Overcoming barriers to person-centered care

By Shari Eberts

In my ideal world, I imagine an audiology appointment that is all about me — my hearing loss, my lifestyle, my communication needs, and my struggles. The audiologist would ask about the listening situations that are most challenging for me, discuss what solutions I am currently using, and make recommendations for ways to boost success. Of course, there would also be a hearing test, a physical examination of my ear and an inspection of any devices I currently used, but the primary focus would be me and the best way to solve my hearing problems. Sometimes this feels far away from the typical patient’s experience. 

Person-centered care (PCC) could make this a reality. Like most people with hearing loss, I wish all providers practiced PCC at every appointment. From the patient’s perspective this includes four main parts: (1) Partner with your patient, (2) Make your office hearing-loss friendly, (3) Embrace creativity and (4) Think beyond the technology. You can read about each of these components in my e-book Person-centered Care from the Patient’s Perspective which is based on a series of articles I wrote for Ida Institute.

Possible barriers to person-centered care

While many audiologists believe strongly in PCC and would like to implement its tenets at every appointment, barriers do exist. Some worry there isn’t enough time in the appointment to carry out all the needed technical tasks, let alone the more personal approaches. Others feel uncomfortable with emotional conversations or believe they have not been trained appropriately for this aspect of care. Audiologists may discern that their patients are already doing fine without these added steps, or that they must focus on selling hearing aids to stay in business. These are all valid concerns. Here are my suggestions for overcoming them. 

There is not enough time in the appointment 

Have your patients answer specific questions related to their hearing loss in writing prior to the appointment. This should include things like the situations where it is easiest and hardest for them to hear and what hearing goals they have. These types of questions will help them think through their answers ahead of time so the conversation will be more efficient. Ida’s Living Well tool is a good model for this. Ask family and friends to provide input in a similar way to gain a more complete view of the patients’ challenges. 

At the appointment, set the stage, letting your patients know the general flow of the appointment and how much time is allocated to each portion. Patients are more likely to keep their commentary to the most important aspects if they know additional steps lie ahead. If you still keep running out of time at every appointment, consider lengthening the time you set aside for different types of appointments and charging accordingly. 

Emotional discussions make me uncomfortable

This is true for many people. More training on counseling is likely needed, both as part of the initial audiology degree curriculum, and as continuing education. You may need to find alternative ways to learn these skills. Find a colleague that is good at this part of the job and get tips from them. Role playing is also a relatively easy and cost-effective way to hone your skills and become more comfortable with different situations. 

My patients have always done fine without it

Maybe this is true, but perhaps they would do even better with it. Conduct a survey to see how satisfied your patients are with their care. Take a look at the trend in your referral rates from existing patients. Does that indicate increasingly satisfied customers? Even if your patients have always done fine without PCC, the standard of care may be changing and you don’t want to fall behind. Stellar PCC is a great way to set yourself apart from your competition. 

Selling hearing aids is my livelihood

Maybe it is time for a financial audit of your practice to see if your pricing is appropriate. Are you valuing your time as highly as you should be? Can you make any changes to your cost structure or think about unbundling your fees to charge for your time and services separate from the hearing aids? Taking a clean eye at your business model could help you identify profitable new areas of focus and free you up to incorporate PCC more effectively. 

Change is hard, so don’t be discouraged if PCC seems difficult to implement. Experiment with a variety of procedures and methods to find what works best for your practice and keep in mind that change can be gradual. Don’t feel like you need to change everything overnight. Educate yourself on new trends through Ida’s Inspired by Ida certification program. It walks you through the practical steps needed to implement PCC in your practice. Upon completion, your clinic will receive an Inspired by Ida certification showing your dedication to PCC. 

Shari Eberts is a hearing health advocate, writer, speaker, and avid Bikram yogi. She is the founder of Living With Hearing Loss, a blog and online community for people living with hearing loss and tinnitus. She also serves on the Board of Hearing Loss Association of America. Shari has an adult-onset genetic hearing loss and hopes that by sharing her story she will help others to live more peacefully with their own hearing issues. Her e-book, Person-centered Care from the Patient’s Perspective, details her experience living with hearing loss. She hopes the book will provide audiologists with valuable insights they can use to make their practices more person-centered. Connect with Shari: Blog, Facebook, LinkedIn, Twitter.