Hello and welcome back for another episode of the Future Ear Radio podcast!
For this week’s episode, I had the pleasure of speaking with Patricia “Tish” Gaffney – Professor of Audiology at Nova Southeastern University and President Elect of the American Academy of Audiology.
During this episode, Tish and I discuss:
– Her backstory, how she ended up in Audiology, and her path to becoming a professor at Nova Southeastern University
– Getting involved early in her career with various professional organizations, which she attributes as a major accelerant to her career’s growth & establishing her professional network
– Her specialization in vestibular diagnostics and the growing interest in the vestibular side of Audiology among young professionals
– A brief overview of the trends happening in the nascent field of pediatric vestibular diagnostics
– The American Academy of Audiology’s (AAA) goals in 2024 and then beyond during her tenure
– The intersection of Public Health and Audiology and how Hearing Professionals can “extend themselves” by imparting their institutional knowledge to allied medical professionals
-Thanks for Reading-
Dave
EPISODE TRANSCRIPT
Dave Kemp
All right, everybody, and welcome to another episode of the Future Ear Radio podcast. I’m thrilled to be joined today by Dr. Tish Gaffney. So Tish, thanks so much for being on the podcast. How are you doing today?
Tish Gaffney, Au.D.
I am doing great. Thank you for having me on.
Dave Kemp
Absolutely. Absolutely. Well, thank you so much for coming on, I wanted to have you on, you know, we are heading into 2024, you’ll be the president of the American Academy of Audiology. You know, you’re a professor at Nova Southeastern in Florida, you got a lot of different titles and things that you’re focused on right now. But I wanted to go back to the start, like I do with most of my guests on the podcast to just kind of get a sense of like, how did you come into this space, and more or less discuss how you got to where you are now? So let’s go back to the start.
Tish Gaffney, Au.D.
Sure. So, um, so I had always loved science and healthcare, and I knew I always want to do something in health care, you know, I thought maybe doctor, I thought, you know, all these different things you do when you’re in high school, and in those early years of college, and I really discovered audiology from my uncle, who was an ear, nose and throat physician. And during the summers, I kind of go down to his office and Delaware. I’m from Philly, originally, the suburbs of Philly. And so I would go down to Delaware and kind of help Alec filing and stuff like that. But his audiologist would let me observe her. And it was really a great opportunity to kind of see how ENT function as a physician, versus how the audiologist gets to function and have that more interaction and personal care with their patients compared to that, you know, more fast paced physician approach. And so, you know, when I was in college, I, I decided to do Speech and Hearing Sciences. I was doing my undergraduate at the George Washington University in Washington, DC. And then I went to University of Pittsburgh for graduate school. And when I entered into grad school, it was kind of in that transition period where there were some ad programs. Some of the early ones, most of them were still masters. My undergraduate advisor was like, Yeah, we’re not sure if the ad is going to work out. So don’t apply only if the Apply happened half. And I ended up getting into the University of Pittsburgh, which is a great school, and at that time, it was still a master’s program. It wasn’t an AUD yet. And I decided to go I would have been in state for me, you know, so it was a great opportunity to go to great school. And my first year there, they’re like, we’re gonna transition to the ad. And I was like, Well, this is great, because I kind of wanted to do it up anyway. And so this was a great opportunity. And so I learned a lot at University of Pittsburgh and I, you know, have a great relationship with a lot of the faculty who taught me then I ended up doing my externship at the VA hospital in Miami. So that moved me down to Florida for my externship. And I graduated, they offered me a job and I stayed there for a couple years. And then right up the road here in Fort Lauderdale. Nova had a position open. And and I decided to apply it was two years after I graduated. So I graduated in 2005. And I ended up starting here in 2007. And so being very young, and new to the profession, stepping into a faculty position was interesting, and definitely a learning curve, you know, from being that student to now being that faculty member. But I thought, you know, my interest has always been vestibular and so I thought that I could really, you know, lean into that in this in this, you know, role at this university. And so it’s been great. I’ve been here 16 years still here. And I have had the luxury of, you know, being able to build our vestibular program here. And we could talk about that later. But kind of in tandem to that I was always interested in the professional side of things too. And so when I was in, in school it hit my first conference was the Philadelphia conference, which was great for me i my first year as an ADC and I got to go home to a conference. And that’s when I learned about that though, which is the National Association of future Doctors of Audiology. And that was an organization that was specifically designed to help promote the AUD because it still was in that transition period. And so my classmate and I brought it back to hit and we started our NAFTA chapter there, which put me on the national, the national representative for Pitt on the National Board for NAFTA. And from there like my IT professional kind of career took off to just getting to know tons of people and, you know, then rolling into an executive position. And then I have basically volunteered the whole rest of my career for various committees and organizations. So it’s kind of had these two things between the the, you know, my day to day job, but also my volunteer life has kind of really stemmed from that, that University of Pittsburgh experience kind of in both ways,
Dave Kemp
it’s interesting that, you know, like, we’ve, I’ve had this conversation a few different times on on the podcast about this, like whole period, when it was kind of the Wild West, when it was transitioning from the master’s degree to the doctoral and like, I just think that’s such an interesting wrinkle, for a lot of people that are in this profession is like, whether they started before the transition existed. And so they’re all like master’s degree in some of them. You know, like, afterward they went, and they got their doctoral, others, you know, they didn’t have an option. And really, the AUD was the only one that exists. But I just find this to be it’s part of the like, whole story of what is still kind of a nascent profession, I think. And I think it’s interesting that like, we’re kind of at this crossroads in many ways, as an industry, and I think audiology is, in particular, is kind of identifying, like, what is the role into the future, given some of these like changes that are happening, some of these different external pressures and all that. But I, you know, so that’s one thought that I have based on what you said, but the other is like this, this pattern that is now very visible, I guess, from from the guests that I’ve had on the podcast, that have really sort of like leapfrogged in their career by putting themselves out there getting involved in whatever way they can. And it’s obviously like, dependent upon the circumstances of when these opportunities present themselves do like you said, you know, you kind of had this opportunity come about that was for like young professionals that were to more or less represent the new doctoral level degree. Whereas today, you know, those might take different shapes. But I think that the kind of the pattern is that if you’re willing to do these kinds of go above and beyond just the norm, it seems like there’s almost undeniably going to be some positive, sort of, like, secondary order effects that come from that.
