The 40th annual Academy of Doctors of Audiology (ADA) AuDacity convention was held at the Mohegan Sun Casino and Resort in Uncasville, Conn, on September 25-27. As with several recent national conventions, attendance was down. Although more than 350 people were registered for the event, HR estimated an attendance of probably fewer than 250 member audiologists, as the effect of the recent hurricanes, and possibly some push-back from positions taken by the Academy in support of the establishment of over-the-counter (OTC) hearing aids, may have dampened participation. Certainly, the center of conversation at the conference was what impact OTC hearing devices would have on the market, the pros and cons of OTC, and how best to prepare a practice for changes in the wake of the OTC Hearing Aid Act of 2017 being signed into law by President Trump this August.
The convention exhibit hall featured 45 companies, including PSAP (and probably future OTC) manufacturers Bose, ClEAR, Doppler Labs, Ear Technology Corp, Etymotic Research, Nuheara, and Sentibo. Notable in their absence was all but one (Sonova) of the “Big 6” global hearing aid manufacturers.
As usual, the convention’s educational program did not disappoint, and AuDacity 2017 was kicked off with two days of excellent pre-convention seminars. On Sunday, former ADA President Kim Cavitt, AuD, presented one of her popular all-day “boot camps” on coding, reimbursement, managed care, and pricing. In a concurrent all-day session, former AAA President Richard Gans, PhD—a world authority on vestibular and audiological care—presented “Bringing Balance Back: Seven Rules of a Successful Balance Practice.”
OTC and Me. On Monday, a pre-conference general session brought together three separate panels of experts to address issues related to OTC devices. The first panel addressed the new OTC legislative and regulatory environment, moderated by long-time industry executive Delain Wright of Intricon, and featuring comments from Vicki Walling of ADA’s lobbying firm Prime Policy Group, Brian Markwalter of the Consumer Technology Association (CTA), Dr Cavitt, and Mark Kaal, the former president of ExSilent who is now CEO of the start-up company Samplified Audio. Additionally, Srinivas “Nandu” Nandkumar, PhD, the branch chief of the FDA’s Division of Ophthalmic and Ear, Nose, and Throat Devices joined via a remote video connection. Dr Cavitt noted that the new legislation, as currently written, is pre-emptive, meaning that it would prohibit state or local governments from thwarting consumer access to OTC devices; however, depending on state licensing provisions, professionals will still need to comply with their specific and unique dispensing laws. She emphasized that these licensing requirements are typically not monitored or influenced by the national dispensing organizations, but rather by the individual providers and state associations. Dr Nandkumar provided no real details about the FDA’s deliberations, except to note that a formal comment period would be held in which stakeholders could weigh in, and that FDA has been actively listening to input during their many meetings, as well as the PCAST and NASEM workshops and publications. Wright pointed out that the OTC category—whether labeled a “hearing aid” or “hearing device”—will include devices that rely on self-service and/or will be serviceable by hearing care professionals, with the latter yielding superior results but at higher costs.
The second panel provided OTC/PSAP industry insights from Mead Killion, PhD, of Etymotic Research, K.R. Liu of Doppler Labs, Kevin Franck, PhD, MBA, of Bose Corp, and Dan Schumaier, PhD, of Ear Technology Corp. The general consensus of the panel (all audiologists except Liu) was that OTC devices were inevitable and will ultimately lead to greater consumer engagement and increased demand for professional services. The changes are not unlike previous times of great innovative periods in the industry, noted Dr Schumaier, who recounted the huge technology leaps in impedance, infant screening, and other devices. He says, similar to previous eras, business models and providers will be required to adapt. Dr Franck believes the net effect will be that audiologists will spend less time dealing with devices and more time focusing on the patient’s unique audiological needs. Dr Killion said that most, if not all, of the major hearing aid manufacturers already have designs for OTC-type devices and are already prepared to compete in this sector if and when it becomes commercially desirable or necessary to do so.
