Introduction: Interventional Audiology Services | October 2016 Hearing Review
Some 40 years ago, a group of innovative physicians pioneered modern medicine with the invention of angioplasty and catheter-delivered stents for the treatment of heart disease. In one commonly cited example, a catheter was used to open the blocked artery of an 82-year-old woman who refused amputation surgery. At the time, the use of a catheter to keep her gangrene-ravaged left foot was considered a radical alternative to the traditional approach of treatment by amputation. To the surgeon’s disbelief, the intervention worked. The patient’s pain ceased and she started walking again. Even though she did lose three gangrenous toes, she left the hospital on her feet—both of them.
Today many conditions that once required surgery can be treated non-surgically by interventional cardiologists and radiologists. Relying on minimally invasive targeted treatments, these interventional specialists offer the least invasive treatments available, coupled with their diagnostic and clinical expertise.
It’s time for hearing healthcare to innovate in a similar way. This issue of The Hearing Review—which builds on the concepts of interventional audiology first introduced by Bob Tysoe, John Bakke, and me in a series of three articles1-3 published here in 2013 and 2014, and a subsequent 2015 online article by Catherine Palmer4—is another step in the implementation of less invasive, more precisely targeted approaches for treating and managing hearing loss in adults. Although hearing care professionals don’t perform surgery, their “invasive” technique is the selection and fitting of hearing aids. For savvy patients who have lived their entire lives under the auspices of modern medicine, the hearing aid acquisition process appears to be a series of arduous time-consuming appointments.
Of course, the traditional approach of selecting and fitting hearing aids, as well as the series of appointments associated with the device delivery, is likely to remain a necessary part of the services provided to individuals with more complex hearing problems. However, for individuals with gradual (often mild) hearing loss who don’t consider themselves to have a hearing “problem,” the traditional provision of hearing aids predicated around numerous office appointments is analogous to the amputation of the gangrenous foot. When a more elegant, targeted, and/or cost-effective solution is available, why not use it? It’s up to our professions to pioneer these solutions. Here’s why.
The number of adults in the United States over age 65 is expected to nearly double over the next 15 years, and more than one-third of them will have hearing loss. Yet many in this group will not seek treatment for their condition: a chronic condition affecting conversations with family and friends, workplace communication, enjoyment of music, and all types of daily interactions. Further, many recent studies in the peer-reviewed literature show a strong link between untreated age-related hearing loss and the exacerbation of certain downstream conditions such as dementia, social isolation, depression, and overall quality of life. From a public health perspective, it is clear that affordability and accessibility of hearing services are issues that need to be addressed, as adult onset of hearing loss is not a benign condition, and just a fraction of those suffering from it seek help.
Historically, hearing loss in adults has been considered a medical problem necessitating the need to consult with a professional, such as an otolaryngologist, audiologist, or hearing aid specialist. Given the nature of hearing loss of adult onset and its underlying stigma (and other accompanying behaviors), it’s not surprising that the customary binary approach—either you are a hearing aid candidate or you are not—is undesirable to a large swath of individuals with hearing and communication deficits.
Many of the concepts discussed in this issue of The Hearing Review are not really new, but the rise of mobile health (mHealth) offers us new opportunities to rethink and more effectively implement programs, such as community-based automated hearing screenings, tele-audiology counseling services, and self-fitting smartphone-based hearing aids. As healthcare continues to evolve (see the article by Dr John Bakke in the October 2016 edition of Hearing Review), hearing care professionals are sure to feel the effects of the changing demands of the marketplace, as well as the changes to professional licensing laws and industry regulations that may follow.
Over the next few years, amid uncertainty, we have the unique opportunity to bring new ideas to the marketplace. Through experimentation, systematic evaluation, and evolution, a small group of innovative entrepreneurial hearing care professionals are the ones most likely to create sustainable business models in which future generations of professionals will stake their careers. Interventional audiology, this emerging broadly defined subcategory of the profession, is the vehicle in which public health, personal adjustment counseling, tele-audiology, and consumer electronics will converge to meet the market demands of that large segment of patients whose needs remain unmet. Interventional audiology will take us from behind our audiometers and place us, often virtually, in some unfamiliar territory: the community center, a primary care physician’s office, the trauma center, a pharmacy, or maybe even a consumer electronics store or a person’s home. Let’s innovate.
Taylor B, Tysoe B. Interventional Audiology: Partnering with physicians to deliver integrative and preventive hearing care. Hearing Review. 2013;20(12):16-22. https://hearingreview.com/2013/11/interventional-audiology-partnering-with-physicians-to-deliver-integrative-and-preventive-hearing-care2
Taylor B, Tysoe B. Forming strategic alliances with primary care medicine: interventional audiology in practice: How to leverage peer-reviewed health science to build a physician referral base. Hearing Review. 2014;21(7):22-27. Available at: https://hearingreview.com/2014/06/forming-strategic-alliances-primary-care-medicine-interventional-audiology-practice
Taylor B, Bakke JN, Tysoe R. Interventional Audiology, Part 3: Changes in primary care and health belief systems are opportunities for hearing healthcare. Hearing Review. 2014;21(12):14-19. Available at: https://hearingreview.com/2014/11/interventional-audiology-part-3-changes-primary-care-health-belief-systems-opportunities-hearing-healthcare
Palmer C. Interventional Audiology: When is it time to move out of the booth? Sept 14, 2015. Available at: http://www.audiologyonline.com/articles/interventional-audiology-when-it-time-15226
Correspondence can be addressed to HR or Dr Taylor at: [email protected]
Original citation for this article: Taylor B. Interventional Audiology Services: Meeting the Demands of Today’s Consumer. Hearing Review. 2016;23(10):14.?
Other Articles in This Special Edition about Interventional Audiology Services:
What Hearing Care Professionals Need to Know About Today’s Healthcare Economics, By John Bakke, MD, MBA
Intervening in the Care of More Patients: Beyond Clinic-based Testing and Fitting, by Brian Taylor, AuD
Incorporating Health Literacy into Your Hearing Care Practice, by Jennifer Gilligan, AuD, and Barbara E. Weinstein, PhD
Patient Complexity and Professional Time: Improving Efficiencies in the Service Model, by Dan Quall, MS, and Brian Taylor
Thinking Outside the Booth: Three Overlapping Categories of University Audiology Outreach, By Melanie Buhr-Lawler, AuD