Certain equations are woven into the fabric of American culture as the stars and stripes are in old glory:
• A touchdown—plus the extra-point kick—gives you seven on the scoreboard.
• Get down to the local diner before 5 p.m. to get that early-bird special at a fixed price.
• Drop $5 in a volunteer fireman's boot and find a place to park on the grass at the county fair.
• Get more votes, you are elected–unless it is for president, where the Electoral College formula overtakes the popular vote.
Others? Well, a bit more open to debate and less so to what can be etched into the proverbial stone.
Take the factors used to determine the nation's most—and least—stressful jobs by CareerCast.com in January of this year. Chief among the 11 factors analyzed were: deadlines, hazards, public scrutiny, physical demands, competition, and career growth potential.
In this context, there were the obvious—pilot, police officer, and firefighter—as well as newspaper and broadcast reporters who not only deal with deadlines but lawsuits and layoffs.
Flipping the script, there are the jobs with the least stress, and audiologist (annual median income of $74,890) ranked fourth (behind diagnostic medical sonographer, compliance officer, and hair stylist and in front of university professor and medical records technician).
But is it really as simple as crossing the goal line on a gridiron or choosing between soup of the day or salad before your liver and onions? A police officer could walk the beat in a sleepy town where jaywalking equates to a federal offense, while an audiologist needs to keep pace with ever-changing technology—such as over-the-counter (OTC) hearing aids now law and competition from big-box retailers and other audiologists—or get left in the dust.
With October being National Audiology Awareness Month, it is the perfect opportunity to examine the profession's changes and challenges and determine whether the assessment is accurate enough for audiologists to come dressed among the nation's least-stressed workers for Halloween.
MYTH OR FACT
“One person's source of stress and worry is another's stimulant and source of excitement,” said James W. Hall III, PhD, whose experience in the field spans four decades and whose list of achievements includes founding the American Academy of Audiology (AAA). “The greatest opportunities for professional growth and development present themselves in times of change and even uncertainty. We audiologists just need to shape the future rather than vice versa.
“Actually, I think audiology's new reputation as one of the least stressful professions is quite true. We generally work reasonable weekday business hours with no requirements for taking calls or working a night shift. Aside from a little cerumen, we don't deal regularly with blood or other bodily fluids. Patients certainly feel better about visiting their friendly audiologist than going to their dentist's office or prepping again for their occasional colonoscopy. And audiologists are invariably compassionate folks who are fun to be around. As for salary, there is the potential to live a very comfortable life.”
Neil J. DiSarno, PhD, CCC-A, the chief staff officer of the American Speech-Language-Hearing Association (ASHA), is more cautiously optimistic. He views the field at such a vital point in its evolution that it cannot be without some sprinting to keep pace.
“Where some see challenges, others see opportunity,” DiSarno said. “Bringing to the public's attention the growing number of individuals who are experiencing the effects of impaired hearing will result in greater awareness and knowledge that treatment is available. I cannot think of another time when awareness has been this front and center.”
STATUS: ‘IT'S COMPLICATED’
While it could be argued that the notion of audiology and stress lists its relationship more as “complicated” than proven fact or fiction, it is certain that the field is in for changes looming on the not-so-distant horizon.
According to the Bureau of Labor Statistics, the field of audiology is on the precipice of a growth spurt, with a projected 29 percent increase in jobs by 2024, making it a pace-setter in the race for the title of the fastest-growing job in America (BLS, 2015).
Considering the World Health Organization (WHO) citing advances in medical care and awareness as the main reason for a boost in life span of five years since the start of the current century, and with the projection that the population of those over 65 years old will double by 2050, we have a match made in professional heaven.
While medical advances are extending lives, age- and noise-related hearing loss will leave many of the unprecedented number of senior citizens in theoretical need of hearing assistance.
The WHO is also keeping an eye on the future with the current amount of at-risk young people—an estimated 1.1 billion—using earbuds at unsafe volume levels and extended usage.
Jill M. Gruenwald, AuD, CCC-A, associate director of the adult hearing aid program at the Vanderbilt Bill Wilkerson Center, sees the field as ever-evolving.
“The first thought I had to this question was ‘the only constant is change,’” Gruenwald said, paraphrasing the philosopher Heraclitus. “I have been around the field long enough to have experienced the reality that there have always been changes and challenges throughout the years. Before my time, audiologists could not sell the hearing aids they would recommend. It was believed this was an ethical compromise and the sales portion was left to local dispensers. There continues to be ongoing issues surrounding insurance reimbursement for audiology services.”
