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Patient Referrals: When It's OK Not to Know

Jorgensen, Lindsey E. AuD, PhD; Messersmith, Jessica J. PhD

doi: 10.1097/01.HJ.0000442740.26852.2d

Dr. Jorgensen, left, and Dr. Messersmith, right, are assistant professors in the Department of Communication Sciences and Disorders at the University of South Dakota in Vermillion.

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Audiology is considered a profession in its infancy. As such, we are still trying to prove our knowledge, necessity, and professional boundaries. Sometimes, this situation may make us feel like we should be able to provide all audiologic services ourselves.

Given the breadth of our profession, though, it is unrealistic for any audiologist to be able to “do it all.” Not everyone can be a pediatric audiologist, just as not everyone can be a geriatric audiologist—and this is fine. There are nuances in each of our specialties that require a depth of knowledge to provide appropriate patient care.



Audiology practice is a science and an art. The science requires a foundation of knowledge, which is expanded by training and education. The art of audiology is developing a depth of experience, which takes time and work. You can change or expand focus, but only with a significant commitment.



While we can't be experts in every area, what is critical is that we have a working knowledge of all aspects of our profession's scope of practice.

When an audiologist is unfamiliar with the situation a patient is presenting, there are two options. The provider can decide: 1) I want to increase my depth of knowledge in this area, or 2) I am confident enough in my knowledge that I am going to refer this patient to another audiologist.

In audiology, teamwork will propel us as specialists, allowing us to tap into the resources and knowledge each of us possesses to provide patient care. This is how much of medicine works.

We have to be OK with saying, ‘I am not knowledgeable about the pathologies, medications, histories, assessment, diagnosis, treatment, etc., of every population and area in our scope of practice. Therefore, if I see a patient who is not within my area of focus, I will refer the patient to another audiologist who has specialty experience in this area.’ For example, we should be able to identify a possible cochlear implant candidate and refer the patient to the appropriate professional if this is not our area of focus.

It is through having expertise in a few areas and a foundation of knowledge across our scope of practice that our colleagues in audiology and in other fields will see us as experts. It is with this expertise that we as individuals, and as a profession, will advance.

Just as with athletics, to be on the team, you must have foundational knowledge of your sport. But, to make the starting lineup, you must show excellence in a specific position.

© 2014 by Lippincott Williams & Wilkins, Inc.