Tish Gaffney, Au.D.
Absolutely. And, you know, my involvement in NAFTA, which, you know, for some of the young people, they don’t even know that that existed. And, you know, that’s now basically what I say. SAA has become, due to some agreements that were that took place many years ago at this point. But yeah, that was that was truly the catalyst for so much of what I’ve done. And actually, you know, even just getting my job here, it was super helpful. So, you know, when I was a student on the NAFTA board, you know, I got to so the way that NAFTA function, which is a little different than how SAA functions, was that because there were so few au grams, every ad program had a board member. And so you were the national representative for your chapter for your school. And we all met. And so, you know, I just found actually, the one year to both years, I was on the NAFTA board, I was in charge of the conference, either on the conference committee, or, as the Secretary, the conference call underneath that NAFTA had its own conference, the day before triple A. And I was I was, I just moved and so I was going through like an old piece of luggage that I had, and I pulled out and there was the room list because we needed for the rooms. Yeah, and we put four students in a room. And I found a room lit and I was going through it. And I was like the number of people who were involved at that time, who are now really successful either, you know, through their State Academies, through their professional organizations, industry, like there’s so many people on that that, you know, have done so much with their career. And it really started with doing stuff at that student level. And, you know, if you, you kind of get into that mindset that you want to be involved, you want to give back to your profession, because you don’t get paid anything, right. And so it is your mind that you’re paying to participate, you do get back to having really enriching experiences with colleagues from around the country, I can pretty much go to any city. I know somebody, they’re probably cool, all of the time that I’ve been on, you know, involved in my profession. And so, it’s really, I mean, it has really, that has been such an important part of my journey of you know, starting at that, that that point in my you know, student years of really being engaged I’m interested in, you know, knowing people and things like that. And, you know, at heart, I’m really an introvert. So for those introverted people out there, like, I am truly like an pardon an introvert how, however, because I’ve made so many friends in audiology I, I’ve been able to, so people don’t realize that, and they’re like, Oh, you’re so extroverted. How? And I’m, like, you know, like, audiology is like my home, and they’re all my friends. And so it’s become really easy to, you know, kind of blossom in that way, throughout my career from, you know, my 20s Up until now.
Dave Kemp
Yeah, I mean, I, again, I just think that’s, it’s really important to his like, to your point, you don’t get paid. So it’s not like you get like these super tangible direct benefits. But to your point, you know, you sort of reflect back and I think many people can sort of, you know, they can relate to this, because they’ve had similar things happen in their life, which is, you know, again, just a testament of like, just do more, especially when you’re just getting started out, because I think it, it’s just going to lend itself to you like, you know, putting giving yourself more opportunities for like serendipity to happen for luck to happen, for you to kind of meet that right person that is going to be, you know, some sort of colleague in some capacity down the line, you don’t ever really know what’s going to happen. So like, I guess, to just real quickly, going off a tangent with this as a professor as somebody that works with water young people. And then as the president of AAA, what would you say to people that are, you know, kind of young now? Like, what, what kind of like, what are some of the specific ways that you can get more involved? I know, you know, you can join your SAE chapter and all that the student academies, but like, is there anything that comes to mind in terms of ways that you think you as a young person could like, set yourself up to be successful by kind of like, going out and about and doing things that are maybe not as cut and dry as just following your curriculum?
Tish Gaffney, Au.D.
Yeah, you know, volunteering for, you know, SAA is a fantastic way to start. But there’s other organizations out there too. And, you know, I had several students who have become Board Representatives to the American balanced society. So they’re getting leadership from from that role. Once you graduate, you know, those first couple of years, you know, volunteering, either at your seat academies, your, you know, national, you know, professional organizations like AAA, Asha Ada, or more specialty ones, like balanced society, or if you’re a VA, you know, we the VA audiology group, or, you know, so there’s so many, there’s so many organizations, which is a is a given take in the profession, right? Sometimes it’s a great thing, sometimes it’s not, like, you know, when you volunteer, and you show up, and you participate and do the work, when they’re looking for people to do the next thing. They say, oh, so and so was really great on this committee, we should ask them to be part of this. And that’s really what happened. And I’ve seen that snowball, especially within AAA, because I’ve been so involved in that organization for so long. You absolutely see that happen, you know, people who show up, participate in the meetings. You know, and most most committees are not overbearing amounts of work, you know, their monthly meetings, maybe some work in between. But when you when really participate, and not just sign up and sit there, when you actually participate, people remember that, and people say, you know, and I was just literally talking to one of my friends, and she’s like, do you know someone, so because they’re on this committee, and I think they were on one of your committees before, and they’re doing such a great job, like, they would really be good in a board position, or they’d be really good as a committee chair. And so that’s how that snowballs into these higher level, you know, positions. I mean, there were periods of time where I was on, like, five committees at once. You know, and some are more amounts of work, some are less, you know, and, you know, that’s how you kind of build this is, you know, when people ask you, you say yes, and you you put your you put effort into it. And it definitely pays off, for sure.
Dave Kemp
Yeah, I couldn’t agree more with that. So, you know, thinking about your trajectory, so you, you get your AED, you know, you’re kind of one of the first generation of the new doctoral level graduates, and then you go in you join down at NOVA. What was that like? You had said that it was like you kind of almost were maybe thrust into the lion’s den or something like that. It sounds like you were put out outside of your comfort zone, which is another kind of, you know, testament of personal growth is, you know, being uncomfortable as to kind of grow your comfort zone.
Tish Gaffney, Au.D.
