Audiologists possess amazing knowledge and skills that can change someone’s life, but we have had a difficult time spreading the word. The work we do day in and day out can truly enhance the quality of life of the individuals we serve. But, the messaging to the general public has been limited and ineffective, thereby reducing the number of people who seek our care.  

There is a lack of public awareness of the audiology profession. We can all contribute to reverse the narrative of public “unawareness” and tell a better story about the benefits of hearing and balance wellness.

Audiology has made some progress through the years toward increasing the level of public awareness. However, most of the general public, fellow health-care providers, insurers, regulators, and legislators do not know who we are or what we do.

There have been several events in the past highlighting the importance of hearing health care. C. Everett Koop, MD, a pediatric surgeon by training, served in the U.S. Public Health Service and acted as the 13th Surgeon General under President Ronald Reagan in the 1980s. Koop facilitated many important public health campaigns on tobacco use, AIDS, and rights of disabled children, and he became a stalwart advocate for early hearing loss identification and prevention for people of all ages (Wikipedia, 2017).

During this time, President Ronald Reagan, the 40th President of the United States, publicly announced that he was using hearing aids to treat his hearing loss. Subsequently, President Bill Clinton, the 42nd President and our first “baby boomer” in the Oval Office, made it publicly known that he was using hearing aids for his hearing loss, at the age of 51 (Shogren, 1997).

More recently, hearing-loss prevention issues received major nationwide coverage in 2010 when New Orleans Saints Quarterback Drew Brees and his wife Brittany had their son, Baylen, sporting a nifty set of headphones to protect their infant son's hearing from the crowd noise at Super Bowl XLIV. 

Then there was Michael Phelps, the most-decorated Olympic athlete in the history of the games, and his then-fiancée, Nicole, protecting their son’s hearing at the August 2016 Olympic games in Rio de Janeiro, Brazil. 

These public examples of hearing care and protection were powerful images. There was some immediate public notoriety but limited sustainable effects with regard to the elevation and recognition of the benefits of hearing and balance wellness.

What’s the Scope of the Problem?

There are dozens of online articles, television/cable interviews, and press releases on hearing and balance-related stories each week, yet we lack the recognition many other medical specialties garner on a regular basis. To quote the captain in Cool Hand Luke (1967), “What we've got here ...is a failure to communicate.” Also lacking is a comprehensive, well-coordinated plan to share information and education with the general population regarding hearing and balance wellness. Not to mention the importance of educating health-care providers about healthy hearing and balance across the lifespan has been overlooked for coordinated effort. So how do we get our message made known by the masses? 

The U.S. Bureau of Labor Statistics (BLS) under the Department of Labor is the federal agency responsible for measuring labor market activity, working conditions, and price changes in the economy. The BLS reports there are about 15,000 employed audiologists annually and projects that audiology will grow by 29 percent from 2014 to 2024 (faster than average for all occupations) as an aging population places increasing demands for hearing and balance health care (2015).

A 30 percent increase over a 10-year period will still only net us a few thousand audiologists, once we consider the typical rate of retirement for an aging profession (Kawa, 2017). So the number of available audiologists for the tens of millions of people who need our services will not be sufficient; we will need to think of creative ways to provide care to all of those individuals. Despite the growing need for our services, audiology remains a relatively unknown medical profession. 

The need to reach the general public is a recurring theme for audiologists’ conversations at professional meetings and conferences. The general public associates teeth/dental care with dentists and vision loss and treatment with optometrists/ophthalmologists, but, for the most part, they do not immediately associate hearing loss, tinnitus, and balance disorders with audiologists. Many other health-care providers have been slow to embrace the need for audiology care for their patients.

Who Do We Need to Influence and Educate?

In the past, the profession of audiology has focused on developing relationships with primary care physicians (PCPs). This outreach is important but too narrowly focused; it has overlooked specialty health-care providers who manage complex cases with co-morbidities that include hearing and balance issues. Audiology could benefit from developing relationships and co-educational programs with these individuals who spend a great deal more time with each client/patient than do PCPs. 

There is room for partnerships with non-physician providers including optometry, physical therapy, assisted care managers, home-care providers, and more. As an example of a co-educational model, let’s look at diabetes educators. Nearly 30 million people in the United States have diabetes, with a high prevalence of associated hearing and balance co-morbidities.  (AADE, 2017). By aligning more purposefully with these educators and others, audiologists will open many new venues of access to individuals who need the knowledge we have about the deleterious effects of untreated hearing and balance deficits. 

Another example of possible co-educational opportunities includes in-home care providers who assist hundreds of thousands of individuals as they remain in their own homes as they age or who need care at home after a hospital stay. Home care is a growing alternative to traditional assisted-care facilities. Currently there are over 500,000 providers of daily home care for seniors and others who are homebound or are “aging in place” (HCAA, 2017). 

