Questioning Audiology

[serena8976]

I'm not even half way through my Au.D program at this point and I have so many doubts and frustrations about this field I don't even know where to begin. I am so disheartened for my future in this profession. I don't even know if this post will do all my thoughts/feelings about audiology justice so here goes nothing...
1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.
2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.
3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.
4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.
5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?
6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.
7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)
8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.

Well, glad that's off my chest. This profession has so much potential, but I don't see anything changing. These are all issues I have raised to my classmates and they are all (except maybe 2 or 3) so aloof to the issues our profession faces they won't even entertain these ideas. How are we to ignite change with such complacent people? This seems to be a trend in audiology honestly and it needs to change! I want to talk to my professors, but since audiology is such a small field I'm afraid I will offend them with my opinions and I'll be blacklisted in the profession somehow.

I don't know what I'm looking for posting this, I want to see if any other students feel the same way. I want to know other students care so maybe we can do something about these issues in the future if I even stay in this profession. I plan to finish out my Au.D because I've already invested too much time and money. Of course there are things I enjoy about this field to have committed to my program. I think about med school all the time. I've looked into post-bacs/MCATs/shadowing/etc. BUT from what I've read it's frowned upon to drop out of a grad program then apply to med school, so I'm finishing my Au.D. I don't know, I just can't accept these issues and this pathetic salary. I regret going into this field in the first place, I should have done my research years ago, I really only have myself to blame.

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[DefEarRing]

You’ve brought up some great points, imo. I’m not in grad school, I’m a sophomore in CSD/Deaf education, but I’ve done tons and tons of research about this career. It is growing and eventually we may receive the recognition we deserve.

My reasoning for going into this field was more of a personal matter but nonetheless to help others like me, and many more not like me. No amount of money will deter me although it does seem unfair to pay so much in student tuition/loans and not make much in the professional world. But it is, what it is. Maybe some people are acceptingthe lower wages because it keeps them closer to their family? {shrug} If I wanted to be back in Oklahoma (from the east coast) then I would take at least a $20,000 salary cut. It is cheaper to live there though, and starting pay would be something like $73,000. I could live happily on that, with my three children. Here my starting pay could be $80,000 depending on where I go. Walter Reed hires Audiologist’s starting at $100,000.

It’s okay to feel upset about all the things you’ve stated. I would suggest a mission trip to find your passion in this field. Sometimes we just need a reboot on perspective.

“Blindness keeps people from things, deafness keeps people from people.”

 

[TheEarDoc]

I'm not even half way through my Au.D program at this point and I have so many doubts and frustrations about this field I don't even know where to begin. I am so disheartened for my future in this profession. I don't even know if this post will do all my thoughts/feelings about audiology justice so here goes nothing...
1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.
2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.
3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.
4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.
5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?
6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.
7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)
8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.

Well, glad that's off my chest. This profession has so much potential, but I don't see anything changing. These are all issues I have raised to my classmates and they are all (except maybe 2 or 3) so aloof to the issues our profession faces they won't even entertain these ideas. How are we to ignite change with such complacent people? This seems to be a trend in audiology honestly and it needs to change! I want to talk to my professors, but since audiology is such a small field I'm afraid I will offend them with my opinions and I'll be blacklisted in the profession somehow.

I don't know what I'm looking for posting this, I want to see if any other students feel the same way. I want to know other students care so maybe we can do something about these issues in the future if I even stay in this profession. I plan to finish out my Au.D because I've already invested too much time and money. Of course there are things I enjoy about this field to have committed to my program. I think about med school all the time. I've looked into post-bacs/MCATs/shadowing/etc. BUT from what I've read it's frowned upon to drop out of a grad program then apply to med school, so I'm finishing my Au.D. I don't know, I just can't accept these issues and this pathetic salary. I regret going into this field in the first place, I should have done my research years ago, I really only have myself to blame.

1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.

- I agree our salary is pretty low considering the amount of schooling required. I think our programs should be 3 years for a doctorate and then a 4th year externship as a doctorate level audiologist. This is how many other fields do it. We do not need to be 4 years in graduate school and paying a school tuition during the 4th year while doing an externship. I think part of the reason the salary is so low is because many of the master's level audiologists have not left the field and the biggest reason is hearing aid dispensers can do the same job with just having a GED and being VD free. The dealers will never be pushed out because they actually have a strong lobby and their members actually donate to their PAC. It's pathetic how many audiologists piss and moan about issues in audiology, but never even donate $5 to their professional organization's political action committees. Sorry, but in legislation money talks.
- The other reason our field suffers salary wise (and not to sound sexist because I am not in the slightest!), but we
are a profession dominated by one gender. Many audiologists are female and I know many that decided to take a few
years off to be stay at home mothers. No judgement here. I think if you can financially stay home with your children in
their younger years and want to that's amazing! This does drive down the wages though for our field as many of these
same folks will take whatever they can get when they jump back into the field after a break to raise children. Maybe
if we were a more gender neutral field you wouldn't see this issue?

2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.

- I don't think anyone who joins this field goes into it thinking they will be a medical doctor. IF they do then they are in the wrong field and are going to be in for a rude awakening. I know more medicine as a previous nursing student than most 10+ years in the career field audiologists do. Dental hygienists do make more. Why? Because Dentists make much more and they are better reimbursed. Reimbursement matters. See point 1 about donating to the PAC. You want better reimbursement? You need your legislators to do that.

3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.

