Forty years ago, it was common for audiologists to expect that those suffering from hearing loss would see an increase in access to services. Looking back, I see this lack of penetration as a cause because audiology has not expanded from our traditional referral base. Most pediatricians and otologists generally know and respect the services we provide, but we must still prove our value to primary care providers, internists, and family practice physicians.
Medicine and Audiology: Moving Toward a Strong Alliance in the Health Care Landscape
Tysoe R Audiol Pract 2012;4(1):28
Tysoe R Audiol Pract 2012;4(1):34
Robert Tysoe described a disease management model outlining ways that audiologists can help primary care providers manage the hearing impaired. He argued that audiologists know how to measure hearing loss, but they sometimes lack the underlying knowledge for the reasons behind hearing loss such as the disease causing the loss, how a hearing loss diagnosis may help define the disease's progress, or how we can work with physicians to manage the disease.
Mr. Tysoe is a marketing consultant who focuses on relationship marketing and disease-state marketing. Relationship marketing is the process of developing personal contact and a relationship with individuals, whether it is with the hearing-impaired patient or a referring physician. Most audiologists are well trained in establishing a relationship with their patients but not necessarily with developing a productive professional relationship with their referring physicians. Disease-state marketing is educating the physician how a particular disease causes hearing loss by presenting an article from a reputable source. The audiologist then discusses the problems presented by hearing loss.
Mr. Tysoe labeled this process “educate to obligate,” and said disease management will help audiologists “engage the healthcare professional who shares our mutual patients; by sincerely expressing our desire to become part of their patient care team; by becoming their hearing healthcare provider of choice; and by changing the standard of care for the hearing loss patients.” (Audiol Pract 2012;4:34.)
It is important to become better educated about the incidence and metabolic causes of hearing loss in adults to better identify those who need our services using the disease-management model. The incidence of hearing loss in diabetic patients, for example, is twice as high as nondiabetics. (NIH, 2008. Hearing loss is common in people with diabetes; Ann Intern Med 2008;149:1.) Similarly, smokers are twice as likely to have hearing loss as nonsmokers. (JAMA 1998;279:1715.) Secondhand smoke also causes twice the hearing loss in those aged 12 to 19, with a higher rate of unilateral, low-frequency hearing loss of 11.8 percent versus 7.5 percent of 1,533 nonsmoking participants, suggesting some of the hearing loss is conductive. (Arch Otolaryngol Head Neck Surg 2011:137:655.)
Increasing our knowledge base is just half of the equation. We must also relay these data to primary care providers so hearing loss becomes part of the treatment plan. It is our job to let the primary care providers know that diabetic or smoking patients are at high risk for hearing loss and should be referred for hearing screenings. Mr. Tysoe recommended annual hearing evaluations for patients with those conditions.
What are the steps to becoming a disease-state audiologist? The Better Hearing Institute's website has lists of diseases that cause hearing loss and of health problems where hearing loss affects a patient's well-being. Embrace the idea that audiologists can revitalize themselves and their practices by employing the disease-management model. The audiologist should visit the physician on a regular basis. Mr. Tysoe advises contacting the physician once every four weeks.