For the profession of audiology to gain the respect it deserves in the healthcare arena, its practitioners need to become independent and autonomous.

By Susan B. Paarlberg and Tracy Harding

Almost since the AuD movement began, there has been a lot of talk about "upgrading the profession" and "making the professional transition." The AuD has certainly brought audiology increasing success, recognition and acceptance among patients and others in the healthcare marketplace.

But for all its success and far-reaching travel down this historical path, audiology still lags behind in several areas when compared, as it often is, to other doctoring healthcare professions like dentistry, optometry and podiatry. The biggest differences likely stem directly from audiology's model—which has not yet become rooted in practice ownership and rather, for the majority of audiologists, is still built around an employer-employee framework.

However, many of the fruits for which audiology is still searching—increased earnings, greater autonomy, direct access and expanded insurance coverage—may more easily be gained by a profession that stands on its own two feet.

Audiologists work in such wide and varied settings that it is not realistic to expect all practitioners to make the move to private practice. Nor is it a transition that will happen overnight. But all audiologists can adopt an ownership mentality, right now, to contribute to the culture change that will shape and mold audiology's image and future into a more independent and autonomous profession.

Ownership For Everyone

Ownership is about more than a physical space or legal papers. Audiologists can, and should, own their own expertise. They can own responsibility for their patients' care. And they can also own their career and future. An attitude of ownership over all these intangibles encourages a higher level of professionalism and will set the stage for audiologists to further evolve into the respected, independent body of experts they have prepared to become.

Owning expertise means making sure skills and knowledge are kept continually up to date and using that training to always provide the best patient care. It also means consulting with colleagues in a professional and collegiate manner, and it may mean taking a stand for your own expertise among non-audiologist colleagues and others as you navigate successful patient outcomes and advocate on their behalf.

Audiologists also can own complete responsibility for their patients' care, which involves everything from proper and accurate diagnoses to effective and successful communication, clear explanations of options, thoroughly developed treatment plans, and appropriate referrals. Responsibility means providing patients with the outcome they came looking for when they walked in the audiology door, whether it be the ability to communicate again with loved ones, perform more effectively on the job, or explore new, high-tech communications options.

Christine Lomey Ulinski, AuD, has worked as a staff audio-logist at Hines VA Hospital in Hines, IL, for almost 6 years. While not in a private practice setting, she embraces the ownership mentality everyday.

"I see ownership mentality as ÔI own my work' and ÔI own my patient's care,' and taking ultimate responsibility for our patient's care is the first step on this path," Dr. Ulinski says. "Even in a nonprofit situation, you need to be aware of the revenue you are generating as well as the expenses you are generating, because this will let you know what you are worth to your institution. We are all in business, even if we are not self-employed.

"I try to maintain that ownership attitude even when faced with layers of bureaucracy, and that attitude may mean speaking up and advocating on behalf of a patient," Dr. Ulinski says. "In some situations, I have had to research and provide support for specialized equipment for unique patients, or refer out for specific testing. The ownership mentality also means that if I disagree with a referral, I will educate the physician or nurse practitioner about the situation and refuse to do the assessment."

Employee vs. Proprietor

Audiologists are professionals—professionally educated, professionally oriented, and professionally prepared. Audiologists enter the profession expecting all the rights and privileges bestowed on healthcare professionals. It is critical, then, that future performance meet expectation.

Whether or not you work for yourself or someone else, you can go to work every day with a proprietor or "owner" mentality. Don't go to work to be an employee—go to work standing tall for the career you love. Through your actions, demand the respect, independence, authority and autonomy that you deserve as a doctoring professional.

Many employees go to work waiting and expecting to be told what to do. They don't ask questions, they don't think outside the box, and they see their position as a "job" without fulfillment or future options. They allow outside forces and circumstances to control their performance, mood and self-worth, and adopt an "us versus them" mentality.

Professionals, proprietors and owners carry with them a different mentality. They look for the big picture, take pride and ownership in their purpose, and continually strive to improve themselves and the others around them. They rely on their inner strength, believe in their abilities and refuse to allow outside events to influence their performance or decisions. They take personal responsibility for their work, solve problems proactively and share in their company's success, including recognition of their own contributions. They stand up for what they know, work side-by-side with professional colleagues and consider it a privilege to continually work to improve the art of their profession—audiology.

Many of the intangibles everyone is looking for in their life's work—autonomy, respect, authority and independence—are earned through per-formance. Autonomy, individually or as a profession, means recognition for knowledge and skills and attaining a certain level of professional empowerment. Respect comes from patients, who see you as a trusted healthcare professional, as well as colleagues and employers who see you as an essential contributor to the healthcare team. Authority means you have earned the

right to take full responsibility for your patients' audiologic care and can exercise independent judgment—even if it contradicts other evaluations and recommendations. Independence means you can believe in and rely on your own skills and abilities, and stand as a powerful representative of your profession.

These intangibles will come slowly over time as you build your career and make yourself invaluable to your patients and others by taking the extra time and going the extra mile because it matters and is important, not because you have to. The ownership mentality is not something you have to be born with—it's something you can nurture and develop as you practice the art of your profession.

Culture Change

As audiologists increasingly take on greater roles in the healthcare arena they, and their services, will become more prominent and respected. The profession can help speed the process along by initiating a culture change embracing a model of autonomy and independence across all employment settings—something the profession needs as it continues to grow.

"Independence and autonomy are the next natural step as we grow towards being a doctoring profession," Dr. Ulinski says. "It makes sense logically that audiologists be the entry point for hearing and balance care. Many hearing and balance care issues are not treatable through medical or surgical intervention and, with few exceptions, audiologists have the most specific training in hearing and balance care. For the majority of these patients, audiologists are the best equipped to provide treatment for their problems."

As audiologists continue to set high expectations, raise the bar, and display a unified sense of professional ownership, they will set themselves up for a culture change that will bring greater acceptance and respect for their expertise, capabilities, patient care skills and knowledge. It may even make the eventual leap to private practice ownership less intimidating for those who wish to practice their art as business owners.

As part of its redefined mission, the Audiology Foun-dation of America (AFA) seeks to empower audiologists to become more independent and autonomous prac-titioners. The AFA will continue to support the educational preparation, professional practice and leadership development necessary to help this profession find its respected and authoritative home in the healthcare marketplace.

Susan B. Paarlberg is the executive director and Tracy Harding is the publicity and development specialist for the Audiology Foundation of America, located in Lafayette, IN. Contact them at 765-743-6283.