- Nope never felt challenged at all. Then again I was a pre-med major with a Bio degree and Psych degree. I was
able to go to med school or grad school for psych (the PsyD was not around then and I had no desire to get a PhD otherwise I would be a psychologist now probably)
- We need to remove the CSD pathway to audiology. I'm sorry, but the CSD degree is a joke at most schools. I see
lots of 3.8-4.0 CSD students who have no basic grasp of physics, biology, chemistry, etc.. If I were on a selection
committee for graduate programs I would take the Au.D. prospect with a hard science degree with a 3.0-3.5 over the
3.8-4.0 CSD major any day because they will be a better prepared student
- Audiology in theory is a very simple field. You can be a jack of all trades general practitioner in Audiology without
much huge in depth education and function fine. Will you be an awesome audiologist with this attitude? No, but you
will function fine. The material is not hard. It's your bedside manner, how well you can counsel patients, etc. that
makes a good audiologist. Sorry you don't learn that in school. You are usually born with this aspect of it

4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.

- Yep hard science pre-med degree with electives in CSD is what each program should be (see above). I personally ended
up in Audiology because I felt it was the right blend of hard science, lifelong learning (keeping up with hearing aid
features/programs/etc. is a job!), and counseling (from my desire for Psychology). I also love the aspect of not being
on call, not having to deal so much with infection issues because I am not dealing with as many bodily fluids (sorry
if you've never been crapped on by someone other than your own child then you truly don't understand what the
medical field is like haha) as I was in nursing or worrying about needle sticks, etc.. I also love I am not on call. I work
a 9-5 with a pretty laid back day. My medical doctor colleagues and nursing colleagues can't say the same

5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?

- Yep grad school is pretty easy to get into for audiology as there are so many programs. I believe Dr. Jerger at
one point wanted to close many programs and make it more selective. He had his own agenda of course for this (We
all know his program would be one that no way would be shut down), but yes there are many programs churning out
plenty of young naive audiologists who are happy to take a petty salary and stay there. Maybe if we had fewer programs
it would mean less audiologists and hire salary, but we also need to look at the other possible issue. If there is not enough
providers to meet patient needs (and this is the case in many places) the legislators will pick quantity over quality. We saw
this in the VA system when wait times started moving out and then our wonderful legislators started trying to let hearing
aid dealers fit veterans instead of hiring more audiologists. So it can go both ways.

6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.

- Because the fitting laws and many insurance companies require an license in audiology to do so (see PAC comments
above). Your scope of practice is defined by your state licensure board. Hence why every audiologist needs to belong
to and be active in their state organization because that's where shady things happen before they occur on a national
level. Yes hearing aid dispensers can be hired and used, but in many states they cannot bill for the audiometric testing.
They also can't do much of our specialized testing. Most ENT's who use dispensers for their hearing aids are low level
ENT's who are the stereotypical ENT that you hear about in audiology school. Most of the ENT's I worked with (and it's
been many over the years) respected me as a peer and trusted my judgement and opinion and paid me as such

7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)

See above comment

8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.

- Ahhhhhh ASHA the consistent producer of untruthful information. We as a profession have 4 major professional
organizations and they like to fight each other. ASHA doesn't like AAA and most audiologists don't like ASHA
because many of use don't see their value because we pay a huge amount of money and they seem to do nothing
for us and keep perpetuating the myth that if you don't have your CCC-A you aren't a competent audiologist which is
false. AAA does help our field, but I don't always agree with them. ADA seems to hate both AAA and ASHA. ABA seems
to be a good program, but could use some beefing up to be a viable option for people over ASHA C's.

Yes this field has a lot of potential, but needs to expand it's scope of practice. I spoke at a conference for a state and discussed that our field needs to move into the mid level practitioner role more and diagnose and treat middle ear infections with antibiotics. You wouldn't believe the backlash I received! Many said "well I didn't become a doctor because I didn't want to deal with medications!". Well it could be part of your scope of practice (which would improve your usefulness to other medical providers, improve your efficiency with patient care, etc.. I argued how many audiologists do tinnitus therapy, do vestibular testing, do vestibular therapy/rehab, do telehealth audiology? Most don't, but it's part of your scope of practice. You can choose to do your full scope or only part of your scope, but the important thing is if it's in your scope you can do it. With a wider scope you can increase salary. Now the down side is, when you start dispensing medication you open yourself up more to liability. Meaning your liability insurance is going to go way up. So I think our field being a young field has a long way to go. In my lifetime it might happen, but who knows.

 

[JMAuD]

Hi Serena,


I appreciate your input and completely understand where you’re coming from. I finished my AuD last year and have had the same questions and validation issues you’re going through now, so I thought I’d weigh in:


1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.


This is preferential, but I believe part of the reason why our pay is low is because we have lost the art of the private practice. If you look at growing statistics it’s easy to see that private practice AuD’s are making more money, especially when done right. Some might say, “Yeah, but I have to sell hearing aids to do that.” Yes, hearing aids can be a huge money maker. I’m in private practice (I came into an established practice) and hearing aids are about a 1/10 of what I do. My clinic has me doing educational events that I get payed for, industrial Audiology, pediatric Audiology, Audiology in music, as well as continued clinical research. We believe in the art of Audiology not the sales portion. I know this is rare, but I came in making six figures because I negotiated my worth. You can’t put a price tag on quality care and work ethic (but I did and I got what I thought I was worth).


2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.


