The Official Publication of The Academy of Dispensing Audiologists
Transcription
The Official Publication of The Academy of Dispensing Audiologists
feedback The Official Publication of The Academy of Dispensing Audiologists® 7 22 24 A call to action to respond to an assault on our profession. An excellent review of ear candling you can share with inquiring patients. Advance agenda for the ADA 2005 Convention in Savannah. 11 The Public Reviews Small Business Book Review: Hearing Care For The Older Adult Practitioner’s Corner: Self-Test Device Helps Market Your Practice Member Services: Professional Update, Convention 2005 VOLUME 16, NUMBER 2 4(% "%34 *534 '/4 "%44%2 -ÞVÀ] Ì i vÀÃÌ i>À} ÃÌÀÕiÌ ÜÌ ÀÌvV> Ìi}iVi] Ã Ì i ÃÌ>`>À` >}>ÃÌ Ü V > Ì iÀ i>À} ÃÌÀÕiÌà >Ài Õ`}i`° Ü] Üi½Ûi >`i Ì iÛi LiÌÌiÀ° -ÞVÀ Ó ÌÀ`ÕVià Û>ÌÛi iÜ vi>ÌÕÀià i\ 39.#2/ !#4)6)49 !.!,9:%2 !54/-!4)# !$!04!4)/. -!.!'%2 ).#2%!3%$ &)44).' 2!.'% Ì Ã > «>ÀÌ v Ì i "ÌV «ÀÃi Ì VÌÕ ÕÃÞ «ÀÛi iÛiÀÞÌ } Üi ` q Ì i« ÞÕ LÕ` } iÀ iÛià v ViÌ Ã>ÌÃv>VÌ >` Ì i ÃÕVViÃà v ÞÕÀ «À>VÌVi° &/2%6%2 "%44%2 4OLEARNMOREABOUT3YNCRO CALL ORVISIT WWWOTICONUSCOMSYNCRO 3YNCRO &/2%6%2 "%44%2 feedback The Official Publication of The Academy of Dispensing Audiologists® C 5 O N T President’s Message E 24 Craig W. Johnson, Au.D. 6 7 T S ADA Convention 2005 – Advance Agenda Larry Englemann, Au.D., 2005 Convention Chair Editor’s Note Kevin Ruggle, Au.D. Hearing On The Hill - A Spark To Action N 32 Self-Test Device Helps Market Your Practice John Diles Craig W. Johnson, Au.D. 10 The Public Reviews Small Business William J. Dennis, Jr. 18 22 Professional Update Why Ear Candling Is Not A Good Idea 35 Book Review Linda S Remensnyder, Au.D. 37 Your Number Is Up! NPI Update Kevin Ruggle, Au.D. Lisa M.L. Dryer, M.D. Advertisers Index Oticon...........................................Inside Front Cover Unitron Hearing ........................................................5 Siemens......................................................................9 Energizer ..................................................................16 Phonak Hearing Systems ................................20-21 Discovery Hearing Aid Warranties......................30 Hansaton Hearing Systems..................................30 Emtech Laboratories, Inc. ....................................34 SeboTek Hearing Systems....................................36 Widex ............................................Inside Back Cover Starkey .....................................................Back Cover All advertisements sent to Feedback and the Academy of Dispensing Audiologists for publication must comply with all applicable laws and regulations. The appearance of advertisements in Feedback magazine is not an endorsement of the advertiser or its products or services. Neither Feedback nor the ADA board investigates the claims made by advertisers and is not responsible for their claims. Total style. Total performance. A fraction of the size. Open-fitting Moda’s getting noticed for being unnoticeable Delight your style-conscious clients with Moda: the fully featured, open-fitting 10A BTE with all the speech-enhancing features of Conversa.NT: Ultra-small BTE with virtually invisible slim tube open fittings or standard earmolds to satisfy more hearing losses. Conversa.NT’s full set of technologies: adaptive beamformer, speech enhancement, intelligent noise reduction and realtime feedback canceller. Practical features: telecoil, three programs. Slim tubing permits same-day fit with in-stock supplies and no custom earmolds. Check out Moda (you’ll have to look carefully). Let’s talk. USA 800.888.8882 Canada 800.265.8258 www.unitronhearing.com ™ Styled for Conversa.NT President’s Message ADA Craig W. Johnson, Au.D. President’s Message ADA Board Works For You! Y our ADA Board has been working tirelessly on your behalf! In less than four months we will be hosting our 29th convention. Our Convention Chair, Larry Engelmann and his committee have been working diligently to plan another excellent convention that will be held in Savannah from October 26-29, 2005. By tradition, the convention will provide a wide range of topics that reflect our scope of practice, and will highlight our expanding educational interests. The convention includes an update on the latest amplification technologies from both a valuation and fitting prospective. In addition, we hope to expand your knowledge in other important areas that are vital for your practice and patient management.Business resources to meet today’s marketplace challenges will be an important ingredient of your convention experience. If you have any comments or suggestions,there is still time for Larry to “keep his ears open.”In this issue you will find a preliminary convention program that once again demonstrates ADA’s unique educational opportunities. As a member of ADA,don’t miss this vital yearly trek to reinvigorate your practice. ADA Headquarters Relocates As you may remember from a recent letter, the ADA board decided to change the association’s management firm. David Berkey, ADA’s Treasurer, has served you, our members, with great distinction during this transition. The new firm, Smith Bucklin, officially opened for ADA business last month and our offices are now located in Chicago. You can find up-to-date address and phone numbers on our website (www.audiologist.org). Smith Bucklin has developed a team of individuals headed by our new Executive Director, Kevin AFA hosting an “Audiology Summit” conference to discuss issues facing the profession. Board members,Larry Eng and Joe Hibbert, represented ADA during a series of preliminary planning discussions. The time- In this issue you will find a preliminary convention program that once again demonstrates ADA’s unique educational opportunities. As a member of ADA, don’t miss this vital yearly trek to reinvigorate your practice. Hacke, that will provide excellent membership services. One of the key factors in the ADA’s board decision to partner with Smith Bucklin was that their entrepreneurial spirit and corporate culture mirrored our member’s values. The new firm will be better positioned to work with your Board to provide programs that will assist you with your practice and personal growth. Board Activities Earlier this year the Audiology Foundation of America (AFA), contacted the audiology membership organizations and requested a series of meetings to investigate the possibility of frame for the conference is being considered for 2006. The Hear ing Industr ies Association (HIA) proposed a joint project with audiology membership and consumer based organizations to investigate consumer’s perception of hearing aids. HIA envisioned a multi-year, phased, collaborative effort by the hearing care field to learn directly from consumers about their experiences in accessing treatment or deciding not to treat their hearing losses and, based on what is learned, to then create a new hear ing healthcare agenda to improve hearing aid service delivery. We anticipate that the 2006 Craig Johnson, Au.D. ADA President ADA convention will be able to provide an initial report on this consumer project. Board member, Linda Burba, serves as the ADA representative for this project. In early March,I attended the Hearing Industry Association (HIA) Annual Convention. Each year, the HIA, comprised of the leading manufacturers and suppliers, meet to discuss mutual goals and objectives. As part of their meeting,they invite the presidents of the allied associations to observe and participate in several of the events. This meeting is an excellent time for ADA to interface with the HIA members to ensure that they understand the opportunities provided to them by our convention. This interaction assists in the support of our sponsorship programs. Without these manufacturer sponsorships, our convention would not be nearly as productive. This is an excellent opportunity to meet with the CEO’s of manufacturers and supplies in our industry to help them better understand ADA, our objectives, and how we can work together to improve our mutual opportunities. Continued On Page 38 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 5 ADA Editor’s Note Editor’s Note President Craig Johnson, Au.D. cjohnson@audiologist.org Kevin Ruggle, Au.D. Controlling Your Neighbors President Elect Larry Engelmann, Au.D. lengelmann@audiologist.org One of my favorite teachers, Mr.Tom South, once told me as a senior in High School that “you can’t control everything in life, but if you can control your neighbors, it helps a great deal.” He went on to tell us how over the years, he Past President Cynthia Ellison, Au.D. cellison@audiologist.org Treasurer David Berkey, Au.D. dberkey@audiologist.org Secretary Lee Micken, Au.D. lmicken@audiologist.org Board of Directors Linda Burba, Au.D. lburba@audiologist.org had found a home he really liked in Perry, IA, and then subsequently, purchased the home on either side of it. In this way, he had some control over who lived Kevin Ruggle, Au.D. by him, and what went on there. Twenty years later, I realize how right he was. The neighbors he spoke of were just that, people living next door. The neighbors we talk about in Audiology are other professional groups such as AAO-HNS and IHS, who have joined forces to try to move us out of the neighborhood. Please look at the advertisement they placed together on the same day as the Hearing on the Hill (page 8) related to the Direct Access Bill. It is time for all audiologists to stop being the quiet neighbors who close their garage doors and are never seen again. It is time for audiologists to put up their yard signs(talk to your congressman or senator),sign petitions (have your patients contact them as well),and form a neighborhood watch group (become involved with ADA) in order to make our neighborhood flourish. Don’t be foolish enough to sit back and wait, and hope that other Audiologists will accomplish our Lawrence Eng, Au.D. leng@audiologist.org direct access goals. Many homeowners have sat back and watched their neighborhoods decay to such a level that the whole neighborhood must be torn down, or abandoned. We are in involved in a bat- C. Joseph Hibbert, Au.D. jhibbert@audiologist.org Administrative Audiologist Susan Williamson, Au.D. Phone: (828) 694-3834 swilliamson@audiologist.org Feedback Editor Kevin Ruggle, Au.D. 1213 Hylton Heights Road, #105 Manhattan, KS 66503 Phone: (785) 537-4005 kruggle@audiologist.org Feedback is the official publication of the Academy of Dispensing Audiologists®. Feedback is published four times a year with deadlines of January 15, April 15, July 15, and October 15. Contributions are welcomed but the Editor reserves the right to accept or reject any material for publication. All articles published in this magazine represent solely the individual opinions of the writers and not necessarily those of the Academy of Dispensing Audiologists®. tle to establish another footing for our profession, a footing that is vital to our independence. One of the other reasons I really enjoyed Mr. South was that he had this unique ability to get people involved. His students were not allowed to be uninvolved! He was able to convince his students that being involved and being a community contributor was best for them and for the community. He often found a back door that allowed the students to convince themselves to be involved. He was gifted in the area of finding the strong suits of his students, and MAKING them use their abilities. Whatever your abilities are, now is the time to contribute them to the cause of direct access. It is our house, our neighborhood, and our profession, and we should plan to keep it that way! Kevin Ruggle,Au.D. Feedback Editor drruggle@kansas.net MISSION STATEMENT Feedback Editor: Kevin Ruggle, Au.D. Phone: (785) 537-4005 • Fax: (785) 537-0196 Advertising: Susan Williamson - (828) 694-3834 6 It is the mission of Feedback to provide doctoral level technical, professional, business, and Academy information in a way that prepares the ADA membership to achieve professional success, and ensure that Audiologists have the choice of practicing autonomously as the recognized leaders in hearing and balance care and dispensing hearing instruments. FEEDBACK • VOLUME 16, NUMBER 2 • 2005 Hearing On The Hill Feature n May 18th,Susan Williamson and Craig Johnson participated in the Hearing on the Hill Day on behalf of ADA that was sponsored by the Hearing Industry Association (HIA). This was intended as a joint professional association opportunity to speak with legislators and their staffs about hearing loss. All membership groups and organizations dedicated to serving the hearing impaired were invited by HIA to participate in a “non-partisan atmosphere”. O Continued On Next Page FEEDBACK • VOLUME 16, NUMBER 2 • 2005 7 Feature Hearing On The Hill Groups represented were ADA,American Academy of Audiology,American Academy of Otolaryngology-Head and Neck Surgery, International Hearing Society, SHHH and others. HIA’s primary goal was to communicate to Congress concerning their initiative, the Hearing Aid Assistance Tax Credit Act (HR 414). To begin the event, a presentation was made to honor Senator Coleman by HIA,since he has been a longtime advocate of the HIA legislative effort. A luncheon was then held for the staff of members of the Hearing Caucus. Following these events, an afternoon was dedicated to providing hearing screenings and video otoscopy to members of Congress and their staffs. Each organization was invited to setup a display booth to represent their contribution to the field of hearing health care. In a direct departure from the intended collegial tone of the event,AAO-HNS and HIS took out a full page ad in the “Roll Call”,a Congressional daily newspaper. The ad that is reproduced for your review attacks our profession on the issue of direct access. As you can see from reviewing the ad,it was a malicious and untruthful assault on our profession. Members of these two organizations should be remorseful of such an openly partisan attack. How is the profession of audiology responding? AAA, ADA and ASHA have sent a joint letter to each member of Congress to give an appropriate perspective on direct access and its true impact on patient care. This,however,was only the first step. Now it’s vital for you to act to create a groundswell of support for direct access for Medicare. Your leaders have worked to provide the opportunity,now it is time for you to also take responsibility. Here is what we need you to do today!! 