Hello and welcome back for another episode of the Future Ear Radio Podcast! This week I’m joined by Liz Fuemmeler, Vestibular and Concussion Audiologist at Hearing and Balance Specialists of Kansas City. Some longtime listeners might recognize Liz, as she was a guest on my old YouTube show, Oaktree TV, back in 2019. So, it was awesome to reconnect with her and catch up on what’s going on in her world now that she’s out in the field.
When we last spoke, Liz was the President of the Student Academy of Audiology. Now, she’s working as a Vestibular and Concussion Audiologist. During our conversation, Liz shares what it is like working this facet of Audiology and the experience of helping to implement a concussion protocol into her clinic. As Liz describes, concussion-based Audiology is one of the frontiers of this field of science and provides a new area for Audiologists to play a critical role in the diagnostics and treatment of concussions.
Liz is also the co-host of a vestibular audiology-based podcast, “A Dose of Dizzy,” where she and her co-host Daniel Romero discuss the latest and greatest vestibular research. So, the second half of our conversation explores life as a podcaster in the Hearing Healthcare industry.
During this half of the conversation, Liz talks about how she always tries to challenge herself to keep growing by pushing herself out of her comfort zone by opting for public speaking opportunities at Audiology-based events. As she describes, committing to these presentations forces her to constantly be engaging and learning with the latest research. This then serves as fodder for podcast material, creating a nice virtuous cycle of learning > podcasting > public speaking > learning…
As we discuss, one way for young professionals to help themselves chart their own course is to work on developing their personal/professional brands. We share some actionable ways that anyone can get started with developing their own area of expertise and how to start building a network around that expertise. One thing that we both agree on with regard to professional development is that one of the most effective ways to avoid burn-out and feel like you’re always growing is to always be learning.
-Thanks for Reading-
Dave
EPISODE TRANSCRIPT
Dave Kemp:
Hi. I’m your host, Dave Kemp, and this is Future Ear Radio. Each episode, we’re breaking down one new thing, one cool new finding that’s happening in the world of hearables, the world of voice technology. How are these worlds starting to intersect? How are these worlds starting to collide? What cool things are going to come from this intersection of technology? Without further ado, let’s get on with the show.
Dave Kemp:
Okay, everyone. And welcome to another episode of the Future Ear Radio Podcast. I’m really looking forward to this conversation today with Liz Fuemmeler. Liz, welcome to the podcast. Tell us a little bit about who you are and what you do.
Liz Fuemmeler, AuD:
So my name is Liz Fuemmeler. I am a vestibular audiologist. I practice in Kansas City, Missouri in a private practice. And I’m originally from Missouri. So born and raised here, went to school, undergrad here. I got my doctorate at Purdue University in Indiana and then I catapulted to Phoenix for my externship at Mayo Clinic and came back to good old Missouri.
Dave Kemp:
Good old Missouri. Well, two [inaudible 00:01:08].
Liz Fuemmeler, AuD:
I know.
Dave Kemp:
Missourian [inaudible 00:01:08] on the podcast.
Liz Fuemmeler, AuD:
Whatever we’re called.
Dave Kemp:
Whatever we’re called. And oddly enough, just crazy small world circumstances. You went to undergrad at Truman University, which is where my wife went. So you’re fellow bulldogs, which is just, again, just small world type thing, but-
Liz Fuemmeler, AuD:
It is. It helps me trust you a little bit more. So I do appreciate that.
Dave Kemp:
Well, I wanted to have you on. For people that have been listening to the podcast for a long time, they might know that before Future Ear, I actually was doing Oaktree TV and you were a guest on Oaktree TV. So you’ve been one of … truly one of the long time guests that I’ve had on.
Liz Fuemmeler, AuD:
Oh, wow.
Dave Kemp:
And so thought that we ran into each other at AAA in St. Louis here and it was great to catch up with you. And definitely as we were talking, I was like, “Oh, man. I really want to bring you back on the podcast because there’s so many different things that you’re doing that’s so interesting.” So I wanted to just kind of set the stage though and talk about how you came into the world of vestibular. So I know that you also were the president of the Student Academy of Audiology during your time there. So we can touch on that too, but if you wouldn’t mind maybe sharing, how did you come into audiology to begin with and then let alone specialize on the vestibular side of things?
Liz Fuemmeler, AuD:
Yeah. So coming into audiology, I really didn’t know what I wanted to major in undergrad, but I did have a really cool summer job on Catalina Island, which is off the coast of LA for three years. And I worked at a scuba diving camp. And oddly enough, and Missouri people may not know this because we’re not surrounded by water, but to get your scuba diving certification, you have to learn the full anatomy of the ear because there’s a lot of ear related pressure changes that you have to be aware of and have to compensate for as you’re diving deeper. And I thought this was fascinating. I had taken one intro to communication disorders class where they just touched on the ear for five seconds. And I feel like that’s when really I became interested in the anatomy of the ear. It’s super complex and has a lot of function.
Liz Fuemmeler, AuD:
So that was the first thing that drew me in. It was scuba diving. I was convinced I was going to be a scuba diving audiologist, which is again very hard in Missouri. As far as vestibular, so I talk about this a lot with students who come through our clinic, but for a longest time, even up until almost graduation, I wanted to be a generalist. I wanted to see every single part of audiology. I wanted to be good at everything. And I think the more I started to learn about different subsets of the field, the less I wanted to be a generalist.
