Interview with Soriya Estes, Au.D.
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Topic: The HEAR Clinic, Estes Audiology Collaboration with Health Alliance for Austin Musicians
Soriya Estes, Au.D.
CAROLYN SMAKA: Soriya, how did the HEAR Project to get started?
SORIYA ESTES: As an audiologist, I really wanted to do some kind of outreach for musicians, since their livelihood, their profession, depends on their hearing. Many musicians do not have access to hearing healthcare, because they are self-employed and may be uninsured. They also may have lower income levels. Custom earplugs may be out of reach for them financially as well. While we know that $150 for a pair of musicians' earplugs is certainly less expensive than spending several thousand dollars on hearing aids down the road, it's not a priority when you are just making ends meet.
SMAKA: With your practice located in the Austin area, were you already seeing a lot of musicians?
ESTES: You know, living in this community exposes us to a lot of good, live local music and by default we were likely seeing more musicians than a typical audiology practice. We see some large regional bands for custom monitors, and then Ray Wylie Hubbard put together a short promotional piece for our website after receiving services from our practice. It kind of spread word-of-mouth that our practice was proficient in musician products so by default we started seeing more and more. This further peaked my interest in trying to figure out how we could better serve the music community.
Then about three years ago, I was listening to the radio and heard the Health Alliance for Austin Musicians (HAAM) promoting their annual benefit day. HAAM is a 501(c) non-profit organization that provides access to affordable health care for Austin's low-income musicians. Their annual benefit day is a big deal in Austin. Businesses donate 5% of the day's proceeds to HAAM, while musicians perform throughout the city at retail stores, outside stages, City Hall and more. It's a wonderful day to shop, hear great live music and support HAAM.
As I was listening to the radio ad, it went on to list the HAAM healthcare providers. At the time, HAAM's providers included primary care, mental health and dental care.
I went, "Wait a minute! They serve musicians in our community and they don't have hearing healthcare!" It all clicked, as I had been already been thinking for some time that as audiologists, we need to be doing more outreach with musicians.
SMAKA: So you contacted HAAM?
ESTES: Yes. Eventually I contacted Carolyn Schwartz, HAAM's Executive Director, to see about collaborating. When I spoke with her, she said, "Soriya, something's going on here, because we just surveyed 1,000 local musicians and asked them what other services they would like us to provide, and over 70 percent said hearing."
SMAKA: Wow!
ESTES: The timing was amazing, because she had just received the survey results back the week before our conversation. It seemed like it was meant to be.
Because HAAM is a non-profit organization funded by private grants, they needed to get the funding together to offer hearing healthcare. On my end, I worked with both Sensaphonics and Westone, to help get some lower-priced Etymotic filtered earplugs for the musicians.
The HEAR Project was born two years ago as we got our first grant funding.
Once per quarter or four times per year, I close my practices and all of the audiologists and administrative staff come to Austin. We spend an entire day seeing 80 musicians for what we call a HEAR Clinic. We screen their hearing and educate them on noise exposure relative to their specific situation. Some may be in the symphony, so we may talk to them about where they sit in the pit. Some are in rock bands, so we may talk about the hazards with their particular instrument. We try to provide individualized education. And, we take ear impressions for customized musicians' earplugs. The musicians pay a $25 co-pay, and everything else is funded by the grants.
The Estes Audiology Hearing Centers' Hear Clinic team: Back row L-R: Adriana Rodriguez, B.S., Soriya Estes, AuD, Meghann Davis, B.S., Kelli House, M.A., Cathy Edison. Front row (L-R) Amanda Zappler, AuD, Keri Fryer, Shelley Smith, AuD, Mandi Fisher, AuD
SMAKA: What are some of the reactions of the musicians who visit the HEAR Clinic for the first time?
ESTES: They are so appreciative, and just so excited about finally having some good hearing protection. We have heard countless musicians tell us, "I've always wanted good hearing protection, but it's been unaffordable and out of reach until now."
SMAKA: Soriya, what about those who fail the screening or need further follow-up?
ESTES: Great question. Some of the musicians indeed need a full audiological battery and have never seen an audiologist before.
For these people, we partner with the University of Texas at Austin. UT-Austin has a Speech and Hearing Clinic, and a doctoral program for audiologists. They work on a sliding fee scale for these musicians, so we collaborate with them to refer and schedule any musicians who need a full assessment. Also, students from the UT program assist us during the HEAR Clinics and it's a great experience for them. It's a different type of clinical experience than they may have had elsewhere.
SMAKA: How have you and your audiologists gotten training on musicians' issues?
