Change Resistance and Clinical Practice Strategies in AudiologyFunding This study was funded by the Towson University Graduate Student Association.
Background Audiology is experiencing pressure from market forces that may change the profession's nature. Research suggests that understanding resistance needs to change and organizational culture may provide insights that can facilitate change.
Purpose This study was designed to examine audiologists' resistance to change, organizational culture, and clinical practices related to hearing aid pricing and audiology assistants.
Research Design This study utilized a cross-sectional and nonexperimental survey design.
Study Sample Participants were 205 U.S. audiologists, representing diversity across experience, work setting, and location.
Data Collection This survey examined demographics and clinical practice strategies. Resistance to change (RTC) scale examined disposition toward change. Organizational culture profile (OCP) examined organizational culture perspectives.
Results The majority (52%) of respondents use bundled pricing but 42% of these repondents anticipate transitioning to unbundling. Use of hybrid pricing is increasing. Service-extender personnel were reported by 41%. Although the majority (66%) do not work with audiology assistants currently, 32% of these participants anticipate they will do so in the future. Results indicated lower RTC and greater years of experience were associated with more positive perceptions about organizational culture. Pricing structure was related to experience.
Conclusion Trends indicate use of bundled pricing is decreasing, use of hybrid pricing is increasing, and employment of audiology assistants is increasing. Experienced audiologists are more likely to report unbundled and hybrid pricing compared with less experienced audiologists.
Eingereicht: 19. Januar 2022
Angenommen: 26. April 2022
Accepted Manuscript online:
02. Mai 2022
Artikel online veröffentlicht:
23. Dezember 2022
© 2022. American Academy of Audiology. This article is published by Thieme.
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- 1 Amarantou V, Kazakopoulou S, Chatzoglou P, Chatzoudes D. Attitude toward change: Factors affecting hospital managerial employees' resistance to change. In: Kavoura A, Sakas DP, Tomaras P. eds. Strateg Innov Mark. Switzerland: Springer Cham; 2017: 251-257
- 2 Sweetow R. Hearing aid delivery models: part 1 of 2. Audiol Today 2009; 21: 49-58
- 3 Oreg S. Personality, context, and resistance to organizational change. Eur J Work Organ Psychol 2006; 15: 73-101
- 4 Zaltman G, Duncan R. Strategies for Planned Change. New York, NY: John Wiley & Sons; 1977: 63
- 5 Scott-Findlay S, Golden-Biddle K. Understanding how organizational culture shapes research use. J Nurs Adm 2005; 35 (7-8): 359-365
- 6 Schein EH, Schein P. Organizational Culture and Leadership. 5th ed.. New York, NY: John Wiley & Sons; 2017: 6
- 7 Coverstone JA. Fee-for-service models in audiology practices. Audiol Today 2011; 23: 36-46
- 8 Hamill TA, Andrews JP. Audiology assistants in private practice. Semin Hear 2016; 37 (04) 348-358
- 9 Windmill IM, Bishop C, Elkins A, Johnson MF, Sturdivant G. Patient complexity charge matrix for audiology services: a new perspective on unbundling. Semin Hear 2016; 37 (02) 148-160
- 10 Windmill IM, Freeman BA. Demand for audiology services: 30-yr projections and impact on academic programs. J Am Acad Audiol 2013; 24 (05) 407-416
- 11 Fabry D. What gets measured gets done: calculating the value of professional service. Semin Hear 2019; 40 (03) 214-219
- 12 Abrams H. Audiologists respond to disruption with best practices. Accessed January 19, 2022 at: https://www.asha.org/Articles/Audiologists-Respond-to-Disruption-With-Best-Practices
- 13 Fifer RC. Hearing aid reimbursement: a discussion of influencing factors. Semin Hear 2020; 41 (01) 55-67
- 14 Jilla AM, Johnson CE, Danhauer JL. Disruptive hearing technologies and mild sensorineural hearing loss I: accessibility and affordability issues. Semin Hear 2018; 39 (02) 135-145
American Speech-Language-Hearing Association.