1. Locate the name of your representatives in the House of Representatives. http://www.house.gov/ 2. Once you have identified this individual, you need to call their office in Washington,D.C.(they will also maintain district offices) and obtain the name of the legislative aide that handles health care issues. 3.You then need to download a sample letter that is available at the following 8 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 site; http://www.audiologist.org/ prof_legis_onthehill.php. Personalize the letter with the name of the legislative aide in your Congressional office, and fax the letter your representative’s Washington D.C. office. 4. Three days after faxing the letter, call the aide and ask them for their cosponsorship of H.R. 415. We need you to act now! If you do your part, together we will succeed and improve health care services for our patients. Let the “Manager of Hearing and Balance Care”be known and accessible to all Americans. ■ Nice curves. ACURIS™ Life Subtle look. Knockout performance. The right open hearing solution should be easy to fit, easy to use, and barely noticeable. But most importantly, it must perform. And no open solution performs better than ACURIS™ Life. It’s a quantum leap forward in open solution design. With breakthrough ACURIS technology. And e2e wireless.™ For a level of performance no other open ear solution can match. For details call (800) 766-4500. Siemens Hearing Instruments • www.usa.siemens.com/hearing Siemens Hearing Instruments • www.usa.siemens.com/hearing Feature Perspectives In Audiology 10 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 Perspectives In Audiology Feature Editors Note: this is the first in a series of articles designed to give ADA members insight into how we are viewed by the public, our patients, and our colleagues. Look for future articles in these areas in upcoming Feedback issues. The complete research study is available at www.nfib.com. The Public Reviews Small Business by William J. Dennis, Jr. National Federation of Independent Business Research Foundation INTRODUCTION The United States enjoys a culture that strongly supports small business and entrepreneurial activity. The public’s basic faith in small business and technology, and its appreciation of the behaviors and conditions that are essential to the operation and prosperity of small and entrepreneurial ventures,underlie that vitality. In fact, explicit public support for small business appears to be an important American comparative advantage in international competitiveness, even if smaller firms infrequently operate in international markets. Continued On Next Page FEEDBACK • VOLUME 16, NUMBER 2 • 2005 11 Feature Perspectives In Audiology The data that follow reaffirm the longstanding ardor between the American public and smaller enter pr ises. They demonstrate that the ties between American opinion and small business as an empathetic institution and series of behaviors are deep and broad, including those who have limited or no exposure to ownership. They also show that those ties are not centered in certain economic corners,but spread broadly throughout the population. Ultimately, the data underscores the enormously positive influence American public opinion exerts on small and entrepreneurial firms. WHY PUBLIC OPINION IS IMPORTANT The opinions the American public holds about small business are important because they strongly influence small-business success. They do so in at least three ways. First, public opinion influences the number and type of people who will eventually try to form businesses and how often they will try. If opinion is favorable, one can expect the best and the brightest to select business ownership as an occupational (and investment) choice;if opinion is not favorable,one can expect the best and brightest to shun business ownership in favor of occupations (and investments) that command greater respect and reward. The rationale for such expected behavior is clear. People aspire to be associated with socially - as well as economically - desirable activity. When given the choice between a socially-desirable and socially-undesirable task,other factors equal, people typically will select the former. The quantity and quality of future business owners is thereby tied to public opinion. Public opinion also influences the formal rules of the economic game, that is to say, legally permissible and non-permissible conduct,in which small businesses operate. Opinion produces political leadership. Political leadership, in turn, establishes the formal rules. If small business occupies a high position in the public’s regard, it has a greater likelihood of being treated sympathetically by the political leadership. More sympathetic treatment results in formal rules that are more likely to accommodate small enterprise. The immediate consequence is a greater likelihood of more successful small businesses. 12 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 “ One can expect the best and the brightest to select business ownership as an occupational choice. ” Third, the economic game has informal rules stemming from prevailing frames-ofreference and social codes, rules governing trust,permissible aggressiveness,fair-dealing, acceptable risk,honesty and so forth. These informal rules are critical to commerce because they allow parties in a transaction to communicate more effectively (than without them) and often by-pass or minimize expensive for mal procedures. Effectively, these codes mutually enhance understanding of prospective business arrangements and provide shorthand for parties to a bargain. The practical, formal result is lower transaction costs. Small-business owners benefit particularly from lower transaction costs because they typically fare better in a more fluid, less bureaucratic environment. Public opinion provides the basic framework within which these rules develop. The more pervasive and accepted the informal rules, the more that small business can accomplish without resorting to the rigid and most expensive types of transactions. The importance of public opinion to small business argues that small business should periodically evaluate those sentiments. The Public Reviews Small Business is the third time in the last 20 years an NFIB affiliate has undertaken and published such an assessment. The first was conducted in 1986 followed by a similar document in 1997. The documents are not, however, directly comparable as they explore different aspects of the same phenomenon. But they exhibit a consistent theme throughout: small business is highly popular among the American public and can count on support from all demographic groups. PUBLIC ASSESSMENT OF CHARACTERISTICS ASSOCIATED WITH SMALL BUSINESS Considerable folklore has developed over the years regarding the characteristics and attributes of small-business owners and their firms. Most of it has elements of truth, at least anecdotally. But whatever its veracity, the stories and tales which comprise it create an image in the public mind that helps define a national small-business profile. The critical point for current purposes is that public evaluation of each aspect of the smallbusiness owner character or small-business owner behavior appears to lead toward an empathetic evaluation of the overall phenomenon. ONE OF THE BEST WAYS TO GET AHEAD Risk has always been inherent when forming a business,but people starting ventures are typically loaded with optimism. They see opportunity in starting a business, and opportunity as a chance to get ahead. Americans often express faith in business ownership and/or education as key to their success and that of their children. Two-thirds (66 percent) of the population believe that owning a business is one of the best ways to get ahead in the United States; 38 percent believe it strongly. Thirty-one (31) percent take the opposite view with 10 percent holding it strongly. Minorities are most apt to see business ownership as an avenue of opportunity. Eighty-one (81) percent of minorities and 81 percent of those who said “other” or refused racial classification claim that business ownership is one of the best ways to get ahead. A comparatively slim 62 percent of the majority population express the same opinion. One possible reason for the comparatively low majority population number is risk. Opportunities in business are great, but there is also the potential for loss, including wasted time on a break-even venture. The balance therefore may not be obvious, particularly when alternatives are plentiful. Those with household incomes Perspectives In Audiology Feature over $75,000 are also less likely to think that business ownership is one of the best ways to get ahead. The group has high opportunity costs reinforcing the risk/reward explanation. Owners, the alumni, and almost-owners express relative enthusiasm for the opportunities involved. However, 60 percent of the not-exposed, the most distant relationship to ownership, also believe owning a business is one of the best avenues for success in the United States. The survey captured a tangential perspective on business ownership as opportunity. There are two primary motivations for business entry: the first involves the person who forms a business because he/she wants to create an enterprise (opportunity). The second involves the person who enters because he/she has no better alternative (necessity) than to go into business. The survey asked respondents whether they believe most people go into business because they really want to, or because they have no better job prospects. Eighty-two (82) percent believe that most people go into business because they want to form their own enterprise, compared to 15 percent who believe most people enter because they have no better alternative. These proportions generally parallel the proportion of Americans who say that they enter due to opportunity rather than necessity. Seemingly, the American public has a realistic grasp on basic motivation for forming businesses. Distance from ownership has no relationship to one’s view of business ownership as primarily opportunity- or necessity-driven. However, household income is strongly tied. Ninety-one (91) percent of those with household income of $75,000 or more believe that business entry is primarily opportunity driven; 75 percent of those in households with less than $25,000 believe it. A gap is reasonable given the relative opportunities of each group. The surprise in this data is not the difference in perspective by income, but that the difference is so small. INDEPENDENCE AND CONTROL Many people form their own businesses to have greater independence and exercise more control over their lives. Whether or not they actually achieve the goal they set out to achieve is debatable. Most successful business owners would probably argue in the affirmative,but the responsibilities associated with ownership consume owners in ways that most people cannot appreciate. Still,72 percent of Americans say that smallbusiness owners have more independence and control over their lives than do those who work for other people. Forty-four (44) percent believe that strongly. Owners most frequently think that they have more independence and control than wage/salary workers (85 percent and 58 percent strongly). Others are more skeptical. Employees of small businesses are the least certain. Just 67 percent of employees judge that owners have more independence and control and only 35 percent believe it strongly. While a healthy majority still agree that their employers have more independence and control over their lives than they do, employees appear to notice things that others do not. Minorities accept the independence and control characteristic as an attribute of smallbusiness owners most frequently. More than 80 percent of minorities and non-classified races say that owners have greater independence and control over their lives than people who work for others. The majority population is less frequently certain with only 70 percent believing that owners have greater independence and control. “ Two-thirds (66 percent) of the population believe that owning a business is one of the best ways to get ahead in the United States. ” JOB SECURITY Job security concerns many Americans. A less secure job is generally viewed less favorably than a more secure job, other factors equal, and maybe not even then. However, new businesses are noted for their rapid turnover. In that sense, business ownership offers little job security, though job security undoubtedly increases as the business ages. The survey first pitted business ownership against one of the more secure positions in the country, that is to say, a federal government employee. It then pitted business owner job security against what formerly, but no longer, is a source of very secure jobs, a large firm. Seventy (70) percent of Americans believe that small-business owners have less job security than do federal employees; 18 percent believe that they have more job security, and 9 percent believe they have equal amounts. The public sees greater security in federal employment,though given the reputation of each, the results are closer than would have been expected. One possible explanation for the closerthan-expected result is the basic confidence of business owners in their ability to control situations, and hence an increase in job security. Still, owners and the alumni hold views similar to the public’s. The outlying group is the not-exposed. It is just 33 percent more likely to believe federal employment is more secure than selfemployment compared to 52 percent for the entire population. For three groups the job security issue is different than for their counterparts. Employees of government and non-profit organizations are