Correct, you’re not a physician, but you do have the highest degree in your field, which makes you a doctor of Audiology. Don’t pretend that you’re a medical doctor (I know AuD’s that do). They are wildly outside of their scope and it never ends well for them. I’ve learned that to get in with the physicians in my city I have to present my field to them in a professional matter. No matter the area of the body we’re dealing with, whether medicine or Audiology, we have to be the experts in that. At the end of the day, an MD is a trade doctoral degree just as much as an AuD is. We are taught a skill and are to execute that skill to better help patients. Establishing yourself as an expert, i.e. educating yourself continually, leading and trying new things, etc. help further your professionalism. Don’t take the title lightly, because what I have found is that if you present yourself as the expert in hearing health you’ll be treated like the expert in hearing health. I have noticed that ENT’s from 35-70 years of age call me asking about hearing healthcare. This isn’t a brag, rather I say this to show you that when you become innovative people want to see it, touch it, and be a part of it. Allow the blend of technology and medicine to be played to your advantage.


3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.


I came from the field of psychology. In fact, I have a master’s degree in it. I felt challenged many times in that field, probably more so than Audiology. Reality is the challenge comes in the field. Putting into practice what I had learned was the hard part. Understanding how to take care of people while remember my studies was tough. Don’t forget that you’re in graduate school because you can handle the workload. Not because of some fluke.


4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.

We do need a better entrance test. But we don’t have a governing body to fix this, so we rely on other fields standards to do it for us. Tests like these will separate our field and make it more professional. I can’t disagree with you there...

5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?


Think about this: medical school has thousands and thousands of applicants a year. My program had 40 applicants and only accepted 8 students. Our field, while in demand, simply does not accommodate students with facilities, professors, and other resources. We’re a young field. Give it time and we’ll see a vast growth. Programs will vary. Professors will vary. My school was extremely science heavy. In fact, I would go as far as saying that it might have been too heavy in the medical sciences. We had ENT’s for professors, so we got a lot of that education. Educating yourself outside of your schooling isn’t a bad thing, and frankly, is required in a field that changes as often as ours does. It’s the nature of the beast. I can tell you though that my family members who are physicians go through the same thing. Again, we’re all tradesmen and our trade is going to continue to expand.


6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.


I had a professor say to me that we can’t be technicians. We must understand the why in order to separate ourselves. Why is real ear important? Why is amplification valuable? Why is speech therapy a great solution for this kid? Technicians can say that you have a hearing loss, but we define it, create a plan, and treat it. If we need external resources then we can call on an ENT. Our job is the ear and it has to be treated as such. That’s what makes us audiologists. Yes, I refer to ENT’s but they also refer to me. I say to patients all the time: I don’t know what they know and they don’t know what I know. If I establish myself as the doctor of Audiology they will treat me as an equal. I have and I am treated as such. I never walk into my own doctor’s office and get called anything but “Dr.” A for the record, I don’t like being called that to begin with...


7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)


I am not sexist. I am a male and believe in female empowerment and equal pay. Reality is, however, that many of the females I went to school with have stopped working, already, to have children. When they do, it doesn’t solidify their pay. It’s not fair, but it’s reality. Once they are ready to work again they have dropped down the pay scale and most likely have dual income because of their partner or spouse. Therefore the pay is less of an importance. Any medical field, whether paramedical like Audiology or actual medicine demands consistency. My sister is an internal medicine doctor (DO). She has a one-year-old. She doesn’t make the money she once did because she can’t keep consistent hours in her clinic. But she loves being a mom and that’s great too! I can tell you that I make six figures a year. I also work 80+ hours a week seeing people, working on holidays, writing, researching, and pushing myself to better our field and legitimize our place in the medical community.


8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.


You are not wrong about this. A true governing body is needed. 2 things come into play here. Finance and workers. For the finances: AAA doesn’t have the money to create a solidified governing body to issue us a national board exam worthy of the doctoral student (and by no means am I saying that ASHA has met those guidelines because the praxis is an outdated exam that is essentially garbage). They know it and they admit it. I know this because I asked the same questions to AAA when I was taking the praxis. Workers: it’s really easy to say that we want this change, but the cruel reality is that words are meaningless and action is necessary. I do not promote that I have my C’s. I have them so I can take resident students (which our clinic treats like physicians: on-call hours, different rotations, etc.). I advocate for AAA because I believe that our Audiology forefathers would have wanted it. It’s easy to point the blame, but man oh man, it’s hard to get people to stand behind the cause in person.


I feel your pain. I was just there. I’m young and I’m ambitious and I’m not stopping till change occurs. We need voices like yours to evoke a movement, but we need workers to pursue the goal. I appreciate your post and I’ll be thinking about you as you finish your studies!

 

[TheEarDoc]

Hi Serena,


I appreciate your input and completely understand where you’re coming from. I finished my AuD last year and have had the same questions and validation issues you’re going through now, so I thought I’d weigh in:


1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.


This is preferential, but I believe part of the reason why our pay is low is because we have lost the art of the private practice. If you look at growing statistics it’s easy to see that private practice AuD’s are making more money, especially when done right. Some might say, “Yeah, but I have to sell hearing aids to do that.” Yes, hearing aids can be a huge money maker. I’m in private practice (I came into an established practice) and hearing aids are about a 1/10 of what I do. My clinic has me doing educational events that I get payed for, industrial Audiology, pediatric Audiology, Audiology in music, as well as continued clinical research. We believe in the art of Audiology not the sales portion. I know this is rare, but I came in making six figures because I negotiated my worth. You can’t put a price tag on quality care and work ethic (but I did and I got what I thought I was worth).


2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.


Correct, you’re not a physician, but you do have the highest degree in your field, which makes you a doctor of Audiology. Don’t pretend that you’re a medical doctor (I know AuD’s that do). They are wildly outside of their scope and it never ends well for them. I’ve learned that to get in with the physicians in my city I have to present my field to them in a professional matter. No matter the area of the body we’re dealing with, whether medicine or Audiology, we have to be the experts in that. At the end of the day, an MD is a trade doctoral degree just as much as an AuD is. We are taught a skill and are to execute that skill to better help patients. Establishing yourself as an expert, i.e. educating yourself continually, leading and trying new things, etc. help further your professionalism. Don’t take the title lightly, because what I have found is that if you present yourself as the expert in hearing health you’ll be treated like the expert in hearing health. I have noticed that ENT’s from 35-70 years of age call me asking about hearing healthcare. This isn’t a brag, rather I say this to show you that when you become innovative people want to see it, touch it, and be a part of it. Allow the blend of technology and medicine to be played to your advantage.


