By Don Nielsen, Ph.D.
The field of audiology is poised for a prosperous future characterized by promising developments in healthcare. In every corner, healthcare is being transformed by the emergence of Generative Artificial Intelligence (GenAI) and its powerful applications in genomics and precision medicine. The consequence of this transformation will be a complete revolution in the profession, as it redefines its fundamental principles and establishes a cutting-edge operational model to maximize healthcare potential.
This transition will fundamentally transform HHC and challenge the longstanding assumptions that have directed our actions, roles and boundaries. Audiologists are called to embrace a new mindset, develop innovative strategies and deliver services that foster sustainable, transformative changes. The significance of this transition cannot be overstated, as it enables us to address the dynamic demands of Hearing Healthcare (HHC) and drives the progress of audiology as we embrace a GenAI-driven system, all while staying true to our core principles. This article is the first installment in a series designed to empower AuD students to navigate this transformation.
Resistance to Change
Anytime we face change, we can frame it as a threat or an opportunity. Our reliance on what we have always done, our struggle to keep pace with rapid technological advancements and our fear of the unknown all contribute to framing the transformation as a threat. When we frame these transformations as a threat, it’s easier to continue traditional HHC approaches than it is to realize the opportunity new changes could provide. Understanding these challenges is the first step towards preparing for HHC’s transformation. We will provide a more thorough analysis of the details of this transformation in the following articles.
Experts Say It’s Impossible and Dangerous!
For years, experts said that the human body is incapable of running a four-minute mile. It isn’t just impossible, they said; it is dangerous. Then, in 1954, Roger Bannister ran the four-minute mile in 3:59.4, doing the impossible. As a youngster, this event taught me that the impossibledoes not mean it can’t be done. It just means we haven’t done it yet. My experience in healthcare research has taught me that doing the impossible also applies to medicine.
In graduate school in the 1960s, we were taught that there was no sensory neural hearing loss treatment, and it was impossible to see how the problem could ever be solved. Then, in 1974, I attended the First International Conference on Electrical Stimulation of the Acoustic Nerve. The conference was a raucous debate, with some of the country’s most respected scientists saying the cochlear implant (CI) would never work. It was impossible! They also raised concerns that the CI was dangerous because it could cause brain infections. But as with the four-minute mile, the expert nay-sayers were wrong. Today, more than one million CI devices are implanted worldwide. We even have brainstem implants for patients whose auditory nerves are cut to treat their Neurofibromatosis type 2.
While this series introduces new ways to practice and deliver hearing healthcare, it’s essential to acknowledge that experts may strongly criticize some as dangerous or impossible. But remember, what appears impossible at first may only be a few conquerable steps away from possible.
The Tradition Trap
One of the greatest challenges to transforming HHC is tradition and precedent. People and their professions are often trapped by implicit historical concepts that guide their decisions and actions. Because many of these concepts are not conscious, they can’t be refuted with data or logic. But consciously or not, they influence actions and create precedents over time. So, precedent becomes crucial in influencing healthcare practices.
Unfortunately, the implicit and unverified assumptions precedent brings to the table often promote obsolete historical perspectives that restrict or deny promising new medical procedures, thus hindering the advancement of current and future healthcare services. Here are five ways tradition and precedent traps the advancement of healthcare (Pfeffer et al., 2000).
- When your profession, university or clinic has a strong identity, anything new is considered “inconsistent with who we are,” thus denying or delaying constructive change that may require rethinking or redefining the group’s identity.
- When you’re pressured to stay consistent with past decisions, avoid admitting mistakes and minimize challenges. This resistance is often seen in healthcare, where errors can be disastrous, making them challenging to admit.
- When people have strong needs for cognitive closure and avoiding ambiguity, as we often experience in healthcare.
- When decisions are made based on implicit, untested and inaccurate models of behavior and performance. “It’s the way we have always done it.”
- When people carry expectations from the past about what is and isn’t possible and what can and can’t be done in the future. This is often the first challenge experienced when considering novel or innovative changes.
To flourish during this HHC transformation, we must identify and eliminate these history-based barriers to doing things differently. This requires altering systems or structures that undermine the change vision.
