Commentary

Carefully approach the addition of audiology services

What do Usher’s, Down and congenital rubella syndromes all have in common? All are conditions in which two of our most precious senses – vision and hearing – are affected. And they are not alone. As we all well know, there are a variety of dual sensory impairment conditions in which vision and hearing loss are intertwined.

Furthermore, even in the absence of an inherited or infectious etiology, it is almost inevitable that our patients experience visual and auditory decline as they age. It is for precisely this reason optometrists must be cognizant of hearing loss and audiologists be on the alert for visual deficits amongst their patients. Given these realities, should optometrists screen their patients for hearing loss, and audiologists the same for visual problems? Or does it just make sense that both of these services be rendered in the same practice? Well, it depends on who you ask.

For sure, there is an emerging trend toward eye care – both optometry and ophthalmology – providing audiology services (see “Eye care practices find incorporating audiology improves patient care, loyalty,” page 7). In some eye care practices a licensed audiologist simply leases space. In others, the eye care practice actually owns the audiology diagnostic equipment and sells the hearing devices, while a consultant audiologist provides professional services.

Michael DePaolis, MD

Michael D. DePaolis

Regardless of the model, these eye care providers share a common philosophy: they perceive hearing care as an extension of eye care. They are quick to point out that patient need, a level of comfort and trust with the practice, and convenience are all factors in providing these services. In short, they feel the majority of their patients see no reason for seeking hearing care elsewhere. So, why don’t more optometrists and ophthalmologists provide hearing care?

I have asked a number of colleagues and have found they generally do not do so for a few reasons. First, and foremost, many feel that providing high quality eye care is demanding enough … they simply do not have the time or interest in being in the audiology “business.” Second, a number of our colleagues cite professional respect as a factor. They believe hearing care is exclusively within the domain of audiologists, and it is not optometry’s (or ophthalmology’s) place to compete with them. Finally, some colleagues perceive incorporating audiology services as mercenary – and fear our involvement will cast a negative shadow on optometry. Whether it is a practical issue or perceived ethics, many of our colleagues have no interest in providing these services.

So, should eye care practices provide audiology services? I do not think there is a right or wrong answer. I do, however, believe there is a right and wrong way of going about it. 

If you are serious about adding audiology services to your practice, be sure to perform due diligence by:

  • abiding by your state statutes governing audiology services within an optometric practice
  • selecting a delivery model that best suits your practice and the needs of your patients
  • providing screening services for all “at risk” patients
  • partnering with a professional audiologist who provides the same level of expertise and service your existing patients have come to expect
  • fostering a culture in which everything is done in the best interest of your patients and not because it is a revenue stream

In short, be certain to do so for the right reasons and in the right way. The proper approach will elevate you and your practice in the eyes of your patients. Anything less and your patients – and practice’s reputation – will suffer.

What do Usher’s, Down and congenital rubella syndromes all have in common? All are conditions in which two of our most precious senses – vision and hearing – are affected. And they are not alone. As we all well know, there are a variety of dual sensory impairment conditions in which vision and hearing loss are intertwined.

Furthermore, even in the absence of an inherited or infectious etiology, it is almost inevitable that our patients experience visual and auditory decline as they age. It is for precisely this reason optometrists must be cognizant of hearing loss and audiologists be on the alert for visual deficits amongst their patients. Given these realities, should optometrists screen their patients for hearing loss, and audiologists the same for visual problems? Or does it just make sense that both of these services be rendered in the same practice? Well, it depends on who you ask.

For sure, there is an emerging trend toward eye care – both optometry and ophthalmology – providing audiology services (see “Eye care practices find incorporating audiology improves patient care, loyalty,” page 7). In some eye care practices a licensed audiologist simply leases space. In others, the eye care practice actually owns the audiology diagnostic equipment and sells the hearing devices, while a consultant audiologist provides professional services.

Michael DePaolis, MD

Michael D. DePaolis

Regardless of the model, these eye care providers share a common philosophy: they perceive hearing care as an extension of eye care. They are quick to point out that patient need, a level of comfort and trust with the practice, and convenience are all factors in providing these services. In short, they feel the majority of their patients see no reason for seeking hearing care elsewhere. So, why don’t more optometrists and ophthalmologists provide hearing care?

I have asked a number of colleagues and have found they generally do not do so for a few reasons. First, and foremost, many feel that providing high quality eye care is demanding enough … they simply do not have the time or interest in being in the audiology “business.” Second, a number of our colleagues cite professional respect as a factor. They believe hearing care is exclusively within the domain of audiologists, and it is not optometry’s (or ophthalmology’s) place to compete with them. Finally, some colleagues perceive incorporating audiology services as mercenary – and fear our involvement will cast a negative shadow on optometry. Whether it is a practical issue or perceived ethics, many of our colleagues have no interest in providing these services.

So, should eye care practices provide audiology services? I do not think there is a right or wrong answer. I do, however, believe there is a right and wrong way of going about it. 

If you are serious about adding audiology services to your practice, be sure to perform due diligence by:

  • abiding by your state statutes governing audiology services within an optometric practice
  • selecting a delivery model that best suits your practice and the needs of your patients
  • providing screening services for all “at risk” patients
  • partnering with a professional audiologist who provides the same level of expertise and service your existing patients have come to expect
  • fostering a culture in which everything is done in the best interest of your patients and not because it is a revenue stream

In short, be certain to do so for the right reasons and in the right way. The proper approach will elevate you and your practice in the eyes of your patients. Anything less and your patients – and practice’s reputation – will suffer.