Liz Fuemmeler, AuD:
So in the last few months of my externship, I realized that I actually wanted to be a specialist because when you think about it from the patient perspective, who do they want to see? Do they want to see a generalist or a specialist? And I know who I would want to see. And so I think I just determined that in order to be the best professional, I really should just dive into one subject set and get really, really good at it so that I could provide the best care for my patients and so that patients would seek me out as the specialist. For vestibular in particular, I did not like vestibular going into grad school. It was not a subject that I was interested in. I always describe it as a Plinko type situation, if you’ve seen Plinko on prices, but I kept getting directed into different vestibular experiences. And at a certain point I had way too much experience to say no to a future in vestibular. So I feel like that’s more accredited to my mentors than to any of my own efforts.
Dave Kemp:
Yeah. That’s awesome. Lots that I want to touch on there. Actually just a quick side note. When we had our Christmas party this year, we actually built our own Plinko board.
Liz Fuemmeler, AuD:
Oh, that’s amazing.
Dave Kemp:
And so everybody got to go and put a couple pucks in and go down the Plinko board. So Plinko amazing for any of you-
Liz Fuemmeler, AuD:
It is a fun game.
Dave Kemp:
… that doesn’t know.
Liz Fuemmeler, AuD:
Until it goes where you don’t want it to go. And then you’re like, “No.” That’s how I was with vestibular. I was like, “Wait, where am I going?”
Dave Kemp:
I didn’t know either that … Scuba diving audiologist, is that really a thing?
Liz Fuemmeler, AuD:
I don’t think so, but maybe that’ll be my next specialty. I just noticed there’s a lot of ear related injuries due to pressure problems as you’re scuba diving. And I’m like, “Who do these people go to?” I don’t know. I still don’t know.
Dave Kemp:
I could totally imagine that being a thing. Okay. So you said you didn’t originally like vestibular, but then you decided … you kind of got pulled in that direction. When did you fall in love with the vestibular or at least where do you stand today with your love for vestibular audiology?
Liz Fuemmeler, AuD:
Anyone that has ever done vestibular knows that you may never 100% love it. And that may be true with every subset, but it’s a really challenging field. And I don’t know if I’ll ever be at the point of loving it. I think there’s days that you absolutely love it, but I think it challenges me more than anything. I think for my personality, I’m like a puzzle piece putter together. And I think vestibular was a really, really good subset for that aspect. And honestly, diagnostics in general are really good for problem solvers or people who are seeking solutions because we can use all these different test results and try to put it together in the context of that patient. So I think for me it really benefits to focus in that vestibular aspect because it is so puzzle driven.
Dave Kemp:
Yeah. And I was going to say too, I think with vestibular, it seems like you’ve really specialized too even a niche within the niche. And when we were talking in St. Louis, you were saying … And I’ve seen some of the stuff that you’ve been publishing and doing talks about, but largely around concussions. So I wanted to just get into that a little bit too because I think that on the surface for someone like me that’s not as well versed and immersed into all the different nooks and crannies of audiology, I would’ve just thought vestibular is sort of … it encapsulates a handful of different things, but as I’ve started to kind of learn more, it seems like it’s actually quite robust with all the different tangents and different fields or subdomains within it. So can you tell me a little bit about how you got into that side of the vestibular audiology?
Liz Fuemmeler, AuD:
So I was super, super lucky to work with a vestibular audiologist named Jamie Bogle who’s at Mayo clinic in Arizona. And she is one of a few professionals that are on a concussion management team at Mayo. And they actually started a clinic that’s called the Return to Play Clinic and it’s super interesting. It’s a neurologist, it’s an audiologist, and it’s a neuropsychologist that see people. And I thought that was fascinating. That audiology is right there with neurology evaluating concussion on the frontline. And then they send them out to therapy and they keep coming back for reevaluations. And that the audiologist was the main person with that. So that’s why I got experience in how potential vestibular reflexes and vestibular pathways can be impacted post head injury.
Liz Fuemmeler, AuD:
When I accepted the job in this private practice that I’m currently in, I started a concussion program, which was kind of difficult actually looking back as a new grad, especially since I didn’t totally know what I was doing at the forefront of it. I took Mayo Clinic’s protocol and did my own research in trying to expand and just learn and test what works well with patients. But that’s been a really, really amazing subset we’ve grown. I see probably five out of my 15 vestibular patients or concussion a week, which is an unreal volume. I have connections with the neurologist around Kansas City who see post head injury, but it was … I’ve learned so much, not only just being in the concussion subset because that’s like there’s very, very, very few people in the nation doing it, but also just from aspect of starting a new program, what it takes from physician marketing to protocol development, to mentorship and research. It’s been really great for me personally. And it’s been awesome because my patients are actually seeing benefit to my evaluation, which is the most important.
Dave Kemp:
So let’s unpack a little bit of this.
Liz Fuemmeler, AuD:
Yes.
Dave Kemp:
So I find this really cool how your audiology is on the same level as neurology with the concussion protocol. How are the two sort of delineated? What’s the role of the audiologist within the concussion protocol?