3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.


I came from the field of psychology. In fact, I have a master’s degree in it. I felt challenged many times in that field, probably more so than Audiology. Reality is the challenge comes in the field. Putting into practice what I had learned was the hard part. Understanding how to take care of people while remember my studies was tough. Don’t forget that you’re in graduate school because you can handle the workload. Not because of some fluke.


4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.

We do need a better entrance test. But we don’t have a governing body to fix this, so we rely on other fields standards to do it for us. Tests like these will separate our field and make it more professional. I can’t disagree with you there...

5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?


Think about this: medical school has thousands and thousands of applicants a year. My program had 40 applicants and only accepted 8 students. Our field, while in demand, simply does not accommodate students with facilities, professors, and other resources. We’re a young field. Give it time and we’ll see a vast growth. Programs will vary. Professors will vary. My school was extremely science heavy. In fact, I would go as far as saying that it might have been too heavy in the medical sciences. We had ENT’s for professors, so we got a lot of that education. Educating yourself outside of your schooling isn’t a bad thing, and frankly, is required in a field that changes as often as ours does. It’s the nature of the beast. I can tell you though that my family members who are physicians go through the same thing. Again, we’re all tradesmen and our trade is going to continue to expand.


6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.


I had a professor say to me that we can’t be technicians. We must understand the why in order to separate ourselves. Why is real ear important? Why is amplification valuable? Why is speech therapy a great solution for this kid? Technicians can say that you have a hearing loss, but we define it, create a plan, and treat it. If we need external resources then we can call on an ENT. Our job is the ear and it has to be treated as such. That’s what makes us audiologists. Yes, I refer to ENT’s but they also refer to me. I say to patients all the time: I don’t know what they know and they don’t know what I know. If I establish myself as the doctor of Audiology they will treat me as an equal. I have and I am treated as such. I never walk into my own doctor’s office and get called anything but “Dr.” A for the record, I don’t like being called that to begin with...


7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)


I am not sexist. I am a male and believe in female empowerment and equal pay. Reality is, however, that many of the females I went to school with have stopped working, already, to have children. When they do, it doesn’t solidify their pay. It’s not fair, but it’s reality. Once they are ready to work again they have dropped down the pay scale and most likely have dual income because of their partner or spouse. Therefore the pay is less of an importance. Any medical field, whether paramedical like Audiology or actual medicine demands consistency. My sister is an internal medicine doctor (DO). She has a one-year-old. She doesn’t make the money she once did because she can’t keep consistent hours in her clinic. But she loves being a mom and that’s great too! I can tell you that I make six figures a year. I also work 80+ hours a week seeing people, working on holidays, writing, researching, and pushing myself to better our field and legitimize our place in the medical community.


8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.


You are not wrong about this. A true governing body is needed. 2 things come into play here. Finance and workers. For the finances: AAA doesn’t have the money to create a solidified governing body to issue us a national board exam worthy of the doctoral student (and by no means am I saying that ASHA has met those guidelines because the praxis is an outdated exam that is essentially garbage). They know it and they admit it. I know this because I asked the same questions to AAA when I was taking the praxis. Workers: it’s really easy to say that we want this change, but the cruel reality is that words are meaningless and action is necessary. I do not promote that I have my C’s. I have them so I can take resident students (which our clinic treats like physicians: on-call hours, different rotations, etc.). I advocate for AAA because I believe that our Audiology forefathers would have wanted it. It’s easy to point the blame, but man oh man, it’s hard to get people to stand behind the cause in person.


I feel your pain. I was just there. I’m young and I’m ambitious and I’m not stopping till change occurs. We need voices like yours to evoke a movement, but we need workers to pursue the goal. I appreciate your post and I’ll be thinking about you as you finish your studies!

I like a lot of your answers. I too have cleared over 100k a year before as an audiologist (not in private practice), but I also worked a full time job and a lucrative contract job. There is tons of money to be made in this field if one wants to put in the work. My guess is anyone who is successful as an audiologist would have been just as successful doing just about anything else in life. Could I have made more as a nurse practitioner or PA or Psychologist (could have done any of those easily with all my undergrad education), but I like not being on call, not worrying about needle sticks, and having to worry about a lot of the other BS that nurses, PA's, and MD's have to deal with.

You told it correctly. It is all how you market and sell yourself. I've walked out of several job interviews because they tried to underpay me even though I loved the position and location. I refused to settle. Unfortunately many young students don't have that attitude and just as I and you mentioned several audiologists have no problem leaving the workplace for a few years to have children (nothing wrong with this at all!) and then many return back to the field and take whatever salary they are offered just to get back into the field often times because their spouse makes enough to support both of them so their paycheck is just extra spending money.

Me? I am the primary breadwinner in our household. That's why I've worked at least 2 jobs for about half of my career so far as an audiologist. I am also a type A workaholic and a 50-60 hour work week is the norm for me. It's not for everyone.

