Interview with Robert Manning Au.D., President of the Academy of Dispensing Audiologists (ADA)

AO/Beck: Hi Bob. Thanks for spending a little time with me tonight. I know your time is rather precious since becoming the president of ADA. By the way, congratulations on achieving your doctorate.

Manning: Thanks Doug, it's a pleasure to be with you and to work with Audiology Online.

AO/Beck: Bob, let's start with a little about your background. When did you get your Master's degree and when did you enter private practice?

Manning: I graduated in 1977 from Illinois State University with my Master's degree. I went to work for an ENT in Lexington, Kentucky. I stayed with him for five years, and frankly, I attribute a great deal of my success to this ENT. When I got out of school, my head was full of all sorts of idealistic practice protocols and philosophies which turned out to be unrealistic in real life. I mean no disrespect to my professors in my program, but many of the concepts I learned in school turned out not to be the reality I experienced. The ENT helped me focus on sound business philosophies and patient management practices.

AO/Beck: So after five years with him, you went into private practice?

Manning: Yes, that's correct. At that time I felt comfortable with my profession and my abilities and I thought the time was right. I opened the first office in a small coal town in eastern Kentucky. My main contract was the United Mine Workers Health and Retirement Funds Benefits. I was approached by them to locate an office in the area. It was a great arrangement as I had a built-in referral source and they had a local provider. I saved them a lot of money and I built a nice practice right out of the starting gate.

AO/Beck: Sounds like an ideal way to start a private practice.

Manning: Yes it really was. I've built the practice based on a lot of industrial audiology and hearing conservation, noise abatement and school audiology as well as diagnostic audiology and hearing aid dispensing. I have spent time in underground mining operations taking noise measurements, making recommendations for noise abatement, and helping the companies to establish their hearing conservation programs. I have been given the opportunity to lecture to students at the community college at least once per semester, and I provide continuing education training for nursing staff, school instructors, etc.

AO/Beck: How many offices do you operate at this time?

Manning: I have two full-time offices and two satellites. I have one other audiologist and two hearing instrument specialists who work for me.

AO/Beck: How does it work out having Hearing Instrument Specialists working for you?

Manning: In our setting it works out very well. In the state of Kentucky, the office personnel cannot change a tube on an earmold unless they have a license. So, over the years, they've received all sorts of training and we've developed a harmonious relationship. I think it is a win-win situation for all of us.

AO/Beck: As you know, as a profession we are terrifically short-staffed. Simply, there aren't enough audiologists to go around. I've heard of many audiology offices using Hearing Instrument Specialists for specific dispensing activities, and the converse exists too. That is, audiologists working in an HIS office for diagnostic purposes. Is this the trend for the future nationally or is it just an applied fix that works here and there?

Manning: I think a collaborative model may supply us with some nice synergies, while addressing the audiologist shortage. Of course, we need to be cautious in these instances regarding the definition of professional roles and responsibilities. However, I can see the two professions working together in specific capacities and I think that may help solve and address some of the issues that are out there.

AO/Beck: Bob, I think I met you about ten years ago when your book titled CERUMEN MANAGEMENT first hit the shelves. Is the book still available?

Manning: Good memory, Doug. Yes, the book came out in 1991. Actually that book is somewhat outdated with respect to sterilization and infection control. There is much new equipment and new information on cerumen management, and that has changed clinical techniques and added to our knowledge base so I'm rewriting the book. The new one should be available by the end of summer, 2001. The original book is still available through the ADA website, and the new book will also be available through the ADA website at www.audiologist.org, or they can call 1-800-445-8629.

AO/Beck: How long have you been on the ADA Board?

Manning: I've been on the Board since 1991 in a non-voting capacity, and then in 1994 I was elected to two terms as Treasurer. In October, 2000, I assumed the presidency of the Academy of Dispensing Audiologists. My term will end in 2004.

AO/Beck: You've got a big task ahead of you, filling the shoes of Dr. Jim McDonald.

Manning: How well I know! Dr. McDonald was instrumental in bringing the AAA and the ADA back together on a number of projects. We still have our differences in some areas but now we can agree to disagree and work beyond that. There have been many projects which the two organizations have collaborated on, particularly in Washington DC. As a result, we have made terrific progress. As you know, the Federal Blue Cross Blue Shield issue and the National Mail Carriers Insurance have now recognized audiologists as reimburseable professionals. The recent Health Care Finance Administration (HCFA) decisions were the result or many meetings and much hard work by both organizations in Washington. The ADA continues to enlist the services of Dr. McDonald, even though he is out of the office. HCFA and the whole political process is Dr. McDonald's forte, and his guidance and contacts are invaluable to the Academy.

