed when issues are identified. The information obtained through self-assessment and counseling is, to me, significantly more valuable than the numbers on the audiogram.

AP: Tell us about your career. Where did you receive your training and who are some of your influences?

JM: I’ve been practicing as an audiologist since 1977. Early in my career I realized I was interested in audiologic rehabilitation; in fact, I ran my first AR group with Down Syndrome adults during my CFY. I’ve spent most of my career in clinical practice (Manhattan Eye Ear and Throat Hospital and Weill Cornell Medical College) and academia (Long Island University, C.W. Post). I became a member of the Academy of Rehabilitative Audiology in 1983 and knew I had found my professional home. When I think of the major influences in my career, three people come to mind: Maurice Miller, my professor at NYU during my Master’s degree training, Ira Ventry, who encouraged my exploration of AR as a dissertation topic and, Mark Ross, who to this day, exemplifies to me, the heart and soul of audiology.

AP: What advice do you have for aspiring audiologists?

JM: We continue to hear about the ever changing health care landscape with some predicting gloom and doom because of competitors such as big box stores, online hearing aid sales and physician dispensers. I don’t feel that way at all. In fact, bring ‘em on. When you realize that the art and skill of managing a patient’s hearing loss is within the audiologist, the importance of who sells a hearing aid is minimized. We are the product. Developing a career as an audiologist with a patient-centered mindset will enable you provide the quality care that patients will seek.