ESTES: I credit my audiologists for doing a lot of the research on their own. There's a textbook, "Hearing Loss in Musicians: Prevention and Management" by Marshall Chasin that's been a great resource for us, and we've also received information and support from some of the manufacturers such as Sensaphonics and Westone. In addition to understanding hearing protection, there is an ever-changing array of new products, i.e. monitors, custom solutions, etc. and it can be a challenge to keep up. So we have in-services in all of our offices to try and stay up to date.
We're constantly tweaking and looking at what we can do better, as far as the HEAR Clinic is concerned. After every clinic, we send out a Survey Monkey to the musicians served to find out about their experience. We want to know: did they understand the screening and feel it was valid? Did they find the education helpful, or do they want more information? That sort of thing.
SMAKA: I'm assuming with all the people that you've served so far, you've seen the full gambit of people with normal hearing, to high frequency hearing loss from noise, etc.
ESTES: Absolutely. We have seen the full range. With some, we've been very pleasantly surprised to find normal hearing screening results even though they've been a musician for 25 years and have never used hearing protection. We're like, wow, how'd you get away with that? We've also seen some failed screenings for musicians who turn out to have big noise notches even though they are in their early 20's. In those cases we really drive home to them that they've got to take action now if they want to have another 30 - 40 years in the business.
Counseling an Austin musician about noise exposure and hearing protection at the HEAR Clinic.
SMAKA: As far as you know, are there HAAM-type organizations in other parts of the country?
ESTES: The whole concept of providing health insurance for musicians is gaining ground in other communities. HAAM was founded five years ago by a wonderful woman, Robin Shivers, and some other extremely insightful local Austin activists, but other music communities are now looking at the same model. Nashville, for example.
I really want to encourage audiologists to seek out these organizations, or to think outside the box to determine what you can do in your area to create hearing protection awareness.
It is such a good way to give back to musicians, who give us so much with their music. Not to mention all they add to the local economy, especially in a place like Austin. You don't realize, but sometimes they come to the Hear Clinic and they're extremely nervous. They're anxious because most of them haven't ever had their hearing tested and they're antsy because they think they're going to receive bad news. So we try to stay upbeat and positive, and have fun as well. All of our staff love HEAR Clinic days because we respect musicians so much and we enjoy giving back.
SMAKA: Well this interview seems perfectly timed, since October is both National Protect Your Hearing Month as well as Audiology Awareness Month.
ESTES: I agree. As professionals, we often focus on our clinical services such as our diagnostic test batteries or our hearing aid business, and we're not doing as much as we can individually to get audiology out there in the mainstream. Even though we didn't get involved in the HEAR Clinic to promote our practice, by default, it has gotten our name out there. It's been great publicity even though that is not our goal, it's not our reason we're doing this and it is not something we focus on. It's been a good thing for us but more importantly it's hopefully been a good thing for the hundreds of musicians we have served so far through the HEAR Clinics.
SMAKA: Tell me about your practice, Estes Audiology Hearing Centers.
ESTES: I live in Austin, and we have two private practices - one in New Braunfels, which is between Austin and San Antonio, and the other in Georgetown, north of Austin. We also have audiologists in Kyle and Boerne, where we contract with two otolaryngologists to provide audiological diagnostic and hearing aid services.
SMAKA: You seem to be someone who is passionate about music. What kind of music do you like?
ESTES: I like many different genres of music. You should see my radio dial, I've got everything from classical music stations to hard rock to adult alternative, and just about everything in between.
Here in Austin there's a music festival coming up, called The Austin City Limits Music Festival. The festival includes 150 bands on 8 stages over 3 days and has every kind of music you can imagine.
We make a point of going, and I force myself to go to listen to new stuff, and figure out what I like.
SMAKA: And you wear your hearing protection, I take it, when you go?
ESTES: I do. I've got my ER 15s;they're purple and yellow with white swirls. They go with me wherever I go, and my daughters wear their Peltnor muffs, and together we safely enjoy the festival.
SMAKA: When is the next HEAR Clinic?
ESTES: We're done for this year, but the HEAR Project is funded for 2011 so we're looking forward to continuing next year. We had our last HEAR Clinic for 2010 two weeks ago. In total, we saw 320 musicians this year and I would love to set our goal for 400 next year.
Soriya taking an ear impression of one of the musicians attending the HEAR Clinic.
SMAKA: That's a lot of impression material.
ESTES: Yes, a lot of impression material! For the two years we've been doing this, we've seen just over 500 musicians.
SMAKA: Excellent. I've really enjoyed speaking with you Soriya, and viewing the photos from the HEAR Clinic. I would love to catch up with you down the road to see how things are going with next year's program. Thank you for your time.
ESTES: That would be great. Thank you, Carolyn.
