This letter is reprinted here in its entirety, with permission from ASHA. We are grateful to ASHA for allowing Audiology Online to reprint this document. ---Editor
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December 10, 2001
Dear Colleague:
We know that a number of questions have been raised about ASHA's joining the America's Hearing Healthcare Team (AHHT) initiative. There also has been much misinformation circulated, largely by the leadership of the American Academy of Audiology and the Academy of Dispensing Audiologists regarding this alliance. ASHA's audiology leadership believes that such strategic alliances with related professional and consumer organizations on a specific topic are in the best interest of the profession. The AHHT initiative, outlined in a joint statement with AAO (which can be found in 2001 Audiology in ASHA and on ASHA's Web site), includes the following goals:
- Increasing public awareness of the impact of hearing loss
- Serving patients by a team approach with multiple points of entry to the hearing healthcare team
- Expanding access to care and enhancing the treatment of hearing and balance disorders
Specifically, the America's Hearing Healthcare Team initiative is a public awareness activity designed to help the public and referral groups know more about how to access the hearing health care system. Over 80% of individuals who need hearing and balance services do not obtain them or do not access the appropriate professionals for services. This project targets that population.
The early literature produced by the originators of the AHHT initiative contained substantial amounts of misinformation, a disparaging definition of audiologist, and an inaccurate definition of hearing instrument specialist; this was a major concern to audiologists and the ASHA audiology leadership. The AAO-HNS Web site also described the otolaryngologist as the leader of the team, which was in conflict with the joint statement signed by ASHA's and AAO-HNS's leadership in September 2001. The audiology leadership of ASHA's Executive Board and its National Office had two choices: either let the misinformation continue to be distributed unchallenged and thus place audiology in an unfavorable position in the AHHT initiative or approach AAO-HNS about changing the AHHT initiative promotional materials. We elected to try to effect a positive change in the materials associated with the initiative. ASHA was able to convince the AAO-HNS leadership that their Web site contained gross (and objectionable) misinformation regarding audiologists and that such misinformation could be confusing to the public and all referral sources and detrimental to all hearing healthcare providers. As a result, AAO-HNS dramatically modified the AHHT initiative information on their Web site (
www.entnet.org and www.entnet.org/ahhti.html) as of 9 November 2001.
ASHA's leadership felt strongly that otolaryngology needed to recognize audiologists as autonomous and independent. Thus, ASHA and AAO-HNS established the following mutually agreed-upon definition of audiologists:
Audiologists are autonomous professionals and an integral part of America's Hearing Healthcare Team. They collaborate with otolaryngologists and other members of the hearing healthcare team to provide the most efficient access and best quality care to children and adults with hearing and balance disorders. Audiologists may practice independently to identify, assess, and manage disorders of the hearing and balance systems. The nationally accepted certification standard for audiologists is the ASHA Certificate of Clinical Competence.
This was the first time that any physician's group recognized audiologists as autonomous and independent practitioners. AAO-HNS also acknowledged that there are multiple points of entry into the system, which indicates that patients can and should be served by audiologists. We believe that public recognition by AAO-HNS of audiologists as autonomous professionals who may practice independently and serve as a point-of-entry into the hearing healthcare system is a significant change from the previous philosophy and statements by AAO-HNS that audiology was not an appropriate entry point for individuals in need of hearing and balance services.
ASHA looked at the original materials and articles relating to this project and was horrified at the description of audiology. We elected to insert ourselves into the situation in order to develop many positive changes when no other group was either willing or able to do so.
We recognize that the differences between audiology, otolaryngology, and non-audiologist hearing instrument dispensers have historically overshadowed our common interests in improving hearing healthcare for all Americans. By coming together at the same table, we can focus on resolving the differences associated with the language used in the AHHT initiative. This will eventually allow us to better serve the 28 million people with hearing loss. ASHA is committed to continuing its support of the audiology profession and plans to do so in positive ways-by using our resources to achieve our desired outcome of increased access, autonomy, recognition, reimbursement, and respect for the profession of audiology and improved services for individuals with hearing loss.
Additionally, as a result of concerns that hearing instrument specialists had been added to H.R. 2934 (the Medicare Aural Rehabilitation and Hearing Aid Coverage Act of 2001), ASHA lobbyists recently met with the chief of staff and health legislative aide for Congressman Mark Foley (R-FL). Congressman Foley's staff made it clear that the bill does not designate hearing aid specialists as providers and that Foley had no intention of reintroducing the bill in the 107th Congress (which continues through the end of 2002). ASHA is very interested in the aural/audiologic rehabilitation portion of this bill and is working hard to see it gain support and visibility. ASHA will continue to actively seek other opportunities for coverage of audiologic/aural rehabilitation (AR) services by audiologists through both public and private health insurers.
We will continue to proceed in the best interests of audiologists and will update the membership on these important matters. In the future we want to be able to get information of this kind to you as quickly as possible. To help us do this, please provide your e-mail address as soon as possible by calling the Action Center at 1-800-498-2071 or by registering on the Web Portal at https://community.asha.org/pages/GettingStarted/ if you have not yet registered for an ASHA username and password on the new professional site. You will be prompted for your e-mail address as part of the registration process. If you have already registered with the ASHA site but need to update your e-mail address, go to https://www.asha.org/eweb/ashalogin.aspx?site=ashacms&webcode=aulogin&endpoint=sso&returnurl=/eweb/startpage.aspx.
Thank you for your continued support. If you have questions, contact any one of us or Vic S. Gladstone, chief staff officer for audiology at vgladstone@asha.org.
Best wishes for the New Year.
Sincerely,
John Bernthal
President
Susan J. Brannen, CCC-A
Vice-President for Professional Practices in Audiology
Kenneth E. Wolf, CCC-A Coordinator
Audiology and Hearing Science Assembly
ASHA Legislative Council
Nancy Creaghead
President-Elect
George O. Purvis, CCC-A
Vice-President for Quality of Service in Audiology
Kathleen Peterson, CCC-A Associate Coordinator Audiology and Hearing Science
Assembly
ASHA Legislative Council
Larry W. Higdon, CCC-A
Vice-President for Governmental and Social Policies
