Angela Shoup, PhD
Professor, Otolaryngology; Chief, Communicative & Vestibular Disorders, UT Southwestern Medical Center
BS: Speech Pathology and Audiology, University of Texas at Dallas, 1989
MS: Communication Disorders, University of Texas at Dallas, 1992
PhD: Human Development & Communication Sciences, University of Texas at Dallas, 1994
Why are you interested in serving on the Academy board?
As an active and engaged audiologist, I appreciate the shared responsibility of contributing time and effort to the betterment of our profession. I have been a member of the American Academy of Audiology for many years and have had the opportunity to serve in multiple capacities. Through these experiences, I have recognized the multifaceted contributions of the Academy to the professional life of members and to the quality of services we provide to our stakeholders. These stakeholders include patients who come to us for support with hearing, tinnitus or balance difficulties, and also their families, the public, students, and scientists. The Academy serves to elevate our profession by providing an aspirational code of ethics, scope of practice, and guidelines for professional comportment.
The Academy provides tools to achieve these aspirations through web-based continuing education, publications, practice management tools and educational offerings at conferences, including but not limited to the annual Academy meeting. Further, the Academy seeks to educate other stakeholders through legislative efforts and public relations outreach. The Academy promotes educational excellence for audiologists and for students entering the profession and supports research and innovation in hearing and balance. All of these are crucial for the profession to remain viable—and all require not only financial support but also time and talents of volunteers. My personal and professional philosophies align with the dedicated vision of the Academy. As I have benefited from the efforts of my colleagues, I am interested in contributing to service on the Board of Directors.
What challenges or key issues do you see for the audiology profession in the next five years? What would you hope to accomplish relative to these challenges during your term on the board?
There are many issues confronting audiologist in today’s health-care arena, many of which are intertwined. These include appropriate reimbursement, devaluation of audiology services, and workforce shortages.
Health-care providers are experiencing heightened pressure to reduce costs and increase efficiencies. Changes in the delivery model for hearing aids, with increased competition from big box stores and over the counter devices, has increased competition and further exacerbated downward pressure on cost. Insurance companies have become involved in either coverage of or direct provision of devices to members. Audiologists are often provided with reimbursement for services and products that do not cover costs incurred. Further, current CMS reimbursement for many diagnostic procedures is insufficient. Since private insurance frequently follows CMS rates, audiologists are impacted by reduced reimbursement from multiple payers.
Many do not recognize the type of intellectual and technical work required to effect positive outcomes for our patients and thus devalue audiology services. For hearing aid services, this is in part due to the legacy of “bundling” devices and services. Professional services have historically not been monetarily recognized as a “valued” part of hearing aid dispensing and ongoing care. Consumers and payers want decreased cost for products but may become confused or distrustful when providers charge for services. Many audiology billing codes have little or no professional component, reflecting the history of audiology services as “technical” procedures provided under the supervision of a physician. The delivery model for hearing aid services is different than the processing of other types of services by insurance companies. To be appropriately reimbursed, audiologists must advocate for appropriate rates, and also ensure they are billing/coding for all products and services as expected by the payer. In doing so, audiologists must be more aware than before of regulatory requirements for compliant and consistent billing practices.
The Bureau of Labor Statistics predicts that audiology employment will grow by 20 percent from 2016-2026. If there is a shortage of audiologists there is the potential of the scope of practice “creep” by other, less qualified providers. This would further exacerbate the devaluation of audiology services and, more importantly, decrease the quality of services and outcome expectations for those we serve. In our current educational model, audiology students are incurring excessive debt, especially for expected entry-level compensation. Such a debt to compensation ratio expectation may lead some to choose another profession, which will contribute to an even greater workforce shortage.
Addressing these issues requires coordinated efforts in all areas of Academy activities. We must continue with educational and advocacy efforts to ensure the public understands the professional/intellectual value of audiology services and continue efforts to improve reimbursement. We must also continue educating practicing Audiologist and students about the importance of following best practices in audiology. We must also support and encourage outcomes research. Since these issues are interrelated, we must carefully evaluate from a variety of perspectives opportunities to affect positive change that may be beneficial to the challenges we face.