Liz Fuemmeler, AuD:
Yeah. So typically how I describe it to physicians or neurologists that are sending to me is I look at eye related and ear related reflexes and muscle pathways to see where the breakdown occurs or in what situation a patient has symptoms. What’s interesting about and where I think vestibular audiologists have the greatest benefit in today’s world is we have equipment that allows us to be super objective about what the abnormality is and is that normal for their age. So for example, if someone were to send a seven-year-old who had a fall and hit their head to me, I could tell you if a specific eye movement is normal for their age or not. So therefore is it a result of the recent head injury or not? And I think that is super beneficial information to neurology.
Liz Fuemmeler, AuD:
Most of the time neurologists do bedside assessments and same with our physical therapy colleagues. A lot of them do bedside assessments. They’re using their eyes to look at your eyes. With our equipment that really only vestibular audiologists have, we have standardized stimulus, we’ve got objective measures, and we have age-based norms that allow us to say, “How normal is this for your age and for your particular situation?” And then we help interpret that for the neurologist and measure progress throughout their recovery. I think there’s two really big challenges in the field of concussion where I think vestibular audiology is going to really come in as a big benefit. Number one is just identifying whether a concussion has occurred, because there’s actually no one test that can say, “Yes. This person has had a concussion.” Or, “No. They haven’t.” It’s all based on symptoms, which is really challenging for a lot of patients to describe. The other thing is a lot of neurologists don’t know when it’s safe to discharge a patient back to work, back to the soccer field. And so when we can use physiologic data that’s really concrete, we’re able to say, “Hey, things are 100% back to normal physiologically and they feel asymptomatic. So things are looking good.” And that gives the neurologist a lot of peace of mind that they’re not putting them into a dangerous situation.
Dave Kemp:
So is this relatively new where audiology has, I guess, been brought to the table within this whole concussion protocol discussion or has this been ongoing and it’s just been something where there’s only a finite amount of people that’s been doing it? So just kind of help me understand how long has this even been part of the scope of audiologist is the question, I guess, I’m asking.
Liz Fuemmeler, AuD:
Yeah. I’d say you’re at the forefront by asking that question right now. So there’s not a lot of research in vestibular audiology about concussion. And concussion is super interesting. So in the last 10 years, you’ve probably even noticed that there’s been a lot more focus on concussions. There was that big NFL study. People get really worried about having concussions all of a sudden. When we were kids, we hit our head all the time. It didn’t even matter, but now there’s been increased focus on that. There’s a lot of people who have their hands in play in concussion. And historically, it’s been physical therapists, athletic trainers, and primary care physicians, and neurologists. I think this is a huge opportunity for vestibular because of the tools that we have and the training that we have. I know for a fact I’m one person that needs to start publishing a lot of the data that I’m seeing because there’s not a lot of people doing what I do and there’s not a lot of research published on what … how we can be of benefit. So that’s one of my goals in my spare time, but I’d say we are in the forefront of the beginning of this. It’s not very common.
Dave Kemp:
It’s obviously really exciting when we’re … I was talking to you before we started recording and I said one of the most exciting things about doing this podcast is I really do get to get a finger on the pulse of where the whole field of science is moving in these new directions. And I think that as has been the theme on the podcast is we kind of all I think are coming to the agreement that the profession of audiology needs to diversify away from just hearing aid sales. I think that’s still going to obviously play a role, but there’s lots and lots of new opportunities. And this is just another one of those areas that is really starting to expand and become more of a focal point I think for the profession.
Dave Kemp:
So when you’re saying, “Okay. I need to start publishing some of this data.” I guess can you sort of sum up some of the things that you’re seeing without, I guess, spoiling any future publications that you’re going to put out? But I’m just really curious to hear when you say we have all this special equipment that we use and we’re starting to compile all this data. Broad strokes, what are some of the things that you’re seeing that you’re like … it gets you excited about this work and the longevity of like, there’s a lot of legs here and we as a profession need to start to kind of throw our weight collectively behind this.
Liz Fuemmeler, AuD:
Yeah. One publication that’s in process right now, so it’ll be the first one that everybody sees and I’ve presented on, it is on a eye movement that’s called the anti-saccade eye movement test. The test has been around for a while. And there’s a lot of chiropractors functional neurologists that have been using this for a long time. But really with how much we look at the eyes, it could be in our domain very easily. So we just finished collecting normative data for micro medical inter acoustic system, which will be implemented this fall. And everyone already has access to the anti-saccade module, but it’s been really, really sensitive to identifying acute post head injury cases. So that’s one example of something to look out for, something called the anti-saccade. There’s a lot of different balance, specific balance patterns, rotary chair patterns, other ocular motor or eye related deficits that are very patterned. Some of these are consistent with previously what’s been reported on the “bedside” from physical therapy literature and some of it is new. So honestly there’s just so much to cover with different subsets of what I’m finding, but I do think I’ve got some resources I can share about where I’ve talked about these different findings already. And I think we’ll be touching on one of those subsets later, but I have a lot of resources that if people are interested in, they can dive a little bit deeper.
Dave Kemp:
So you had mentioned like you’re seeing the Kansas City Chiefs. You have football players coming in. And I’m just curious, is it a pipeline of just professional athletes or are you seeing kids? Are you seeing just all different walks of life? You had mentioned maybe some older adults that are falls, those kinds of things. So can you just help me understand the type of patients that are coming in. And now that I am kind of unpacking what you said earlier, it is pretty crazy that one in three patients that you’re seeing in the vestibular realm is a concussion patient. So it does seem like there’s … we’re just tapping into something that’s really, really big here.