My biggest frustration with our field is I see responses like this one about complaints about our field and I say to those people, "well what do YOU plan to do about it?". Anyone can complain. Anyone can criticize. That's the easy part. Jumping in and joining state or national organizations and committees and actually trying to be a solution to the issues is the real work and sadly it's a fight always to find volunteers to do so. I've seen our PAC donations for AAA and for my state organization and they are pathetic. If every audiologist practicing in my state gave even $50 a year we would be so much more ahead as a profession than we are now, but many don't want to contribute. They would rather pay their dues to ASHA, AAA, and complain. Perhaps we need to do like other professions do and make licensure extremely expensive. I have a buddy who is an optometrist. I have had state licensure in a few states. One state was $200 every 2 years, another was around $125 every 2 years, one was as low as $50 a year. That is nothing! My buddy pays over $600 a year for his state licensure to practice his profession! Perhaps that's the way we need to go?

 

[DefEarRing]

1) Our salary is pathetic - for how long we're now in school + all the additional training it's crazy to think we'll be lucky even reaching $80k. So many people have just accepted this- BUT WHY!? We deserve so much better! I don't think its rude at all to want a higher salary. This also plays into my next point.

- I agree our salary is pretty low considering the amount of schooling required. I think our programs should be 3 years for a doctorate and then a 4th year externship as a doctorate level audiologist. This is how many other fields do it. We do not need to be 4 years in graduate school and paying a school tuition during the 4th year while doing an externship. I think part of the reason the salary is so low is because many of the master's level audiologists have not left the field and the biggest reason is hearing aid dispensers can do the same job with just having a GED and being VD free. The dealers will never be pushed out because they actually have a strong lobby and their members actually donate to their PAC. It's pathetic how many audiologists piss and moan about issues in audiology, but never even donate $5 to their professional organization's political action committees. Sorry, but in legislation money talks.
- The other reason our field suffers salary wise (and not to sound sexist because I am not in the slightest!), but we
are a profession dominated by one gender. Many audiologists are female and I know many that decided to take a few
years off to be stay at home mothers. No judgement here. I think if you can financially stay home with your children in
their younger years and want to that's amazing! This does drive down the wages though for our field as many of these
same folks will take whatever they can get when they jump back into the field after a break to raise children. Maybe
if we were a more gender neutral field you wouldn't see this issue?

2) We are not 'doctors' by any means- sure we have a doctorate but our scope of practice hasn't changed much. I'm just going to say it, this should just be a master's program. Salary is so ****ty a dental hygienist honestly makes more. I abandoned the whole idea of being a 'doctor' long ago, we don't even come close.

- I don't think anyone who joins this field goes into it thinking they will be a medical doctor. IF they do then they are in the wrong field and are going to be in for a rude awakening. I know more medicine as a previous nursing student than most 10+ years in the career field audiologists do. Dental hygienists do make more. Why? Because Dentists make much more and they are better reimbursed. Reimbursement matters. See point 1 about donating to the PAC. You want better reimbursement? You need your legislators to do that.

3) Does anyone else not even feel that challenged by their Au.D program? Some kids in my class seem to be sliding by, I don't think we'd see this in an optometry program. The kids in my program complain nonstop the second they are challenged, I'm always frustrated by this.

- Nope never felt challenged at all. Then again I was a pre-med major with a Bio degree and Psych degree. I was
able to go to med school or grad school for psych (the PsyD was not around then and I had no desire to get a PhD otherwise I would be a psychologist now probably)
- We need to remove the CSD pathway to audiology. I'm sorry, but the CSD degree is a joke at most schools. I see
lots of 3.8-4.0 CSD students who have no basic grasp of physics, biology, chemistry, etc.. If I were on a selection
committee for graduate programs I would take the Au.D. prospect with a hard science degree with a 3.0-3.5 over the
3.8-4.0 CSD major any day because they will be a better prepared student
- Audiology in theory is a very simple field. You can be a jack of all trades general practitioner in Audiology without
much huge in depth education and function fine. Will you be an awesome audiologist with this attitude? No, but you
will function fine. The material is not hard. It's your bedside manner, how well you can counsel patients, etc. that
makes a good audiologist. Sorry you don't learn that in school. You are usually born with this aspect of it

4) I can only say so much because my undegrad was in CSD, but as I'm learning more in my Au.D program it is clear we need a 'hard' science background. How can we really expect to get the same respect as Optometrists/Podiatrists/Dentists/PTs/OTs if we have no hard science background! I've literally been trying to teach myself genetics and pharmacology. How can we really compete with these other professionals and gain the respect I do believe we deserve if our education was so much 'easier.' Let's be real the GRE isn't that hard, nothing compared to the MCAT/DAT/OAT. I'm sure many of us ended up in audiology because we initially wanted to be an SLP and it is difficult to change majors as college progress. I regret not picking up a biology minor but I can only blame myself for not taking that initiative.

- Yep hard science pre-med degree with electives in CSD is what each program should be (see above). I personally ended
up in Audiology because I felt it was the right blend of hard science, lifelong learning (keeping up with hearing aid
features/programs/etc. is a job!), and counseling (from my desire for Psychology). I also love the aspect of not being
on call, not having to deal so much with infection issues because I am not dealing with as many bodily fluids (sorry
if you've never been crapped on by someone other than your own child then you truly don't understand what the
medical field is like haha) as I was in nursing or worrying about needle sticks, etc.. I also love I am not on call. I work
a 9-5 with a pretty laid back day. My medical doctor colleagues and nursing colleagues can't say the same

5) Is it just me or was it not even that hard to get into grad school?? I graduated with my CSD degree (with honors) and surely did not do the work of my friends in bio and kinesiology. Again, how can we want to same level of respect as other medical/health professions when our education can't even touch the work MDs/DOs/ODs/PharmDs have put in?