more likely than other employee groups (66 percent compared to 51 percent among the population) to believe that the federal government is the more secure employer. Minorities and others/those refusing racial classification more frequently see it the other way. They still believe federal employment is more secure, but by a 15 percentage point smaller margin than the public. The reason for these divergent views is not obvious. The public is less certain about relative job security when comparing small-business ownership to employment in large businesses. Forty-eight (48) percent think that Continued On Next Page FEEDBACK • VOLUME 16, NUMBER 2 • 2005 13 Feature Perspectives In Audiology people working for large firms have greater job security than small-business owners; 32 percent think small-business owners have greater job security. No evidence exists to indicate whether or not the relative numbers have changed over time. Still, it is difficult to believe that the relative fortunes of large and small business have not gone unnoticed by the public. Distance from ownership is directly and strongly tied to opinion regarding relative job security. Owners are 12 percentage points more likely to believe that they have greater job security than wage and salary workers in large businesses. The alumni more often believe that wage and salary workers in large firms have more job security, but only by a 5 percentage point (-5 percent) margin. However, small business employees see the relative job security of their bosses even more pessimistically. They produce a -17 point divide. The not-exposed, the group most distant from ownership,expands the gap to -30 percentage points. Thus, perceived job security in business ownership is highly sensitive to personal association with ownership, higher here than on any other dimension in the survey. Owner comparisons with federal employees and wage-salary workers in large businesses produce dissimilar results. Distance from ownership appears to have no influence in the federal employee comparison, but considerable influence on the big-business worker comparison. That difference may reveal more about what owners and associated groups think of the two employer sets than what the public thinks about small business. People closest to ownership seemingly believe that the federal workforce is an inert mass possessing enviable job security. The public believes that as well, at least compared with owners. It appears to regard employment in larger firms the same way, though not to the extent of the federal workforce. Curiously, people currently employed in large firms have a similar outlook for their job security as do those 14 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 employed by small business, government, etc. But owners and, to a lesser extent, the alumni disagree. What is not clear is why they disagree. Do they disagree because they see more job security in ownership or less security in big business employment? RISK Job insecurity is not the only risk business owners encounter in forming and operating a business. They frequently go into debt and have those debts personally collateralized. Even if they can avoid debt, the time and effort invested in a business are costs that can be easily lost in an unsuccessful venture. So,besides the upside opportunity,the own- er must recognize the downside risk. The survey defined risk for the respondent and asked whether starting a business is typically risky. The question read: If I define risk as losing all the money and time invested,do you believe that starting a business typically is: very, somewhat, not too, or not at all risky? Note the question references only the amount invested, not all wealth - one’s home, etc. Virtually everyone believes that starting the typical small business is risky if risk means losing one’s time and money. Fortythree (43) percent term starting a venture “very” risky. Fifty-three (53) percent say that it is “somewhat”risky. That puts 96 percent on the risky side. Three percent opine that it is not too risky,and 1 percent say that it is not at all risky. The facts do not bear out the degree of concern. Most ventures are break-even to modestly profitable. Few involve substantial loss (and few, but a larger number, substantial gain). Distance from ownership is not related to perceived risk. No demographic group assesses risk differently from others. The belief that business ownership involves substantial risk is a common theme throughout the population. BANKRUPTCY Business bankruptcy is always possible. As a practical matter however, business bankruptcy as opposed to business closure occurs infrequently. But it has almost become legend that entrepreneurs going bankrupt is typical and bankruptcy is even a useful experience.Such nonsense has absolutely no foundation in fact. Still,it is true that Americans are forgiving of bankruptcy. The survey presented bankruptcy to respondents for evaluation in a moral tone,rather than in terms of economic loss. It asked respondents:Which better describes your view of someone who starts a business and goes bankrupt in it? Has the business owner been irresponsible and hurt people? Or,has the business owner made a good faith effort and things didn’t work? Overwhelmingly, the public believes that bankruptcy stems from good faith efforts. By an 87-13 percent margin, Americans choose to view business bankruptcy in the forgiving manner. Owners appear marginally less,not more, forgiving than others. The rising number of personal bankruptcies probably means that they far more frequently see the creditor side than the debtor side of the problem. Men are twice as likely as women to term a business bankruptcy irresponsible. And,the least educated are three times as likely (17 percent) to call one irresponsible as the most educated (5 percent). But on balance even Perspectives In Audiology Feature the most critical groups consider bankruptcy the result of bad fortune rather than irresponsibility. HARD WORK We all work hard, or at least like to think so. Part of the small-business lore is that owners work harder than other people. They are the first to arrive at work in the morning and the last to leave at night. Work on weekends and evenings is expected,particularly in the formative years. No view of small business is more pervasive,though the empirical evidence is sketchy. Ninety-two (92) percent of Americans say that small-business owners work harder than people like themselves (owner responses not included in the tabulation). Fifty-seven (57) percent strongly believe that they do. Few disagree. Even people who have no association with ownership, the not-exposed, think owners work harder than people like themselves (88 percent). Ninety-five (95) percent of the alumni concur. Small-business-owner hard work is another view held broadly by all segments of society. No group believes that small business or people like themselves work harder than owners. However, the most educated and those with the highest household incomes are about 10 percentage points less likely to strongly agree and 10 percentage points more likely to simply agree than others. These are mostly successful people themselves and apt to believe that they, too, work very hard. Part of the response is predictable. Those outside the labor force are most likely to attribute harder work to owners. Still,even among the employed, the response is overwhelming. Ninety (90) percent of employed people feel that way. CONTRIBUTION TO COMMUNITY Contributing to the community is a large part of the persona of many successful business owners. They adopt leadership positions in organizations, contribute financial and moral support to local drives and charities, and generally promote community welfare. Eighty-three (83) percent of Americans believe that local owners contribute more to the betterment of their community than people like themselves. However, just 30 percent say that they contribute much more (owner responses not included in the tabulation). That 30 percent represents the fewest in the superlative category on any of the assertions evaluated about small-business owner behavior.Still,more than four in five attribute to small-business owners a greater contribution to their community than their peers, while 13 percent believe people like themselves are the greater contributors. Again, some groups, in this case government/non-profit employees, are somewhat less inclined to agree strongly than others. But they are more likely to simply agree meaning the distr ibution between agree/disagree is remarkably similar across groups. The group most likely to strongly agree with the assertion is small-business employees. It is also the group in the best position to make a comparison. TAKE-HOME PAY Despite the fact that many small-business owners do not maximize their income potential when owning/operating a business, take-home pay (profit) is important. The question is how much do owners earn and keep. Available statistics indicate a different pattern for self-employed people than for wage and salar y owners. Effectively, the bell-shaped curve of the earnings distribution for the self-employed is flatter on top compared to wage and salary workers with bulges on the ends for those who do very well and those who earn nothing. The public has no consensus view on small-business owner take-home. A slim plurality (36 percent) thinks that a typical small-business owner working full-time in his or her business takes home less money than the typical full-time wage and salary worker. Meanwhile 30 percent think wage and salary workers take home more money than owners and 29 percent think they take home similar amounts. Perspectives vary considerably by the demographic characteristic of the persons making the evaluation. Those with higher income are much more likely to believe owners’ take-home is more than wage and salary workers, and vice versa. In contrast, women and older people believe owners typically take home less. “ …people starting ventures are typically loaded with optimism. ” OVERVIEW The American public not only holds small business in high regard as an institution, but thinks very much like owners on fundamental issues involving business ownership and operation and the personal behaviors necessary for success. Yet, general consensus on fundamental questions is an inadequate representation of the overlapping perspectives. There is a more important point. The shared understandings also contain heavy doses of approval and respect. For example, there exists overwhelming agreement that owners work harder than most of us; the implicit extension of that opinion about hard work is - and that’s good - an admirable character trait. The public and owners see bankruptcy from the same perspective, at least as framed here. Both largely agree that business bankruptcy is more frequently the result of matters beyond an owner’s control rather than irresponsible actions; that makes a bankrupt owner a sympathetic rather than contemptible person. Both also think that people go into business because they want to rather than because they have no better prospects. That means owners are affirmative, action-or iented winners - a favorable image to portray. Thus, the shared views about smaller firms, and implicit positive connotations that are almost always present, arguably produce a public affinity that continually reinforces itself. Continued On Page 17 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 15 Perspectives In Audiology Feature CONCLUSIONS Small business is highly regarded by an American public that believes smaller enterprise is a positive influence on the way things are going in the country today and should have more influence over its course. Virtually no institution receives parallel, let alone superior support and/or empathy. The tie between favorable public opinion and small enterprise has a long tradition in the United States,and that tradition appears unusual, if not unique, in a world context. The salient question is why should that be? One likely reason for the close relationship between American public opinion and smaller enterprise is that so many members of the public are associated with it. About one in four Americans has been selfemployed at some point in their careers;over half have had some type of direct association with private business ownership and operation. Another huge segment has ties through personal friendships or employment in small firms,particularly friendships. Only about 15 percent of the population have not been exposed directly or indirectly to business ownership. This pervasive exposure to ownership is very important in creating a broad understanding, healthy respect, and underlying support for small business and associated behaviors. The public likely relates so well to small business because “we are them.” The members of the public most closely associated with ownership, owners and the alumni, sometimes exhibit a different perspective than those who have not been directly or indirectly exposed to ownership. In those instances, the former tend to demonstrate greater empathy for the smallbusiness phenomenon. However, groups between the extremes on the distance from ownership continuum, including personal friends and small business employees, typically congregate with owners. That leaves the not-exposed group as an outlier. But even then, the not-exposed group’s differences from owners are typically matters of degree rather than of kind. Broad exposure to ownership is likely associated with the minimal difference in public views on small business across disparate demographic groups. No demographic group seems to have captured small business and its characteristics; they are shared. Though owners are more likely to be middle-aged, white males with aboveaverage education than their numeric share of the population,approval and support runs high among women, minorities, people of all ages and so forth. Those least frequently represented (proportionally) are also the most likely to see business ownership as an important source of opportunity. In that sense, the institution is open to