Yeah, I mean, you know, I think that’s it, you know, being a faculty member is an interesting position because you play so many roles in it. And it’s not just the T. Ching, you know, there’s other responsibilities too. But if we look at this, you know, so I, I became a faculty member at, you know, 2728, and around there. And I was only two years out of school, my students were my same age, you know, like, they were, you know, a couple years younger than me. So having having to, to create an authority type role. And I don’t mean that in a negative way, but, you know, in a way that you’re in charge of your classroom, and you’re in charge of this one work, but also being so close in age actually, is it it’s a little bit of a struggle, because you’re like, Oh, these are my, these are my peers, because they’re so young, and they’re doing the same things that you’re doing, because you’re so young. But then having to, you know, create this, this academic persona in order to, you know, effectively lead them as their faculty member. And, yeah, it took some it took some learning to, to kind of develop that I have always had the same philosophy the entire time I’ve been here is that I’m very clinician forward. So, you know, what is it that clinicians need to know when they go out in the world, this is an AUD, this is a clinical doctorate, what clinicians really need to know when they go out into the world as a clinician on the other thing is that and this is something I get consistently on teaching about, and things like that is tough, but fair. So you know, I have the standard of where I expect performance to be, here’s what I’ve taught you, here’s the tools I’ve given you, I expect the student to put in their work, you know, studying and learning the material, here’s where the bar is, I expect you to hit that bar. But it’s also fair, I don’t like pulling obscure things like pretty much every exam question I can pull exactly from the slide where it is. Because it’s not meant to be tricky. I’m not trying to trick people, I don’t want to, you know, sabotage students, but you know, I think they’re, you know, I feel like there has to be a bar that we’re attaining to this. So, you know, and creating that and, and defining that over time is something that that took some, some time to really establish, by, you know, I, I love what I do, I love teaching students and being able to see those aha moments when a student finally gets it. Or they finally understand how those pieces fit together. I love in the being in the classroom with them. And that was something that took some time to learn too, is that you’re a student and maybe do a 15 minute presentation. Well, now here, you’re expected to teach three hours at a time and filled all that material from scratch. And you know, that that takes, you know, it takes refinement to also be able to teach effectively to So yeah, that that journey as far as a faculty member, you know, took time to finesse. I think I’ve gotten it to a place where I am good with it. I, you know, this year, I was awarded the AAA Outstanding Educator Award. I was nominated by two other faculty members, and they had, you know, some of our former students also write supporting letters. And, you know, I look at where my students have gone and what they’ve done. And that’s always a testament to how good you are is, is, you know, what the product is produced and your product is is in this case as a student?
Dave Kemp
Yeah, I’ve met a few Nova Southeastern students. Oh, yeah, over the years. And I can agree to that. Yes, some very impressive graduates that are doing really impressive work already in their young careers. But I was going to ask you, I, first off congrats on winning that award. That’s, that’s really cool. And that’s, that’s got to be extremely gratifying. So as somebody that’s kind of been teaching, you’re kind of on the front lines of seeing, you know, like, whatever kinds of trends, I think are developing within the younger population that the future generations of the providers, you know, some of which are, you know, kind of maybe well established in their careers now, but my point is, is that I feel like you maybe more than anyone would be kind of seeing where you think people are like, where the like workforce is trending toward what changes are you noticing, with recent grads today and the students today that you’re seeing that might be different than say, a few years ago or 10 years ago? You know, what’s the what what are some of those like market changes that you feel are noticeably different?
Tish Gaffney, Au.D.
I think that So there’s a bias towards what I think as far as like we did my specialty. And then there’s kind of an overall I think that I think that there has been some disruption to, you know, the audiology marketplace, right. And there’s all these concerns about various, you know, ways in and I’ve seen students take more innovative approaches to how they’re providing care, or their business models. And I think that that’s going to continue to change, I think people are going to start thinking outside the box box in the traditional, you know, I’m gonna go work for an EMT, I’m gonna go work in hospital, there’s been, you know, definitely some differences in how people are, you know, kind of going out there into into the world. You know, within my area of expertise, which is vestibular there, there’s absolutely been a change in, you know, the acceptance, and I don’t wanna say acceptance of how involved people are investing in our, since when I was a students, and now and, you know, when I was a student, there was very few people who did vestibular, and who did it, you know, well, and that was their expertise. You know, there’s this sort of have been around, right, and, you know, people were doing it. But I think this true interest in vestibular has really changed quite a bit. When I was in school, nobody talked about pediatric vestibular at all, like it pretty much didn’t exist. And so watching that develop over time has been really interesting. All of the new technology, like when I was in school, The Vamps didn’t exist, actually, they were just starting to be talked about. A lot of the early Vamp literature was in the early 2000s. Right when I was in school, but you know, that was really see vamp, and then oh, that didn’t exist V hit didn’t exist. So you know, watching that develop has been really interesting. And, you know, students being interested in that has changed. You know, when, like I said, when I was a student, nobody really, nobody really talked about vestibular that much. It was kind of this very specialized thing. It was part of somebody’s course, it didn’t have its own curriculum to a large extent. And, you know, now when I go to AAA, I presented vestibular Grand Rounds. I think it would not this past year with your sewing Lewis one. Yeah. And I asked that room, you know, there’s 200, and something people in there, how many of you guys are students, and I’d say, 80% of the room, raise their hand. And that interest has really grown. I have students I know, you’ve talked with Liz venlor and Ramiro, and they have their Dizzy podcast. And I have students who come to me and they’re like, saw, I was watching the Disney podcast, and they were up there. So they were talking about word reach and have a rotary chair and like it, use their excitement for that. And part of that is also you know, who’s teaching it right. So if you have somebody who’s interested in vestibular, it’s easy to generate more of that interest. But that is one thing that has absolutely changed over time for sure. That’s
Dave Kemp
an extremely interesting. Oh, well, I mean, first off, shout out to Daniel and Liz, I love a dose of dizzy podcasts, they’re, they do a great job. And I think that one of the things we talked about was like, you know, when you have like something that you’re podcasting about, or creating content, that’s very, very niche. There’s not a huge addressable market, per se, but the market that does exist is extremely hungry for more content, because there’s so little content that is that specific, which I think is just kind of an interesting, you know, like trend to be observing in general. But, you know, with regard to the whole explosion, it kind of feels like that in terms of the interest around vestibular. What I’m kind of curious about because I’ve heard the same thing after that St. Louis, AAA was that the Grand Rounds for the vestibular, the vestibular grand grand rounds, was very well attended, and it was dominated by young people. And I’m curious of like, why that is. And you kind of got to, I think part of it, which is, you know, I think there’s maybe more the science in the field of that has has matured more, the technology has gotten better. So, you know, diagnosing and treating vestibular symptoms might be just naturally getting better. Again, this is kind of a nascent profession. And so in that’s, I think an even more nascent subset of the profession is, even though it’s been around to your point, it’s really only recently it feels like garnered the same level of interest as like the outer ear disorders, or the middle ear disorders. And so, I find that really interesting, but I know another area that you’re very, you know, well read and researched and you do Do a lot of presentations on is around student debt. And I’m wondering if there’s a correlation there, basically, are you think that students are sort of reading the writing on the wall and saying that the viability and sustainability of just being a, you know, call it an audiologist that fits hearing aids primarily, is that sort of a risky endeavor to assume a whole bunch of debt in risk. Whereas maybe it’s safer to really become a full blown clinician, that is a medical professional that has more sustainability around a differentiated skill set, like the vestibular diagnostics and treatments, that are going to be maybe harder to disrupt. That’s my own sort of sense. But I’m curious to get your take on this as is there may be an element of that as to why you’re seeing this huge uptick in, you know, the interest around vestibular.
