Ashley Paige Peterson, AuD, PhD
Board Certified in Audiology
Director of Hearing and Balance/Chief Operating Officer, Great Hills ENT/Hearing and Balance Center of Austin
BS: University of Wyoming
AuD: Audiology, University of Kansas Medical Center, 2007
PhD: University of Kansas, 2010
Why are you interested in serving on the Academy board?
As I see it, if you feel that something needs to change you have one of two options: (1) Step up and be part of the solution, or (2) Keep your opinions to yourself. As an entrepreneur, clinician, and preceptor I see many areas where our profession can improve. I am interested in service to the Academy board because I believe that bringing new ideas and insights to the table may lead to solutions we may not have thought possible.
It is easy to sit in the comfort of your own home and criticize how things are going from the safety of Facebook or an e-mail thread, it is quite another to actively attempt to be part of the solution. Having served on two committees in the past, I know the dedication of those who volunteer to serve our profession as well as those with the Academy. It takes work. Messy, dedicated, unrecognized, long hours away from your family work. I am willing and able to put the time in to help make the future for other audiologists a bit brighter at the end of my term.
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?
I think that the next five to 10 years will be very different, and exciting for the profession of audiology. Within the next five years, I see key issues within some areas we already know, direct access of care, third-party payers, equitable reimbursement for services rendered, movement toward a limited liability physician status, and a clear ability to distinguish an audiologist from a hearing aid specialist as the diagnosticians and experts we are in hearing and balance. It will be important that audiologists and hearing instrument specialists are not considered the same or interchangeable by our fellow professionals, as well as within our own ranks (take the AAA hiring post board as an example of needed change).
Areas that are emerging as challenges will be the OTC market (regulation of and integration into practice), use of remote/tele clinics (billing, licensing, ethics), standardization of residency programs (renumeration, placement, competency requirements to pass), academic training programs that produce clinicians with the same competency across the board, prescription of medical grade amplification systems with changes in FDA requirements, increasing the ability to obtain quality CME as they do in the otolaryngological world, and the movement of audiologists as clinical doctors in their own right instead of identification as just hearing aid dealers. Audiologists, master or doctoral, have invested way too much time and money expanding their knowledge base to just be equated to a hearing aid specialist with far less training and a smaller scope of practice.
What experience do you have in the planning, evaluation, and implementation of a strategic plan?
Within Tribal service, I was responsible for the planning and implementation of the strategic care plan for four Tribal communities. This included the entirety of the audiology scope of practice. To effectively care for 85,000 individuals with four providers, a truly synchronous tele-audiology model was created and tested for efficacy within 12 months. Services offered increased to include sedated ABR all while increasing profit.
In 2012, I joined a private ENT practice. At the time it was a single ENT, one PA, and myself. Audiology was rarely billed and the hearing aid revenue gross was less than $14,000. Over the next five years, audiological services have increased to adult and pediatric diagnostics and amplification, BAHA & CI support, full neurophysiological assessments to include sedated ABR, fully functional vestibular diagnostic clinic and supporting vestibular physical therapy
I have acquired a physical therapy practice for vestibular rehab and created a concussion assessment/treatment protocol for both adults and pediatrics. Otolaryngology has expanded to incorporate sleep medicine and play a more instrumental role in audiological and physical therapy support. A much different paradigm that has historically been seen. As of FY2016, audiology has grown to be a seven-figure department with plans to expand and grow. We are looking to add a secondary and tertiary clinic with full staff within the next 18 months and will complete this expansion with existing profits from current activity.
List any experience in financial management. Describe your experience in developing and implementing a budget for practice, business, department, or organization?
I have extensive experience in the formulation of research, business, practice and multi-disciplinary departmental budgets and financials. I have created and maintained telemedical company financial spreadsheets and employee ledgers for seven years as the founder and CEO of TeleDoc. Within my clinical practice, I maintain the staff and departmental budgets for otolaryngology, audiology, and physical therapy. I also maintain yearly contract negotiations for third-party reimbursement, vendor pricing, state reimbursement as well as quarterly price negotiation for hearing aid/assistive devices between manufacturers. I routinely calculate productivity against P&L margins to determine profit sharing, and just this year orchestrated the acquisition of a physical therapy practice and build out of a new facility.
Within the next 12 months, a secondary practice location with full staff will be included amongst my roles as the chief operating officer. Practice deposits are made to two primary accounts with one being utilized for third-party payers within the medical clinic and the creation of a medical model for our hearing aid clinic (fee for service). Under my stewardship, we have shown overall practice profits of >30% each year.
From the list below, select three competencies you feel best to represent your leadership strengths.
Decision-making, leadership skills, and problem-solving
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.
Throughout my career, I have excelled at identifying a problem and creating a solution, many times outside the "audiological box" and often times without support. While in government service, I was often the only clinician within a multiple hundred-mile radius and most often than not the only health-care provider in the entire clinic. I did not have the comfort of a preceptor or work associate to bounce ideas off of. If something needed to be done, fixed, addressed or if staff concerns arose, I had to facilitate a solution immediately.
This directly led to identifying and creating a truly synchronous tele-audiology model that was debuted at AudiologyNOW in San Diego in 2010. I had spent time seeking the advice of who those that I viewed as pioneers on the matter. I had a need of being able to reach 85,000 people with 4 providers. In many cases, the providers were only able to go to a clinic once a month, and in the case of weather, it might be longer. This is not good health care. Not a single one of us would stand for this availability of services, but it is, in fact, a reality in our country for many people. It was not a possibility to sit around and discuss what needed to be done, it had to be done. So, from 2009-2010, the pilot and efficacy of the model were assessed and presented upon just one year later.
Once I joined the private practice world, I faced another set of challenges. I had to build a practice within a care model that I had never once received any training. When I was in school the business audiology course was one semester, and it didn't go over anything that needed to be known to successfully run a practice. I had moved to a new state and had not graduated from the local program, so my reception was not warm. This was in 2012 and since that time, I have grown the practice to include audiological and physical therapy staff. The staff within my clinic routinely utilizes the entirety of the audiological scope of practice. With my staff and the students and residents who rotate through my clinic, I have a unique ability to identify their strengths, personal motivating factors and create an environment to which they can excel.
In relation to the Academy Board, I believe that these three skills are vital for anyone to possess. Delegation of duties to those most capable to effectively compete for a task is essential, deciding on the immediate course action to be taken given a myriad of options for Academy resources, and as well as looking at the issues that face our profession with a fresh mind are all things I believe I can not only contribute but excel during the appointed timeframe.