everyone with the subsequent effect of spreading direct association with business ownership to all segments of the society. One can never dismiss the vital role smaller firms play in stimulating competition, innovating, and producing goods and services, and the impact of their effectiveness in these roles on public perceptions. Small business is still fundamentally an economic institution and will always be judged on how well it performs those functions. But, as long as business ownership continues to permeate all corners of society,it will enjoy enviable status, empathy, and consideration because the public will implicitly demand it. EXECUTIVE SUMMARY • Current business ownership,prior ownership, operation of a substantial part-time venture, engagement in concrete steps to form a business, and/or investing in another’s business directly has exposed 52 percent of adult Americans to business ownership. The number exposed rises to 85 percent when the business ownership tie also includes personal friendship with a business owner and working in a small business. No more than 15 percent of the American public have not been exposed directly or indirectly to business ownership. • A net 66 percent (positive minus negative) of Americans think that small business exerts primarily a positive influence on the way things are going in the country today. Of the eight institutions evaluated,only science and technology fares better (80 percent). Colleges and universities places third (62 percent) with the remaining five, such as the federal government and labor unions, lagging badly. • A net 55 percent of the American public believe that small business has too little influence over the way things are going in this country today. The public is not nearly as acquiescent with any of the other sev- en institutions assessed. A net 60 percent think big business has too much influence. • Ninety (90) percent of Americans would approve if a daughter (or a son) went into business for herself (himself). Half that number would strongly approve. Women and minorities are the most likely groups to be favorably disposed. • Most Americans evaluate small business and its operational characteristics in an empathic manner. For example, 89 percent characterize a business bankruptcy as a good faith effort that did not work while 11 percent characterize a business bankruptcy as an owner who has been irresponsible and hurt other people. Two-thirds consider business ownership one of the best ways to get ahead. • Americans think small-business owners often possess desirable personal attributes. Ninety-one (91) percent say that smallbusiness owners work harder than people like themselves. Eighty-two (82) percent believe that local business owners contribute more to the betterment of the community than people like themselves. • Americans typically believe that it is difficult for someone like themselves to start a successful small business, let alone start one and grow it into a large firm. • The American public thinks that the more effective way for public policy to support small-business owners is to lower government imposed barriers (59 percent) rather than to provide direct assistance (34 percent). Current and former business owners favor the barriers approach most frequently while those farthest removed from business ownership more frequently select the direct assistance approach. • Public opinion is pessimistic about small-business opportunities 20 years (one generation) from now. Just 40 percent say that opportunities for small-business owners will be greater in 20 years than they are today, compared to 48 percent who believe that they will be fewer. • All demographic groups express strong support for small business and empathy toward owner behaviors that allow operation of these enterprises. Distance from ownership appears to play a modest role in the public’s view except for the group almost entirely removed, the not-exposed. The group not exposed to ownership is decidedly less positive. ■ FEEDBACK • VOLUME 16, NUMBER 2 • 2005 17 ADA Professional Update Professional Update AFA “Rounds Up” Audiologists to Raise Money for the Au.D. MovementAFA “Rounds Up” Audiologists to Raise Money for the Au.D. Movement, Sponsors Outreach Program for Au.D. Students, Unveils New Website, WOW Factor at AAA Convention 2005, NAFDA Board Welcomes Ph.D. Candidate and Announces Call For Papers AFA Update AFA Art Auction and Golf Tournament at ADA 2005 Convention The AFA is once again holding their annual fundraisers at the convention in Savannah this year. The 2005 AFA Golf Tournament is being held on Hearing Aid returns to Savannah for the AFA Art Auction party. Friday, October 28th, 2005 Shotgun start at 1:00 pm. Duffers and experts alike are welcome! The Club at Savannah Harbor is onsite of The Westin Savannah Harbor Resort! This impeccably maintained course is home of the PGA Champion’s Tour, Liberty Mutual Legends of Golf during 2003-2006. Mingle with friends and colleagues and help raise money for the Au.D.! Fee includes lunch, drinks, 19th hole party and prizes, etc. The fun is free!!! See fliers in your registration 18 packet to sign up or contact the Audiology Foundation of America at 765-743-6283 or by e-mail at info-afa@audfound.org. The 2005 Audiology Foundation of America Art Auction is scheduled for Thursday, October 27th at 5:15-7:15 pm in the Harbor Ballroom. There will be a free cocktail party and once again,live music by Hearing Aid! Unique,elegant and interesting items will be auctioned live! Funds raised will support the Au.D. movement! Come join the fun! We need art donations! To donate an item, please contact Dr. Christine Ulinski at 708-202-8387,EXT 21002 or the AFA office at 765743-6283; info-afa@audfound.org. ADA Exhibits at AAA Convention The AAA convention represents an opportunity for ADA representatives to answer member’s questions, participate in NAFDA activities, meet with other association and vendor leaders and to begin preparing FEEDBACK • VOLUME 16, NUMBER 2 • 2005 for the Fall Convention in Savannah, Georgia. Craig Johnson, ADA’s President, received an award from NAFDA for serving on their advisory board. He also spoke at the NAFDA luncheon for the 3rd year students where he reviewed the history of ADA spoke about their responsibility to advance the profession to improve patient care and access to services. The AAA convention is the Professional Update audiologist, Dave Burnell, representative from Smith Bucklin (ADA’s new management fir m), Lar ry Englemann, Convention Chair, Larry Eng, and Craig Johnson,represented ADA at the Convention. They were also assisted by three first From left to right: Larry Eng, ADA Board member, Susan Williamson, staff audiologist and Dave Burnell, representative from new management firm of SmithBucklin. First year Au.D. students volunteer at ADA Exhibit while their professor and AAA ‘05 Convention Chair, Catherine Palmer visits. From left to right: Kelly Schnoor, Melissa Tamres, Melissa Friedman, and Catherine Palmer official beginning of ADA’s effort to announce the availability of exhibit space and sponsorship opportunities to vendors. Susan Williamson,staff year Au.D. student volunteers from the University of Pittsburgh, Melissa Tamres, Kelly Schnoor, and Melissa Friedman. Professional Update ADA Now Online: The American Academy of Audiology Store Makes Shopping a Snap! Drum roll please.... The Amer ican Academy of Audiology proudly introduces our new online Academy Store! With just a few simple clicks of your mouse,you can now order all your favorite marketing and educational tools as well as cool logo apparel and Audiologyrelated gifts utilizing our secure server. You can access the store by visiting www.audiology.org and selecting the Academy Store link on the left-hand side menu of our home page. (Academy members will want to sign in with an Academy ID and e-mail address to receive special member-only discounts.) Then you can start shopping for apparel and gifts or marketing/educational tools. Just select the amount and/or size and it will appear in your shopping cart. Choose a method of payment, click “submit” and voila, your order has been completed. Be sure to print out the confirmation page for your records. The store has a wide variety of brochures, CDs and marketing kits, as well as hats, t-shirts, mugs and AAA Foundation note cards and Better Hearing wristbands. Now you can take care of all of your audiology shopping needs – day or night! patients have in common with their audiologists? A:The worry that they don’t know what to do about the condition. That’s where the American Tinnitus Association comes in. The ATA designed an easy-toaccess online course to put immediately useful information about tinnitus - its causes, triggers, mechanisms, medical and audiological evaluations, treatments, alternative approaches, coping techniques, and current research - directly into the hands of hear ing health professionals. Self-paced and completely online, the course lets audiologists, ENTS, psychologists, RNs, and other healthcare providers chat weekly with instructors and each other, use a special Course message board, and take weekly quizzes to earn CEUs offered through the Amer ican Academy of Audiology (1.6 CEUs). Comments from past Course participants: “I feel much more confident in being able to support and counsel my patients.” “The faculty was greatly knowledgeable. I appreciated their expertise.” “I would not hesitate to recommend this course to my colleagues.” The next course dates for Tinnitus Treatment and Management - ATA’s Course for Professionals: October 3- October 28, 2005 and January 16-February 10, 2006 ATA Designs Online Tinnitus Course Be positive, informed, and confident with your tinnitus patients! Q: What do most tinnitus Instructors: Dhyan Cassie, Au.D.; Norma Rivera Mraz, Au.D.; James A. Henry, Ph.D.; Michael Seidman, M.D.; Carol Bauer, M.D.; and Cheryl McGinnis, M.B.A. Course Fees: $150 - ATA Member $185 - Non-ATA-member (in the U.S.) $200 - Non-ATA member (outside U.S.) Class size is limited to 20, so register early.Online or mail-in registrations are available. For a more detailed syllabus, chat dates and times,and to register, visit: www.ata.org and select Professional Course. For more information, contact Barbara Tabachnick Sanders, ATA Director of Education, at 800-634-8978 ext. 216, or barbara@ata.org. Phonak U 2005: August 11-13, 2005 Phonak U will be held in Warrenville, Illinois (a Chicago suburb) at Phonak’s US Headquarters. Last year, over 160 doctoral students from more than 30 Au.D. programs participated in the meeting, and this year proves to be even better! Resident and Guest faculty include Drs. Richard and Patr icia Gans, Robert Sweetow, Paul Pessis, Alan Frient, Ron Gleitman, and Catherine Palmer. Students had the opportunity to “customize” their learning experience by selecting from a wide variety of lectures and “handson” workshops. Topics include: - Hearing aid selection & fitting - Aural rehabilitation - Reimbursement - Practice development -Vestibular diagnosis & treat- ment and many more! In addition, participants will have the opportunity for “hands-on” experience with real-ear measurement equipment, hearing aid programming, and FM devices. Participants will have the opportunity to assemble, modify and repair hearing aids and see firsthand how digital hearing aid shells are made. To be eligible for participation, students must be enrolled at a residential AuD program. Resident faculty include: David Fabry, Ron Gleitman, Liz Brassine,Ann Foppe, Chas Kuratko, Jodi Sasaki, Melissa Pacey, and other Phonak staff. Guest faculty include: Drs. Richard Gans, Paul Pessis, Robert Sweetow, Pat Gans and Catherine Palmer. There will be plenty of opportunities for interaction with course faculty and fellow Au.D. students from across the United States. “Full Steam Ahead” October 26-29, 2005 Savannah, Georgia FEEDBACK • VOLUME 16, NUMBER 2 • 2005 19 H A V E YO U H E A R D T H E L A T E S T “BUZZ” ABOUT PHONAK? With legendary astronaut and Savia™ wearer, Buzz Aldrin, Phonak Hearing Systems is on a mission to help hearing professionals meet every hearing loss, lifestyle and budgetary need of their patients. 