Major Progress, But Miles to Go

By Kenneth L. Lowder, AuD

As a profession, audiology is currently enjoying a pretty sweet ride. The number of AuDs is at an all-time high and more practitioners are seeking the degree. Hearing aid sales are ever increasing with demographic data showing a huge increase in the number of future potential patients. Research and development of new technology has produced more sophisticated and effective devices for audiologists to fit to our patients.

Much also has been made about audiology's prominence on lists of top jobs, best professions and "in-demand" occupations. But let us not forget that we have only taken the first few steps toward achieving full autonomy.

The first and most crucial step along the path was the recognition that our training programs were inadequate. They were failing to provide our students with the necessary skills to practice our profession. With practitioners demanding action, long overdue change of our education system followed. Consequently, all of our master's degree programs have either closed or converted to AuD programs. These two steps combined to mark a giant leap forward for our profession, but they certainly are not the end of the AuD transition story.

It is widely recognized that there are still too many AuD programs. We currently have 70 training programs and, as a result, our resources are being spread too thin. Other professions have recognized the need to consolidate their programs in order to provide high quality education. For example, dentistry has 55 training programs, optometry has 17, and podiatry has seven.

The AuD professoriate also will benefit from change in response to the new degree. Other healthcare professions rely on scientists and researchers to provide their students with a basic educational foundation. But after that, students are largely taught by those holding a first professional degree. MDs teach medical students. DDSs teach dental students. Since the AuD is intended to prepare audiologists for professional practice, it is time for our training programs to utilize our growing corps of AuDs to teach and train student audiologists.

As of this writing, we still do not have our own independent accrediting body actively engaged in the process of oversight and accreditation of audiology training programs. A healthy, vigorous accreditation program should be the primary agent of change in our educational system. In my opinion, the jury is still out on whether we will ever see the ACAE become a viable, competitive alternative to ASHA's CAA.

Antiquated State License Laws

Change is also needed in state licensure. Most state license laws are out of date, not recognizing the AuD as audiology's entry-level degree. State statutes need to be updated to reflect our new educational status and our changing scope of practice. Other healthcare professions continuously work to keep their licensure laws current because changes in science and technology never stop. Audiology would profit from embracing this notion and commit to making licensure change an ongoing process.

In terms of scope of practice, audiologists still do not have the same rights and privileges as other doctoring professions. Audiologists continue to be denied direct access to Medicare patients–a clear indication that the federal government does not recognize audiologists as independent providers of care. Most state statutes deny us the legal right to diagnose and treat patients within our scope of practice. Until political/legislative change occurs, audiology will remain a "dependent" doctoring profession.

Challenges Ahead

Our profession has come far in a short time. But now is not the time to rest on our laurels. We continue to confront significant challenges. But with the help and support of all of us, I feel confident of eventual success.

The Audiology Foundation of America (AFA) has recently entered into a contract with the Institute for Alternative Futures to identify the key factors important to the success of the profession. We need to be ready to embrace and even guide the healthcare and technology changes that will come and anticipate our role in the marketplace of opportunity. Using the vision of professional futurists will help the AFA map our progress and prepare for the work that needs to be done in the future for the betterment of audiology and its final transition to true independence.

Kenneth L. Lowder, AuD, is the past chair of the Audiology Foundation of America (AFA) and currently serves on the AFA board of directors.