"Direct access" means giving Medicare beneficiaries the option of going directly to a qualified audiologist for hearing and balance diagnostic tests. The American Academy of Audiology favors giving Medicare beneficiaries the option to see either a physician or an audiologist first for hearing health care. The Academy supports direct access because:

• The Medicare program should keep pace with other federal health care programs and private health plans that already allow direct access to audiologists.
  • The Federal Employees Health Benefits Program (FEHBP), the model for President Bush's Medicare reform proposal, encourages participating plans to allow direct access to audiologists.
  • Many private health plans, including most preferred provider organizations (PPOs), allow their enrollees direct access to audiologists.
• Direct access would provide for the delivery of high-quality patient care.
  • Audiologists are educated to recognize problems requiring medical attention and to immediately refer such patients to a physician.
  • Audiologists are highly-educated, licensed health care professionals. They must hold a graduate degree, either at the masters or doctoral level. Soon, the masters degree will be phased out, and a doctoral degree will be required for all entering the profession.
• Direct access is cost-effective.
  • The requirement of an initial physician visit is costly to the Medicare program.
  • During the initial visit, audiologists perform a number of procedures, including case history, otoscopy, and immittance, that serve as a screening for medical conditions. As a result, entry into the hearing health care system can be made safely without a perfunctory physician visit.
• Medicare currently allows beneficiaries direct access to a range of non-physician practitioners.
  • Medicare beneficiaries do not need a physician referral to see a dentist, oral surgeon, podiatrist, optometrist, chiropractor, clinical nurse specialist, clinical psychologist, clinical social worker, nurse-midwife, nurse practitioner, and physician assistant.
• Direct Access would not expand the scope of practice for audiology.
• Direct Access would not diminish the important role played by physicians