Liz Fuemmeler, AuD:
Yeah. And like I said, I’m just in Kansas City, Missouri. So think about some of these bigger metros, the opportunity is huge. So causes of head injuries range and ages range. So I see typically ages eight to 90 is probably what I see. It’s all across the spectrum. I’d like to get more into the pediatric realm because that’s obviously where a lot of head injuries are happening, but top causes of falls are motor vehicle accidents, falls, and sport related concussions. I’d say older adults tend to obviously be falls and it’s possible they were already at risk for a fall and that’s why they had their head injury. So it’s kind of which came first, the balance problem or the head injury? So there’s a lot of different opportunity, but I’d say every single concussion patient is so incredibly unique from age to how they present with their head injury that it’s just … it keeps things exciting and interesting.
Dave Kemp:
Yeah. I think it’s just really neat to hear how much opportunity there is here. And so changing gears a little bit, you had alluded to it just a minute ago, but one of these resources that I know that you’re sharing a lot of this information is with your podcast, a dose of dizzy. Is it a dose of dizzy or a dose of dizziness?
Liz Fuemmeler, AuD:
A dose of dizzy. Yeah.
Dave Kemp:
A dose of dizzy. Okay. So it’s you and Daniel, that’s your co-host. So I want to just give you an opportunity to plug your podcast a little bit and share about what it is that you do. And before I do though, I just want to say, I thought in your … I listened to a couple episodes and I listened to the trailer. And you said something that really resonated with me in the trailer, which is we’re all so busy. I don’t know if it’s just millennials or really just all of us today, learning via … through auditory ways of learning is just more and more conducive to our lives today. You can learn on the go, you can do all this. And so I just think it’s really neat how you’re kind of boiling down some of the key takeaways from all this different research that I think a lot of people would love to take the time to do it, but it’s like it becomes a challenge to find the time.
Dave Kemp:
So if you give people the opportunity to summarize that information through a podcast by summing up some of that so that they can listen on the go, I just find that to be so appealing in this day and age. And so conducive to that type of format of taking information, boiling it down of these research talks and different papers and stuff like that. So good on you on the format because I think it’s really neat, but I just wanted to give you a chance to kind of share how you even started this, how you and Daniel met, and what a dose of dizzy entails for anybody that might be interested in this.
Liz Fuemmeler, AuD:
For sure. So first of all, I met Daniel through National Student Academy of Audiology. So you had mentioned before I was on the national board. I started as a second year volunteering with the national essay. And I was actually on a committee with Daniel who was also a student at that time. And we were helping play in the SAA Conference that happens every year in conjunction with AAA. And we both stayed involved with national SA. We both were on the board the year after our volunteering. So the national board, there’s about 10 members that get nominated and voted there. And then I was president my last year of school, but that’s how we met. And we just worked really well together. We both were trending towards similar interests. Daniel is an AuD-PhD focused completely in vestibular. He’s at Vanderbilt now.
Liz Fuemmeler, AuD:
He had this idea during COVID. We had been talking back and forth. And I’m fully in the clinic and at that point he was fully in the research world. And so we tried to stay in touch because he wanted to know what was happening in the clinic and I wanted to know what’s going on with research. I don’t have time to read any of that. And so he proposed that maybe we should start a vestibular focus podcast that could discuss what’s coming out, current research in the vestibular field, and not only to keep us accountable, but maybe other people would be interested as well. And the goal for us, and we say this in our trailer, is we want it to be accessible, but digestible. Dose of the vestibular research and vestibular topics and super conversation-based. I’m sure a lot of people feel this way, but the best conversations happen over a beer talking about what’s happening. That’s what gets us excited. And so we wanted it to be very conversation-based so that you could learn the best about vestibular in the most digestible way.
Liz Fuemmeler, AuD:
So we’ve been doing this. This is one of those COVID projects that we actually stuck with, which not every COVID project you did, but we’re through … halfway through our second season. And we have been very shocked at how many people are interested in this subset niche. We have vestibular students, interested students, vestibular audiologists, and a lot of physical therapists that listen to it. And I think anything and everything learning vestibular-wise is so beneficial because there’s not a lot of resources at certain programs. Not everybody has great vestibular programs. It’s actually more rare to have a good vestibular training. And so we wanted more resources available to students. I also think that it’s been really helpful for me being in the clinic to have some sort of something keeping me on track with keeping up with research because I think that makes me a better clinician and provider for my patients if I know what’s going on.
Liz Fuemmeler, AuD:
I’m a person that’s not going to just go home and read some research articles. That is not my style. So this is a really good way for me to stay in touch with what’s going on. And I think that’s been the case for people listening. It’s way more accessible than sitting down and reading that research.