1- 8 0 0 - 7 7 7 - 7 3 3 3 o r v i s i t w w w . p h o n a k - u s . c o m BUZZ ALDRIN, APOLLO 11, is wearing Phonak’s Savia If you believe Phonak is the leader in FM, BTEs and Pediatrics, you’re right. But it doesn’t stop there. Over the past five years, as an industry innovator, Phonak has: • Launched more than 12 innovative hearing aid product lines, at all price levels, from CIC to BTE, including Savia and mini Valeo™ in 2005. • Received five awards for superior product design, quality and technology, including the 2005 Medical Design Excellence Award for Savia. • Provided unsurpassed hearing-in-noise benefit in ITC to BTE hearing aids and advanced the AudioZoom™ tradition with Savia’s 20 channel digital SurroundZoom™. • Invested millions to create awareness and educate Americans about hearing health through consumer advertising, public relations and promotions. It doesn’t take a rocket scientist to understand that Phonak is on a critical mission to reach more of the hearing impaired market than ever. Join us. To learn how you can bring “The Buzz” to your office with customizable marketing programs, visit phonakpro.com or call us at 1-800-777-7333 for details on our full-line product offerings. Feature Ear Candling Why Ear Candling Is Not A Good Idea by Lisa M.L. Dryer, M.D. 22 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 Ear Candling Feature Editors Note: We have all been asked about this from our patients. The following is an excellent piece to hand out to those patients who inquire about ear candling. “Ear candling,” also known as auricular candling or coning, refers to various procedures that involve placing a cone-shaped device in the ear canal and supposedly extracting earwax and other impurities with the help of smoke or a burning wick. The procedures supposedly create a lowlevel vacuum that draws wax and other debris out of the ear canal. Some proponents even claim that impurities are removed from the inner ear, the facial sinuses, or even the brain itself, all of which are somehow connected to the canal. Proponents claim that candling can: • relieve sinus pressure and pain • stop tinnitus (ringing in the ears) • cleanse the ear canal • help TMJ pain and stiffness • improve hearing • relieve vertigo • assist lymphatic circulation • fortify the central nervous system • regulate pressure • clear the eyes • purify the mind • purify the blood • strengthen the brain • act as an anti-inflammatory, antiseptic, or antibiotic • relieve pain and fever associated with a ruptured eardrum • cure Meniere’s syndrome • cure swimmer’s ear and other infections • aid sinusitis • release blocked energy • relieve earaches • reduce stress and tension • act as an alternative to “tubes put in your ears” •cure auricular zona (a herpes zoster infection of the ear) • sharpen the senses of smell, taste, • open and align the chakras and color perception • open the spiritual centers and cleanse the auric bodies • stabilize emotions PRODUCTS AND PROCEDURES Most ear candles sold in the United States are manufactured here or in Canada and retail for between $2 and $10. They can be made of linen or cotton (often unbleached, as practitioners claim that chlorine is bad for the ears) soaked in wax or paraffin and allowed to harden. (Ironically, one manufacturer uses only pure beeswax, claiming that paraffin is carcinogenic.) Some candles are colored, which is controversial in ear-candling circles, though the color of pure beeswax varies. Home varieties include wax-soaked newspaper and cones of pottery into which herbal smoke is blown. Some waxes contain herbs or other substances, including sage, chamomile, rose, rosemary, burdock root, osha root, periwinkle, jojoba, quassia bark, yucca root, or honey. Most instructions direct the person undergoing the procedure to lie on his or her side. A collecting plate is placed above the ear, and the candle is inserted through a hole in the plate and into the ear canal. The candle is lit, and as the wick burns down, it is often trimmed. Some advocate using a toothpick to maintain a hole in the top of the hollow candle throughout the procedure. After the candle is blown out and removed, a cotton swab is used to gently remove visible earwax from the ear, and “ear oil” is often applied. WHY CANDLING CAN’T WORK Since wax is sticky, the negative pressure needed to pull wax from the canal would have to be so powerful that it would rupture the eardrum in the process. However, candling produces no vacuum. Researchers who measured the pressure dur ing candling of ear models found that no negative pressure was created. The same investigators candled eight ears and found that no ear wax was removed and candle wax was actually deposited in some of them! DANGERS REPORTED Candling poses several dangers, the most serious of which involve burning caused by the hot wax. Candle manufacturers claim that their candles will drip only down the outside of the ear, but shamefully few direct the user to hold the candle horizontally to prevent this. A 1996 survey of 144 ear, nose and throat physicians, found that 14 had seen patients who had been harmed by ear candling, including at least 13 cases of external burns, seven cases of ear canal obstruction with candle wax, and 1 perforated eardrum. Another case was reported by the London Free Press, a Canadian newspaper. A woman who experienced stuffiness in the nose and ear pains while scuba diving went to a local health-food store and was referred to a “qualified” candler. During the “treatment,” she felt an intense burning in her ear. At the emergency room, attempts to remove wax that had dripped from the candle onto her eardrum failed. Surgery was required, and a hole in her eardrum was discovered,which presumably was caused by the procedure. She recovered fully, and luckily her hearing was not affected. The practitioner apologized, compensated the woman,and stopped performing ear coning. Alaska Fire Marshall Gary L. Powell has reported two instances of significant fires associated with ear candling, one of which led to the user’s death. On January 27, 2005, a 59-year-old woman ignited her bedding when she dropped an ear candle that she was attempting to use in the ear without any assistance. The candle ignited the bedding and quickly spread to curtains and other combustibles in the room. The woman did escape but suffered an asthma attack and died in a hospital emergency room REGULATORY ACTIONS Candles marketed with health claims are classified by the FDA as medical devices. As such, they are illegal to market without FDA approval, which none of them have at this time. ■ FEEDBACK • VOLUME 16, NUMBER 2 • 2005 23 The Westin Savannah Harbor Golf Resort And Spa October 26–29 24 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 2005 ADA Advance Program ADA 2005 ADA Convention Advance Program ll aboard for the 2005 ADA Convention! On behalf of the Academy of Dispensing Audiologists, we invite you to attend this premier event at the Westin Savannah Harbor Golf Resort and Spa, October 26-29, 2005, in Savannah, Georgia. Themed “Full Steam Ahead,” this year’s convention will set sail as the hearing industry’s top educational and networking opportunity. This conference will provide valuable, current information that you will be able to apply immediately in your practice.Your office staff can also attend the exclusive Staff Workshop to improve their skills.Attend lectures and workshops in the following areas: business/ practice management, amplification/ALD, diagnostics/ A treatments, legislative/professional issues and biomedical/ related professions. Our post-convention surveys over the years have documented the value you place on the conference exhibits.This year’s exhibit hall will feature a wide array of available products and services.The conference will also offer numerous social events that will provide great opportunities to network with your colleagues. The home of the S.S. Savannah, the first steam-powered vessel to cross the Atlantic Ocean, Savannah, Georgia is the perfect city to host our “Full Steam Ahead” conference. Don’t miss the boat! Register now for the 2005 Academy of Dispensing Audiologists® convention! Schedule-at-a-Glance Wednesday, October 26 7:00 a.m. - 7:00 p.m. Registration Open 8:00 a.m. - 9:00 a.m. Continental Breakfast 9:00 a.m. - 4:00 p.m. Optional Workshops 10:00 a.m. - 6:00 p.m. Exhibitor Registration Opens 11:30 a.m. - 1:30 p.m. Luncheon - Workshops 2:00 p.m. - 5:00 p.m. Manufacturer Training Sessions 6:30 p.m. - 10:00 p.m. Opening Reception in Exhibit Hall Thursday, October 27 7:45 a.m. - 8:45 a.m. Breakfast 8:00 a.m. - 1:00 p.m. Registration Open 9:00 a.m. - 11:00 a.m. Opening General Session & Keynote 11:15 a.m. - 12:15 p.m. Concurrent Sessions 11:00 a.m. - 1:00 p.m. Luncheon 11:00 a.m. - 5:00 p.m. Exhibit Hall Open 1:00 p.m. - 5:00 p.m. Concurrent Session 3:15 p.m. - 4:00 p.m. Refreshment Break 5:15 p.m. - 7:15 p.m. AFA Art Auction 7:30 p.m. - 11:00 p.m. Evening Event Friday, October 28 7:45 a.m. - 8:45 a.m. Breakfast in Exhibit Hall 7:45 a.m. - 1:00 p.m. Exhibit Hall Open 9:00 a.m. - 10:00 a.m. Concurrent Sessions 10:00 a.m. - 10:15 a.m. Refreshment Break 10:15 a.m. - 11:15 a.m. Concurrent Sessions 11:15 a.m. - 12:15 p.m. Lunch in Exhibit Hall 1:00 p.m. AFA Golf Tournament 8:00 p.m. Manufacturers’ Open Houses Saturday, October 29 8:30 a.m. - 10:00 a.m. Breakfast 10:00 a.m. - 4:15 p.m. Concurrent Sessions 11:00 a.m. - 11:15 a.m. Refreshment Break 11:15 a.m. - 12:15 p.m. Concurrent Sessions 12:30 p.m. - 2:00 p.m. ADA Business Lunch 2:00 p.m. - 4:15 p.m. Breakout Sessions 6:30 p.m. - 7:30 p.m. Reception 7:30 p.m. - Midnight President’s Banquet *Schedule as of June 10, 2005 Keynote Speaker Opening Session- Thursday, October 27, 2005, 9:00 a.m.-11:00 a.m. Martie Ormsby-Bradbury,an experienced corporate executive and founder of Recruiting Solutions International (RSI), has a well-deserved reputation as a visionary, strategist,highly skilled motivator and effective long-range planner.Throughout her 24year career,Ms.Ormsby has been committed to achieving lofty goals as they relate to excellence in service,personnel and the field of audiology and hearing healthcare. In 1995, the Academy of Dispensing Audiologists recognized Ms.Ormsby’s contributions to the field by presenting her the “Audiology Awareness Award.” In her keynote address, Ms. OrmsbyBradbury will provide an informative,entertaining and inspirational look at the profession of audiology.With both an industry insider and outsider point of view,she will help attendees see the hearing healthcare industry and the audiology profession through various eyes, ears and languages. The goal of this presentation is to remind attendees why they chose this particular profession and to examine the path we must all embrace today to advance the field of audiContinued On Next Page ology in the future. FEEDBACK • VOLUME 16, NUMBER 2 • 2005 25 ADA 2005 ADA Advance Program Wednesday, October 26 9:00 a.m. - 4:00 p.m. Workshop 1 Getting Your Financial Life in Order Joseph K. Kiely, Ph.D. The objective of this hands-on workshop, customized to the economical concerns of the audiologist business owner and non-owner employee, is to help you better understand the importance of preparing for and managing a secure financial future. Dr. Kiely uses a simple, proven, step-by-step approach to managing your financial future. In an unbiased manner, he untangles the maze of investment alternatives to illustrate how to establish and monitor a financial plan and an investment portfolio. This workshop will teach you how to examine and document your current financial position, then re-align and take control of your future based on your unique situation and goals. Workshop 2 - Cerumen Management A.U. Bankaitis, Ph.D. Dispensing audiologists provide a variety of services that require the patient’s ear to be relatively free of cerumen. Cerumen removal represents an essential element to the overall hearing health care management process. The objectives of this workshop are to review pertinent ear canal anatomy and pathophysiology of cerumen, present standard instrumentation for cerumen removal, and to address professional issues related to cerumen management including reimbursement and licensure. You will be able to identify specific techniques and strategies for removing cerumen, describe instruments and/or equipment associated with each technique, and outline activities for which infection control protocols must be implemented during cerumen management procedures. Workshop 3 Auditory Electrophysiology in Audiology Today: Clinical Applications in Adults James W. Hall, III, Ph.D. This workshop reviews current applications of different auditory electrophysiology techniques for diagnosis of auditory dysfunction in adults, including electrocochleography (ECochG), neurodiagnostic auditory brainstem response (ABR), auditory steady state response (ASSR), and cortical auditory evoked responses. 26 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 Participants will be able to explain the rationale for application of auditory evoked responses in adult patient populations and construct a neurodiagnostic ABR test protocol and then record, analyze and interpret ABR findings efficiently for the auditory assessment of adults. Participants will also be able to describe the advantages and disadvantages of ASSR in specific patient populations and integrate cortical auditory evoked responses in the diagnostic assessment of adults at risk for central nervous system dysfunction. Thursday, October 27 1:00 p.m. - 2:00 p.m. So, Now That I Have My Au.D., What’s My Value? Barry A. Freeman, Ph.D. This session will attempt to unravel the mystery and discuss the complexity associated with valuing an audiologist. Audiologists need to change from the traditional mind-set of “where can I work and how much are they going to pay me” and move toward “where is there a good practice opportunity for me that I can use my knowledge and skills and maximize my revenue producing potential.” Similarly, practitioners and employers need to readjust their thinking and recognize the knowledge, skills, and revenue generating opportunities of audiologists. The session will include mechanisms to approximate the “value” of an audiologist and discussion of what all of this means to the future of the profession. Participants will be able to develop projections of the revenue they can generate as a practitioner, describe the components that will generate revenue and develop strategies to become associates in a practice rather than employees. 1:00 p.m. - 2:00 p.m. The Role of Bluetooth in Hearing Rehabilitation Jerry L. Yanz, Ph.D. Bluetooth is a short-range, low-power, wireless communication protocol that allows transmission of audio signals and data from one device to another, representing an important and revolutionary treatment tool. This course will review the principles of Bluetooth technology, describing and demonstrating related products. As a result of this session, participants will be able to use Bluetooth devices to solve telephonic issues for patients and to enhance other challenging listening tasks. 1:00 p.m. - 3:15 p.m. The Audiology Practice Lifecycle: Strategies for Buying and Selling a Practice Bill Urwin, B.S. In the hearing healthcare field, there are a variety of methods for valuating the worth of a full-service audiology practice. Attendees will learn to accurately assess their practices to analyze salability on the open market by breaking down the business from an audiological and financial platform, generating a value profile of the practice and positioning the practice for the future. Key financial and performance metrics needed to analyze whether or not to purchase an existing practice will also be identified. 1:00 p.m. - 3:15 p.m. Foundations of an Efficient, Compliant, and Profitable Audiology Practice Kim Cavitt, Au.D. candidate This session will focus on the necessary building blocks of an efficient, effective, and profitable audiology private practice. These include aspects of training and education, computer software, human resources, pricing, marketing, insurance contracting, billing and reimbursement and HIPAA compliance. Participants will also learn about outsourcing certain tasks in order to maximize time and money, the need to have forms and processes in place for managing day-today operations. 