AO/Beck: What can you tell me about the ADA and the AAA as far as continued collaborations?

Manning: I believe we will continue to work together for the benefit of the profession. The ADA and the AAA have a marvelous history together and we can certainly anticipate more progressive and beneficial results from continued collaboration. There are many projects in the works as we speak, but unfortunately, I am not at liberty to talk about some of them at this time. We continue to make our presence known in Washington, where we each have a powerful lobbying firm. With the recent appearance by Tommy Thompson, newly appointed head of the Health Care Finance Administration (HCFA) at the AAA convention this year, we anticipate a renewed attitude of respect and cooperation for our profession. This visit served to demonstrate to Tommy Thompson that AAA and ADA speak for our profession.

AO/Beck: Bob, what are your goals for the ADA during your tenure as president?

Manning: My primary goal is to continue to develop and enhance membership services and programs. We are in the process of expanding our web site to include interactive chats and instructional forums. We have worked with Freehearingtest.com to get the ADA membership directory included as a resource for audiology services across the nation. We are working to develop a buying group exclusively for ADA members. Doug, as you know, we have looked to optometry for guidance during our transition to the doctoral profession. The ADA has a committee which is currently in the process of identifying some of the key elements which should be incorporated into a 'model law'. Of course there is no true 'model law' because the needs of every state vary. However, there are core elements which can be common across states. The optometry profession has been very helpful with guidance and advice.

AO/Beck: What are your thoughts on accreditation and certification?

Manning: We are currently bound by an accreditation structure which mandates that candidates must receive credentials from the accrediting organization as a requirement of program accreditation. These credentials are tied to a membership organization in a loosely veiled manner that is designed to promote membership in that organization. I feel there is a mandate to break this tie and develop an independent accrediting body whose sole intent and purpose is the welfare and protection of the general public through professional education standards and training.

AO/Beck: So you're advocating a brand new accreditation program which would not include the ASHA CCC-A, or the ABA's Certification, and the accreditation of programs would likewise not be based in ASHA or AAA?

Manning: That is exactly right. I can envision the need and the desire for both credentialing and accreditation to be managed and executed by a totally independent body.

AO/Beck: Of the three major organizations, ASHA, AAA and ADA, what is the unique role that ADA plays? In other words, why do the ADA members belong to the ADA? What do they find at ADA that they don't find at ASHA and AAA?

Manning: The ADA provides networking and leadership to the practitioner in Audiology. Our focus at conference goes beyond diagnostic testing and advanced technologies. We focus on how to successfully integrate this technology into daily practice, how to operate a business, how to plan for retirement, how to provide ethical services, etc. In addition, the ADA has a very strong presence in Washington where we continue to promote the profession of audiology. We continue to promote autonomous professional practice issues, revision of SOC codes, redefinition of audiologists as diagnosticians instead of therapists, reimbursement issues, etc.

AO/Beck: Are ADA members uniquely members of the ADA?

Manning: No, in our most recent ADA survey, we learned that 75 percent of our members are also members in the AAA. ADA was formed as an informal discussion group, and it's grown tremendously. One of the more popular events that we offer at conference are the 'Day Ahead' sessions. These sessions integrate didactic instruction with hands-on experience. I know lots of audiologists are interested in these sessions for their practicum and academic knowledge. This year we will present a new and updated 'Cerumen Management' course. We will also have 'Recreational Audiology' instruction where participants can learn about new technology regarding noise protection for hunters and sportsmen. This too, has proven to be a popular topic. Mary Beth Wright will be repeating her 'Tofu 2001' session on patient satisfaction, and David Smriga will be introducing the new NOAH 3.0, an updated version of the fitting platform used by over 95% of our members.

AO/Beck: Where will the ADA meeting be held in October 2001?

Manning: This year the meeting will be in Ashville, North Carolina. It's a beautiful place in the mountains where the leaves are turning colors and the cool mountain air is very relaxing. The San Diego meeting in October 2000 brought in about 1000 people which was fairly typical of our attendance. The Grove Park Inn has just completed their world class health spa and they have a beautiful golf course nestled among the hills of North Carolina.

AO/Beck: Bob, would you please give me the names and contact information for the other ADA Board members?

Manning: If I may Doug, rather than list everyone here, I would simply encourage your readers to visit our web site at www.audiologist.org. All of our officers are listed with addresses and emails addresses.

AO/Beck: Bob, I wish you and the ADA continued success, and I thank you for your time and energies.

Manning: Thanks Doug, I appreciate the opportunity to address the Audiology Online audience.