Tish Gaffney, Au.D.
I think that that could definitely be the case. So I, you know, the entire time I’ve worked here, I’ve also taught amplification classes, which I always talk about, like these two very different sorry. And, you know, when I teach one on one, you know, especially amp one, where they’re first coming in, and, you know, people see, you know, the, you know, the issues about OTC hearing isn’t, and that was a concern, even before, you know, they came out last year, like, that has been a concern for a while we’re like, are we going to have jobs and I’m like, you will absolutely have a job, you, you know, regardless of what happens with hearing aids, you will absolutely have a job because, you know, anything that’s available, available over the counter is not going to fix everybody’s needs. And you know, and even if you don’t go that route, and you want to go a diagnostic route, that’s really where we get paid is on our diagnostic. And so, you know, I think that I think that also, you know, there’s this financial component, but I also think there’s this, you know, sophistication component is let you know, you’re spending more time and energy and financial resources to become a doctor of audiology. And how do you raise that bar of what you are as a professional? And what can you do that is, you know, high level? And, you know, I think that and I would hope that that’s really, you know, a driving force is that people want to do gold standard care. And we know that that doesn’t happen across the board. But that should always be the goal. And I think that the Steeler is an opportunity to address some of these high level things in a way that isn’t the same as you know, just doing urine test and doing repeated hearing tests over time. You know, I always address you know, vestibular, in, you know, my intro vestibular class, like day one, if you like puzzles, and you’re the type of person that likes to put pieces together, then you will love vestibular, because that’s what you’re doing is that you’re taking all these pieces and putting it together. And I think that that’s one place where vestibular really shines in that that kind of complex synthesis aspect where you’re putting a lot of pieces together. And audiology is super important for that. I know Devin McCaslin had done some research when he was still at Mayo, looking at their AI system, their AI triaging and you know, having audiology at the start of the vestibular path was really important and triaging patients effectively, because you know, patients going and tea if there are migrant, or EMTs, don’t want to see them. So, you know, audiology really does have a great place in this in this model of vestibular. And I also think the other thing that’s helping with Mr. Mueller is that there’s more of people like me out there at other universities, you know, back in the day, there weren’t that many. And so, you know, vestibular was either being taught by somebody adjunct, or they were being taught by needing electro phys person, maybe the low man on the totem pole who was like, you don’t want to teach this, you’re new. That’s the course you teach. And that you know, and that absolutely has an impact. But now oh, I you know, I think about this teaching at other universities. And there’s more and more people who are truly interested in vestibular teaching at other universities and imparting that, that love for it, you know, if somebody’s teaching it really dry and invested is not easy. You know, there’s a lot of things and it’s like, well, it couldn’t be this you have to look at this component, but it could be that and so if you don’t have somebody who’s really good explaining it, then it just seems a bunch of gibberish and you know, No, it’s not as effective. So the more of us that are out there that are like, look, here’s how you put it together. Here’s why it’s so important, I think also drives that. So I think there’s a number of factors that are really playing into it. And I also think there has been an uptick in some of the accreditation requirements to teach it. So that also helps.
Dave Kemp
Yeah, that’s, I mean, I agree with that, it’s probably multiple factors that are influencing the, you know, sort of the like gravitational shift that in that direction, I just think about sort of, you know, the existing marketplace. You know, the number one thing that I hear whenever I talk to owners of private practices, or really like anybody that’s in any kind of capacity where they need to hire people, that’s like, their number one challenge these days is, how do you find good talent. And so there’s a lot of like, really interesting innovation happening around upskilling, you know, front office assistance and stuff like that to be audiology assistance and all. But I think that, you know, that’s, that’s one thing. I think, where I’m going with this is that, again, if I’m kind of putting myself in the shoes of somebody that’s just entering into the workforce, or is considering going into this workforce, is that there’s a lot of, there’s a lot of existing practices that probably really wish they had some sort of vestibular offering. So not only are you in demand, because there’s sort of a labor shortage, but if you can have specialty expertise, you know, not necessarily just vestibular, it could be with tinnitus, it could be with, you know, APD, like, whatever you choose to sort of specialize in, I think there’s just a lot of value in that if you, you know, want to kind of like join an existing practice or something like that. And, you know, kind of work your way up to maybe where you want to own your own thing, or do your own thing, be your own boss, whatever. But I just think that it’s, it’s, it’s a, if you’re already going to be kind of incurring the debt, I think that it makes a lot of sense to think about your, you know, sort of your value in the marketplace when you enter, and how can you increase that value. And if you look at it from the perspective of what is there a shortage of, there’s a shortage of labor, but more importantly, a shortage of the specialty type labor that you would need as a practice owner. And that’s where I think that this could be kind of a saving grace for a lot of the existing practices that are, are sort of facing this, whether it’s like managed care, or whatever it is, these different things that are kind of eating into their, their bottom line, I just feel that this macro trend of diversification into ancillary services and offerings, has been something that’s been a big focal point of discussion within the industry for a while, but it feels more tangible and real than ever, especially when you kind of see how the young professionals seem to almost be realizing this writ large.