Dave Kemp:
Yeah. This resonates so much with me because in many ways that’s kind of what I was doing with the podcast. With this podcast initially was taking information that I was really … I found really interesting and appealing and then trying to just make it as digestible as possible knowing that the target audience are busy people. That was basically who I was targeting, and I know that’s what you’re doing with this too. And this is just kind of speaking about podcasting. And broadly speaking is one of the fears that you have early on, and I don’t know if you shared this as well, is am I going to run out of things to talk about particularly if it’s this small niche thing? But I feel like as you get going, you realize, “Oh, okay.” Even this one topic I can break apart into three different things. I could do an in-person interview, and I could talk about it with my co-host, and then we could maybe have another thing that’s … another spin on that one topic. So it always felt like a fear that was never founded when you actually got going. And so I’d be curious to hear your thoughts on [inaudible 00:23:20]. Did you ever feel like we’re going to run out of things to talk about 10 episodes in or did you feel comfortable that there was plenty of material to cover?
Liz Fuemmeler, AuD:
I felt pretty comfortable there was plenty of material. Mainly just based on my own lack of knowledge of things that I want to learn more about vestibular, I felt pretty confident about that. And the goal is we want to evolve with research in vestibular. This is still the newest part of audiology. Vestibular research lags way behind auditory research. And so I never scared about running out of things. Also, because Daniel and I are also very talkative. So we could probably talk about nothing for a really long time. More of my concern, I had already done research on how to run a podcast and Daniel is the smart one that edits all of it makes it sound really good, but I was kind of curious how many people would find benefit to it. And I didn’t really care because I found benefit to it. Like I said, it was helpful for me, but we’ve just received way better feedback than I thought that we would have. I think our most challenging thing is just keeping consistent with developing episodes just because we both are really busy as well. And we do this just as a hobby. It’s not like anything that we’re instructed to do. It’s just out of our own free time. So that’s probably the hardest part, I think.
Dave Kemp:
Yeah. Consistency is the name of the game with podcasting and content creation in general. And I’ve noticed that you’ve recently started bringing on guests, which is always a great way to diversify the episode formats. And I feel like one of the things that I’ve felt when I do podcasts, all of mine are with other guests, is that the guests … The great thing about having guests is that they make you just think differently about every single topic. And so it spurs on future content because even just something that’s said in passing might lead to a totally new subset of content that you can create down the line. So how has this experience been where you’re now starting to get into these different formats? You’re in your second season. It looks like you’ve done probably, I don’t know, 20 episodes, or 30 episodes, or something like that. So are you feeling like you guys have even as challenging as it might be to just stay consistent, that you’re starting to just kind of find yourself looking to change it up and try new things and just diversify it as things get going and momentum builds?
Liz Fuemmeler, AuD:
Yeah. So our first season, our main goal was to go test disorder, test disorder, every other just to give kind of the basics of what vestibular is for people that were just tuning in. I feel like this season we’re trying to do still the test and disorders, but throwing in that guest speaker we had. I work with a physical therapist who was hired onto our private practice. She’s vestibular in concussion. So we had her. That was probably one of our best episodes learning about vestibular rehab. I work with her every day and it was until I interviewed her on the podcast that I learned all these amazing things she does, because again it’s … part of it is just sitting down and asking those questions that we don’t have time to ask on a daily basis. So I think having guests, like you said, is just the best way to learn. And you learn things about people that you work with every single day, which is amazing.
Dave Kemp:
So I feel like you are really inspiring for, let’s call it, prospective audiologists or incoming audiologists. Some of the young professionals in this field. You have five years under your belt now or however many that since-
Liz Fuemmeler, AuD:
Two and a half. Thank you.
Dave Kemp:
Two and a half. Okay. Well, it seems longer than-
Liz Fuemmeler, AuD:
I’m flattering.
Dave Kemp:
Okay. So you have a few years under your belt. You’ve started the concussion protocol, but I think between the podcast, and I know you always challenge yourself to go and speak at different events. And I feel like this would be a good opportunity to maybe just kind of speak to that portion of the audience and say the benefits of … You’ve obviously been thinking this way for a long time, going all the way back to pushing yourself to be involved in this Student Academy of Audiology, to the point to where you became the president of the Student Academy of Audiology, then you get this job and you immediately take it upon yourself to develop a new curriculum or a new program, I’m sorry, within the clinic. You start a podcast. And so I just feel like you’re very emblematic of this idea of pushing yourself out of your comfort zone. And there’s clear benefits that you can show of. You’re probably met tons of people, you’ve opened a lot of doors for yourself just by putting yourself out there.
Dave Kemp:
I feel like part of the challenge for young professionals is imposter syndrome. You’re always worried of like, “Am I really qualified to talk about this? Am I really qualified to do this and that?” And so if anyone can speak to this, I feel like you’re really qualified here to just talk through did you have that? And how did you battle that? And it seems like you’ve just incrementally pushed yourself to higher and higher levels. So just to the people that are out there that look up to you, what would you say of where do you even start in terms of how you did this?
Liz Fuemmeler, AuD:
Yeah. This is challenging because I think especially in today’s world, we’re all very, very busy and time is a very precious resource. And I hope that everyone who’s entering audiology or is in audiology cares about the future of the profession in general, but I don’t think that’s always the case. I always encourage students that you should do one thing outside of what you’re required to do for the profession because ultimately we are going to be stronger as a profession if everybody does one thing outside of what they’re required to do, whether as a student or in your professional life. And the good news is everybody has their own unique talents and skill set. So we don’t all have to be doing the same things outside of our clinical responsibilities. Some people really have benefits to legislation and helping with state advocacy. That’s probably not my top skill set. Some people are just good about advocating or volunteering in facet that help tell other people about what audiology is. Some people do research, which is critical so I think there’s a lot of different ways that we can push our profession forward.
