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Let Me Hear From You

Let Me Hear From You

Understanding Through Dialogue Leads to Cooperation and Collaboration

By M. Patrick Feeney, PhD

In October 2008, I sent a congratulatory letter to David Kennedy, MD, on his election to the presidency of the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS). I indicated that I looked forward to opportunities to collaborate on issues of mutual interest to the American Academy of Audiology (Academy) and AAO-HNS. He responded that he, too, was interested in collaboration between our organizations. Earlier in 2008, Cheryl Kreider Carey, CAE (the Academy’s executive director) had established communication with David Nielsen, MD, the executive director of AAO-HNS. They had successfully communicated regarding several situations over which AAO-HNS and the Academy had been at odds, including our direct access legislation (HR 1665) in the 110th Congress, which proposed to allow Medicare beneficiaries to go directly to an audiologist for an evaluation without a referral from a physician. There was a doubling of cosponsors on that direct access bill, totaling 108 in the 110th Congress. As a result of the communication with Dr. Kennedy, we arranged a meeting to include Ms. Carey, Dr. Kennedy, Dr. Nielsen, and myself to discuss issues of common interest and opportunities.

We met at the AAO-HNS headquarters in Alexandria, VA, on December 12, 2008, prior to the AAO-HNS Board meeting with a pre-arranged agenda including direct access legislation. One issue that concerned AAO-HNS about the legislation was the lack of language in the bill describing the collaborative relationship that audiologists and otolaryngologists enjoy in our joint practices throughout the country on behalf our patients. I discussed the collaborative relationship that exists between audiologists and otolaryngologists in my work setting at the University of Washington Medical Center. In fact, I have been working collaboratively for the last six years as chief of audiology in the Department of Otolaryngology, Head and Neck Surgery with Ernest Weymuller, MD, who currently serves on the board of AAO-HNS. Both Dr. Kennedy and Dr. Nielsen related that in their experience the best patient care occurs when audiologists and otolaryngologists work collaboratively to diagnose and treat hearing and balance disorders.

At the end of our meeting, Ms. Carey asked a simple question that has resulted in what is likely the most significant collaboration to date between AAO-HNS and the Academy. She asked Dr. Nielsen what he thought could be changed in the language of the direct access bill, particularly regarding collaboration between audiologists and otolaryngologists, that might make the bill acceptable to AAO-HNS. We agreed that only minor changes in the bill would be acceptable given that one of the bill’s strengths is its simplicity. Dr. Kennedy accepted the challenge and established a task force during the subsequent meeting of the AAO-HNS Board of Directors to investigate how the bill’s language might be changed to reflect the collaborative spirit between audiologists and otolaryngologists for the benefit of our patients. After initial AAO-HNS Board discussions, Dr. Nielsen and the AAO-HNS’ government relations staff formed a writing group with the Academy’s government relations staff, Ms. Carey, and myself to negotiate minimal language changes in the bill that would hopefully be acceptable to the boards for both organizations. After several weeks of negotiations in the writing group, both the Academy Board and the AAO-HNS Board unanimously accepted the revised language in the bill. AAO-HNS has thus agreed to be an endorsing organization for our direct access legislation. The revised language was then sent to Representative Mike Ross’ (D-AR) office for consultation and drafting of the final bill. On __(date)________Representative Ross introduced HR_________ the Medicare Hearing Health Care Enhancement Act of 2009 in the House (please go to __LINK_____to see HR_XXXX). Senator Tim Johnson (D-SD) intends to reintroduce the bill in the Senate.

Both the Academy Board and the AAO-HNS Board see this initiative as the beginning of a new era of collaboration between these two associations for the good of our members, the professions and ultimately our patients. The following audiology-related organizations have joined in a press release supporting HR___________. Please contact your representative and encourage him or her to be a cosponsor on this bill. With the additional support of the AAO-HNS for this legislation, the time is right for Medicare beneficiaries to have direct access to audiologists.

Endorsing Organizations for HR XXXX The Medicare Hearing Health Care Enhancement Act of 2009.