- Yep grad school is pretty easy to get into for audiology as there are so many programs. I believe Dr. Jerger at
one point wanted to close many programs and make it more selective. He had his own agenda of course for this (We
all know his program would be one that no way would be shut down), but yes there are many programs churning out
plenty of young naive audiologists who are happy to take a petty salary and stay there. Maybe if we had fewer programs
it would mean less audiologists and hire salary, but we also need to look at the other possible issue. If there is not enough
providers to meet patient needs (and this is the case in many places) the legislators will pick quantity over quality. We saw
this in the VA system when wait times started moving out and then our wonderful legislators started trying to let hearing
aid dealers fit veterans instead of hiring more audiologists. So it can go both ways.

6) Literally EVERYTHING we do can be done by someone with less education. Why would an ENT pay more for an audiologist in a practice when a hearing aid dispenser can be hired at half the cost and the ENT can just interpret the results. Seriously all we do is refer to them anyway, we can't do **** except hope the ENT fixes whatever problem there is then just throw an over-priced hearing aid on the person.

- Because the fitting laws and many insurance companies require an license in audiology to do so (see PAC comments
above). Your scope of practice is defined by your state licensure board. Hence why every audiologist needs to belong
to and be active in their state organization because that's where shady things happen before they occur on a national
level. Yes hearing aid dispensers can be hired and used, but in many states they cannot bill for the audiometric testing.
They also can't do much of our specialized testing. Most ENT's who use dispensers for their hearing aids are low level
ENT's who are the stereotypical ENT that you hear about in audiology school. Most of the ENT's I worked with (and it's
been many over the years) respected me as a peer and trusted my judgement and opinion and paid me as such

7) No diversity in this field, it's sad. I truly wonder if the salary is so low because this is a female dominated field. That idea pisses me off and it should piss off a lot more Au.D students than it does! (Obviously this is based on my own experiences)

See above comment

8) ****. ASHA. I truly don't believe audiology will make much progress unless AAA just takes over licensing and accrediting. I personally do not like being grouped in with SLPs. There is not as much overlap as we are led to believe in undergrad.

- Ahhhhhh ASHA the consistent producer of untruthful information. We as a profession have 4 major professional
organizations and they like to fight each other. ASHA doesn't like AAA and most audiologists don't like ASHA
because many of use don't see their value because we pay a huge amount of money and they seem to do nothing
for us and keep perpetuating the myth that if you don't have your CCC-A you aren't a competent audiologist which is
false. AAA does help our field, but I don't always agree with them. ADA seems to hate both AAA and ASHA. ABA seems
to be a good program, but could use some beefing up to be a viable option for people over ASHA C's.

Yes this field has a lot of potential, but needs to expand it's scope of practice. I spoke at a conference for a state and discussed that our field needs to move into the mid level practitioner role more and diagnose and treat middle ear infections with antibiotics. You wouldn't believe the backlash I received! Many said "well I didn't become a doctor because I didn't want to deal with medications!". Well it could be part of your scope of practice (which would improve your usefulness to other medical providers, improve your efficiency with patient care, etc.. I argued how many audiologists do tinnitus therapy, do vestibular testing, do vestibular therapy/rehab, do telehealth audiology? Most don't, but it's part of your scope of practice. You can choose to do your full scope or only part of your scope, but the important thing is if it's in your scope you can do it. With a wider scope you can increase salary. Now the down side is, when you start dispensing medication you open yourself up more to liability. Meaning your liability insurance is going to go way up. So I think our field being a young field has a long way to go. In my lifetime it might happen, but who knows.

I like some of your point of views, thank you for sharing in such detail. I, also, wanted to be a Psychologist. My major is now CSD and minor is psych. Not heavy in hard science but I am taking some upper level classes like Neuroscience, which btw, I’ve been told from reaching out to a few professors that their college/university IS indeed looking for heavy hard science classes when reviewing applications. I’ve also worked in the field of nursing. Like you said, I’m so glad I don’t have those hours.

Also, the programs I’m looking to apply to are 3 year programs with 4th extrenship. For me, I wouldn’t take an externship unless it paid me. I don’t care if it was in underwater basket weaving. If it paid, and helped me offset my tuition costs, then I’m there. I think other students should be looking at the grand scheme of things. Leaving the Aud program with 100,000+ in debt to make 60,000 starting out? Come on! It’s ridiculous. The rationale isn’t there.

I’m a Non-trad student though. I’m in my 30’s just finishing up my BS. I see the world differently and I’m not making commitments about debt-to-income-ratios, unless I know I’ll come out on top.

Anyway, this reply isn’t about me. I like your idea about dispensing antibiotics. I’d be okay opening myself up to liability and the insurance, if I was paid what I needed. I think its most accurately in our scope of practice. How long do Pre-meds learn about the ear? Like a semester or two, possibly. This is our realm and we should be allotted whatever comes of it. Otitis media? That’s our ****. Let us do our thing.

I also feel SLP’s and Audiology should be separate. I’m going through more SLP classes than I’d like to admit, and I’m sad to say this but their god aweful boring. Don’t get me wrong I’m SO glad there are people out there that will do this job, but it’s not my passion. And when we assigned ASHA assignments, I felt ASHA really is the problem. Not giving audiologists the credit they deserve. It does seem like they’re still living in the Masters level reality. Bump up your game ASHA, what the hell?! It doesn’t feel as though they’re in it, to win it for us.

Where I’m from most providers do not hire HIS, and I’m thankful for that. Either we need to give up hearing aids and let them have it, or we need to fight for better regulations. I agree with going to and helping fund our legislators.