Liz Fuemmeler, AuD:
And why I say that’s important is if we aren’t pushing our profession forward, our reimbursement is not going to get better, our pay is not going to get better, our acceptance of how primary care sends to our office is not going to get better. All these aspects and challenges that we have on a daily basis, even the insurance walls of like hearing aids not being covered by insurance. All of this is rooted in what are we doing to advance the profession outside of your day to day job. So I think that’s one perspective that I have, is I want my job in 10 years to continue to get better. If I’m not doing something actively to make that happen or make the profession move forward, then I’m not ensuring that for myself. I think as far as the things that I’ve personally done, the biggest benefits that I’ve noticed is that I’m a better clinician to my patients when I push myself to learn outside of clinic. And some days are easier than others. You’re signing up to give talks at conferences. It’s kind of the best and worst thing all in one because it’s stressful and I wait until the last minute, but ultimately I … Those things are the best thing though because they push you to learn more outside of what you would normally learn.
Liz Fuemmeler, AuD:
I also think just getting involved and getting in these situations, like you said. My network is large and I think that’s really important because you’ve got mentors and peers that you can rely on for questions or advice that you need to help give best patient care. And then from a personal brand aspect, I think it’s just important to build your own credibility because that helps. First of all, just being a young female doctor, I think it is really challenging. I wish this was something that was covered in grad programs and I always bring it up to students, but how to respond to patients who don’t trust you, who don’t think you’re qualified enough, who don’t think that women should be doctors. Whatever you can think of, I’ve heard. I think one doing some of those things helps me feel confident telling the patient like, “I am credible.” And I already told them that just from going through school and I felt that, but I think that’s one thing that’s really challenging for young females entering the profession, is feeling that credibility. And I think for me, I feel more confidence when I’m learning outside of clinic and pushing myself to do things that give me better credibility to the patient. So I think that’s where I’ve seen the most benefit.
Dave Kemp:
Yeah. I couldn’t agree more with all that. I think that your whole point too, on just forcing yourself to do something is so … It’s painful at the time, but it’s so beneficial. You always walk away from it happy that I signed up for a talk or for somebody that maybe you don’t feel like you’re quite qualified yet for presenting at even a state chapter. And I would challenge anybody. I would say, “I bet you probably are.” But look at the podcasting circuit. It’s really starting to merge in this industry. There’s more and more podcasts coming out. You don’t necessarily have to start your own, but I think just identifying what it is that you’re really passionate about. It could start with, what’s the thing that was your grand rounds topic? And figure out, okay, so this is going to be I had my poster session. It was focused on this topic. And so find ways to just make a presentation based on that. Start compiling different research, just connect the dots between a few different pieces of research that you’re reading and come up with your own spin on it.
Dave Kemp:
You don’t have to reinvent the wheel, but I think that just formulating anything to start with is so important because that’s how you push the ball down the mountain. You got to get it started some way and then you can just build on everything. So if you start off with, “I’m going to try. My goal is going to be I want to become a guest on one of these podcasts or I want to be a … I want to have a speaking opportunity at the podium at any in-person show.” Start small figure out, “Okay. So I’m going to start with my Missouri Academy of Audiology.” Or something like that. And seek out who is the program director and contact them. And so a lot of this stuff I think the takeaway is nobody is going to really do it for you. You have to take the initiative to do that.
Dave Kemp:
The broader point is it’s probably a lot easier than you think though in terms of you’re probably going to be more accepted than you think. People are always seeking call for proposals. As like event organizer, they’re always looking for these types of things. So you’re probably more in demand than you think. And I think that to your point, as soon as you get started and you can kind of use that as your pillar of that’s your foundational piece, you can start to build your personal brand around that. That can start to be kind of what your identity is and allow for you to start to use that as your tool of how you start to network in that circle and then it just starts to just expand from there.
Liz Fuemmeler, AuD:
Yeah. One thing that I have found very interesting in the last couple … Honestly, the last year or two is the increase in audiology related Instagram accounts. I think that has been really awesome. And I think there’s a lot of really talented people who are graphic artists or just really good at that content creation. I run our offices marketing and so I run our Instagram. And frequently I will share a lot of these awesome graphics that people make or drawings and I’m like, “This is so cool.” Because you’ll notice, if you’re spend any time on Instagram, for example, physical therapists are all over it, chiropractors all over it. They’ve got videos, they have content and people are sharing and saving. I have a friend who has been a PT. And he started Instagram and has hundreds of thousands of followers just based on little videos on how to help different pain points. I think it’s really interesting and audiology needs to kind of catch up. And that’s where young professionals are going to be the most beneficial. It’s in the podcasting domain, the TikTok. That’s been huge for audiology, in Instagram, because those are the things that are capturing our new target market for audiology that needs to get to our practice. Those younger people.
Dave Kemp:
I could not agree more. Actually the episode I just published today, I had Dr. Michelle Hu on, who has the Mama Hu Hears Instagram account. And the thing that gets me so excited about this, it’s her. Listen With Lindsay or it’s what you’re doing. One of the coolest things about today’s day and age is the outsize impact that one person can make. You’re one page alone could be … When I was talking with Michelle, she has thousands of these deaf, or hard of hearing individuals, or the loved ones of the individuals like parents or whoever it might be. She is seeing 10 to 12 patients a day in her clinic, but she’s really seen thousands of people a day in a sense because so many people are coming onto her page asking all of these different questions.