The third panel, moderated by Amyn Amlani, PhD, took on the issue of how to incorporate OTC devices in a practice and included ADA President-elect Alicia Spoor, AuD, Jacque Scholl, AuD, Chris Hamilton, AuD, and Debra Abel, AuD—most of whom are already offering PSAPs and/or “hearables” in their independent practices. As with the previous panels, these audiologists advocated for moving away from a product-oriented business model to one that emphasizes service and patient-centric care, and in most cases unbundling prices so they can help consumers who may already have a device. Dr Scholl set up a separate LLC business (what she calls her “widget shop”) based on a retail model that complements her PLC audiology practice, and a “birth to earth” full-scope-of-practice philosophy was advocated by Dr Spoor. Finally, a Top-10 list of “What Audiologists Can Do That OTC Can’t” was presented by Dr Hamilton that included, at #1, the real-ear unaided response (REUR) test which can be used to assist in the fitting of any amplification device.
A Monday luncheon seminar further familiarized attendees with a half-dozen devices related to the OTC/hearables market, including presentations on Sentibo by David Akbari, AuD (Intricon Europe, product currently not available in US); Bose Hearphones by Lisa Cronin; Clementine Wear and Snow Owl by Mark Kaal (Samplified Audio); the EarVenture economy hearing aid by Rick Musselman (Intricon/ADA); IQbuds by Bruce Borenstein (NuHeara), and the PLAID Personal Listening Device by Dr Schumaier.
Other seminars and learning events. On Monday afternoon, Dr Amlani and John Pumford, PhD, of Audioscan showed how REM can help build patient loyalty and success in a practice. Numerous other excellent seminars and special presentations were offered throughout the 3-day the convention, ranging from “Integrating Person Centered Care Into Your Practice” presented by Barbara Weinstein, PhD, and Jennifer Gilligan, AuD, to “Hearables Now and Later: A Review of the Products Today and Tomorrow from CES 2017” by Dan Quall, MS.
On Tuesday afternoon, after the General Session, a special presentation titled “The Role Your Staff Plays in Patient Conversion” featured practical advice from CareCredit Director of Provider Marketing (Vision & Hearing) Randy Baldwin, AHAA President Tina Soika, and long-time industry consultant and trainer Von Hansen. Soika made the point that everyone in a practice is responsible for generating positive online reviews, and especially emphasized that the “front office person or patient care coordinator is the ‘CEO of first impressions.'” Hansen demonstrated the merits of having staff members who have been provided with scripts and in-depth training so they can accurately and easily answer common questions such as “How much do your hearing aids cost?” Baldwin reviewed interesting CareCredit research findings from the company’s “Path to Purchase” consumer study, pointing out that 27% of consumers researched payment and financing options online, and 47% looked at the online reviews of providers.
Also on Tuesday afternoon, a panel discussion moderated by former ADA President Brian Urban, AuD, featured comments from President-elect Spoor, dentist Patricia Takacs, DDS, and optometrist Barry Barresi, OD, PhD. Dr Barressi had served for many years as executive director of the American Optometric Association (AOA) and was CEO of its wholly owned, profit-making subsidiary, AOAExcel. He pointed out that healthcare is a business shaped by regulation and payment policies, and the key to optemetry’s success was in having parallel expansion of scope of practice and scope of payment. He also noted that there were only two key optometric professional associations, and both worked side-by-side to achieve their goals with one focusing on legislation and scope of practice, and the other focusing on academic and clinical matters. He said that, although there was a lot of consternation from AOA members when direct-to-consumer glasses became available, the real threats to the field continue to come from attacks on optometry’s independent diagnostic authority—not from OTC manufacturers.
On Wednesday morning, Dr Amlani reviewed sound quality ratings for traditional and OTC products obtained under real-world and laboratory conditions. That afternoon, a special luncheon presentation was hosted by Unitron’s Jason Mayer and Craig VanDeVelde titled “Using Big Data and Benchmark Metrics to Become a Best-in-Class Practice.” Also, later in the day, retired Air Force Master Sargeant Sean Lehman offered insights into understanding the unique needs and mindset of veterans in his seminar, “Heros with Hearing Loss: Treating Our Nation’s Veterans.”