Not to sound like an ***hole here but I had an acoustic neuroma that was misdiagnosed by a masters level audiologist for YEARS. She sent me for an MRI of my neck. My neck! From a car accident that happened years prior. Seriously lady? But I wasn’t the provider, I didn’t know any better. I think we should fight for masters level clinicians to bump up their education, or retire.. Now that’s just my personal opinion and perspective. I think we would get the recognition and pay we deserve if the masters level peeps weren’t available that way hospitals or providers or what have you have no choice to bump up the standard of our salary.

 

[DefEarRing]

For the general concensus, there are quite a few areas available to us AuD students, if we choose to do something different. Not just hearing aids. UT Dallas has a good program and they have means for us with Implantable Devices. Their Cochlear Implant Program is pretty neat! I personally wouldn’t mind scrubbing into the OR to monitor a CI surgery (intraoperative monitoring audiologist). UNC-Chapel Hill has great resources as well, and a nice CI track.

Did you know there is only on non-medical profession that is permitted to provide monitoring independent of medical oversight? That’s audiology.




If we know and understand the whole scope of what we desire, then the sky is the limit.

 

[JMAuD]

I like a lot of your answers. I too have cleared over 100k a year before as an audiologist (not in private practice), but I also worked a full time job and a lucrative contract job. There is tons of money to be made in this field if one wants to put in the work. My guess is anyone who is successful as an audiologist would have been just as successful doing just about anything else in life. Could I have made more as a nurse practitioner or PA or Psychologist (could have done any of those easily with all my undergrad education), but I like not being on call, not worrying about needle sticks, and having to worry about a lot of the other BS that nurses, PA's, and MD's have to deal with.

You told it correctly. It is all how you market and sell yourself. I've walked out of several job interviews because they tried to underpay me even though I loved the position and location. I refused to settle. Unfortunately many young students don't have that attitude and just as I and you mentioned several audiologists have no problem leaving the workplace for a few years to have children (nothing wrong with this at all!) and then many return back to the field and take whatever salary they are offered just to get back into the field often times because their spouse makes enough to support both of them so their paycheck is just extra spending money.

Me? I am the primary breadwinner in our household. That's why I've worked at least 2 jobs for about half of my career so far as an audiologist. I am also a type A workaholic and a 50-60 hour work week is the norm for me. It's not for everyone.

My biggest frustration with our field is I see responses like this one about complaints about our field and I say to those people, "well what do YOU plan to do about it?". Anyone can complain. Anyone can criticize. That's the easy part. Jumping in and joining state or national organizations and committees and actually trying to be a solution to the issues is the real work and sadly it's a fight always to find volunteers to do so. I've seen our PAC donations for AAA and for my state organization and they are pathetic. If every audiologist practicing in my state gave even $50 a year we would be so much more ahead as a profession than we are now, but many don't want to contribute. They would rather pay their dues to ASHA, AAA, and complain. Perhaps we need to do like other professions do and make licensure extremely expensive. I have a buddy who is an optometrist. I have had state licensure in a few states. One state was $200 every 2 years, another was around $125 every 2 years, one was as low as $50 a year. That is nothing! My buddy pays over $600 a year for his state licensure to practice his profession! Perhaps that's the way we need to go?

I actually don’t mind the added cost if it would create a solidified, governing body that took care of their audiologists.

While I was in school the conversation was always about the “medical model” and if we as audiologists should approach our degree as such, meaning that we do 2 years academic, 2 years rotation, graduation, then a year of residency. In my opinion the time amount is just too much for thinking about the return on investment. However, the private clinic I work in has already started taking that approach.

We take AuD residency students and commit them to practicing Audiology. For example: we have on call hours, weekend hours, and holiday hours. Our goal is to be treated like doctors. That means we have to follow hours that represent what doctors do. I worked 5 hours on thanksgiving day helping patients with hearing aids, had musicians off the road needing impressions for new in-ear monitors, etc. We will have residency students come with us for those hours. We want them to understand that the art of private practice starts with the audiologist and how much they want to work. That said, we pay our audiologists in those hours appropriately and understand that it’s taking time from their families and their private life. I feel like students, and this is including myself during the schooling process, miss the reality that opportunity is there (as you’ve pointed out). The work is just extreme.

A new thing in our area is the glorified hearing aid stores that are run by audiologists. These places promise amazing hours, great benefits, and amazing commission on hearing aids to the audiologists that commit themselves to these places. Practices like these can make Audiology look like a car dealership (I’m not saying that all places are like this, but some can be). At the beginning of 2018 the partners in my clinic decided to turn all of our marketing to service-based marketing as opposed to product-based marketing. I remember having a conversation with a hearing aid rep that said we’d lose business. On the contrary. We saw our profit margins increase within 2 months of the marketing campaign and found almost a 40% increase in patient clientele. We found that, even with hearing aids, people want personalized evidence-based practice. When they visit the audiologist they want to see a doctor, talk to a doctor, vent to a doctor, and know that they’re talking to a professional.

Lastly, it’s so unbelievably important that audiologists define the “gray” between hearing aid dispensers and audiologists. This has to start with educating the public. Our clinic has taken this educational portion very seriously. Once a month one of our AuD’s are out in the field speaking to students in schools, teachers, businesses, rotary clubs, etc. trying to show the differences in what we can offer vs. what they can offer. We can’t be afraid to flaunt the hours we’ve put in to receiving our titles, the studying that gave us our degree, or the hours upon hours we worked to get to this position. We have an HIS in our office. He’s amazing! He’s handy with the hearing aids, loves people, verifies his fits, and does a bang up job on repairs. But he KNOWS his lane. He stays in that lane and respects us as the AuD’s in the office. He never oversteps. I understand we’re lucky, but if we don’t educate the public we are not creating a better name for ourselves in society.

