A Fork in the Road: Where is Audiology Heading?

The field of audiology is due for a shake-up.

I’m not saying that I’m necessarily in favour of it, instead I’m saying that it’s going to happen whether we like it or not.

The driving force of this coming change is the ability for people outside of the traditional field of audiology to create and sell their own hearing aids or alternatives. Whether these devices can provide the best possible patient care is debatable, but the fact is that their affordability and availability may render that question irrelevant.

Currently, there are a tonne of online companies providing hearing solutions at a fraction of the cost of conventional hearing aids, often with no need for multiple appointments to fit them. Every so often a news story goes viral of a student-made cheap hearing aid, or a new IndieGoGo or Kickstarter campaign pops up with an affordable alternative. Many groups, including major hearing aid manufacturers, are currently working towards the development of fully self-fitting hearing aids, which wouldn’t require seeing a professional at all. In fact, you can even build your own hearing aids at home if you know just a little bit about computers. (http://uosdesign.org/designshow2016/group-design-project/the-raspberry-pi-hearing-aid/).

Is there another side of the story? I think so, but its certainly not getting as much attention. For me, the important change in the industry is a better understanding of how properly hearing the world around you leads to better health, specifically brain health. Its been well known for a long time that hearing better in childhood can lead to better language abilities, and ultimately academic success, later in life. However, its only now that we’re beginning to understand how maintaining hearing ability later in life can lead to better quality of life, and possibly even reduce Alzheimer’s and other forms of dementia.

Though evidence around this research is still limited, it makes intuitive sense. The human brain is entirely based on the “use it or lose it” principle. New neural connections are made when more stimulus is added, and neural connections deteriorate when stimulus is reduced. For older adults, it follows that as hearing levels decrease, so do the neural connections involved, from periphery structures in the brainstem, all the way up to the brain’s language areas. Being the language based creatures that we are, this deterioration of the language areas of our brain could potentially have rippling effects across all areas of brain functioning, including higher level functions like memory and emotion.

Despite being a young person in the field of audiology, I do have a very old-school way of thinking. In my opinion, audiology is a health profession. We need to work hard to ensure we are treated as such, and that intervention with health devices like hearing aids be kept under our sphere of influence. However, I also recognize that no matter how hard we work, we won’t be able to completely quell people’s desire for affordable, readily available devices.

It seems like there is a fork in the road ahead, but that’s not the way it has to be. What if the road just widens to encompass a broader scope of responsibilities for audiologists? Maybe we can still provide hearing health care to populations who are at greater risks for negative consequences without that care, but also provide assistance to those who seek services from other sources and just need help with fine-tuning to meet their needs.

Whatever the future looks like, there is one certainty. We as audiologists need to not only promote our profession, our skills, and our knowledge, but also use those factors to provide more value to patients. The days of having the entire field of hearing care to ourselves is over. If we want to continue to be a part of hearing healthcare system, we need to give people more reasons to use our services. What does this value look like? Is it better choice? More attentive care? A more enjoyable clinical experience? I don’t quite know, but I think we better find the answer fast.

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