1:00 p.m. - 3:15 p.m. Beyond the Cochlea and the Semicircular Canals Brenda Berge, Au.D Tabitha Parent-Buck, Au.D. This session will explore the peripheral structures of the audiovestibular system to the central pathways with emphasis on understanding the central nervous system and its vast connections and functions. Explore the locations and functions of the auditory and vestibular brainstem nuclei as well as the connections to the cortex, cerebellum, oculomotor nuclei, cerebellum and spinal cord. Attendees will be able to recognize the structures of the central auditory and vestibular pathways and describe the neurovasculature from the vertebrobasilar system to the audiovestibular peripheral organs. 2005 ADA Advance Program ADA 2:15 p.m. - 3:15 p.m. Look at More Than the Audiogram When You Treat the Elderly Lynn Sirow, Ph.D. This course will cover the special considerations the dispensing audiologist needs to address when treating the elderly, including changes in memory and learning capacity, speed of processing, binaural interaction and integration as well as changes in visual, motor and tactile abilities. Participants will better understand auditory processing in the elderly, how to apply its principles to hearing aid fitting and how to modify equipment and counseling to facilitate hearing aid use. 2:15 p.m. - 3:15 p.m. Digital Frequency Compression (Transposition) - Addressing the Complexity of Hearing Loss Wendy E. Davis, M.S. This session will discuss the benefits and limitations of recent trends in digital technology, focusing on three main topics: hearing loss that falls outside the moderate range, hair cell viability, and how these two issues affect the speech signal in this dynamic session. Digital Frequency Compression (transposition) will be reviewed as a signal processing strategy using the processing power of DSP to address the complexity of hearing loss, maximize useable residual hearing and access speech cues necessary to improve speech understanding. Participants will become familiar with the concept of cochlear dead regions and the clinical implications for hearing aid selection and fitting, understand the differences between various frequency compression algorithms and technologies and identify a candidate for proportional frequency compression hearing aids. 4:00 p.m. - 5:00 p.m. Getting Patients to Accept and Follow Treatment Prescriptions Bill Urwin, B.S. This program helps the audiologist recognize and understand the reasons why patients do not follow their treatment prescriptions. By reviewing the reasons for non-compliance, establishing methods for better understanding and implementing these methods, the audiologist will have the tools to better care for their patients’ needs. This session will identify the steps of counseling a patient as well as provide strategies for becoming more effec- tive at solving hearing impaired problems and helping patients to follow the Audiologist’s prescription. 4:00 p.m. - 5:00 p.m. Space and Motion Discomfort and Agoraphobia in Vestibular Patients Richard E. Gans, Ph.D. Individuals who present with phobic type responses to space and motion as well as open areas and crowds have often been thought to present with psychogenic dizziness, when they may have experienced earlier acute vestibular events and are left with a chronic uncompensated vestibulopathy condition. Attendees will learn to differentiate between vestibular and psychiatric disorders that cause dizziness, accurately describe two theoretical mechanisms of space and motion discomfort, categorize patient symptoms and clinical test findings, and list the treatment options available to this clinical population. 4:00 p.m. - 5:00 p.m. Audiology Licensure Update Kenneth Lowder, Au.D. State licensing is at the core of the effort to transition audiology to a doctoring profession and to improve the quality of practice. Only a uniform model statute that contains the impor- tant and necessary policy features, such as the one created by the AAA, ADA and AFA, can advance the cause. This session will provide an overview of the model statute and recent changes to state licensure laws. Attendees will better understand the proposed model licensure law for audiology and the fundamental requirements for audiology to become an independent doctoring profession. 4:00 p.m. - 5:00 p.m. TransEar™: Effective, Non-surgical Approach to Treatment of SSD Daniel R. Schumaier, Ph.D. This session introduces TransEar™, a bone conduction device that looks like a traditional hearing aid but utilizes a miniature vibrator seated in the ear canal to send amplified signals through the skull to the individual’s better ear without surgery, bulky headpieces, or occlusion of the “good” ear. Participants will learn surgical and nonsurgical approaches to treatment of single-sided deafness (SSD), understand pros and cons of bone conduction as a solution and describe fitting parameters for the TransEAR bone conduction hearing aid relative to both conductive and sensorineural hearing loss. Continued On Next Page FEEDBACK • VOLUME 16, NUMBER 2 • 2005 27 ADA 2005 ADA Advance Program 4:00 p.m. - 5:00 p.m. Implementing an Infection Control Plan in the Dispensing Environment A.U. Bankaitis, Ph.D., FAAA Infection control procedures and protocols have become a more important issue in the scope of audiologists’ clinical practice in recent years. With information justifying the importance of infection control, guidelines on how to effectively implement such a program within the dispensing environment is needed. This session will provide practical guidelines and strategies for implementing an infection control program, including five standard precautions and prioritizing clinical service scope for implementing step-by-step infection control protocol training for clinical and administrative staff. Friday, October 28 9:00 a.m. - 10:00 a.m. Patient Satisfaction in a Changing Industry - Managing for Quality Brian Taylor, Au.D. This session will explore practical and innovative ways to drive patient satisfaction while offering several field-tested tools to measure the savvy patient’s experience in your clinic, such as a customer comment card. With insights from clinical audiology and business practice management, attendees will learn how to recognize new consumer and industry trends and how they impact the delivery of hearing health care, to identify key drivers of patient satisfaction and loyalty in the hearing aid industry and to implement tools to measure patient satisfaction and increase profitability. 9:00 a.m. - 10:00 a.m. The Administration and Interpretation of Neurological Screening Procedures Joel A. Greenberg, M.D. As Audiology moves to a doctoring profession, we need to further our knowledge in the area of neurology. This session will explain how neurological screening can be incorporated in the evaluation of patients with hearing loss and dizziness. Participants will discuss anatomy and physiology as well as proper screening procedures and interpretations. The session will include case studies to help reinforce the key concepts presented. 28 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 9:00 a.m. - 11:15 a.m. Marketing to the Mature Marketplace Don Marsh, B.A. This session offers insight into understanding the unique nature of the mature marketplace (55+) and the key concepts that motivate this target market audience. As such, the session will focus on establishing strong positioning within the marketplace using marketing tools, including activities used for new patient acquisition, retention marketing, and free media and community outreach programs. Participants will gain insight into each form of activity, their comparative strengths and weaknesses, and the best integration for a coherent, consistent marketing campaign. 9:00 a.m. - 11:15 a.m. Verification and Validation of LACE (Listening And Communication Enhancement) Robert W. Sweetow, Ph.D. Dr. Sweetow has combined his research interests in amplification, management of the tinnitus patient, neural plasticity and aural rehabilitation into the creation of an interactive, adaptive, home-based training program called LACE (Listening And Communication Enhancement). Participants will gain knowledge about how the principles of learning theory and neuroscience can be combined into a cost effective adjunctive therapy hearing aid fitting and audiologic counseling. Participants will also be able to recognize emerging aural rehab programs and how they might be incorporated into clinical practice. 10:15 a.m. - 11:15 a.m. Risk Factors and Genetic Syndromes for Hearing Loss in Newborns and Infants Micheal Castiglione, Au.D. Danielle Rocktaschel, Au.D. Because newborn infant hearing screening is becoming more universal, this session will provide an overview of risk factors and genetic syndromes for hearing loss in newborns and infants using case studies. A suggested protocol for newborn infant hearing screening as well as diagnostic follow-up and monitoring will be discussed. Attendees will be able to establish necessary monitoring protocols, gain an appreciation for genetics and how it relates to the practice of audiology and recognize the need for referrals to other professionals for improved patient care and management. 10:15 a.m. - 11:15 a.m. Pharmaceutical Therapy CEU Course Development Barry A. Freeman, Ph.D. Craig Johnson, Au.D. Over 75% of ADA membership is Doctors of Audiology who are receiving better access to patients from third parties than at any time in our professional history, which leads to increased responsibility for managing the hearing and balance care of our patients. This includes the need to understand the patient’s pharmacologic history and its potential impact on the auditory and vestibular systems. Historically, education precedes government regulators and legislative recognition of increased patient management knowledge. The session will provide the rationale and framework for the development of an agent therapy curriculum for audiologists. Saturday, October 29 8:00 a.m. - 9:00 a.m. Breakfast Session: Free at Last - The ACAE Sets Sail Doris Gordon M.S., M.P.H. The Accreditation Commission for Audiology Education (ACAE) presents CAP, a new and innovative computerized accreditation program that facilitates ease in management. An overview of how programs proceed through the process, retrieve national trend data and keep abreast of accreditation requirements will be given, followed by a panel discussion and question-andanswer period with members of the ACAE Task Force. Attendees will gain a basic understanding of the ACAE electronic accreditation process and understand its primary benefits. 9:15 a.m. - 10:15 a.m. Integrated Directional Processing Michael Block, Ph.D. The top complaint of current hearing instrument wearers continues to be the inability to understand speech when background noise is present. Directional technology is the only proven strategy to improve speech understanding in noise; however, only 30% of the hearing instruments sold in 2003 were directional. This seminar will detail directional design issues and solutions with use, including practical fitting considerations and counseling techniques. Participants will be able to recognize the benefits of directional listening systems as well as 2005 ADA Advance Program ADA clinical situations and the proper locations for their effective use. 9:15 a.m. - 10:15 a.m. Patient Factors and Drug Reactions Tabitha Parent Buck, Au.D. Henry Trahan, Au.D. Some patients demonstrate uncommon drug effects and may require alterations in drug dose. The ability to understand such variations is dependent on knowledge of pharmacokinetic or pharmacodynamic changes in the expected response to a drug due to various patient factors. Participants will learn to list possible changes in drug absorption, distribution, biotransformation and elimination for pediatric and geriatric patients and understand how drugdrug and drug-food interactions occur. Participants will also learn to explain the importance of compliance with drug regimen and the factors that may influence patient compliance. 9:15 a.m. - 11:30 a.m. Predicting the Future of Audiology: Lessons from Optometry Steve W. Henson, Ph.D. The entrance of Baby Boomers into today’s audiology healthcare market will lead to dramatic growth in new patients, spurring consolidation among manufacturers and retailers, changing the competitive marketplace and forcing changes on the audiology profession. An understanding of markets and businesses becomes as important as clinical skills. This session will help audiology professionals understand the major demographic, technological, and political changes that will impact the audiology profession and to be prepared to take advantage of opportunities that will emerge. 9:15 a.m. - 11:30 a.m. Comprehensive Case History and EMR Software in Audiology: High Quality, High Speed and High Tech Anita Pikus, Au.D. Ted Wendel, Ph.D. Effective case history information is essential in audiology, demanding comprehensive patient medical information as well as precise annotation, organization, secure storage and retrieval. This session will demonstrate how to develop and use a comprehensive case history and how technology, namely tablet PC hardware and electronic medical record (EMR) software, offers speed and safety. Attendee’s will learn expanded case history principles, the review of systems, and become comfortable with syndromic perspective for intake and referral. 10:30 a.m. - 11:30 a.m. Ethical/Legal Issues in Audiology Robert Gippin, Esq. While there are well-defined sets of ethical standards for audiologists, ambiguities continue to arise in applying them in the context of statutes, regulations and case law. By examining the key ethical issues from a lawyer’s perspective (especially concerning manufacturer relationships and patient counseling), audiologists can resolve some of these issues. As a result of this session, attendees will be able to better understand the legal context of ethical standards, apply the standards to pressing ethical problems and consider clarification of the standards. 