Time for Audiologists to Hear
Audiology’s role in chronic disease care is an emerging issue for NIH, CDC and Healthy People, as well as state and local diabetes and chronic disease agencies. However, the link between diabetes, cardiovascular disease, chronic kidney disease, thyroid disease and hearing loss/balance issues is still relatively unknown by many in the medical community, including those in our own profession. Audiology must focus on establishing medical necessity as a reason for testing and billing insurance linking these diseases. You can start right with the evaluation. Even using the case history to document diseases and medications that potentially affect testing protocol and diagnosis can be added to our billing forms, to substantiate medical necessity for our services.
We have found that other professions, such as Optometry and Dentistry, realized early the importance of looking at the case history of each patient to provide care of their own professional focus, but also the health of the patient as a whole. This opens collaborative care between the patient’s history, their specific problems (to include chronic diseases), and ultimately-other professionals. Although Audiology understands what is causing the disruption in hearing and balance, it has not taken the important steps to talk to other medical professionals about the silent epidemic of hearing loss and risk of falls caused by chronic diseases. Audiology has been late to the table of medical management for patient needs as a whole person, including possible chronic disease.
Here are several steps that will ensure our place in chronic disease care:
1) Educate state Chronic Disease agencies on the link with hearing loss and risk of falls for each disease
2) Plan in your state how audiology can participate in programs for diabetes care, fall prevention, etc. Become a member of your state diabetes council, state deaf and hard of hearing council, state heart health council so that you can communicate with the professionals who design and implement state plans for health.
3) Start a state audiology cohort to collaborate among audiologists in different regions of the state to bring the message of audiology chronic disease care to local medical clinics and health departments.
4) Ensure that Audiology training programs in universities include chronic disease pathophysiology, Audiology with a medical management focus and monitoring in the curriculum for audiology students
5) Reach out to other allied health professional groups in the state to collaborate on diabetes and chronic disease care for everyone. Audiology can begin a checklist for each person with diabetes and discuss the importance of being evaluated not just for hearing, but also vision, foot care, dentistry and pharmacy. Host a summit conference with these state professional organizations to discover how each provider can collaborate to be a part of the solution in diabetes care.
There is no magic bullet to create recognition of audiology in chronic disease collaborative care. Clinical Audiology is a person to person medical service which can combine with other professions to treat the whole of the patient . Our knowledge and expertise is explaining to our patients the extent of their hearing and balance status, why they have their hearing or balance issues, what can be done to correct/manage hearing and balance, all while encouraging them to take steps to improve their quality of life.
To start in your practice, use the checklist added HERE with each person with diabetes (other chronic diseases will be brought forward soon) to ensure that they receive diabetes education, have regular visits to the dentist, podiatrist, pharmacist and optometrist. These valuable one on one communication tools can be deployed with our state and local medical agency directors with a simple call or face to face meeting.
Take the time to do something important for the future of our profession and the future of better patient care.
Kathy Dowd, AuD
The Audiology Project