. 2018 audiology survey: clinical focus patterns. 2018. Accessed May 24, 2022 at: https://www.asha.org/siteassets/surveys/2018-audiology-survey-clinical-focus-patterns.pdf.
- 16 Karzon R, Hunter L, Steuerwald W. Audiology assistants: results of a multicenter survey. J Am Acad Audiol 2018; 29 (05) 405-416
- 17 Hearing professional dispensing survey. Accessed January 19, 2022 at: https://hearinghealthmatters.org/wp-content/uploads/sites/6/files/2018/09/aud-survey2a.pdf
- 18 Antonites A, Ross A. Audiology, entrepreneurship and innovation: a perspective on private practice. Afr J Entrep Small Bus Manag 2013; 6: 87-114
- 19 Choi M. Employees' attitudes toward organizational change: a literature review. Hum Resour Manage 2011; 50: 479-500
- 20 Mareš J. Resistance of health personnel to changes in healthcare. Kontakt 2018; 20: 262-272
- 21 Rubenstein LV, Pugh J. Strategies for promoting organizational and practice change by advancing implementation research. J Gen Intern Med 2006; 21 (Suppl. 02) S58-S64
- 22 Oreg S. Resistance to change: developing an individual differences measure. J Appl Psychol 2003; 88 (04) 680-693
- 23 Sarros JC, Gray J, Densten IL, Cooper B. The organizational culture profile revisited and revised: an Australian perspective. Aust J Manag 2005; 30: 159-182
- 24 Sjoblad S, Warren BW. Can you unbundle and stay in business?. Audiol Today 2011; 22: 37-45
- 25 Nemes J. To bundle or not to bundle? That is the question. Hear J 2004; 57: 19-20 , 22, 24
- 26 Hearing Health & Technology Matters. The 2020 audiology professional dispensing survey. Accessed January 19, 2022 at: https://hearinghealthmatters.org/hearingnewswatch/2020/audiology-professional-survey/
- 27 Hammill T, Freeman B. Scope of practice for audiologists' assistants: Survey results. Audiol Today 2001; 13: 34-25
- 28 Andrews J, Hammill T. Audiology assistant scope of practice and utilization. Audiol Today 2017; 29: 48-55
- 29 American Speech-Language-Hearing Association. Support personnel excluding school settings. Accessed January 19, 2022 at: https://www.asha.org/uploadedFiles/Support-Personnel-Excluding-School-Settings.pdf
- 30 American Speech-Language-Hearing Association. 2020 standards for ASHA audiology assistants certification. Accessed January 19, 2022 at: https://www.asha.org/Certification/2020-Audiology-Assistant-Certification-Standards/
- 31 Carlström ED, Ekman I. Organisational culture and change: implementing person-centred care. J Health Organ Manag 2012; 26 (02) 175-191
- 32 Johansson C, Åström S, Kauffeldt A, Helldin L, Carlström E. Culture as a predictor of resistance to change: a study of competing values in a psychiatric nursing context. Health Policy 2014; 114 (2-3): 156-162
- 33 Carlström E, Olsson LE. The association between subcultures and resistance to change–in a Swedish hospital clinic. J Health Organ Manag 2014; 28 (04) 458-476
- 34 Doucette WR, Nevins JC, Gaither C. et al. Organizational factors influencing pharmacy practice change. Res Social Adm Pharm 2012; 8 (04) 274-284
- 35 Rosenthal M, Tsao NW, Tsuyuki RT, Marra CA. Identifying relationships between the professional culture of pharmacy, pharmacists' personality traits, and the provision of advanced pharmacy services. Res Social Adm Pharm 2016; 12 (01) 56-67
- 36 Luetsch K. Attitudes and attributes of pharmacists in relation to practice change - a scoping review and discussion. Res Social Adm Pharm 2017; 13 (03) 440-455.e11
- 37 Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change?. Can Pharm J 2010; 143: 37-42
38 American Speech-Language-Hearing. (2021). 2021 Member & affiliate profile: annual demographic & employment data. Accessed May 24, 2022 at: http://www.asha.org/siteassets/surveys/2021-member-affiliate-profile.pdf.