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cerumen management

HearWHAC HearWHAC at netins.net
Sun Feb 18 22:41:41 EST 1996

In article <Pine.A32.3.91.960216123431.38321A-100000 at yu1.yu.edu>, 
danto at yu1.yu.edu asks...
>Paul, Do you have any concern that even if you recommend an 
>over-th-counter medication you may be prescribing medication?
>Even if it is topical!

Joe, this is an excellent question. In one sense I am not "prescribing 
medication." (Assuming you are referring to my use of Afrin to stop bleeding 
in the ear.) I am applying it topically to stop bleeding in the ear canal. 
Like you, I have a question about my doing this. Does anyone on this list 
have an answer? Can I "legally" use an over-the-counter product in my 
practice? The technical question is am I working within the legal "scope" of 
my practice as defined by both state and federal regulations?

I'll toss out another one! Many years ago I believe it was Darrel Teter who 
suggested we advise our patients to apply Ban liquid (roll on?) 
anti-perspirant in their ear to stop perspiration problems with ITE hearing 
aids. How about that? I believe it does solve some problems for us. 

Twenty-five years ago an ENT presented a seminar at an Iowa Hearing Aid 
Society seminar in which he advised each of us to purchase curettes and 
remove cerumen from the human ear. My father about died over that one. He 
would never do it.

To repeat something that I have previously posted to this list, my 
daughter-in-law graduated about ten years ago at the top of her class from 
the University of Iowa Medical School. She confided in me that in four years 
of medical school, she had never been taught how to remove cerumen from the 
human ear. This explained something I knew but had not understood - when I 
referred my patients to physicians for cerumen removal, they often came back 
with bloody ears and would state they would never go back to that docter 
again. Needless to say, I have taken the classes in cerumen removal and am 
quite good at it.

Paul Woodard ;-)
Des Moines Iowa USA

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