Maybe Audiologists Are Too Attached to the Medical Model

The medical model governs many of the practices of audiologists. It dictates the vocabulary they use to talk about their services and it prescribes a causal logic when they engage in diagnoses and rehabilitation. This article, while acknowledging the usefulness of the medical model, invites audiologists to consider alternative models to broaden their thinking and expand their services to their patients. The social and narrative models are offered as alternatives and/or supplements to the medical model. In the social model the emphasis is on identifying barriers to social engagement and facilitating social access for those with hearing impairment. In the narrative model, the emphasis is on aligning with patients as they deal with personal issues associated with a hearing impairment. To pick the best model for service provision, it is recommended that audiologists examine their own values and the situational requirements for particular practices. If the workplace militates against certain practices, it is recommended that audiologists avoid taking “no” for an answer. Instead they should consider ways to try out and advocate for new models.

KEYWORDS

Medical model - social model - narrative - service delivery - value-based practices

REFERENCES

• 1 Texas Speech-Language and Hearing Association .Minutes of the Educational Audiology Caucus. 2000 Available at: http://www.txsha.org/prof_issues/caucus.html
• 2 World Health Organization .International Classification of Functioning, Disability and Health (ICF). Geneva, Switzerland; World Health Organization 2001 Available at: www3.who.int/icf/icftemplate.cfm
• 3 Swain J, Finkelstein V, French S, Oliver M Disabling Barriers-Enabling Environments. London, UK; Sage Publications 1993
• 4 Tregaskis C. Social model theory: the story so far.  Disability and Society. 2002;  17 457-470
• 5 Barnes C, Mercer G, Shakespeare T. Exploring Disability: A Sociological Introduction. Cambridge, UK; Polity Press 1999
• 6 Groce N. Everyone Here Spoke Sign Language: Hereditary Deafness on Martha’s Vineyard. Cambridge, MA; Harvard University Press 1985
• 7 Maxwell M, Poeppelmeyer D, Polich L. Deaf members and nonmembers: the creation of culture through communication practices. In: Kovarsky D, Duchan J, Maxwell M Constructing (In)Competence: Disabling Evaluations in Clinical and Social Interaction. Mahwah, NJ; Lawrence Erlbaum 1999: 125-148
• 8 Flores K. Eradicating the deaf world. Available at: http://www.delmar.edu/socsci/rlong/creation/kristina.htm
• 9 English K. Psychosocial aspects of hearing impairment and counseling basics. In: Schow R, Nerbonne M Introduction to Audiologic Rehabilitation, 4th ed. Boston, MA; Allyn & Bacon 2002: 225-246
• 10 English K. Psychosocial aspects of hearing impairment and counseling basics. In: Schow R, Nerbonne M Introduction to Audiologic Rehabilitation, 4th ed. Boston, MA; Allyn & Bacon 2002: 225-246
• 11 Maynard D. The perspective-display series and the delivery of diagnostic news. In: Boden D, Zimmerman D Talk and Social Structure. Berkeley, CA; University of California Press 1991: 164-192
• 12 Maynard D. On “realization” in everyday life: the forecasting of bad news as a social relation.  Am Sociol Rev. 1996;  61 109-131
• 13 Maynard D. The news delivery sequence: bad news and good news in conversational interaction.  Res Lang Soc Int. 1997;  30 93-130
• 14 Byng S, Cairns D, Duchan J. Values in practice and practising values.  J Commun Disord. 2002;  35 89-106
• 15 Duchan J. Frame Work in Language and Literacy. New York; Guilford Press 2004
• 16 Mishler E. The analysis of interview narratives. In: Sarbin T Narrative Psychology: The Storied Nature of Human Conduct. New York; Praeger 1986