Questions for the American Academy of Audiology, Specifically Related to the "Supporting Expanded Access to Audiologists Policy Position Statement"

American Academy of Audiology

I just read the American Academy of Audiology’s (AAA) “Supporting Expanded Access to Audiologists Policy Position Statement” that was released on November 6, 2024. I have read it over and over several times and each time I am left with more questions than answers.

If a national professional association creates a position statement that potentially affects all professionals, that professional association should be prepared to address questions from all professionals, even those who are non-members of their professional association.? After reflection and in that vain, I pose the following questions to AAA leadership:

• AAA is asking audiologists to follow their tutelage. As a result, what successful federal initiatives has AAA introduced and spearheaded, especially in the past decade? Have any been successfully enacted?
• AAA mentions that Academy members “provide only those services that they are competent and licensed to perform based on their education, training, and experience” and to practice in accordance with the Academy’s Code of Ethics”. I have a question related to this statement: Has AAA ever sanctioned or revoked the membership of a member because of an ethics violation? If not, then why does this matter?
• Can AAA provide examples where they have successfully engaged in state advocacy? Where and how have AAA engaged?
• AAA states that ?“the Academy is well positioned to assess whether local legislative proposals conflict or have messaging that conflicts with other legislative priorities in the state and federal arenas” .? How are AAA well positioned? Does AAA employ a lobbyist? Why is ASHA (with its human and financial resources and audiology membership numbers) or ADA (who has a history of engagement on the state and national levels, including employing a lobbyist) not better or equally situated?
• Has AAA spoken to ASHA, ADA, or any other professional association (ie AAO-HNS) about this position statement? Do they share AAA’s sentiments and positions?
• What ideas, processes, education, and resources can AAA offer members and state associations?
• Will AAA’s state and federal resources be shared with non-AAA member audiologists, like ASHA and ADA does?? If not, why should the entire profession follow any aspect of AAA’s position statement if its access is restricted?
• What is AAA’s opinion and position on modernization bills that have already passed in many states, including but not limited to Maryland?
• AAA states that AAA will “carefully assess the potential benefits (improved access, improved quality of care, reimbursement potential, etc.) against potential costs (increased legal liability, payment failure, reputation loss when individual practitioners fail to meet expected standards of care, etc.) and communicate these to local proponents. How will AAA do that? Who will do that? What if other national associations or, more importantly, the leaders in that state, disagree with AAA’s assessment? Is AAA’s support solely tied to their adherence to AAA’s opinion?
• AAA state that AAA want to “promote standards for audiology curriculum and continuing education offerings that align with the local legal scope of practice”. What are those standards? How will you do that given that the majority of AuD courses are not ACAE accredited?
• I am interested in what AAA believes is the full scope of practice of audiology. Can AAA share this with the audiology community? The ASHA scope of practice can be found at https://www.asha.org/policy/sp2018-00353/?srsltid=AfmBOooywMHyVZML-8bV137bLpyWV2ORYj-TpRTcqAKQI--KWtxWxxHx and the ADA scope of practice can be found at https://www.audiologist.org/students/prospective-students/scope-of-practice. I looked an I could not find a scope of practice document available. I admit that it could exist within the member firewall.
• What if the audiologists in a given state already are “fully comprehending any proposed legislation's potential beneficial and adverse effects on the practice of audiology”? Is AAA planning to formally weigh in, even if AAA was not asked by a state association to engage and if it conflicts with the thoughts of the leaders in that state?

I have been involved in state and federal advocacy for most of my career and been heavily involved in many legislative activities. Here are my closing thoughts on this position statement.

• Audiologists in any given state should have the right to fulfill THEIR own destinies.? These audiology leaders should be supported in their efforts by national associations, within the time limitations of the legislative process and in the means requested by the state leaders.
• State association and advocacy leaders from across the country should be part of these stakeholder discussions about scope modernization, not just national association leadership.
• The leadership or advocates of other national stakeholder associations, including smaller organizations (those part of the Audiology Quality Consortium), should be approached and included as EQUAL partners in this discussion to make sure the needs of ALL audiologists and all patients are considered in legislative initiatives.

As AAA is proposing things that affect all audiologists, not just AAA members I think it is important for all of us to know the answers to these questions.? The position statement was not very defined or prescriptive.