Interview with Kenneth Lowder Au.D., Chair, Audiology Foundation of America (AFA)

AO/Beck: Thanks for your time this evening Dr. Lowder. I'd like to learn a little about you and the Audiology Foundation of America (AFA).

AFA/Lowder: Sure, I appreciate this opportunity.

AO/Beck: I understand you recently earned your Au.D. Congratulations on that wonderful accomplishment. How long did you practice audiology prior to seeking your Au.D.?

AFA/Lowder: I practiced audiology for about 20 years before earning my Au.D. However, prior to that, I was a Speech-Language pathologist for 13 years before becoming an audiologist.

AO/Beck: What was it that made you decide to leave Speech-Path in order to pursue audiology?

AFA/Lowder: I met a great woman -- who is now my wife -- Mary. Mary is also an audiologist. Basically, the more I learned about audiology from Mary, the more I felt audiology was a better fit for me. In brief, once I decided to become an audiologist, I went back to the University of Iowa, took the master's level audiology courses, took the NTE exam and obtained my audiology license in Iowa. I practiced with dual certification for some time.

AO/Beck: Ken, tell me about the AFA. When did you take over as chairperson?

AFA/Lowder: I was elected by the Board of the AFA in May, 2000. As you know, we're essentially a non-profit educational foundation, not a membership-based group. Therefore, the Board of Directors nominate and vote on our leadership.

AO/Beck: Who else is on the Board?

AFA/Lowder: The immediate past-Chair is Dr. George Osborne, Dr. Leslie Neal is our Vice-Chair, Larry Englemann is the Secretary of the Foundation, Rich Burba is the Treasurer. Dr. David Goldstein and Dr. Tabitha Parent-Buck serve on the Board. Additionally we have Dave Cieliczka, Nancy Green, Eric Hagberg, Darrell Micken, Donca Porter, and Tom Morris. Our newest Board members are Dr. Mike Hartman and Linda Remensnyder. Dr. Hartman graduated from the University of Florida with his Au.D. and Linda has just finished her classwork and will be receiving her Au.D. in August.

AO/Beck: How many audiologists are actively involved with the AFA?

AFA/Lowder: Again, we don't have memberships. However, we send our quarterly newsletter to essentially the entire profession to help keep all audiologists informed as to the status of the transition to the Au.D. and of our activities and our goals. The AFA is fortunate to enjoy the support of a substantial group of practitioners.

AO/Beck: When did the AFA start and what was the initial mission?

AFA/Lowder: The AFA was founded in 1989 as an outgrowth of an ADA conference which recognized the need for the establishment of the Au.D. degree for practitioners. The sole purpose of the AFA was to transform the profession of audiology into a doctoring profession. Importantly, among the early goals was the recognition of the 'Au.D.' as the designator of the professional doctoral audiologist.

AO/Beck: What is the role of the AFA now that we have a small tidal wave of audiologists actively pursuing and obtaining their Au.D.?

AFA/Lowder: You're right, there are many audiologists who have already sought and achieved their Au.D. I think the numbers are something like ... By 2002, twenty-five percent of all full-time audiologists will have or will be seeking their Au.D. By 2004, NAFDA expects that number to hit 3400. Of course that is phenomenal growth, particularly when you consider that there were no Au.D.s just 6 or 7 years ago. Nonetheless, we need to continue to recruit, educate and encourage our colleagues to pursue the Doctor of Audiology degree until the profession is in fact a doctoral profession, and until it is recognized as such. We need to complete the transformation of the profession to doctoral status. This will be critical for our move to obtain limited license practitioner status for audiologists.

AO/Beck: Dr. Lowder, what do you tell audiologists who say 'I don't want to pursue the Au.D., I don't need it'?

