Leo Doerfler in 1990. Courtesy of the Audiology Foundation of America (AFA).

A remarkable scientist, administrator, and entrepreneur, Leo Doerfler played a key role in solidifying "dispensing audiology" as a profession, as well as helping to establish the Academy of Dispensing Audiologists, the American Academy of Audiology, and the Audiology Foundation of America.

Shortly after Leo Doerfler retired in 1984 from his position as director of audiology at Pittsburgh Eye & Ear, we were talking about some new opportunities. One he mentioned was a prestigious position in Washington DC with the US government. Knowing Leo’s distaste for Washington and anything bureaucratic, we questioned why he would even consider it. “It would give me the opportunity to reward my friends and punish my enemies,” came his wry reply with a smile.

A Man for All Seasons
Leo Doerfler died on July 7th of this year, leaving a legacy of achievement that few could match. Acting on the advice of Raymond Carhart, Leo pursued a doctorate in audiology and became the second person ever to receive a PhD in this field. He went on to co-develop the well-known non-organic Doerfler-Stewart Test for pseudohypacusis, become president of the American Speech-Language Hearing Association (ASHA), direct one of the most prestigious audiology programs in the country, and contribute greatly to hearing care science and education. These accomplishments alone would satisfy a lesser person and rightly fill them with professional pride and fulfillment. Not Leo.

Background. In the late-70s, the community of US audiologists was tightly controlled by the dictates of ASHA and its “plantation mentality”: you could work with (or for) an MD in a hospital setting, or in a university or private practice setting. Whatever the case, your income was to be derived exclusively from audiology services rendered or a base salary. Although the outcome of many tests and consultations indicated the need for amplification (hearing aids), this mode of rehabilitation was under the complete province of what was then referred to as “hearing aid dealers,” and by ASHA dictates, no revenue from these transactions could inure to the audiologist.

A few daring souls attempted to leave the “plantation” to open private practices and sell hearing aids, but they were immediately demonized and summarily dumped from the corps. Leo realized that, if audiology was to survive and thrive, the situation had to change. He and several others began a revolution to secure audiologists as full-time, legitimate professionals standing on their own in the hearing health care market, beholden to no one.

The strategy. Pittsburgh Eye & Ear had about 10 full-time audiologists referring in excess of 1000 hearing aid recommendations each year. A quick survey indicated that in less than 50% of these cases did the patient follow through and seek help by purchasing a hearing aid. So, not only was the quality of care diminished, but patients with real needs were living diminished lives for lack of help. Pittsburgh Eye & Ear committed a year to training and setting up the first major audiology-based hearing aid dispensary in the US, contacting manufacturers to see who would go along with the program. Some agreed to sign on, others politely declined, while many others said “no” with letters of vilification and scorn. When ASHA got word of Leo’s plans, saber-rattling and threats ensued. However, they knew from past experience that they were dealing with perhaps the one person in the United States with the reputation, credibility, and determination that could see this program through. ASHA capitulated in small graduated steps, each one sillier than the last, until finally all sanctions were lifted. This format does not allow for enumeration of all the threats and intimidation engineered as obstacles to the program’s success.

Academy of Dispensing Audiologists. As a by-product of all this activity, Leo realized that: 1) “Dispensing audiologists” were going to need additional education in aspects of business, marketing, finance, etc, that was not a part of their formal education, and 2) Even after the dispensing war was won, there was still an ongoing battle for the soul and survival of audiology from many directions.

The answer was strength in numbers—an organization of like-minded professionals. After a brief but effective anecdotal survey, he felt that the number of potential members was sufficient to launch further action. When Leo contacted some industry friends and associates seeking support, he received a very positive response from Chauncy Hewitt, president of Vicon Instruments in Colorado Springs, Colo. Hewitt offered financial support and, more importantly, a location that could be used as a contact point for potential members who might want to remain incognito for the present time. As the word got out, the response grew stronger, and the time came to act.

