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Private Practice Headed for a Cliff?

Discussion in 'Audiology [ Au.D ]' started by White Noise, Jun 15, 2012.

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  1. White Noise

    White Noise

    May 14, 2012
    When the Student Doctor Network (SDN) recently interviewed the past-president of the American Academy of Audiology, Alison Grimes (Au.D.), I was taken aback by the response she gave to the question “where do you see audiology in ten years?” She replied, “I think we are at a crossroads. As long as the primary driver of profitability in private practice is the sale of hearing aids, we are headed for a cliff.” Perhaps Dr. Grimes was being slightly dramatic, but it seems obvious that the hearing aid market will continue to move online as more people purchase hearing aids on the internet. Recently, when Dr. Gregory Frazer (Au.D.) was asked the same question by the SDN, he said, “I see private practice audiology ending and audiology being controlled by large corporations or insurance companies or ACOs.” My question is will audiology continue to be a lucrative field if online hearing aid sales become the norm and what does it mean for our profession if private practice audiology ceases to exist? More importantly, should I be worried about pursuing a degree in a field that’s slowly losing its primary means of profitability?
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  3. TheEarDoc

    TheEarDoc Au.D., CCC-A, F-AAA 5+ Year Member

    Dec 28, 2010
    The dirty south
    Well, in my opinion we have a couple big hurdles we need to jump if our field is to be worth the education.

    1. We need to sunset hearing aid dealers. Yes there are great dealers and there are more bad dealers than good (in my opinion and experience), and yes there are bad audiologists too, but I feel like in most states the penalties for doing shady business are more severe for audiologists than hearing aid dealers. We need to sunset dealers and make audiologists be the only ones able to dispense hearing aids. This will do a few things, some of which are self-serving, but some are beneficial to patients too.

    1. We will corner the market to be sure we remain viable. If we are the only providers able to dispense hearing aids then we will increase the demand for our services, as demand increases, profits will increase through shear numbers of patients.

    2. Increase demand will equal increased awareness for our field. I am still amazed how many people still ask what I do after I say I am an audiologist. I remember being at a party and a few people walking over to me and saying, "hey we heard that you have the same job as so and so (so and so was a hearing aid dealer in the area), but she doesn't have a doctorate in her field.". It was quite frustrating to have to explain why I had to earn a doctorate in my field to do the same things in the eyes of a patient that someone with a high school diploma and little training does.

    3. Increased demand will equal increased awareness, which will need to increased respect. Most patients who come to me after dealing with hearing aid dispensers and dealers remark at how much more knowledgeable I am and how the experience was much better.

    4. Our patients will get care from people who are trained to find things other than sensorineural hearing loss. I grow so tired of seeing pure tone audios from dealers that were done in open offices while other noises are present and considered viable results by dealers! I have lost count of the amount of people with moderate losses I've seen who had conductive losses that were cured with PE tubes or minor surgery instead of paying 6k for hearing aids that the dealer wanted to sell them! I have seen a couple of acoustic neuroma patients that were missed by dealers that warranted surgery. 1 of which was a CPA tumor and could have done serious damage.

    If insurance companies do jump on the bandwagon to start offering hearing aid coverage (which many have now begun to Anthem, United Healthcare, Humana have all begun this in many states), then we need to be the ones sitting down at the table to explain why limiting someone to economy digital only is not a good idea. We need to be working hand in hand to explain why dealers and online sales will not work for hearing aids! We need to be the ones sitting down with the big wigs at hospitals when they do insurance contract negotiations so we aren't agreeing to provide high end digital hearing aids for the price of low end digitals and making $0 profit. This will tank an audiology program in many hospitals and basically cause audiologists to work themselves out of a job.

    Dr. Grimes is right we are at a crossroads and the cliff is getting near. We need to take the reigns and tell insurance companies, state boards, and federal insurance programs, that we are the experts in hearing and balance healthcare and that anything that bypasses us is a violation of healthcare law.

    Unless insurance companies are going to start letting high school graduates perform medication dispensing and prescription writing, then they need to listen to us for the healthcare we provide.
  4. CIAuD

    CIAuD 2+ Year Member

    Aug 4, 2011
    Outstanding. Thank you. Good to hear this from a practicing professional!
  5. Ducco Cement

    Ducco Cement

    Sep 20, 2012
    I believe the insurance companies are trying to take over, but once someone purchases a hearing aid via the internet, someone must program it. Then, sending it back and forth to have adjustments made is not really viable. I believe audiologists need to educate and ADVERTISE, market to the public to really keep private practices alive.

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