She added: “I do not envy the challenges of my colleagues in graduate studies. Audiology is multi-faceted, and the student in your classroom may have a future serving adults or children, a future in diagnostics like balance, or in rehabilitation like hearing aids or cochlear implants… Historically, it may have been feasible to save the business training for those students, requiring it post-graduation. Today's Doctor of Audiology student will likely demand an evolved educational model to develop skills in addition to those needed solely for patient care.
“As the line between patients and consumers blurs, universities are in a position to see these changes in the marketplace and adapt accordingly. I think the most successful training programs will embrace these changes as readily as they embrace changing curricula with every new study published.”
Receiving the baton in the race into the future will be the likes of David Kessler, a second-year audiology student at Vanderbilt, and it would seem he has his eyes wide open.
“It's pretty clear that the field of audiology is going to experience changes in the next few years, especially as OTC hearing aids loom on the horizon,” said Kessler. “It's hard for me to say where I think the field will go as so many variables are still unknown. One direction it seems that audiology is going towards is telepractice/remote services. As a future professional, it will be interesting to see how remote services will be incorporated into the clinic schedule.”
OPPORTUNITIES OR STRESSORS
A four-year bachelor's degree is a precursor to four years of graduate work toward an audiology clinical degree (AuD), and required state licensing make audiologists among the most educated and highly trained health care professionals, dispelling many public misperceptions about the complexities of their jobs.
ASHA shows that most audiologists, 47 percent, are employed in non-residential health care, while 25 percent primarily work in hospitals. Others are found in schools, as employees of school districts, and at universities and the military. Additionally, it's not uncommon for audiologists to opt to work more in research.
This means that varied work situations bring different sets of circumstances that cannot be placed in one neat box labeled “not stressful.”
For example, audiologists in private practice need to combine their professional skills with business acumen. They deal with managing employees, marketing and diversifying their services, staying ahead of competitors, and other daily realities.
One burgeoning reality, sure to trigger stress-related emotions, are OTC hearing aids. With the ink starting to dry on this summer's Over-the-Counter Hearing Aid Act of 2017, sponsored by Elizabeth Warren (D-Mass.), this could be the tip of the iceberg in the movement to create free market hearing aids.
“Let's look at just two populations, those individuals over the age of 75 with impaired hearing and those under the age of 18,” said DiSarno. “Both of those populations have needs that in most cases can only be addressed through professional services. If there are individuals in between those age groups who can benefit solely from a boost in amplification, then devices they find on pharmacy shelves or on the web may alleviate some of the handicapping effects of decreased hearing sensitivity. What audiologists need to be concerned about is that prior to purchasing an amplification device, individuals be seen for an audiological evaluation.”
While its intent is to be more consumer-friendly and help put devices in the ears of those who need them—according to ASHA, fewer than 25 percent of all people needing hearing aids actually get them, with cost cited as an overriding reason—Warren's bill could lead to self-diagnosis and treatment.
“More recently, there has been the rise of big-box and online stores offering hearing aids, as well as the rise in PSAPs that has paved the way for the over-the-counter hearing aid legislation,” Gruenwald acknowledged. “Change can be hard. Are OTC hearing aids a disruptive innovation, making the audiologist a typewriter in a market full of computers? Or does audiology still have a place in the future market? It is natural for that change to be stressful. I do think there is room in the marketplace for different hearing care delivery models; however, it may mean changes to what some audiologists have considered ‘business as usual.’”
A seasoned audiologist like Hall sees no reason why the new wave of audiologists can't find solid footing in the new world order.
“I suspect most baby boomer audiologists remain very positive about the future of audiology, and most actually view our current challenges as a good opportunity to advance the profession in exciting new directions,” said Hall, a professor at the Osborne College of Audiology at Salus University, Elkins Park, PA, outside Philadelphia, and at the University of Hawaii in Honolulu. “My optimism about the profession applies to all of the oft-cited challenges, such as OTC hearing aids, PSAPs, big-box hearing aid dispensing, service delivery models, and potential threats from other health care professional groups.”
So despite the changes and challenges facing audiology, Hall would advise buying those Halloween costumes in bulk. There will be plenty of work for audiologists, enough that stress over losing work due to obsolescence is not in the tea leaves.
“Projections about the increased number of people needing audiology services is one of the main reasons for my optimism,” he said. “The demand for audiology services already exceeds the supply of audiologists, and the demand versus supply discrepancy is likely to increase in years to come. That seems to be a good problem for a profession to be grappling with. I would be rather discouraged and far less optimistic if the profession was attempting to deal with a glut of audiologists and a shrinking demand for services.”