Leo chose a group of 10 collaborators representing different areas of the country, all of whom had the desire for change and the required intestinal fortitude. This group got together on a cool fall evening in 1977 at the Vicon plant in Colorado Springs. Leo was elected the first president by acclamation, and a committee was set up to look into various aspects of starting an organization: legal, financial, structural, marketing, membership, etc. But the key foundation of that evening was the group consensus that this organization’s mission was to perpetuate the independence and autonomy of the private practice audiologist in the role of an entrepreneur, and to take their place in the ranks of professional health care specialists. The Academy of Dispensing Audiologists (ADA) was born with its first meeting on November 20, 1978 in San Francisco; a few blocks away at the ASHA convention, that organization’s leadership was in the process of changing its Code of Ethics to permit audiologists to dispense hearing aids. Attendance at the ADA meeting was over 300. As they say, the rest is history.

Audiology Foundation of America. In his continuing passion for the success of the private practice audiologist, Leo was a founding director and participant in the 1988 conference where the AuD degree was born. Leo realized that something more was needed to define the audiologist and distinguish them in the eyes of the patient and the health care world. The audiology profession today bears solid evidence to that foresight, as hundreds of audiologists have now obtained their AuD. An outgrowth of that meeting in 1988 was the Audiology Foundation of America (AFA), which flourishes today as an important resource and has proven invaluable to the AuD movement. Leo had been a member of its Advisory Committee since 1994, and was a substantial contributor to the organization.

f01b.jpg (14874 bytes)Leo Doerfler and Barry Freeman (holding infant) in 1993. Courtesy of AFA.

“Leo had a wonderful dry sense of humor,” says AFA Executive Director Susan Paarlberg. “His manner encouraged other audiologists not to take life too seriously but to pay attention to the important things. With a twinkle in his eye he would make his point, often highlighting facts that support his case that the profession needs to pull itself up by its bootstraps. One common theme was that people should become active in the profession, support the AuD and the AFA.” A memorial scholarship in Leo’s honor has recently been established, and it will be awarded to an outstanding AuD graduate student.

Scientist and Trailblazer
Leo Doerfler was an exceptional scientist, remarkable administrator, and a successful entrepreneur. At the same time, he was a man of great humor, genuine humility, and a time-tested friend to a multitude of people.

Among many other accomplishments, he was present with James Jerger and 30 other audiologists at the founding of the American Academy of Audiology (AAA) in 1988. Leo established the first audiology-based buying cooperative in the industry, Audiology Co-op, which (although ill-fated) was successful for many years and was certainly ahead of its time. He also built a thriving private practice.

But of all his accomplishments and contributions to the profession, his greatest was his foresight early in the game to realize that the growth, success, and future of audiology as a respected profession would ultimately rely on the independence—both financial and professional—of those practitioners who choose private practice as their career path. More importantly, he backed that prescience with strong action that constituted substantial risk to his personal resources and professional reputation.

Leo realized that, without a strong, independent, private-practice component, audiology as a profession could be relegated to a technician’s job. Audiologists could be reduced to the status of lowly dial-twisters subject to the whims of medical doctors, hospital administrators, and university boards. Truth be told, there is still today the need for vigilance and banding together, presenting one image to the public—branding, if you will, the profession of Audiology as a pathway to excellence in hearing health care.

Our tribute to Leo and ourselves should be continuing to strengthen our place in the hearing health care world with the same vigor and conviction that Leo exhibited throughout his whole life and career.

Correspondence can be addressed to HR or Steve Walsh, Dunhill Marketing, 7833 E Ponderosa Ct, Orland Park, IL 60462; email: [email protected].

Stephen Walsh is president of Dunhill Marketing, Orland Park, Ill. A long-time friend of Leo Doerfler, Walsh held an executive position at Vicon Instruments, Colorado Springs, Colo, in the late-70s and attended the meeting that would initiate the founding of the Academy of Dispensing Audiologists (ADA).