Many of these individuals receiving in-home care have hearing and balance co-morbidities. In-home care providers could work with audiologists to learn how to assess the hearing and balance needs of their customers then refer their clients for care. Opportunities to align with care providers from assisted care, retirement facilities, and skilled nursing care should not be overlooked. These groups and more represent hundreds of thousands of care providers who interact with individuals of all ages who have hearing and balance problems and need the care of audiologists.

What Are Some Ideas on How to Campaign?

Attendees learned how we use our ears to locate sound sources during an interactive demonstration of visual reinforcement audiometry.
Attendees learned how we use our ears to locate sound sources during an interactive demonstration of visual reinforcement audiometry.

Campaigns highlighting hearing and balance problems have been developed. World Hearing Day, which is promoted by the World Health Organization, is an annual hearing advocacy campaign held in March. May is the Academy’s Better Hearing Month, and October is National Audiology Awareness and National Protect Your Hearing Month. The National Council on Aging (2017) provides educational materials and access to information about fall prevention in September each year. All audiologists must partner with these recurring events and others to raise awareness and promote hearing and balance care locally and nationally. 

Reaching the public requires a multi-pronged approach to disseminate information and educational materials. Social media and on-demand information services require immediate and constantly updated information in order for our message to remain contemporary. 

CHOP Is Setting an Example

The audiologists at Children’s Hospital of Philadelphia (CHOP) are actively working to increase the profile of audiology in their community with their Healthy Hearing Community Education Program.

Not only is CHOP a leader in the field when it comes to pediatric audiological services, they know a thing or two about community outreach and promoting the field of audiology to a wide variety of audiences. After seeing some of their latest endeavors on social media, we decided to reach out to the team and learn more about their experiences.

“We have participated in health fairs for a number of years, but I would say we really ramped things up the year we did a healthy hearing booth at a local radio station's (WXPN) three-day XPoNential Music Festival,” explained Sarah McKay, AuD. Dr. McKay is a clinical audiologist at CHOP and has been involved in CHOP’s Healthy Hearing Community Education Program for several years. 

A Chladni Plate (sound resonance demonstration) was used to engage with Philadelphia Science Festival attendees by showing that sound is a physical energy that can be explored visually.
A Chladni Plate (sound resonance demonstration) was used to engage with Philadelphia Science Festival attendees by showing that sound is a physical energy that can be explored visually.

Even though CHOP’s outreach program has been in place for many years, Dr. McKay reported that it was taken to a different level when Frank Wartinger, AuD, joined the team. “He has both the passion and the expertise on the topic and it has helped us to confidently create information and interactive exhibits for the public.

“After the Music Festival, we participated in some of WXPN’s PB+Jams kids’ concerts, where we had an educational booth. Two years ago, we had our first interactive exhibit at Philadelphia Science Festival’s (PSF) program, Science in the Park, and last year, we participated in one of PSF’s after school programs. We also had a booth in conjunction with CHOP Ophthalmology at the PSF Science Carnival and were involved in a Philadelphia-wide middle school event at Liacouras Center at Temple University,” McKay said.

This past April, CHOP Audiology participated in a few events during the PSF. This nine-day celebration of science with numerous events around the city culminates with the Science Carnival held at Penn’s Landing where close to 50,000 people visit over 300 presenters' booths. “Some of the booths were from small local labs, universities, as well as larger national companies such as Dow Chemical and NASA,” Wartinger explained. “CHOP Audiology has been involved in this for a few years now, and one of the organizers was already asking what we were planning to do for next year. You expect audiology to be present at health fairs, but being able to explain what you do in terms of its scientific roots is outstanding,” Wartinger admitted. 

Not Your Typical “Audiology Booth” and Hearing Screening

“Some of the most popular activities include: The Science of Sound (including a Chladni Plate and Hears My Name), the Guess the Word with a Simulated Hearing Loss Station, and the Dangerous Decibels activity, where the pipe cleaners are used to demonstrate how loud sound permanently affects the cochlear hair cells. They love that! Also, Dr. Wartinger has made a male and female version of Jolene so people can measure the level of their Personal Listening Device. Over the years, some of us have taken a version of the Dangerous Decibels program into our neighborhood schools, as sound is often part of the curriculum in 2nd or 3rd grade,” McKay reports.

In addition to participating in the Science Carnival, CHOP also held a smaller in-house event as part of the city-wide Be a Scientist series, again weaving interactive science experiments that engaged children young and old. “We had about 160 attendees.” To make the in-house program a success, it took about 14 staff members to pitch in and man the six interactive learning stations and escort attendees around the facility. “Even though this event was geared for kids 4–10 years old, their parents and care givers were just as excited to participate and ask questions,” Dr. Wartinger explained. 

What Are Other Ideas for Adults and Kids at Heart?

