Audiology Career Outlook

[MedLove _02]

Hello!
I am a communication disorders student who is currently contemplating what path I should take after my undergraduate degree. I have always had a passion for medicine because I really enjoy helping people, however math and science were never my particular strong suits. While science I can definitely work with, math seems to be something that just does not stick with me.

Now that being said, I have always excelled in English and written language. I thought that what better way to combine my interest in medicine and language than to major in communication disorders: I would get to help people, and be part of a medical team in addition to dwelling in my strengths. As I am progressing in my com dis program, I have been really drawn to Audiology, and I love the idea of being able to treat patients, potentially opening my own clinic, etc.

As I have done more research on the AuD profession, it seems like a lot of individuals have nothing but bad news or less than stellar results in their endeavors after graduating. I've even seen graduates posting that they would not recommend the field to anyone which is sad because I really feel this would be a dream job for someone like myself. Id like to hear your experiences regarding employment and career opportunities presented in the following years after graduation, or during grad school.

1: Is the salary competitive? (I dont need to be rich my any means, but Id like to be able to provide for a family and live comfortably and pay off loans etc.)

2: How is the work life balance? ( This kind of ties into wanting a family and being able to provide, etc.)

3: Is there any hope of opening an independent clinic? (I've been hearing that its relatively hard to get one established and profitable?)

4: Do you feel that there is an over saturation of Audiologists out there?

5: I have also seen concerns about ENT practices and commercial stores (Like CVS) offering hearing aid repairing/ hearing screenings on a mass level, thus reducing the need for Audiologists. Do you feel that this is something that will become more common in the future?

Any information at all about the profession would be greatly appreciated, these questions listed above are just a few that I've seen discussed and debated on multiple forums.


Thank you all for reading!

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[pumpkinhead]

It is not a field I would recommend anyone investing in at this point in time. Your concerns are all very valid. You need to obtain information from people in the field, and NOT from faculty at AuD programs. They will paint a very rosy picture of the field, talk about status, etc. . It is very ivory tower and not at all grounded in the real world. Remember, they promote the program to save their jobs. No AuD students = no professors.

Professional forums are filled with posts by audiologists who have loved their fields, but are desperate to survive until they can retire or sell their practice. Manufacturers and buying groups dominate. Having a successful private practice is extremely hard, if not impossible. The rise of third party administrators holding a large demographic of patients "hostage" to obtain their hearing aids from participating providers eliminates your ability to establish patients. I do mean large demographic. Think of everyone in the Teacher's union, or the entire Blue Cross/Blue Shield population in a state. You cannot join and become a provider because if you do so, you will be operating at a financial loss - limited to a tiny fitting fee, after which you must provide "free hearing tests and free follow up care" for several years, after which you cannot charge more than $35 a visit. No balance billing to patients. Existing on diagnostic fees along is not an option, reimbursement seems to decrease each year for specialty tests such as ABR, vestibular, audiologicals. There is a huge surplus of new AuD graduates, many whom call looking for per diem work because they cannot attract enough patients for their new practices. Or AuD students interviewing, shocked because they cannot command the salary that "their education entitles."

Patients cannot be seen directly by an audiologist and have their hearing tests paid for by Medicare. Direct access is unlikely to EVER happen. Audiology professional groups are at odds with each other; AAA vs. ASHA, ADA vs. AAA. With such infighting, no wonder no progress has been made with lobbying. If as a profession, people cannot agree, who in DC is inclined to listen to what is, a drop in the fiscal budget anyway?

If you look at Audiology professional magazines, the general theme of many articles is "survival" and "how much longer before we are extinct". There's a very good reason. Big Box stores like Costco can buy hearing aids at a third of what an audiologist in private practice can......we cannot compete. Consumers pay attention to the bottom dollar. CVS service delivery is definitely coming. Help wanted ads read "Audiologist or hearing aid dispenser". They would really prefer the cheaper hearing aid dispenser.

As to being called "Doctor"; unfortunately, if you work with MD's (who secretly, no matter how progressive they may seem, are snickering because they view you as a technician anyway), the majority do not like the title being used, and are quick to point out that they can hire a technician anyway, because after all, you just do audiograms anyway (very true-many a doctoral student has said "I got my Master's/ doctoral degree to push buttons?). They stop doing vestibular tests because they don't get payment, balance centers close and don't justify operating costs. But, they keep the audiologist because they can bill Medicare for testing and they hope for hearing aid sales.

