Referring to Kevin's and Mark's commentary: Over a year ago several
audiologists in our area got together to discuss possible projects that
we could work on. We discussed group aural rehab but decided to put it
on the back burner because it would not be financially feasible (at that
time). Since then we have opened a Balance Center which has a conference
area large enough to accomodate groups of up to 15, along with
audiovisual instrumentation. I believe that this coming year we will
have our aural rehab class in the PM and maybe on Sat, with each office
contributing a set amount of the sale of each hearing aid to sustain the
project. We are a varied group, representing all aspects of audiology
(Diagnostic, teaching, Miracle Ear) who realize that group efforts can
accomplish more than one private clinic. By combing billing services,
certain administrative areas and other areas of mutual need each
individual office becomes more efficient. By working together, we can
begin to offer new services and explore new projects that lack of time
has made impossible in the past.
So far it has been a very positive experience. Of course the point of
all this is that for something to be sucessful it has to be either an
extremely large private practice or what we are doing.
In audiology we have a lot of problems. We fit hearing aids with
threshold tests or real ear measurements that cannot give us any idea of
how the patient will perform in the real world. Not many of us give the
patient an initial questionaire to even find out what he/she feels is
the problem (if any) the person has with the hearing loss. We dictate to
the patient the negative aspects of hearing loss and prop up the
positive aspects of using a hearing aid but our selection, evaluation
and followup protocols, are, for the most part, justified only
subjectively, either on our part or the part of the patient.
We have IHAFF (now under revision) Fig6, DSL 4.0, (shades of Berger,
POGO, Nal-R! where is a speech in noise test??). I think that those of
us in private practice have to see the gaps we have in our evaluation
process and have to start budjeting the time to developing materials and
procedures that will allow us to justify taking a hearing impaired
individual along whatever course of action that we have decided will
most alleviate his/her condition.
Boy, this was a long one. Hope no one fell asleep.