Tish Gaffney, Au.D.
I agree, and I agree with you that any specialty, whether it’s you know, tendonitis in any PD are really interesting, because, you know, there is such a need for it. And the, the advantage to it is that you need very little if no extra equipment than you already have, you know, that’s one place where vestibular is a little cumbersome, right amount of equipment, you know, if you want a really high tech vestibular lab, that can cost quite a lot. You know, and I don’t think you need every piece of equipment that’s out there, either. And that could be a whole other subject. But, you know, I think that you know, those other Yeah, I definitely think, you know, having a specialty and that’s not saying that you’re not going to do anything else. But, you know, having those extra skills does make you very marketable to, you know, to other businesses, and you know, even things like we’re seeing, like, you know, this, this increasing talk about like pediatric tinnitus, and he’s a phobia and hyperacusis. And that, I think that will be the same explosion, like a step pediatric did, because you’re starting to hear the small discussions about it, and it’s one thing that hasn’t really been addressed. So yeah, I think that having these these specialized, you know, talents, is, is is beneficial to placing yourself in a more, you know, financially better position, you know, in a role or, you know, giving yourself a new opportunity to really expand things and the more you have that expertise, the more you can expand upon it either through presentations through, you know, consulting, you know, where you can get independent financial gains from consulting issues, gigs, you know, or jobs where you want. Yeah,
Dave Kemp
I couldn’t agree more. I mean, I’ve seen In it, and I think that, you know, again, it’s kind of the same thing is putting yourself out there volunteering and advocating. And just getting involved, it’s it’s similar where as soon as you sort of start to develop these skills that are in such high demand, word gets round in, you find yourself having more opportunities than maybe you thought initially. So, again, it’s not to say like, you’re to your point, it’s not like it’s going to be your only focus, I just think that you recognizing that that’s something that there’s true market demand for is, is, I think, a helpful remedy to the fact that you’re probably as a young person today, given today’s realities, you’re taking on a lot of debt. So you need to be really conscious of like, how are you going to kind of work through that. And again, for me, I just see that as being something that feels kind of like, you know, a safe position is go and get that specialty experience. So with the pediatric vestibular side of things, I found this to be really interesting. I was at the Missouri Academy of Audiology meeting, and I can’t remember who the speaker was, I was actually sitting next to Liz, who was kind of giving me like, you know, tell it to me, like I’m 10 kind of Cliff Notes version of what was being presented on. But like, my main takeaway was kind of to your point. That is only getting started with with what is being discovered. I think they were citing a study that was being done somewhere in Northern Europe, where they were talking about, you know, some of the different paediatric procedures from a diagnostic standpoint that they were doing around, you know, some of these newborn screenings more or less for for pediatric vestibular diagnostics. So can you just kind of shed a little bit of light on what’s happening in that space? And why it’s exciting?
Tish Gaffney, Au.D.
Yeah, so I, what I’m guessing is that was They’re probably talking about the Flanders study that’s happening over in Europe. So they were looking at newborns who failed their newborn hearing screenings, and they were following up with them to establish, you know, vestibular function, because there’s a very high correlation between, you know, newborn hearing loss, since you’re not hearing loss, and you know, the presence of vestibular disorders. And so, you know, they created basically your protocol, looking at these newborns who failed their newborn screening, and they’re finding these these early vestibular losses by doing event with them. And the, I would love to to implement this too, because and I talked about this on the American balance society has journal clubs, and this came up in one of the journal clubs too. And you know, how can we start to establish and I think, first and Jackie over, Boystown has started to do this to the newborn vestibular screenings, and being able to catch these kids really young and get them into you know, physical therapy, because that’s usually what we see kids who have congenital, you know, hearing loss and vestibular disorders, they tend to lag behind on motor milestones. So they tend to crawl they walk late, they tend to have more problems with things like riding a bike doing gymnastics. So getting them in physical therapy earlier to work on that muscle coordination. And you know, getting them, you know, more on target with those motor milestones is, is important. But yeah, and I see, I see pediatric patients, the youngest one, I’d haven’t done any of the newborns, but the youngest one I’ve done, it was about 13 months. So I’ve seen them pretty young. And, you know, it’s really interesting testing that population. And like I said, when I was in school, nobody, nobody did that. So Right. It was very rare. It people did, but it was pretty rare. You know, and a lot of it was in the US. I have to give kudos to be let lavender who in to gave the talk? And really, oh, yeah, be a lead is amazing. And she really has talked about pediatric stem for a long time. And, you know, at Cincinnati Children’s, they were doing it but most other major pediatric hospitals were not done that McCaslin and I did a talk for CO children’s in I think was like 2015 talking to them about starting a vestibular program there. And I know they do it now. They’re by it, I need twice a teamsnap. How long ago that time, most, most children’s hospitals didn’t have it. So that is such a young component of vestibular that has really evolved over time and trying to establish what norms are for young kids and, you know, really knowing what’s going on with them and the pediatric disorders that are related to it. So yeah, it’s it. It’s definitely an interesting place. And I also tell my students, you know, Before all that pediatric audiologists were like, Hey, we have our blinders on. And we have, you know, hearing loss, hearing aids, you know, cochlear implant. And now it’s really expanded. So I talked to my students like, you know, if you want to do peds and have vestibular, you have really created a great niche for yourself, you know, if you want those two specialties together, so yeah, it’s it’s definitely an interesting area of of growth in our subspecialty.