ADA Awards and Honors
At the AuDacity 2017 General Session, ADA President Angela Morris, AuD, said the organization continues to be a catalyst for change, “boldly going where no profession will go.” She said that the Academy does not fear change and disruption, but instead embraces it while preparing its members with new tools, resources, and professional relationships. With ADA’s support of the recent OTC legislation, Dr Morris believes the Academy has gained a lot more respect and political capital with legislators and decision-makers in Washington, DC. She says this will be particularly useful in making headway on its ambitious 18×18 initiative which would by the end of 2018 pave the way for audiologists to be listed in the same category as dentists and optometrists, to provide for a broadened scope of audiology services available for coverage under the Medicare program, and to enable Medicare beneficiaries to have their choice of a qualified audiologist.
Dr Morris also celebrated the achievements of several outstanding audiologists. Jana Brown, AuD, was presented with the Leo Doerfler Award to commemorate the outstanding clinical services that she has provided in her community throughout her career. “Dr Brown is a most deserving recipient who exemplifies outstanding clinical services and the very best in patient care,” said Dr. Morris. “Over the course of her 30-year career, she has consistently demonstrated outstanding efforts to accommodate patients, and to meet them where they are.”
Debra Abel, AuD, was presented with the the Joel Wernick Award, which recognizes an outstanding educational contribution within the profession of audiology or the field of hearing science. “Dr. Abel is a true renaissance woman, widely recognized for her expertise in the areas of billing, coding, and reimbursement,” said Morris. “Dr Abel is an avid teacher and transformative leader who is widely sought after to present at training seminars, to author articles, and to answer one-on-one questions on quality outcome measures and practice operations.”
Kristin Davis, AuD, and Alexandra Tarvin, AuD, were both honored with the Craig W. Johnson Audiology Advocate Award for their work in advancing the Audiology Patient Choice Act in Congress. “They have mobilized legislators and audiologists to secure public policy changes that will improve patient care and provide professional parity for audiologists with other clinical doctoring professionals,” said Morris. “Dr Davis and Dr Tarvin are the examples to follow for effective advocacy to move the profession forward.”
The South Carolina Academy of Audiology (SCAA) was also recognized by Dr Morris with the President’s Service Award for Advocacy to recognize SCAA’s contributions to ADA’s advocacy efforts in support of its mission.
The General Session also featured the ADA Business Plan Competition, which was moderated by Fuel Medical Co-founder Shawn Parker. The competition was created to provide audiology students with practical hands-on business experience, and the opportunity to showcase their knowledge and creativity. Early-round activities included development of a written executive summary and business plan, and finalists received an all-expense-paid trip to AuDacity where the competition culminated in rapid-fire questions from judges Dan Quall, MS, Sarah Laughlin, COPM-C, and Ellen Baker, AuD. Jasmine Wilson, representing the University of North Carolina, earned first place honors and a $5,000 cash grant. Second- and third-place honors went to Salus University students Katrina Smith and Jessica Strzepek, and Roksolana Voshchilo and Amanda McVey, respectively.
The current president-elect of ADA is Alicia Spoor, AuD, and the organization’s board of directors include Past-President Rita Chaiken, AuD; Secretary Patricia Dabrowski, AuD; Treasurer Ram Nileshwar, AuD, and Directors-at-Large Larry Schmidbauer, Christopher Hamilton, AuD, and Jonette Owen, AuD. Stephanie Czuhajewski is ADA’s executive director.
Next year. The 2018 ADA Convention will be held October 22-24 at the Gaylord Palms Resort in Orlando. For more information, visit the ADA website at www.audiologist.org.
Acknowledgements: Awards photos supplied courtesy of ADA.