Dave Kemp:
So she’s becoming one of the default resources that people turn to when … Like the program that she’s put together of, My Child Has Hearing Loss, Now What? I could not agree more with you that this is where you can really start to play to your strengths. Taking these things that we have been told is a toy and finding a way to actually make it really effective and meaningful in a professional setting. If you have really good chops on Instagram, use it, figure out a way to. If you’re working in a clinic, see if maybe that’s an opportunity. You can take over their social feed or at least kind of show a proof of work of like, “This is what I would want to do with it.” And you can create all kinds of campaigns that way.
Dave Kemp:
So there’s so much that I think plays to the strengths of young professionals today, but it’s a matter again of you got to just do it and put yourself out there and not just assume that something is going to magically happen where it’s going to just present itself to you. These things always come from you taking the initiative and kind of being a little bit uncomfortable, but we grow when we’re outside of our comfort zones if you like.
Liz Fuemmeler, AuD:
Yeah. I feel like the hardest thing because I talk to quite a few students and guest lecture, and one thing I always touch on is student involvement. And I think it’s really hard because in high school, you’re doing all these extracurriculars to get into college. Same thing with college. You’re doing all this extra stuff to get into grad school. And by the time you reach grad school, you’re just trying to get a job. So maybe you’re doing what you have to do, but it’s a little bit of a different feel. It’s not the big rush to do everything you possibly can to distinguish your resume. It’s just a little different. So I feel like a lot of times students will say, why? What is in it for me to do something outside of what I’m required to do? And I think that’s challenging to answer and hopefully you’ll realize that when you do something out of your responsibilities, what you give you will get back tenfold. It’s kind of this maybe weird karma thing, but the more you’re able to serve the profession, you really are going to benefit in knowledge, increased knowledge, increased resources, increased support, increased credibility. Whatever you’re looking for, you’re probably going to get it. And maybe you don’t see that in the opportunity that is presenting before you, but I always encourage someone to say yes. Even if it’s something just outside of your program at your university, or in your community, or state national whatever, just say yes. You don’t have to do it forever, but try it. If you don’t like it, try a different circle.
Dave Kemp:
Yeah. I couldn’t agree more with all that. So when you were at AAA, did you present?
Liz Fuemmeler, AuD:
I did. Yes. This is a very busy presentation semester for me. It feels like I’m back in school a little bit, but I presented at the vestibular grand rounds, which is exciting because it was two-third students basically there and there were a few 100 people. And I think that shows that students are valuing specializing in these little subset diagnostic aspects of the field because that’s really where I see the future heading.
Dave Kemp:
I think that if I were a student, if I were a incoming audiologist, it makes so much sense to me to specialize in something because I think you’ll gain the generalized experience undoubtedly one way or another, but I think that the specialty is … That’s kind of how you can future proof yourself, I feel like. And the other cool thing with it is with vestibular in particular, I think that it would be … it seems really exciting that it feels like unchartered waters. There seems to be, as we were discussing with concussions, there’s a lot of space for this thing to evolve and take shape in ways that you’re really starting to see in some of these specialized areas, the audiologist is totally becoming elevated to a status alongside the greater medical professional community in a way that I feel like this is one of the most exciting opportunities broadly speaking for audiology. It is elevating the profession to the minds of the cardiologists and the general physicians out there, and the neurologists, and all of these other allied medical professionals where they start to view an audiologist through a different lens than just the kind of the traditional status quo of like, “Well, aren’t you the ones that deal with hearing aids? No. It’s much, much more than that.
Liz Fuemmeler, AuD:
Yeah. I think I’ve said this a lot, but dizziness is everywhere. One in three people who enter the ER have dizziness. And as soon as they roll out the big scary stroke and heart stuff, they don’t know what to do. So if you’re in an environment where you’re having challenges marketing to people, start with the ERs because they usually discharge people and say, “you have vertigo.” As if that’s a diagnosis. And we all know it’s not. But there’s a huge, huge opportunity. I feel like the coolest moment is when a neurologist calls you and they’re like, “Hey, what do you think about this case?” And it’s really cool interprofessional. And that’s why I like concussion. I’m working with optometrist, neurologists athletic trainers, physical therapists. It’s really cool because I am right there with them and they’re asking me like, “What do you think about this?” And I’m asking them the same thing. And I think that is just a whole new level of elevating our profession and really operating at the top end of our degree.
Dave Kemp:
So with your program that you’ve helped develop within your practice, how has that been going? Obviously it sounds like it’s going great, but I guess today versus even a year ago, what are some of the changes? Because it does feel like it’s just kind of fly by your seat of your pants a little bit and that it’s just changing every single day.