Dave Kemp
Yes, that you explained it. Well, that was that was the study that I was referring to in the speaker that I was referring to. But I agree, I think it’s a, it’s just another testament to how young, this whole field of Sciences, and I think it’s exciting in that regard, because it’s like, you know, it’s to your point earlier about the jigsaw puzzle. I mean, that’s a term I’ve heard a couple people just describe audiology in general like that. It was, I think, Jill Davis that was describing it that way. And she was saying that, like, you know, kind of having this rounded experience of having at least a semblance of, of knowledge of every facet of audiology kind of helps you to piece together for some of these more complicated cases of what’s going on. And, again, I just think that like, even if that’s a small addressable market, for the like, obscure disorders, if you will, you’re still branding yourself within your, whether it’s your practice, the hospital, whoever, in the community of like, you go here for anything, for anything that’s related to this, if they can do something that is this extreme, then certainly, they’re a jack of all trades for every kind of ear related disorder. And so I think it’s just kind of like, it bodes well for the way that you’re being perceived by the community around you as, and I think that’s really kind of like, the task that audiology needs to rise to is, how do how does it almost rebrand itself as a whole, to not just be immediately connotated with the hearing a doctor and the doctor instead be one that is like, for everything related to you know, from amplification, to inner ear disorders. That’s, I think, kind of a tall order. But that’s, I think, where the profession really needs to go. And I hope like with AAA, you know, with some of the stuff that you’re doing, and maybe this is a good segue of like, you know, your 2024 We still haven’t had masa and the different iterations of it past, like, what’s on the big agenda for, for the organization? And what’s the goal right now, you know, in terms of what is 2024 look like? And what are your key goals that you want to communicate here?
Tish Gaffney, Au.D.
Yeah, so the Medicare Access Improvement Act? Yeah, that’s still on the agenda. You know, it’s, it’s, it is a pressing issue. You know, I think the downfall is, is the state of Congress, and just everything that’s happening on Capitol Hill. But, you know, I think our goal is still that we need this direct access that meet need these patients who ever come to us, you know, to have, you know, this reclassification, as a practitioner, you know, without necessarily expanding our scope, to just be recognized that we can do these things, we can do treatment, we can see these patients effectively, we can refer when it’s necessary. I, you know, that’s, that’s going to be a main goal. And that’s one thing that all three major organizations have really, you know, come together on for the past several years of this one particular bill, because I will say like, before this before, it was masa. Now, it’s my, when all three organizations had different bills up on Capitol Hill, it was really crazy going up there because I, you know, I like going, I love advocacy, and I love going up to Capitol Hill. And we do a trek with our students every year to go up to DC and have them advocate on trouble on Capitol Hill. And, you know, you’d be up there and you would you would go to an office and be like, Okay, so is this the AAA bill? Is this the ASHA bill is is the ADA bill, and they’re like, oh, but you know, action buttons here last week. And you know, and yesterday, Ada was there and so it was just me, we’re all asking for different things. It was like the the epitome of the fragmentation of our, our profession that we sometimes see. So, you know, the fact that we’re all on board with this one single dollar bill, and you know, that it’s back in Congress, both in the Senate and in the house, you know, is a great thing. You know, we’re hoping that it can be you know, approved, voted in the law. You know, it We’re, you know, the I know. So being in AAA, the Academy staff has been really looking to see, you know, what are some of the ways that it can get, you know, passed in both houses in both the House and the Senate. And I’m sure that Asha and ADA are looking at the same things, and there is discussion amongst all three organizations. But that’s definitely one thing that is still going to be pressing. It’s just whether Congress can can sort things out there with the struggles that they’re having.
Dave Kemp
Totally, yes. Okay, well, that’s, uh, hopefully, you know, this will all pass under your tenure, and you can play another feather in your cap. So, you know, as we kind of come to the close here, wanted to just kind of get a sense from you, you know, in terms of what types of you had mentioned, you know, some of the work that you’re doing from a public health standpoint, which I think is also really interesting, in light of the achieved study, you know, and I think just like, you see it on the news now, like all the time about, you know, first it was with OTC hearing aids, which, however you feel its exposure to the fact that there are, you know, more people becoming aware of like these things, and these are different options. Which, surprisingly, you know, you looked at the, if you see that HIA, you know, numbers of the number of hearing aids that were sold this year, this was like a blockbuster year for the RX professional market, you know, the same year that the OTC hearing aids were released. So I think it’s interesting that maybe, as a weird byproduct, if you will, the all that exposure actually led more people to go see a medical professional, which may be that’s kind of the way that this whole thing plays out is that you do have a do it yourself market, which is fine. And that’s great. But more people are encouraged then to come and see the professional and have the more prescription, you know, experience. But I’m just kind of curious to get your thoughts of what does, how does audiology from a public health standpoint, make itself more aware or make itself more, I guess, well received by its fellow medical professionals have its role here of in the broader public health sphere, of why hearing loss is something that needs to be taken seriously, from a comorbidity standpoint, from an allied medical professional standpoint. I’m just curious to get your thoughts because I know that’s another area that that you do a lot of work is, is on the public health side of things.
Tish Gaffney, Au.D.