AFA/Lowder: I usually tell them it's a lot like your patients with a high frequency hearing loss - they come in the office and they say 'I can hear fine'. Basically, the patients don't know what they're not hearing. They don't know what they don't know. It's the same with the Au.D. Of course you can go on practicing with your master's. However, there is so much new knowledge, new technology, new hearing aid information, counseling and rehab techniques, new diagnostic procedures, new electrophysiologic tests - it's incredible! The audiology knowledge base simply wasn't as extensive in the seventies, eighties and nineties as it is now. The internet wasn't there and many of the programs producing master's level practitioners simply didn't have the money, the faculty, the practicum sites nor the equipment to train audiologists who were ready to practice. Few were exposed to private practice then. Currently, private practice is growing and expanding rapidly. Having a doctoral degree to recognize and identify your knowledge is very important to your patients, other professionals and the third party payers. Simply put, there is no down side to doctoral knowledge and the pluses are enormous. I believe all of us need to achieve this goal. Personal satisfaction was a big motivator for me. Also, I wanted very much to be a role model for other audiologists.

AO/Beck: What are the issues AFA identified as critical to the continued transformation of the profession?

AFA/Lowder: Early on, we identified three criteria to help transform the profession. The first is the Au.D. program had to be accessible to the working professional. The second was that the program had to be affordable. The third key factor was the allowance of advanced standing based on demonstrated capabilities. Until recently there were no programs which met all three criteria. However, currently, there are two programs up and running - both regionally accredited - which meet all three criteria. I'm referring to the Pennsylvania and Arizona programs. Doug, I'm sure you know that the distance education programs will be phased out over the next few years because their purpose is to allow current practitioners the ability to get their doctorate during the transition phase. The four year residential programs will continue to grow and over time there will be less need for the distance ed programs. Regarding cost, the early distance education programs were excellent, but expensive. Many of the audiologists interested in earning the degree were simply unable to afford the twenty to thirty thousand dollars or more involved over two or three years. The cost for the newer programs is considerably less. The Au.D. degree can now be earned through Arizona and Pennsylvania for between four and six thousand dollars, including tuition, books and related expenses. I think as the competition has increased, market forces have driven down the cost of distance education.

AO/Beck: Will AFA have money available for the audiologist who wants to return to the classroom?

AFA/Lowder: By August, 2000, the AFA will have given out over 412 thousand dollars in Alliance Fund scholarships to Au.D. residential students. We have sponsored over 150 Alliance Fellowships. We give $2500 per year, for up to four years to residential students who apply and are awarded the scholarships. Unfortunately, we do not have the resources to fund distance education students. The AFA also gave the Baylor program a $25,000 grant for opening the first Au.D. program.

AO/Beck: Where does the funding come from to support the AFA?

AFA/Lowder: Primarily manufacturers and individuals donate funds to the AFA to help support our mission. Most of our support comes from individual practitioners who believe in the mission of the Foundation. Manufacturer's contributions comprise 15-20% of our funding.

AO/Beck: Besides the transformation of the profession, are there other goals the AFA has identified?

AFA/Lowder: Yes. As a profession, we don't yet have national standards for Au.D. programs. The current existing programs have done an excellent job in outlining the core curriculum needed by the master's level practitioners. However, the AFA would like to see a national standard for Au.D. programs which all the schools and national groups can support. I see the AFA as a willing and able partner in the development of an Au.D. standard curriculum. Once the standard is created, all the programs can use it as a backbone upon which they can build, enhance, and improve their programs.

The AFA also will be actively working to change state licensure laws to be consistent with our national organizations, which will soon require a doctoral degree in audiology as the entry level requirement.

AO/Beck: Any other AFA goals you can share with us?

AFA/Lowder: The 'Unification of the Profession' is another goal. Wouldn't it be nice if we had one national group which served as the umbrella organization for audiology? The AAO-HNS is set up to have all ENT docs under the AAO-HNS umbrella. Underneath that umbrella organization, separate societies exist for otology, otolaryngology, laryngology, facial plastics etc. That seems like a good political and professional model to maximize our numbers and our strengths. I'm not sure how we get there from here, but it's a great goal, one that we're just beginning to talk about. Besides, wouldn't it be great to write just one membership check every year?

AO/Beck: Dr. Lowder, good luck in your tenure asChair of the AFA and thanks for your time this evening.

AFA/Lowder: Thanks again, Doug, for the opportunity to tell your Audiology Online readers about the Audiology Foundation of America.