 

[TheEarDoc]

I actually don’t mind the added cost if it would create a solidified, governing body that took care of their audiologists.

While I was in school the conversation was always about the “medical model” and if we as audiologists should approach our degree as such, meaning that we do 2 years academic, 2 years rotation, graduation, then a year of residency. In my opinion the time amount is just too much for thinking about the return on investment. However, the private clinic I work in has already started taking that approach.

We take AuD residency students and commit them to practicing Audiology. For example: we have on call hours, weekend hours, and holiday hours. Our goal is to be treated like doctors. That means we have to follow hours that represent what doctors do. I worked 5 hours on thanksgiving day helping patients with hearing aids, had musicians off the road needing impressions for new in-ear monitors, etc. We will have residency students come with us for those hours. We want them to understand that the art of private practice starts with the audiologist and how much they want to work. That said, we pay our audiologists in those hours appropriately and understand that it’s taking time from their families and their private life. I feel like students, and this is including myself during the schooling process, miss the reality that opportunity is there (as you’ve pointed out). The work is just extreme.

A new thing in our area is the glorified hearing aid stores that are run by audiologists. These places promise amazing hours, great benefits, and amazing commission on hearing aids to the audiologists that commit themselves to these places. Practices like these can make Audiology look like a car dealership (I’m not saying that all places are like this, but some can be). At the beginning of 2018 the partners in my clinic decided to turn all of our marketing to service-based marketing as opposed to product-based marketing. I remember having a conversation with a hearing aid rep that said we’d lose business. On the contrary. We saw our profit margins increase within 2 months of the marketing campaign and found almost a 40% increase in patient clientele. We found that, even with hearing aids, people want personalized evidence-based practice. When they visit the audiologist they want to see a doctor, talk to a doctor, vent to a doctor, and know that they’re talking to a professional.

Lastly, it’s so unbelievably important that audiologists define the “gray” between hearing aid dispensers and audiologists. This has to start with educating the public. Our clinic has taken this educational portion very seriously. Once a month one of our AuD’s are out in the field speaking to students in schools, teachers, businesses, rotary clubs, etc. trying to show the differences in what we can offer vs. what they can offer. We can’t be afraid to flaunt the hours we’ve put in to receiving our titles, the studying that gave us our degree, or the hours upon hours we worked to get to this position. We have an HIS in our office. He’s amazing! He’s handy with the hearing aids, loves people, verifies his fits, and does a bang up job on repairs. But he KNOWS his lane. He stays in that lane and respects us as the AuD’s in the office. He never oversteps. I understand we’re lucky, but if we don’t educate the public we are not creating a better name for ourselves in society.

Like I've said before the problem with HIS is they were here first, had dispensing rights first, have a bigger lobby (which their members actually actively contribute to), and they are not going away. If anything I see them getting more scope of practice rights in many states where the state audiology organizations are asleep at the wheel. I work in the VA health system and I saw firsthand how many legislators tried to let HIS folks in the VA system to treat veterans because they said the wait times were too long for audiology, but yet they refused to hire more audiologists. Bottom line they just wanted someone to hang hearing aids on heads and say "hey I helped veterans get quick access to healthcare!" and then use it as a campaign point. So I agree, and I have always sold myself and my skill set when dispensing any type of ALD or amplification device when I was in the private sector. Even in the VA I explain to veteran's the different between me and the miracle ear or beltone dealer and explain to them why the VA won't let those folks give them hearing healthcare. In our clinic we ask a lot of case history questions many other clinics do not ask. We ask about blood pressure, heart issues, dizziness/vertigo, diabetes, depression, cognitive health, PTSD, etc.. Many people are questioning why we ask these questions since we are not MD's. In the VA we are now considered vesting providers meaning many times we are the first provider in the VA a patient is seeing. So we ask these questions and then we can know what other services the patient may have and needs and what services we can get them funneled to. I frequently review lab results (especially for BP, A1C, etc.) so I know what is going on with my patients. I wish everyone did this.

As for working crazy hours, well I've worked Saturday's many times. Holidays no because our clinics were always closed on holidays. Many other medical specialties in hospitals are closed on these dates too. I was on call one time on one job I worked for sudden hearing losses or rescreens of newborns. I was paid dog %$^& wages to do so and I left that job. So I think if that is the expectation for a practice then the pay best be there for the hours and time sink involved too.

 

[TheEarDoc]

For the general concensus, there are quite a few areas available to us AuD students, if we choose to do something different. Not just hearing aids. UT Dallas has a good program and they have means for us with Implantable Devices. Their Cochlear Implant Program is pretty neat! I personally wouldn’t mind scrubbing into the OR to monitor a CI surgery (intraoperative monitoring audiologist). UNC-Chapel Hill has great resources as well, and a nice CI track.

Did you know there is only on non-medical profession that is permitted to provide monitoring independent of medical oversight? That’s audiology.




If we know and understand the whole scope of what we desire, then the sky is the limit.

I've done interoperative monitoring. It's OK, but wasn't my cup of tea. The unfortunate thing is not everyone will need/qualify/have insurance approve an implantable device, and so it is still something that only a small % of audiologists will be able to do or have the caseload to support. I know I did many CI and BAHA patients at one VA and I looked into getting my ABA certification for CI's, but the caseload they required was so insanely high that unless that's all you did there was no you could reach those numbers required for ABA cert.

I do think audiologists need to market our skill set rather than our products more. I think PSAP's are a way to get the conversation started about what we can do for people by getting them in the door to discuss their hearing problems. The issue is how you handle that first time consult. You should bill for it. You should be doing speech in noise testing for every patient. I always found this verified to people with a mild to moderate hearing loss that yes you truly do have a hearing problem and could benefit from my services.