Yeah, so I, I’m in the middle of my MPH, I’ll be done. My master’s of public health will be done in May. And it’s been a really an enjoyable experience, like learning things that are, you know, not audiology, but are audiology adjacent and applicable to audiology. And, you know, I have to say that overall public health has been creeping into the healthcare sphere as a whole. You know, you’ve never heard young people coming in, you know, because I, I’m the admissions chair, so I get to see everybody’s, you know, admission packets and things like that. And you’re, you’re seeing now more people talk about like social determinants of health and health disparities and health equity. And, and those discussions weren’t really happening that much. At the end, I think that there’s still somewhat range in audiology. And I think that’s where we need to really take a look at ourselves and see, you know, how, how, you know, is hearing your access part of, you know, health equity, or is it not? And, you know, are people receiving the care that they should, and, you know, OTC isn’t, is a great example of a public health, you know, consideration and so I always get nervous when people ask me about, I don’t really get nervous, but, you know, I think it’s also, you know, there’s always this tenuous discussion about OTC and, you know, where it really fits in audiology, I, you know, you have the audiologists who are very concerned about, you know, their business and their, you know, widely been, and that’s an absolute concern. But when you look at, you know, health disparities, and the people who can’t afford that access to care, you know, how does that fit in? How are we how are we addressing the hearing needs of people who have these health disparities, because of, you know, factors like race and socioeconomic status, and, you know, all of these, you know, education level and all these other factors, and then not being able to access that here because in many cases, it can be not an affordable price point. And I think that’s going to be a struggle and I think overall health care and that’s not just us, that’s you know, glasses that’s dental care that ended on things and but I think the start thinking about you know, beyond ourselves And I think that’s hard. You know, nobody wants to take a pay cut, nobody, you know, everybody wants to be able to make sure that they can have some food on their table for their family, they went to school, and this is where that student loan debt comes in you, you put on all this time energy student loan debt, you want to make sure you can recoup that and make a living. But I do think we need to think about how audiology can be more accessible to, you know, those who are experiencing health inequities in their daily life. And I think that that’s going to be, you know, something that I think that the future generations of audiologists need to really consider. And so, you know, like, I’m adding in to our curriculum here more about public health, just because it’s an area of interest of mine, but thinking about that, of, you know, what are we able to do, and, you know, with the OTC is there’s been this, you know, positioning of those products were I think that, you know, they weren’t rock bottom prices were the ones that are rock bottom prices are not stellar products, right. So we start getting into kind of these higher level TCS, and then you compare that to cost of care with an audiologist, they tend to be, you know, not that far. All right. So, you know, I think that, that has somewhat helped, you know, with the growth of, of hearing care, with being provided by audiologist and products being provided by audiologists. But I do think we have to consider, you know, as a profession, you know, the impact of health inequities amongst the, you know, the residents that live around us, for
Dave Kemp
sure. And, you know, one of the I think, most interesting, you know, opportunities, I guess, with regard to this, that I’ve come across on the podcast is, you know, like, one audiologists is only one audiologist and well, what is the audiologist, in essence, it’s like, a body of very specific institutional knowledge, that was harder. And so I think that what’s very encouraging is hearing about some of the ways that, you know, different audiologists are taking it upon themselves to sort of be the epicenter within their community. And however you define that community, to be the arbiter of that information, and then disseminate it to other allied medical professionals. So I’ve heard some people talk about how, you know, there’s like, these programs where they’re working side by side with an occupational therapist, and with a physical therapist, you know, with geriatric care, working with, you know, in the medical setting, working with the cardiologist working with the nephrologist, you know, working with some of these different people, that they’re not going to be the audiologist, but they’re going to be an advocate for you. And they’re going to be helping to make sure that that information is passed along. And I think that like one of the things I’ve really realized, as I’ve been in this industry, is the concerning lack of knowledge by the general medical population, like, you know, just basically anyone from a physician on that isn’t fully aware of the full scope of the audiologist role, where they kind of come into this whole thing. And so I just find this to be interesting that like, it’s, you know, I just think that from a public health standpoint, there’s a lot there in terms of extending yourself, so that, you know, you can solve the bandwidth issue by having these ways that you’re extending all this information that you are the hub for, and it doesn’t, I don’t think that it diminishes the audiologist in any way, if anything, it dramatically elevates them, because they become perceived in their community as the expert for all these different things. But that, to me is like, like I had frank wordings, your honest guest not long ago, and he was doing a program around, you know, his whole businesses around hearing conservation. And one of the things he does on the side is this whole chaotic thing. So he’s draining occupational therapists, he is trained over like, I think it’s 710 years, I can’t remember how long he’s trained like 10,000k, EOC, certified occupational therapists, I could be getting these numbers wrong, it was I need to go back in check the record, but it was something dramatically outsize like that. And those are the kinds of things where I’m like, when we talk about accessibility, and how you can really only control what you can you can’t control what’s going to happen on Capitol Hill. You can advocate for it, and you can try to make a difference there. But you can do things sort of within your power. And those seem to be some of the things I’ve heard recently that give me a lot of like, hope is like, man, if every audiologist was able to sort of impart at least a level of that knowledge to say 10 people, you just you just grew the workforce more or less by 10x in some capacity
Tish Gaffney, Au.D.
Yeah, you know, we are such a small profession compared to pretty much all the other, you know, big players, you know, PT ot speech, you know, Optometry, like, we’re really small. And, you know, you think about how many audiologists there are across the country that, you know, somewhere probably around 14 15,000 people versus, you know, some of the other ones that are, you know, 200,000 Brio providers, you know, there’s only so much you can do as a singular individual seeing the patients that you see. And that’s one of the things that I really like about public health, because you’re thinking about, you know, beyond the patient sitting in front of you. But yeah, there was, you know, the other professions know, so little about us, and, you know, having those relationships, I know, in the vestibular world, you work a lot with like PT and OT, because of that, that nature. You know, I have an interprofessional, we have an interprofessional fall prevention clinic. And, you know, I show up with some of my vestibular equipment, and we’re looking at eyeballs and optometry is like, why are you guys looking at eyeballs, we’re gonna retrain, we’re like, well, Barton, looking at a different thing. We’re looking at the VOR. We’re not looking at, you know, visual acuity. And so it’s an opportunity for them to learn, you know, what we do versus what they do, and guess lecturing for optometry as well. But, you know, it’s funny, I, I, I take I took an advocacy class that was an elective in my MPH, and, you know, professors, you know, all about health policy. And, you know, I talked about, you know, one of the projects I was talking about was the Maya, you know, the Medicare audiologist in access improvement. And, you know, and why he did it. And, you know, I brought up so moving back hearing aids, and they’re like, Well, you know, it’s covered by hearings, and I’m like, no, no, Medicare doesn’t cover caring. And this is, and everybody was like, Why, right? Why, you know, and so, even just basics like that, you know, people don’t understand until they’re in that position where they need Medicare, or their family needs Medicare, you know, and so, yeah, that the weeds up infinitely need those other professional, you know, connections to help, you know, help us, you know, help us understand, you know, where we can, you know, take things like so, from a policy perspective, where can we go, we need that support of other professions? And just really being aware of how small piarc alright, you know, and how many patients really are out there. And I think, you know, when you look at that, that he cast report that came out, that kind of was this catalyst towards OTC, you know, one of the issues was, you know, affordability. But if you really look at that, it’s really about access to and how few patients have access to, you know, audiologist, either because of financial or because of just location, like rural aspects, you know, just how you audiologists there are. So it’s, yeah, we have, we have a lot of opportunity to expand our reach through, you know, various different mechanisms between education of our colleagues, policy, all sorts of avenues that we can go down. We didn’t think about it.
