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New Audiologist Employment Dilemna

Lori Walker loriw at gte.net
Sat Jul 12 20:23:50 EST 1997

Zipjack wrote:
> oregon7 at aol.com (Oregon7) wrote:
> >Hi all.
> >
> >  I can now write my name with those little letters after it for the first
> >time and it is truly exciting!
> Congratulations!
> >
> >  My question is regarding a position I have been offered working for a
> >hearing aid dispenser.  He offers commission only and after reading over
> >his price list, it seems rather elevated compared to the offices I had
> >practicums in during my CFY training.
> >
> >  Also, he manufactures ost of his own hearing aids, doesn't use Real Ear,
> >and apparently seems to fit most everyone with an ITC or ITE at
> >most.....he doesn't have a sound booth but he says he may get one if I
> >sell enough hearing aids..
> This is a classic dilemma.
> I worked for 3 years in audiology, and was in such bad employment
> situations,(3 different ones) , that I ended up returning to the
> public schools as a TSHH.
> Now I do some part time for a local dispenser, but I don't really need
> the money in the same way.
> This kind of a situation could work to your advantage, I suppose, but
> not likely. Do you have anything to fall back on as you develop your
> skills? In other words, do you feel comfortable enough with your
> dispensing and rehab skills to agree to the dispenser's offer?
> >
> >  I had not heard of all these ideas during my graduate training and was a
> >little surprised to see fitting completed without any verification
> >procedures.  I have observed and assisted in follow up appts. where
> >patients have been quite unhappy with the aids.
> Its a jungle out there: (the oft quoted line from an unknown speaker).
> Grad school is the ideal, of course.
> Private practices don't have the large university budgets that we tend
> to take for granted.
> If you know how to use the equipment that this office lacks, and if
> you are able to continue to practice using it, your skills won't
> suffer horribly. On the other hand, there's much to be said for not
> going backwards on purpose! The lack of real verification procedures,
> will certainly make your job more difficult.
> >
> >  Perhaps a short course regarding the way hearing aids are peddled in
> >'real=life'  would have been useful.
> >
> >  Has any other audiologist encountered this situation and successfully
> >negotiated a position in these circumstances?   What are the chances that
> >an audiologist can integrate into this situation?
> It also depends on your currnet financial situation. I have always
> lived hand to mouth, and didn't have anyone to support me, so I saw
> this kind of a situation as potentially disastrous.
> (For example, what if you have a two week weather catastrophe, and
> nobody comes in?) Sometimes it works when you can cob together part
> time work...
> Good luck,
> Kate
> -----------
> Dave and Kate
> remove spamproof for reply
> clip n save
> -----------  

Dear Oregon7:

A word to the wise:  Be intimately familiar with the ASHA Code of Ethics, 
as well as your state's regulations concerning the fitting/dispensing of 
hearing aids.  Before accepting a position such as you describe, ask 
yourself several questions, and think about whether you would compromise 
your professional ethics in the course of your duties:  

Would you ever recommend amplification for a client who would not 
Would you recommend amplification which is not the most appropriate for 
the client's hearing loss?
Does a "commission only" basis of reimbursement represent a conflict of 
With the tools you have available, will you be able to adequately 
determine if a hearing aid fitting is successful?  (Subjective feedback 
from the patient is _not_ always sufficient.)
What will you do when you need additional information (such as Real Ear 
data) in order to address a client's complaints?
Will you be able to offer state-of-the-art amplification technology (ie, 
programmables) to your clients?
Are your dispenser-employer's "code of ethics" in line with yours?  I 
have known dispenser's to employ audiologists just to take advantage of 
the advertising benefits.

Only you can answer these questions in determining if you would be able 
to provide appropriate audiologic services to the public.  From the tone 
of your original post, it doesn't seem like your concerns are primarily 
financial.  You'll never get rich as an audiologist, but then that's not 
usually what drives a person to become an audiologist in the first place.

Finally, it's okay to "specialize" in audiology.  The scope of practice 
is becoming wider and wider with new clinical applications, new hearing 
aid technology, etc.  I don't know many audiologists who can "do it all." 
 Some audiology practices are more diagnostic in scope while some are 
more rehabilitative.  Personally, I haven't performed an ABR or ENG in 
the seven years I've been certified.  I feel that my skills in these 
areas are not current, and my ethics prohibit me from performing these 
tests on clients now.  I refer clients to other audiologists who perform 
these tests on a regular basis.  (And they refer their hearing aid 
candidates to me...)

Good luck in your search for employment,

Lori W., MS, CCC-A, (E-I-E-I-O)
Clinical Audiologist

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