In a separate yet related endeavor, Dr. Wartinger also volunteered to speak at a Science Festival event at Yards Brewery called Sensory Overload. He explains, “There were five speakers, each discussing a different sense: a neuroscientist discussing vision and synesthesia, a veterinarian discussing smell, a labor and delivery obstetrician discussing touch, a biochemical researcher discussing taste and me, an audiologist, discussing hearing! I got to introduce audiology in a fun and engaging way to nearly 100 attendees and speak about the amazing things our ears and brains can do with sound. It was really a great night, and a good opportunity for us audiologists to own the subject matter.”

Two staff audiologists Amanda Marchegiani, AuD, and Eileen Rall, AuD, are all smiles during the CHOP Be A Scientist! Event.
Two staff audiologists Amanda Marchegiani, AuD, and Eileen Rall, AuD, are all smiles during the CHOP Be A Scientist! Event.

What About Costs and Staffing These Types of Events?

“When we decided to apply to have an educational booth at the XPN Festival, there was a cost. There was a typical fee associated with hosting a booth at a major music festival, but we also needed to buy educational materials and earplugs. Our department did not have a budget for these expenses. Around the same time, there was a call for grant submissions to provide needed services in the community. We applied for a grant to cover the cost of this festival and we were awarded the money needed. We also found it helpful to connect with earplug companies to explain the goals of the event and see if they could help in anyway. Websites such as NHCA, Dangerous Decibels, www.audiology.org, and Noisy Planet have free educational materials to download or order (e.g., How Loud Is Too Loud bookmarks). 

We also got creative and made wallet size laminated cards on safe listening levels for personal listening devices. Companies such as Etymotic have some good educational materials (e.g., how loud specific band instruments are). They also have the Adopt a Band program, designed to educate about hearing protection for young musicians,” Dr. McKay explains. 

How Do You Measure Success of an Event?

Dr. Wartinger explained, “Feedback from staff and attendees (when applicable) is collected and logged, including attendee comments and quotes, and suggestions for improving future events. Additionally, we track the number of complimentary earplugs, department contact information, and pamphlets that are distributed at each event.”

Any Words of Advice?

“I think any program, big or small can start a community education program. Demos on the science of sound, hearing loss simulations, and educational materials are relatively inexpensive and there are lots of great ideas out there from people such as Dr. Wartinger, who are passionate on the topic of healthy hearing. We would be happy to help anyone who wants to get started,” offered Dr. McKay. 

Conclusion

With an ever-growing need for hearing and balance health care, audiologists can seize the opportunity to transform audiology into a household term. Health care is a rapidly evolving landscape. This evolution provides a moment to direct the narrative and distinguish audiologists from other providers of hearing and balance health care. 

The American Academy of Audiology and the American Academy of Audiology Foundation have heard the collective voices of the professional audiology community and are actively engaging in activities to increase public awareness of audiology. But to truly make an impact and reach the masses, each audiologist must play a role as a professional ambassador to the public. A multi-tiered approach will be necessary to deliver the message to the general public and allied health-care partners. The Academy and Foundation are available to support professionals in this endeavor.   

Bre Myers, AuD, PhD, is an assistant professor with Salus University in Elkins Park, Pennsylvania. She is also an associate editor of Audiology Today magazine and www.audiology.org.

Brenna Carroll, AuD, is a clinical audiologist with Swedish Medical Group in Seattle, Washington. She is also the chair-elect of the American Academy of Audiology Foundation.

Contributors: Frank Wartinger, AuD, is a staff audiologist at Children’s Hospital of Philadelphia and owner of Earmark Hearing Conservation, LLC, and Sarah McKay, AuD, is a staff audiologist at Children’s Hospital of Philadelphia.

References

American Association of Diabetes Educators (AADE). (2017) www.diabeteseducator.org.Accessed May 2017.

Home Care Association of America (HCAA). (2017) www.hcaoa.org. Accessed May 2017.

Kawa L. (2017) Older Americans Are Retiring in Droves. The exodus of the baby boomers from the work force resumes. Bloomberg, January 6. www.bloomberg.com/news/articles/2017-01-01/older-americans-are-retiring-.... Accessed May 2017.

National Council on Aging. (2017) www.ncoa.org/healthy-aging/falls-prevention. Accessed May 2017.

Shogren E. (1997) Clinton to Get Hearing Aids in Both Ears. LA Times. October 4. http://articles.latimes.com/1997/oct/04/news/mn-39089. Accessed May 2017.

U.S. Bureau of Labor Statistics (2015) www.bls.gov/ooh/healthcare/audiologists.htm. Accessed May 2017.

Wikipedia: C. Everett Koop. https://en.wikipedia.org/wiki/C._Everett_Koop Accessed May 2017.

Other Resources

Children’s Hospital of Philadelphia (CHOP)

Philadelphia Science Festival  

WXPN Radio Station