Dave Kemp
I know, I mean, it’s like, again, to just kind of like, you know, close the loop on this whole conversation, I think, you know, you have, I think audiology has such a incredibly opera, incredible opportunity here. Because think of the thick of the equation here and how much better off it is this way, rather than the opposite, which is, you don’t you have a shortage of labor, which is bad for the public, but it’s good for you as the professional because there’s a ton of demand, and there is a lot of demand, you have an aging population that’s becoming more educated on the various roles that the audiologist plays. And then you have all of this stuff that’s happening now, from a public health standpoint, looking at the larger, broader impact of, you know, what hearing loss ultimately might sort of be tied into. And I think that, you know, just looking at the big picture here, it’s like, it’s never been more needed by more people. And there’s just not a lot of people that do it. And so I think that while it’s concerning about, you know, the, you know, there’s obviously a lot of concerns with the debt, and as a young professional, like incurring all that, and I don’t know, how this all shakes out from a, you know, from like a business standpoint, in terms of where the revenue generation is gonna come from in five years, 10 years from now, but I think it’s undeniable that there is like this market demand for this kind of medical professional, and I think that it’s gotta be really exciting from that stamp. point of like, really, in many, many ways, I don’t think that audiology has, like, really come into its own. And it’s exciting to think about what that would look like. Because I think it’s just becoming more and more obvious of how important this specific type of medical professional is to the, to the broader, you know, like healthcare ecosystem.
Tish Gaffney, Au.D.
I agree. And I think that’s, yeah, we have we have a lot to work a lot of work to do. But I think you’re right, I think, you know, you know, they’re watching the profession kind of freak out a little bit about OTC you know, leading up to it, and the other this Chicken Little The sky is falling, and I don’t think that’s the case, I think we have more opportunities, you know, to rethink how we can impact our paychecks. And, you know, the, the hearing aid is one small part of it. And I think going back to kind of everything we’ve talked about, you know, we have a lot of opportunity within our specialties and watching those specialties grow, and being able to, you know, impact patients with hearing aids with hearing care, tinnitus, auditory processing, cochlear implants, vestibular like we have so much to offer. And so much of what we need, or what our patients eat, it is being provided by us, we just need to, you know, make sure everybody knows that. And you know, that we’re providing the highest level of care to us that we’re all you know, on board with best practices and things like that.
Dave Kemp
Then agree more with you Tish? Well, thank you so much for coming on today. Where can people connect with you if they want to reach out and reach up?
Tish Gaffney, Au.D.
So, um, you can find me so I am on LinkedIn, if you want to find me there. I think it’s under Tricia Gaffney. You know, you can find me if you just look at the faculty at Nova Southeastern University. I will become AAA president in 2024 in October, and you know, if you want to come to the conference in Atlanta this year, I would highly recommend it. You can track it down there. I will in there. And actually, this year, just to kind of side notes, we are bringing back trivial so if you were around 2014 was the last year trivial with Gus and Jerry. I said I am bringing you back I am posting with Ryan McCreary night. Oh, we are. So that will be at the end of the week. So you know, to kind of have some fun before everybody goes home.
Dave Kemp
Is it audiology specific trivia?
Tish Gaffney, Au.D.
So we are doing a mix. It’s going to be audiology trivia and some pop culture kind of mixed together. Cool. So a little bit for everybody. And we’re excited to kind of revamp, you know, the trivia the trivia bowl from when it was any other
Dave Kemp
I should have given you more of an opportunity to talk about this coming triple A, which will be you know, sort of under your purview, anything else that you want to shout out about Atlanta and what we should expect. I’m looking forward to it.
Tish Gaffney, Au.D.
So yeah, so this will actually be about quantum Balachandra this year I get to have New Orleans next year, but Oh, god, yeah, so but both braids like Elliott, I think is gonna be great. It’s, you know, it’s an easy place to get to sometimes the conferences can be in tough cities to travel to, but Atlanta is such a huge hub that it should be easy to get to. My favorites are always the Grand Rounds sessions. They’re always, you know, really interesting to hear what cases are going on. You know, last year, they introduced some roundtable discussions. Those were actually really fun. I went to the vestibular one and you know, about to talk with other vestibular colleagues from around the country and kind of seeing what we everybody was doing that was a new thing that was added last year. That’s gonna happen again this year. And then the Friday night party, which is a ticketed event, I think is that is gonna be at World coke. I’m really excited about that, because I’ve never the only time I’ve ever like really been to Atlanta was I was invited to speak at the Georgia Tech Academy meeting. And they had a snowstorm and so everything was shut down. I really liked sightsee but I’m excited to go to the world of coke. I’ve never been
Dave Kemp
I’ve ever been to Atlanta once as well. So I’m looking forward to it. And I’m very much looking forward to New Orleans in 2020.
Tish Gaffney, Au.D.
I’m very excited about New Orleans in 2020. I’ll
Dave Kemp
have to you know avoid talking about that with au because she still has PTSD from the 2020 in New Orleans show that was supposed to be our was supposed to be in New Orleans it got cancelled the AAA that never was the one that she helped plan so she she still has like a little PTSD anytime I mentioned.
Tish Gaffney, Au.D.
I have to do something special for AU I in New Orleans that year. I love
Dave Kemp
for sure. Awesome. Well tus thank you so much. I really We enjoyed this conversation. I really enjoyed learning from you and kind of getting a sense of what you’re hearing on the front lines with, you know, hat Nova, some of the career advice that you’ve given, and just kind of where the profession is going. So thank you so much. Thanks for everybody who tuned in here to the end. We will chat with you next time. Cheers.