10:30 a.m. - 11:30 a.m. A New Definition for Modern Hearing Aids Victor Bray, Ph.D. New evidence challenges conventional audiology wisdom that prescription-based hearing aid fittings, using ‘equivalent’ products, produces equivalent results. Such methodologies will be compared and contrasted using examples from modern hearing aids. Attendees will gain the ability to explain to their patients the potential advantages available in modern hearing aids, incorporate decision rules beyond prescriptive-based fittings in their clinical practice and utilize the predictive value of the AI-DI, the A3, and the NRI. 2:00 p.m. - 3:00 p.m. Integrating Emergent Technologies into the Practice with Ease Roger McGuire, B.A. Successful implementation and practical use of new, sophistictated technology devices requires that new features, patient benefits, and changed fitting paradigms are integrated into an audiologist’s scope of practice. This interactive course examines how practitioners can improve the assessment and selection process to systematically integrate these devices into the practice. Participants will be able to make insightful comparisons between different and complex new hearing instrument technologies, use a practical, structured approach to select technologies to offer patients, and integrate new technologies. 2:00 p.m. - 3:00 p.m. Establishing Tinnitus and Hyperacusis Services: Diagnosis, Treatment, Coding and Reimbursement Pawel J. Jastreboff, Ph.D. Margaret M. Jastreboff, Ph.D. “Ringing in the ears,” or tinnitus, is a common hearing disorder that is generated internally. Hyperacusis is a condition that amplifies sounds from the environment, causing distraction and pain. Both conditions can vary in degree from mild symptoms that can be easily controlled, to symptoms that cause extreme pain and discomfort. The Jastreboffs’ work has led to the conclusion that by retraining the brain to habituate, or ignore certain noises, patients could eventually be free from the annoying symptoms. The method of treatment based on these principles is known today as Tinnitus Retraining Therapy (TRT). Participants in this session will learn how to establish Tinnitus and Hyperacusis services, focusing on diagnosis, treatment, coding and reimbursement. 2:00 p.m. - 4:15 p.m. APD: New Perspectives on Diagnosis, Treatment and Auditory Training using Fast ForWord (Part 1) Maxine Young This session will review new research on how the CANS processes spoken language, innovative approaches to testing for APD and their use in a private practice, selection of the APD test battery, how APD affects HA fittings, use of treatment/training options successfully implemented within a private practice setting, and the business side of APD. 2:00 p.m. - 4:15 p.m. The Importance of Stimulus Type and Duration in Hearing Aid Verification Francis Kuk, Ph.D. In recent years, there is growing recognition that complex stimuli are needed for verification of nonlinear hearing aids. However, many issues remain unresolved. What are the differences in output with the use of different complex stimuli? How should one adjust the target for each stimulus? And, how long should each stimulus be presented to avoid bias and artifacts? These questions have a significant bearContinued On Page 31 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 29 Available through Discovery’s Family of Hearing Aid Companies. For more information call 1.800.525.7936. 2005 ADA Advance Program ADA ing on the verification of multichannel compression hearing aids that use longer time constants, noise reduction algorithms, and/or adaptive directional microphones. 3:15 p.m. - 4:15 p.m. Overcoming Barriers to Physician Marketing Richard Carmen, Au.D. Surveys reveal that patients depend more on physician guidance than any other single resource. Dr. Carmen will offer an overview of the results from his most recent pilot study, which reveal a 5% market response with his physician marketing program and prove how this is one of the most affordable outreach efforts. Participants will be able to identify specific physician marketing benefits and strategies, discuss the practicality and usefulness of such a program in one’s practice and implement a protocol for physician marketing that will measure outcome results. 3:15 p.m. - 4:15 p.m. Panel Discussion - ALDs: Good for Your Patient, Good for Your Business A.U. Bankaitis, Ph.D. Mark Carter, Au.D. William Diles, MA This panel of experts will discuss multiple facets of ALDs, including recognizing ALD income potential relative to your dispensing practice, implementing cost-effective techniques for generating ALD awareness within the business operation of the clinical practice, the advantages of induction loops and Tcoils for patients, and various other strategies for increasing awareness and providing more benefits to the emerging market of hearing aid users wanting seamless and automated solutions. *Program as of June 10, 2005 Convention Overview/ Hotel-Travel Information Golf Tournament Please join your colleagues for the AFA Golf Tournament on Friday, October 28. Tee time is at 1:00 p.m, with a shotgun start. For more information, please contact Becky White at (765) 743-6283. President’s Reception & Banquet End the conference with a bang! Be our guest at the President’s Reception & Banquet from 6:30 p.m. until midnight on Saturday, October 29 for dinner and entertainment. This will be a great time to visit with friends and network with other professionals. AFA Auction The AFA Art Auction will be held Thursday, October 27 from 5:15 p.m.-7:15 p.m. For information about the art auction or to donate art, please contact Susan Paarlberg at (312) 743-6283. Thursday Evening Event ADA is planning a special event for attendees on Thursday, October 27th at 7:30 p.m. Details will be announced on the ADA’s web site. Mark your calendar and plan to be there! Travel/Hotel Reservations Info The Westin Savannah Harbor Golf Resort & Spa One Resort Drive Savannah, GA 31421 (912) 201-2000 Online: http://www.starwoodmeeting.com/StarGroup sWeb/res?id=0504212380&key=A0507 Fax: 1.912.201.2059 Phone: 1.800.WESTIN.1 Rates/Times Single/Double Standard Room: $205US + $12 per night resort fee+ taxes $25 per additional guest (over 18 years of age) Check-in: 4:00 p.m. Check-out: 12:00 p.m. ADA Exhibit Hall As always, the exhibits will be comprehensive in their scope and will feature the latest technology and advances in patient management and product design. Housing Deadline Reservations received after September 19, 2005 will only be confirmed based on availability. ADA discounted room rates are applicable October 7-18, 2005. Exhibit Hall Schedule Wednesday, October 26, 2005 6:30 p.m.-10:00 p.m. Thursday, October 27, 2005 11:00 a.m.-5:00 p.m. Friday, October 28, 2005 7:45 a.m.-1:00 p.m. ADA Manufacturer Training Sessions Manufacturer training presentations offer additional learning opportunities about product innovations, enhancements and new services. These sessions, hosted by exhibiting companies, will be held Wednesday, October 26 from 2:00 p.m.-5:00 p.m. Manufacturers’ Open Houses The evening of Friday, October 28th will serve as an open evening for attendees to attend conference exhibitors’ open houses. Information on these events will be provided on-site. Airport/Ground Transportation Information The Westin Savannah is approximately 15 miles from the Savannah/Hilton Head International Airport (SAV). Taxi transportation is available for a rate of $20-30 each way. Conference Attire Attire will be business casual for all events except the President’s Banquet, which is a formal event. Continuing Education Units ADA will apply for CEUs from the American Academy of Audiology and the American Speech-Language-Hearing Association (ASHA). This educational activity has been submitted to both organizations for approval. If you have time to visit only one city in the Southeast, make it Savannah. It's that special. – frommers.com FEEDBACK • VOLUME 16, NUMBER 2 • 2005 31 Feature Practitioner’s Corner Self-Test Device Helps Market Your Practice By John Diles 32 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 Practitioner’s Corner Feature arPeace Technologies was born by accident 2 years ago at Diles Hearing Aid Center in San Leandro, California. A 75 year old woman came into the office for an evaluation because of her inability to hear a Hallmark musical birthday card given to her at her birthday luncheon. John Diles, not being current on birthday card technology, asked if the card was intended to test her hearing. After all the confusion was sorted out, it occurred to John that if a card can play a happy birthday jingle, then it must be able to produce pure-tones at fixed presentation levels. E John said, “I’ll never forget that day. Being half-Ir ish and somewhat of a gambler, I decided to pursue the development of the screener. Since I am not an audiologist, I had been wondering how much dispensing I had in front of me.After 30 years, I was ready for a little career change anyhow.” Osterhout Design Group in San Francisco was selected as the engineering firm for the project. Originally an electronic toy manufacturer, Osterhout Design moved into defense contracting, designing robotic surveillance equipment for the U.S. government. “We figured that if these guys were smart enough to design rockets with highly sensitive cameras inside that detect movement of the Taliban, they could figure out how to build our screener. Osterhout also had all of the manufacturing contacts that we needed in Asia” The screener was designed with the sole intention of driving hearing impaired consumers into dispensing practices.Originally conceived as a self-test device for reluctant hearing impaired and their spouses, the screener has been well received by physi- cians, medical assistants, nurses and other health professionals. Although not yet approved as a stand-alone procedure under new Medicare preventative health initiatives, it is being widely used in conjunction with the 10 point questionnaire recommended by AAA. “Probably the most important aspect of our project is the custom label that is affixed to each screener. It is a constant reminder to the physician of where he or she got the screener and where to refer the patient that fails. Our thermal printer creates a customized label that won’t smear when it’s sanitized by office staff. We can even scan practice logos and incorporate them into the design of the label.’ Another opportunity for referrals lays waiting in practice patient files. “Back 20 years ago, it was rare to get a referral from a satisfied hearing aid wearer.There simply were not that many of them. I believe current hearing aid wearers are much more inclined to recommend hearing aids to friends.We feel that our screener can stimulate conversations between friends and family members that will lead to appointments for hearing evaluations and hearing aid fittings. If a practice hands out 100 of our devices, all that needs to happen is one binaural fitting for our screeners to make financial sense. There are lots of practice advocates out there that simply need a tool “ The screener was designed with the sole intention of driving hearing impaired consumers into dispensing practices. ” in their hands. Since our battery lasts three years, there are many opportunities for one satisfied patient to send in lots of friends.” EarPeace is also venturing into consumer markets. Product testing is currently underway in several pharmaceutical chains,consumer electronics retailers and music stores. “Musicians love our screener. I’ve had the privilege of fitting in-ear-monitors to some prominent country artists and their backup bands. Recently, I’ve been handing out my screener to these artists and they are intrigued by the concept of checking their own hearing routinely. Most of them that fail won’t book appointments next week, but it may shorten that 7 year period that they usually wait to do anything about their hearing problem.” EarPeace’s newest design incorporates a 3position switch (off-low-high) that allows the user to toggle between 30 and 40 dB output.