What experience do you have in the planning, evaluation, and implementation of a strategic plan?
As chief of the Division of Communicative and Vestibular Disorders at UT Southwestern Medical Center, I provide support and oversight for multiple programs and a large team of audiologists offering services at the Dallas Aston Ambulatory Care Center, Moncrief Medical Center Ft. Worth, Parkland Hospital and outpatient adult services, Parkland Newborn Nursery Hearing Screening Program, and Children’s Health facilities in Dallas and Plano.
I have been responsible for planning multiple clinics as well as development and introduction of new service lines. Each of these projects have required work with my team and other stakeholders. Typically, this starts with an initial review of our division strengths and weaknesses, the need for our existing services in new locations or the demand for new service lines, and our current resources. We assess how the new service/site fits into our long-term goals and our departmental/institutional purpose. Our initial internal review is a collaborative process as I find it to be important to seek input from team members who are likely to be impacted. As we proceed to the planning and implementation stages, the collaborative environment expands as it must then include multidisciplinary service providers and/or representatives from our affiliated institutions. Strategic planning is an ongoing process as once the new service/site is functional, we then have to track, adjusting or “righting,” and growth planning. I have found that this same essential process has been useful in my volunteer activities as well, such as when I served as president of the Texas Academy of Audiology.
List any experience in financial management. Describe your experience in developing and implementing a budget for practice, business, department, or organization?
In my role at UT Southwestern Medical Center, I am responsible for the Division of Communicative and Vestibular Disorders. This Division is comprised of a large team of audiologists and speech pathologists, as well as some support personnel. We provide services at multiple clinics and hospitals. Although directly involved with budget planning for my division and our services for our department and at UT Southwestern clinics, I also provide input for the annual budget for services provided at our affiliated health systems (Parkland Health and Hospital System and Children’s Health). Further, I have participated in the development of budgets as part of the planning for new clinical sites and also when recommending new service lines. When I served as president of the Texas Academy of Audiology, our treasurer moved out of state. I used this as an opportunity to oversee a complete audit of the Academy and development of a new budget. I have also participated in the budget development and implementation of research grants.
From the list below, select three competencies you feel best to represent your leadership strengths.
Accountability, problem-solving, and teamwork
Based on the three competencies selected above, comment on how you feel these qualities would positively affect your ability to serve on the Academy board.
I continue to evolve and grow in all of the competencies listed but have selected accountability, problem-solving, and teamwork as the three I believe are most integral to my potential contributions to the Board of Directors.
Accountability: I take my responsibilities very seriously and hold myself accountable for meeting my obligations. I find it difficult to separate accountability from commitment, but as I see accountability to be a measurable indicator of commitment I have selected this competency. I am committed to providing value and I recognize very clearly that when serving in a volunteer capacity, there is a cost to the organization. Specifically, there is an opportunity cost in that if I accept appointment to serve, that means another worthy potential volunteer’s time and talents will not be utilized in this specific role. I am accountable for delivering on my commitment to serve.
Problem-solving: I have always enjoyed working puzzles and solving problems. Although I can and do solve many problems on my own, I find that problem solving is often most powerful when combined with teamwork and good communication. Being able to view an issue from different perspectives can often lead to much more innovative solutions and engaging other stakeholders in the process not only brings multiple perspectives but can also increase stakeholder commitment. Being open to other ideas and welcoming diverse input will allow me to work collaboratively with other board members as well as our constituents in seeking innovative solutions to the many challenges facing our profession today.
Teamwork: I work collaboratively with many groups. Being part of a very large team (currently 30 audiologists and 4 speech pathologists) in my division, I am reminded daily of the importance of teamwork. When interviewing candidates for positions at our facility, we consider the ability to work well with a team to be one of the most important determinants. Many of my most rewarding professional activities have been gleaned from serving in multidisciplinary teams. My work with patients and with my audiology and speech pathology team members is enhanced by our experiences and collaborations with other professionals, as well as with each other. Essentially, I serve as a member of multiple teams across my professional life. I value the strength of having team members from diverse backgrounds with unique perspectives and talents. I would bring this respect for the contributions of all team members and a commitment to collaboration to my service on the board of directors.