There will always be specialty pockets that will remain "safe" - Veteran's Administration, Pediatrics, Cochlear Implants, possibly educational audiology (shrinking school budgets mean fewer staff, more paperwork, less diagnostics and patient care). But may have abandoned clinical practice very early, probably a wise move. I mean, just take a look at all the Sales Representatives at hearing aid companies. Many have an AuD. The full scope of practice potential is seldom realized for many audiologists.

There are other fields where your work and money will serve you better. You will be in the hock to loans for a very long time, with salaries very low compared to what you spent.

Full time salaries in hospitals, etc. are not amazing. For as much money as you put into an AuD, take a look at ASHA and AAA's annual salary reports. Cost benefit analysis = not worth it.

Sorry to be a downer, but I am here in the trenches. If you are a good writer, marketing in healthcare in business. Or for clinical work, nurse practicioner CRNP, OT or PT, or SLP. Lots more options, all those fields have good potential for per diem work for life/family balance.
Sorry to be so reality based. . . . .but you can still chart a new course.

 

[AuDacity]

There will always be specialty pockets that will remain "safe" - Veteran's Administration, Pediatrics, Cochlear Implants, possibly educational audiology (shrinking school budgets mean fewer staff, more paperwork, less diagnostics and patient care). But may have abandoned clinical practice very early, probably a wise move. I mean, just take a look at all the Sales Representatives at hearing aid companies. Many have an AuD. The full scope of practice potential is seldom realized for many audiologists.

There are other fields where your work and money will serve you better. You will be in the hock to loans for a very long time, with salaries very low compared to what you spent.

Full time salaries in hospitals, etc. are not amazing. For as much money as you put into an AuD, take a look at ASHA and AAA's annual salary reports. Cost benefit analysis = not worth it.

Sorry to be a downer, but I am here in the trenches. If you are a good writer, marketing in healthcare in business. Or for clinical work, nurse practicioner CRNP, OT or PT, or SLP. Lots more options, all those fields have good potential for per diem work for life/family balance.
Sorry to be so reality based. . . . .but you can still chart a new course.

Just to put a bit of a spin on this towards the positive, I currently am in Government services for Audiology, but I have had a brief stint in at least a few other areas. This means I am no expert on those areas, but I interact with Audiologists across the field enough that either they are a very vocal minority, or these issues are very accurately reported above.

I can agree with a large majority of what was stated in this very well-written post. Unlike many of the anti-Audiology posts in this forum that you can find scrolling back though the various threads, it is specific enough that it is clearly someone who understands the problems facing the field, as opposed to a bystander throwing out vague concerns about "money" or "respect".

The reason I led off with what I stated before is that I do several things that make the job personally fulfilling. Primarily, in government you (currently) are allowed to perform the majority of your scope of practice. I realized very early on that, while PP and Big Box have their places, it is not possible for me to personally enjoy doing audios + hearing aids + some dabbling in marketing. There are people that can be fulfilled by that. Some of those people will be able to run a cost:benefit analysis of their loans and make out on top.

Some of the benefits of government Audiology:
It's not Medicare, just Medicare-like - This is the big one. Medicare will require a large push by Audiology organizations to benefit Audiologists. Being as much larger, more cohesive professions are still seeing reimbursement tank, don't expect Audiology to be a dark horse. Medicare also isn't going to allow direct access. VA allows a version of direct access, so there's a win there. Most importantly of all, if Medicare doesn't want to support anything but diagnostics, and diagnostics won't keep a private practices' doors open, why should anyone deal with Medicare? It's an unfortunate place for Audiology to be, and the boat was clearly missed several decades ago - explaining why there are diagnostic codes for the SISI, Lombard Test, and Bekesy Audiometry, but not things such as vHIT, Vestibular Rehab, Tinnitus Rehab, or specific codes for VEMPs.

The salary is good, and it only gets better. But that is specifically because of the expectation you will reduce your Audiology experience and take on a managerial role. If you are a GS-employee (federal civilian), you will be able to see your salary far into the future. It isn't great, with GS-13 topping out (depending on where you are) where you'd expect a mid-career optometrist to be, but other government options that are not GS, such as military, scale in a much more rapid manner. You just need to know what risk comes inherent to that. Manufacturing can be highly lucrative, and you need strong communication skills for that.

The Ivory Tower paradigm seems to exist not just in University, but also in the national organizations. If you come into this field, it's possible that younger Audiologists will have to provide much of the energy to create cohesion in the disparate national organizations, because it honestly isn't happening right now. The reason I bring this up is because neither the national organizations, nor many university settings, are going to give you any experience relevant to the fields I have mentioned.

