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Audiowhat? Acknowledging and Overcoming the Invisibility of Audiologists

Wallace, Kathleen

doi: 10.1097/01.HJ.0000526532.92080.19
Viewpoint

Ms. Wallace is a fourth-year AuD student at the CUNY Graduate Center. She is completing her residency at Mount Sinai's Center for Hearing and Balance in New York.

When I tell someone that I am pursuing a career in audiology, the most common response is “What?” This creates a perplexing situation; did the person truly not hear me? Does he or she not know what audiology is? Or is this someone's corny uncle making a topical joke? The truth is each answer does hold some merit, and that is exactly the problem.

Audiology, education, doctor, audiologist, physician

Audiology, education, doctor, audiologist, physician

According to the American Academy of Audiology (AAA), the scope of practice of an audiologist encompasses “the prevention of hearing loss and the audiologic identification, assessment, diagnosis, and treatment of persons with impairments of auditory and vestibular function” (AAA, 2004). In layman's terms, doctors of audiology work clinically in the assessment and rehabilitation of hearing and balance.

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MISUNDERSTANDINGS AND STEREOTYPES

With such a broad scope of practice, one must wonder: Why are audiologists one of the best-kept secrets in health care? It certainly is not due to a lack of prevalence. Hearing loss ranks as the third most prevalent chronic health condition in the United States, ahead of more commonly acknowledged conditions like diabetes (CDC, 2016). Yet, only 23 million Americans with any degree of hearing loss actually pursue intervention in the form of hearing aids (Arch Intern Med. 2012; 172[3]:292). And those who do decide to act on their hearing issues wait an average of seven to 10 years from when they begin to experience hearing difficulties to when they enter an audiologist's office (ASHA, 2012). This is due to many factors, including the general public's misunderstanding of hearing loss and the confusion about how to get hearing health care.

Most Americans succumb to the ageist assumption that hearing aids are only for the old and that wearing them will cement one's elderly status—a social white flag signifying that one has surrendered to the aging process. It's a position few covet in a society that often fails to acknowledge the value and worth of its elders. While this viewpoint is flawed in many ways, particularly as hearing loss can happen at any age, it has been a commonly held notion that has grown nearly impossible to shake.

But even if hearing aids were coveted, most people don't view their hearing difficulties as severe enough to warrant any form of intervention. Hearing loss most commonly occurs gradually over time, making it notoriously difficult to perceive. While those with vision loss can easily notice when images grow blurry, we are far less acute in our ability to assess our own hearing. As a society that craves immediate results and simple solutions, hearing aids fail to meet these unrealistic expectations. Hearing loss requires a great deal of effort, and while hearing aids certainly ease the burden of communication, the complexities of hearing loss prevent a complete return of normal hearing. Rather, hearing aid users must learn to use these new devices and develop effective communication strategies to maximize the benefit of their increased access to sound.

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OVERCOMING INVISIBILITY

However, audiologists would be remiss to not acknowledge their own role in the hearing health care crisis. Audiologists have failed to convey the importance of safe listening and the repercussions of hearing loss—commonly noted as an invisible disability. It has left the public in the dark, with limited knowledge of who to turn to or where to go if one has hearing concerns. As a potentially powerful and influential voice, audiologists have not advocated to the necessary extent for the millions of Americans with hearing loss and their concerns that range from health care legislation to accessibility in public spaces and the workplace. Audiologists should be visible allies of the hearing-impaired community, and serve as a beacon for hearing health within the broader medical community.

Yet, the invisibility of audiology is also a grave disservice to its own profession. With less than 13,000 professionals nationwide, the field must collectively find its voice and standing ground within the broader landscape of health care by advocating for its scope of practice and educating fellow health care providers on the importance of hearing, including how to most effectively communicate with patients with hearing loss (Bureau of Labor Statistics, 2016). Though a small profession, audiologists have not solely devoted themselves to one professional organization. Multiple governing bodies, such as the AAA, American Speech-Language-Hearing Association, and Academy of Doctors of Audiology, all represent the profession to some degree and, at times, with conflicting visions for the field. This lack of unity only aggravates the confusion and mystery surrounding our profession.

Perhaps it is time for audiologists to fundamentally re-evaluate the duties of our profession. We must ask ourselves if we are doing enough to improve the public awareness of hearing loss and audiology. It would behoove audiologists to lead the charge in these efforts. We must challenge ourselves to expand the scope of the practice to better advocate for those with hearing loss, educate the public, and promote our profession. If we choose to not view these as equally important facets of our profession, then we are not fulfilling our responsibilities.

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