“We hope that will prompt even more discussion about hearing loss. Our screener certainly gives the physician or consumer a chance to investigate the subtleties of soft sounds and then decide whether or not to seek further evaluation. We’d like to help chip away at the 80% group who is reluctant to seek help for their hearing problems.” For more information, please visit www.EarPeaceTech.com or call 800821-0131. ■ John Diles is a 1980 graduate of Ohio University. He is a former Peace Corps Volunteer, assigned to the St.Lucia School for the Deaf. Diles familial ties to the hearing aid industry may be the longest in the U.S. His grandfather, John Heaton fitted his first Sonotone hearing aid in 1934 and his father,William Sr. joined Sonotone in 1949. John owned and operated Diles Hearing Aid Center in San Leandro, California from 1988 until January of this year. He is also the drummer for the ‘Steelheads’, a struggling Bay Area country band. FEEDBACK • VOLUME 16, NUMBER 2 • 2005 33 Book Review ADA Linda S. Remensnyder, Au.D. Book Review: Hearing Care for the Older Adult – Audiologic Rehabilitation By Patricia B. Kricos and Sharon A. Lesner here seems to be general consensus that the best way for private practice audiologists to differentiate themselves from their competition, whether the competition be hearing aid dispensers,corporate providers, or ENT offices, is to provide better services-more comprehensive services for the hearing impaired. Conducting Audiologic Rehabilitation (A.R.) Classes provides that market niche. One of the most positive repercussions of the distance learning Au.D. program on my practice was my post-doctoral decision to provide A.R. classes for my patients. I believe this new service mimics the nationwide trend of other healthcare providers, including physicians, who are attempting to satisfy what the public perceives as good “doctoring”—treatment of the whole patient, not just an aspect of the patient. Marketing surveys have revealed that patients are flocking to alternative health care providers precisely for this reason. Fully thirty-six percent of adults in the United States use some form of integrative Book Reviews T “Although this text was published in 1995, this comprehensive text demands a second look due to its timeliness as the Au.D. movement is establishing its turf.” or complementary therapies. As Sharon Lesner relates,instead of the audiologist just selling a hearing aid, “programs that focus on self-help and education also provide attention to the psychosocial changes that result from disabilities.” Although this text was published in 1995, this comprehensive text demands a second look due to its timeliness as the Au.D. movement is establishing its turf. This truth was born out recently when my husband approached our banker for a home equity loan and the banker related that he believed my A.R. classes were the differentiating factor that was making my practice grow. I had never, personally, discussed this aspect of the business with him but one of his elderly customers had remarked that my A.R.classes constituted a unique service that far exceeds the value of any hearing aid I provided. As all hearing aid users know: The greatest enemy of people with hearing impairments is often the people who love them most, namely their significant others. Significant others do not have an accurate understanding of the problems associated with hearing loss, and they often have unrealistic expectations of the person with the hearing impairment and of the hearing aids . . .Hearing aids are only a part of the rehabilitative process. The roles of assistive listening devices (ALD’s), audiovisual speech reception, and communication strategies in improving communication also need to be explored and optimized. The authors recommend that group participation be a mandatory part of hearing aid dispensing and they provide guidelines in regards to suggested topics, room selection, and recommended professional-toattendee ratios. Educational techniques such as “simplicity, redundancy, and feedback” during presentation of materials and bonding techniques such as circulating and mingling (“working the room”) prior to the initial class to put attendees at ease were discussed. Some surprising, but mandatory, attributes of the group leader were also defined to help pave the way to success. Materials (books, video tapes, audio tapes, periodicals, computer programs, and compact disks) for use in Audiologic Rehabilitation of Older Adults were listed in an appendix that was worth the price of the book. Another appendix covering Consumer Organizations and Public Information Sources was also an important addition. Chapters were devoted to such pertinent topics as characteristics of the aging population, marketing to the elderly population, and provision of services in extended care facilities. A truly stellar chapter on Use of Auxiliary Aids, by Sharon Sandridge, was invaluable and provided technical information (i.e. side tones on telephones and Ringer Equivalent Numbers, for example) that I had no prior knowledge of despite being an experienced provider of ALD’s. An interesting section on The Real Financial Condition of Elderly People explained that many of the elderly population are very adept at hiding assets and that their “fixed” income may not be as Continued On Page 37 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 35 Book Review ADA “A truly stellar chapter on Use of Auxiliary Aids, by Sharon Sandridge, was invaluable and provided technical information (i.e. side tones on telephones and Ringer Equivalent Numbers, for example) that I had no prior knowledge of despite being an experienced provider of ALD’s.” “fixed”as they would like us to believe. No doubt, the post publication proposed changes to Social Security and the poor return on investments that seems to be occurring universally now may cause our current target population to be a little more skittish in 2005. In summary, the authors note that “although it is important to know about the status of the person’s hearing, it is even more important in the development of a treatment plan to know about the person who has the hearing loss. In fact, a guiding principle should be to determine the strengths, capabilities,and needs of the person with the hearing impairment and not focus only on the persons hearing status.” My exper ience with Audiolog ic Rehabilitation Classes is that often my patients become so empowered that they want to attend subsequent classes and bring others. The patients become the best cheerleaders for A.R. classes as the handicap of hearing loss literally becomes less handicapping with attendance. ■ Linda S. Remensnyder, Au.D.is a private practice Audiologist with Hearing Associates, P.C., located in Libertyville,Il.She is a regular contributor to Feedback. In addition to her regular book review column, Dr. Remensnyder writes on other subjects important to the practicing audiologist.Book review suggestions or article comments can be sent to Dr. Remensnyder at urhearing@aol.com. NPI Update ADA Your Number Is UP! member Audiologists are encouraged to beg in applying for their National Provider Identifier (NPI).The NPI will replace the many health care provider identifiers in use today and simplify them with one common provider number.The NPI is the system adopted by the U.S Department of Health and Human Services as part of the HIPPA act. All health care providers that are considered covered entities under HIPPA,those who file claims electronically or use a clearinghouse to bill insurance, are required to apply for an NPI. The compliance date for this process is May 23, 2007. After that date, only the NPI will be used for all transactions. Previous UPIN, and BC/BS numbers will be eliminated, allowing the Audiologist one single 10 digit provider number by which to bill and track reimbursements. Any Audiologist who transmits health information in an electronic form would be required to obtain and use their NPI’s. Audiologists will be assigned NPI’s upon successful completion of the application form. Data elements required on the NPI application: ADA • Name • Social Security Number • Date of Birth • Medical License Number • IRS Individual Taxpayer ID • Employer Identification Number (EIN) • UPIN Number • Medicare Number • Medicaid Number • Provider taxonomy code (this is a 10digit number that corresponds with your CMS Specialty code.The code for audiologists is 231H00000X) The application can be done through an on-line process, or by a paper application. For additional information, to complete an NPI application, and to access educational tools, visit https://nppes.cms. hhs.gov/. Paper applications may not be submitted until July 1, 2005. You may complete a paper application and send it to Fox Systems. The phone number is 1-800-465-3203 or TTY 1-800-6922326. ■ FEEDBACK • VOLUME 16, NUMBER 2 • 2005 37 ADA President’s Message ADA exhibited at the AAA Convention in April. Susan Williamson, Dave Burnell (a Smith Bucklin representative), Larry Eng, Larry Engelmann, three Au.D. students (Melissa Tamres,Kelly Schnoor and Melissa Friedman), and I staffed our exhibit booth. This was a great opportunity for us to interact with our current membership and potential new members. This member and potential new member interaction once again demonstrated that our colleagues look to ADA for practice management skills. In addition, the AAA convention experience was another wonderful opportunity to interface with a wide range of manufacturers to demonstrate the value of the ADA membership to their businesses, and to develop sponsorship programs to best meet our vendor needs. The Academy in April also responded to two issues in California. First, ADA was requested to support the Califor nia Academy with its opposition to proposed legislation that would allow for over-thecounter sale of hearing aids. ADA’s opposition letter to AB-615 is listed on our website: http://www.audiologist.org/ prof_legis_onthehill.php. The bill sponsor has removed the bill from committee consideration. Also in California, The “Sacramento Bee”, a daily California newspaper, published an editorial questioning the value of a doctorate in audiology “just to test hearing.” The Academy’s response is located at the same bookmark as the above noted reference. On April 23rd,I attended a meeting hosted by ASHA concerning reimbursement and coding (Health Care Economics Committee, HCEC). The purpose of the meeting was to prepare for the first review of physician work related to audiology codes in five years by the American Medical Association’s Relative Update Committee (RUC). It is expected that the review will begin later this year. Currently, the professions’ reimbursement is based on what is referred to as “practice expense”. Thus,our patient management and educational skills are not a part of our present reimbursement. Other independent professionals are valued in the “physician work” category. One of the factors that is bringing this issue to the forefront is that the Centers for Medicare and Medicaid (CMS) is in the 38 FEEDBACK • VOLUME 16, NUMBER 2 • 2005 process of eliminating the practice expense category. Thus, without recognition of “physician work”, audiologists would be left in a precarious reimbursement position. This transition is not intended to increase reimbursement, but rather to maintain our present schedule of fees. The board realizes that this is one of the most important issues that is facing the profession,thus we will pursue this issue with our utmost attention. On May 18th, Susan Williamson, staff audiologist for ADA, and I participated in the Hearing on the Hill Day that was sponsored by the Hearing Industry Association. This provided an opportunity to speak with legislators about our profession.During this event, we completed nine contacts with legislative offices related to direct access for Medicare (H.R.415). I am pleased to report that one of these contacts, Congressman Cummings (D-MD), co-sponsored the direct access legislation on May, 26th. Gathering co-sponsors is the key component to direct access gathering momentum and its eventual success. You can track the current list of co-sponsors by accessing the following website: http://thomas.loc.gov/ cgi-bin/bdquery/z?d109:HR00415: @@@P. The audiology profession is not a stranger to legislative action. As you recall, in the mid and late 90’s we worked diligently on the Federal Employee Benefit Health Program (FEBHP). This resulted in the successful passage of legislation in 1998. By 2000, Federal Blue Cross/Blue Shield was the first insurance carrier that allowed audiologists to be directly reimbursed. Since then, others have followed such as Government Employees Hospital Association (GEHA). These two carriers represent over 85% of the federal employee marketplace. By working together,making contacts with congressional offices by sending letters asking for co-sponsorship of H.R. 415, and then calling and asking for their support, we will achieve the goal of direct access. A sample letter is posted on the ADA website (http://www.audiologist.org/ prof_legis_onthehill.php) that you can personalize and then fax to your Congressional representative’s Washington DC office. Together, we will continue to change the audiology landscape as it has in the last 10 years. Patient’s access to audiology services will continue to evolve through our joint efforts. As long as we are vigilant, our cost effective patient management care will be recognized by government regulators and legislators. Pharmaceutical Agent Therapy CEU Course Since last June,ADA has been investigating an agent therapy CEU course for Doctors of Audiology. In a recent email ADAlert message, we asked for your input on the development of this project. We were pleased to learn from the member survey that 94% indicated that the board should continue to develop and pursue this educational offering. Last year, ADA reached out to several university programs and received the most interest from Nova Southeaster n University. We have met with a working group comprised of optometrists, Nova Southeastern faculty members, and Hany Mikhail, an audiologist who was a practicing physician. Meetings occurred in March and May of this year. The goal is for ADA to develop an approved curriculum for pharmaceutical education. It is hoped that an ADA recommended agent therapy curriculum will serve as the educational model. Unlike the curriculum for the Au.D., which is quite varied, it is ADA’s desire to set and maintain the highest standard for agent therapy. Once ADA has developed a model curriculum it is hoped that other universities will also offer a CEU opportunity. It is our vision, that this course will parallel the educational opportunities afforded to optometr ists. Additional knowledge regarding pharmaceuticals will allow the audiologist to better manage their patients and interact with medical doctors concerning patient treatment. This is a vital component in the audiologist continued development as the manager of hearing and balance care. We will present a session at convention concerning the agent therapy CEU course. I look forward to welcoming you at our 2005 convention. As you can see from the preliminary program, it is poised to be the best ever. Mark your calendars today! Do not miss this exciting opportunity to reinvigorate your professional career. See you in Savannah! ■ WHEN CELEBRITIES TALK, PEOPLE LISTEN. If you are an Authorized Senso Diva Dispenser, you can now add the power of celebrity endorsement to give your practice a competitive advantage. Kit includes ads, postcards, brochures, a CD, and much more. Call today for your new Ed McMahon marketing materials kit. The World Leader In 100% Digital Hearing Technology TM 1.800.221.0188 • www.widexusa.com Academy of Dispensing Audiologists® 401 N. Michigan Avenue, Suite 2200 Chicago, IL 60611 Return Service Requested PRSRT STD U.S. POSTAGE PAID Columbia SC PERMIT 535