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I think that we can all agree that as audiologists and the end consumer, when it comes to describing today's tinnitus economy, we can use the term "bittersweet." Things are "bitter" in the unfortunate aspect that tinnitus cases are on the rise and that there are not enough audiologists to treat the disease. But things are also "sweet" in that these unfortunate cases have brought a booming business to those of who can treat tinnitus.
Over the past couple of years, the number of patient inquiries that come into my private practice on a daily basis has increased significantly. I'm sure that the response can be linked to public speaking events, physician referrals, marketing efforts, and word of mouth, but I also know that it is linked to the increase in tinnitus cases among our service veterans, prolonged exposure to excessive noise without wearing proper ear protection and possibly the fact that I am the only tinnitus and hyperacusis clinic in the Southern New England area.
Tinnitus has been recognized as a problem that is affecting close to 50 million people in the U.S. alone, at least 10 million of whom are reported to require some form of intervention. The number of audiological clinics providing tinnitus management is scarce. Even more scarce are clinics that can provide treatment in a convenient manner (I have some patients that have to drive over 100 miles to seek care).
Our audiological "tinnitus industry" appears to address the tinnitus issue in a segmented way. Audiologists who have been trained to treat tinnitus and hyperacusis have a broad range of treatment program options. They are: Dr. Pawel Jastreboff's method of tinnitus retraining therapy; Dr. Robert Sweetow's method of cognitive behavioral therapy; masking or minimal masking proposed by Dr. Jack Vernon and Dr. Richard Tyler; music therapy (aka Neuromonics) brought to us from Australia by Dr. Paul Davis; and the recently introduced progressive tinnitus management program by Dr. James Henry.
With all of these treatment options available to us, why aren't there more audiologists treating this ever increasing auditory affliction? Unfortunately, the answer is due to a "mystique" evolved around the ideas that it is difficult to establish such a program, it takes a huge demand of time to help a tinnitus patient and there is lack of reimbursement for such treatment. Many audiologists find themselves pondering these questions: "Do I have the skills? How do I get started? How do I market my services? What tests do I need to do? How much time will it take? How do I organize my business? Where do I get the products I need? Where can I go for help if I need it?" In addition, many still question the lack of evidence as to the outcome of such programs.
I've had the opportunity to meet with many audiologists and audiological groups across the country. After meeting with different practitioners, it occurred to me that hearing aid manufacturers and buying groups give practitioners an amazing amount of support. Assistance ranges from practice management, marketing (brochures, seminars, direct mail, Web design), CEUs and hands-on training, conferences, and discounts on specific quantity purchases. With the support and expertise of the manufacturers and buying groups, audiologists have all of the resources needed to run a successful practice right at their fingertips. So much is focused on hearing aids and hearing loss that tinnitus and hyperacusis are often lost in the shuffle. I started asking myself "Why is this? What can I (or we) do about it?"
I've reacted to my thoughts, and it is with great enthusiasm that I introduce the Tinnitus Practitioner's Association (TPA). The TPA is a professional organization created of, by and for tinnitus practitioners; it is dedicated to professional development, education, research, and increased public awareness of tinnitus and hyperacusis. Below is a list of benefits that members will receive by joining the group:
Structured Approach
There are many methods for treating tinnitus and hyperacusis. The TPA will not limit itself to any particular philosophy. Its treatment guidelines can be used with any counseling and sound therapy management approach. Print materials will include patient inquiries, case histories, standardized inventories, audiological and tinnitus assessments, treatment options and plans, and follow-up schedules and assessments.
Specialty Training
TPA will offer a two-tiered training course for tinnitus management to qualified audiologists. A basic-level training course will be offered for those who want to be able to work with the tinnitus patient but do not want to commit their practices to a more significant involvement. An advanced-level training course will be offered for those who want to get more involved in treatment, as well as in the TPA.
Professional Networking
All members of the American Tinnitus Association will be united for a common cause and will create a stronger voice for legislation, education and research. The TPA also will establish an "association network" for information and referrals.
Business Management
Business specialists will be available to guide members through setting up and maintaining a successful practice. Mentors will be able to assist with everyday practice activities, such as scheduling, billing, procedures, marketing, and record keeping.
Group Pricing
TPA has established and continues to establish partnerships with manufacturers of tinnitus products. A TPA membership would offer preferred group pricing on products, such as external sound therapy devices, ear-worn noise generators, hearing aids, combination units, and tinnitus treatment devices.
Consumer Education and Marketing
Not only do we, as practitioners, need to be educated and have available resources on tinnitus, but so do the patients who suffer from it. TPA will educate consumers by providing them with access to consumer brochures and seminars, Internet information, advertising and direct marketing, and press releases. The TPA also will guide the patient to qualified professionals and create an assurance that there are professionals that are able to provide care.
Professional Marketing and Referrals
With allied professional marketing and referrals, members will be able to establish themselves as the tinnitus specialist in their areas. Members will receive referrals from the TPA network, Internet and allied health professionals. Certification will assure professionals and patients that a TPA member has the necessary professional qualifications and continues to maintain the educational level necessary for quality care.
On-Demand Professional Support
Ever had a question that requires more information from a colleague or an expert in the field? Our "on-demand" professional support services will have experienced audiologists available for "on-demand" advisory and mentoring services for TPA members, including consulting services available by phone or online for patient cases.
Accreditation
In order to provide the highest standard of service to our patients, TPA will be an accredited organization.
Research Support
The TPA will strongly support all academic and clinical research endeavors, especially established funded organizations such as the American Tinnitus Association. After administrative costs, money raised from various TPA activities will be distributed for research.
These highlights are only the building blocks of the TPA. We have developed an advisory board of leading tinnitus professionals and are looking forward to implementing and establishing this high-demand group. Let us "tinnitize" our profession, as tinnitus is part of the scope of our practice.
I encourage all interested audiologists to get involved! Membership applications will be available soon, as will our Web site, www.tinnituspractitioners.com. In the meantime, I encourage you to send an e-mail to tinn_practitioners@snet.net with your contact information so that we may notify you as soon as the information is available. The time is now to get involved in not only helping the tinnitus and hyperacusis patient, but also in setting up a successful, reputable and profitable business.
Natan Bauman, EdD, MS, Eng, FAAA, is the founder and director of The Hearing, Balance and Speech Center and the New England Tinnitus and Hyperacusis Clinic, both based in Hamden, CT. He invented the Vivatone open-ear hearing aid.
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