There is a lot of possibility in Audiology, still, but most of the energy from practitioners seems to die out in only a few years of participation in the field. That should speak to the paradigm difference between what is taught versus what the actual field experiences.

 

[TheEarDoc]

Just to put a bit of a spin on this towards the positive, I currently am in Government services for Audiology, but I have had a brief stint in at least a few other areas. This means I am no expert on those areas, but I interact with Audiologists across the field enough that either they are a very vocal minority, or these issues are very accurately reported above.

I can agree with a large majority of what was stated in this very well-written post. Unlike many of the anti-Audiology posts in this forum that you can find scrolling back though the various threads, it is specific enough that it is clearly someone who understands the problems facing the field, as opposed to a bystander throwing out vague concerns about "money" or "respect".

The reason I led off with what I stated before is that I do several things that make the job personally fulfilling. Primarily, in government you (currently) are allowed to perform the majority of your scope of practice. I realized very early on that, while PP and Big Box have their places, it is not possible for me to personally enjoy doing audios + hearing aids + some dabbling in marketing. There are people that can be fulfilled by that. Some of those people will be able to run a cost:benefit analysis of their loans and make out on top.

Some of the benefits of government Audiology:
It's not Medicare, just Medicare-like - This is the big one. Medicare will require a large push by Audiology organizations to benefit Audiologists. Being as much larger, more cohesive professions are still seeing reimbursement tank, don't expect Audiology to be a dark horse. Medicare also isn't going to allow direct access. VA allows a version of direct access, so there's a win there. Most importantly of all, if Medicare doesn't want to support anything but diagnostics, and diagnostics won't keep a private practices' doors open, why should anyone deal with Medicare? It's an unfortunate place for Audiology to be, and the boat was clearly missed several decades ago - explaining why there are diagnostic codes for the SISI, Lombard Test, and Bekesy Audiometry, but not things such as vHIT, Vestibular Rehab, Tinnitus Rehab, or specific codes for VEMPs.

The salary is good, and it only gets better. But that is specifically because of the expectation you will reduce your Audiology experience and take on a managerial role. If you are a GS-employee (federal civilian), you will be able to see your salary far into the future. It isn't great, with GS-13 topping out (depending on where you are) where you'd expect a mid-career optometrist to be, but other government options that are not GS, such as military, scale in a much more rapid manner. You just need to know what risk comes inherent to that. Manufacturing can be highly lucrative, and you need strong communication skills for that.

The Ivory Tower paradigm seems to exist not just in University, but also in the national organizations. If you come into this field, it's possible that younger Audiologists will have to provide much of the energy to create cohesion in the disparate national organizations, because it honestly isn't happening right now. The reason I bring this up is because neither the national organizations, nor many university settings, are going to give you any experience relevant to the fields I have mentioned.

There is a lot of possibility in Audiology, still, but most of the energy from practitioners seems to die out in only a few years of participation in the field. That should speak to the paradigm difference between what is taught versus what the actual field experiences.

I too have been in practice for over 5 years. I've been around here for over 7 years. I've done several jobs besides audiology. I've also had several jobs in Audiology in various settings. I've been in the university clinic setting. I've worked regional hospitals in rural areas. I've worked for large university hospital systems. I've worked in multiple VA facilities.

I am currently working in a VA facility and have been with the VA for awhile now. I think it's one of the best places to be as an audiologist. You don't have to sell a widget. You get to practice your full scope of practice in most VA's (not always. I know some VA's I was not allowed to do CI's or balance testing, but others were). I also have supervised many students and been at facilities where I was not allowed to do so. I really think the big issue with the VA is there is a saying. "If you've seen one VA you've seen one VA". It holds a lot of water! Every VA I have worked at has been different. It shouldn't be that way, but it is.

I will agree the salary and benefits are great. The frustration I have with VA audiology is you hire as a GS-12 and you retire as a GS-12 unless you are lucky enough to be at a large enough facility that gives you GS-13 status for supervising students or practicing a specialty such as vestibular or CI or you slide into a chief slot somewhere. I still think the VA is one of the best places to work as an audiologist though.

 

[TheEarDoc]

Oh and my suggestion to young audiologists is this: GET INVOLVED IN YOUR STATE AND NATIONAL ORGANIZATIONS!!!!!!

I hear too much bellyaching from other audiologists who never volunteer their time for state or national boards/organizations and they can't even give $5-10 for lobbying efforts for their profession, but they won't contribute anything.