Overcoming ingrained behaviors can be difficult but not impossible. Freeing ourselves and our clinics, universities and professional organizations from the limiting restrictions of precedent requires that we bring to the surface the implicit assumptions on which past decisions rest. Once we decide to make changes, we must carefully consider which practices to keep, which to invent and which to borrow from other groups. We can also build a culture that encourages people to question tradition and resist automatic reliance on old ways of doing things. For instance, we can encourage continuous learning to ensure precedent never eclipses positive change. We can also decentralize decision-making to motivate people to learn. In a decentralized organization, people are responsible for educating themselves prior to decision-making rather than relying on direction from above.
Understanding and adopting these precedent-freeing strategies will help you thrive in the fast-changing world of HHC. As you progress on your professional HHC journey, you will embrace these strategies in groups that strive to be leaders and incorporate novel HHC practices.
The Technology-Driven Advancements Trap
Striking technological healthcare advances are announced regularly. However, while innovative technology changes rapidly, professions, stifled by tradition and self-interest, change slowly (Susskind, R., Susskind, D., (2022). As time passes, the gap grows between flourishing technologically driven advances, like artificial intelligence and genomics, and audiology’s ability to keep pace. We have the opportunity and responsibility to close that gap.
Closing the gap is not easy. These transformations are disruptive, even destructive, of best practices and current healthcare and business models. They involve radical change and introduce promising alternatives to traditional practice. This series of articles will help you navigate this transformation that will dominate much of your professional life.
The Fear Trap
Transformation raises fear of an unknown future. It is the fear that accompanies uncertainty. To increase the odds that a new healthcare operating model will be effective today, leaders must ensure that the model addresses the problems of operating under highly uncertain conditions. Here are some transformation concerns and pitfalls that fear and uncertainty create (Roberto, (2011).
- There is fear of personal failure, as people worry about whether they can succeed in a new environment and whether their power, status or even job security will be lost in the transformation.
- Paralysis is also an issue during uncertainty. Employees may be concerned that the transformation cost may exceed the benefits, and the resulting turmoil can lead to paralysis.
- AI and genomics may threaten personal values as employees become concerned about the new ethics of the transformed HHC and whether those values will resonate with them.
- If people perceive a loss of control over their career and work, this will also inhibit the transformation.
We need to provide people with the knowledge they need to alleviate fear of the unknown. A proven way to accomplish this is to give them a vision of the future that explains how this healthcare transformation will benefit them and their patients. Persistent, interactive communications are required to clarify the unknown and build trust in the transformation.
Incorporate the Change into the Culture
The knowledge that transformation is necessary isn’t always enough to alter behavior. We must develop strong relationships that give people hope that change is possible and positive. We must adopt a long-term transformation-focused mindset. We must repeatedly learn, practice and master activities and actions that allow and facilitate the changes we are trying to make. The main objective of these articles is to help you reframe your mindset, empowering you to take charge of the future and develop the courage to lead in this revolution.
Resources
Transformational Leadership: How Leaders Change Teams, Companies, and Organizations
By Roberto, M. A., (2011), The Teaching Company, The Great Courses, Chantilly, VA.
Discover an essential handbook for strategies, concepts and insights into the dynamics of transformational leadership in these 24 lectures, which take you on an in-depth examination of the leadership behaviors and capabilities essential to creating positive change in teams and organizations. Filled with case studies and lessons from leaders in business, politics, sports and the military, as well as a range of specific skills and strategies you can use in your career, this lecture series is an authoritative guide to successful transformational leadership.
Professor Roberto has arranged Transformational Leadership into four key modules, each of which offers a focused look at a particular aspect of leadership: models of leadership (which surveys critical issues such as human behavior and long-term goals); the change process (which focuses on resistance to change as well as ways to institutionalize it); critical skills and capabilities (including motivation, persuasion, negotiation and teamwork); and creativity, innovation and learning (which is devoted to everything from after-action reviews to systems thinking to mentoring). This is a stirring call to responsible leadership and a learning experience that’s as informative as it is inspiring.
The Knowing-Doing Gap: How Smart Companies Turn Knowledge into Action.
Pfeffer, J., Sutton, R., I. (2000) Harvard Business School Press.
The Knowing-Doing Gap is the first book to confront the challenge of turning knowledge about how to improve performance into actions that produce measurable results. Jeffrey Pfeffer and Robert Sutton, well-known authors and teachers, identify the causes of the knowing-doing gap and explain how to close it.