Liz Fuemmeler, AuD:
Yeah. So one huge issue with concussion evaluation in general from the vestibular side is there’s no really dedicated research to say what protocol is appropriate. So that’s still a developing process. I feel like the things that have changed the most are my protocol has changed. And I think that’s just as I’m learning what is really resonating and helping pick out people’s symptoms the most. The other thing is the main neurologist that I work with here in town who sees most of the concussions, originally he would send me patients after they’ve been through a round or two of physical therapy and then fail and still have dizziness. And I have been working really, really hard to be on the initial front side of that. And now I feel like he sends me the patients right away for evaluation to help direct treatment. What’s really interesting about head injuries, especially in young populations, not everybody needs physical therapy. And I think that’s kind of the automatic response for a lot of physicians. They will send straight to physical therapy and then find out what doesn’t get better. I am operating under the different thing that the more information we know up front, the better we can direct decisions on what they actually need. And most of the time it’s not just physical therapy.
Dave Kemp:
So if it’s not just physical therapy, what else would it entail?
Liz Fuemmeler, AuD:
So optometry is a big thing. There’s a lot of eye related ocular motor issues, cognitive therapy through a speech therapist. There’s a high prevalence of anxiety, depression, or psychiatric changes. Obviously when people have a head injury and they can’t go to work, they’re not getting the money they’re used to, they can’t do their daily activities. That is very understandable. Sometimes it’s cardiologic changes, post head injury. There’s quite a bit of information out of Mayo, Arizona about that. So there’s a whole realm, even neck-related or back-related issues that are causing dizziness. There’s a million different ways a patient could go and sometimes I just see a patient track their abnormalities, bring them back a week later and things naturally recover because the brain naturally does want to rehab. So at that point, no intervention is needed, which saves everybody time and money.
Dave Kemp:
Yeah. Okay. As we kind of come to the close here, this has been so interesting. I feel like there’s so much more here that I would love to discuss with you at a later date, but with the podcast, what are some of the highlights that you’ve had? Both in terms of just doing the podcast broadly speaking, but some of the topics that you’ve covered, what really stands out in your mind?
Liz Fuemmeler, AuD:
So for me personally, I had mentioned earlier having our physical therapist as a guest I think was really amazing because one thing that I didn’t know much entering the field is really what happens once I send a patient out to vestibular rehab. I worked kind of on the outskirts with physical therapists, but never really been able to see what they do and hear what they do. So that’s an incredible episode. If you just want to learn the basics of vestibular rehab, that’s a really good one. We just released the other day, it might have been yesterday, I’m not sure, Ototoxicity. So when I was president of SAA, we did this big survey for students and we found out that two-thirds of students don’t have a dedicated pharmacology class, and I was one of those. That’s one of my weakest subsets of knowledge. So we had another past president of SAA, Riley DeBaker who came on and he did his PhD in Ototoxicity and kind of talked us through the basics of what to know, which was amazing for me personally. But I think I’ve learned something with every single episode. We’ve, like I said, covered everything from disorders to how to run certain tests and what to look for as an abnormality. So I think depending on what you want to learn about, you’re going to be able to learn about it.
Dave Kemp:
I just think it’s so cool. Riley DeBaker right? That’s his name?
Liz Fuemmeler, AuD:
Yes.
Dave Kemp:
This is the thing I like most about podcasts. It’s that you really do start to kind of get a sense of who’s who. I recognize him because he was on this weekend hearing episode. He was interviewed by Ashley Hughes and they were talking about collaborative negotiation and stuff like that. And so the point I’m making though is he made an impression on me with that episode and then I recognized him and I saw that he was on your episode. And so it just against kind of reinforces this whole point around personal brand building and understanding who’s who.
Dave Kemp:
Okay. So he’s really heavy into the pharmacology Ototoxicity space. That’s so interesting to me. Knowing the different people that have really strong backgrounds in different areas, I just feel like you can really start to … you can build up your knowledge tree of this space rather quickly just by identifying who the key experts are. And I think again, that’s the plug of why it’s so important as a young professional to just try to figure out what do you want to be known for? When people think about you, what do you want that to be synonymous with? It doesn’t have to obviously be your whole identity. But I think from a professional standpoint, there’s so much value there because it again allows for you to just completely open doors and connect with people that are in similar fields and similar interests. And then once you’ve done that, even more doors start to open up. So that’s, again, just a massive plug for how important this whole brand building aspect of being a young professional is.
Liz Fuemmeler, AuD:
And most of us even, Riley, we all started with SAA because that’s a really low threshold, low risk way to figure out what you like and what you like to do both within your field and outside of your specific subset. We all started there. That’s probably where most of the people that I drawn on a daily basis are from.
Dave Kemp:
Yeah. Absolutely. So cool. All right Liz. Well, for anybody who’s interested in following up with you, where can they connect with you? How can they find the podcast? Just a few more plugs for you.
Liz Fuemmeler, AuD:
Sure. Yeah. So our podcast is a dose of dizzy. You can find it anywhere you listen to your podcast. It’s on everything. We also have an Instagram and a Twitter. It’s a dose of dizzy podcast and we try to post things, but I’m in charge of that and it doesn’t always happen. Yeah. We’re connected through my personal Instagram on there. So you’re welcome to find me, message me.
Dave Kemp:
Awesome. Well, that’s been great. Thank you so much, Liz, for coming on. Thanks for everybody who tuned in here to the end, and we’ll chat with you next time.
Dave Kemp:
Thanks for tuning in today. I hope you enjoyed this episode of Future Ear Radio. For more content like this, just head over to futureear.co, where you can read all the articles that I’ve been writing these past few years on the worlds of voice technology and hearables and how the two are beginning to intersect. Thanks for tuning in, and I’ll chat with you next time.
