By Nancy J. Rennert, MD and Carolyn Ginsburg Stern, MBA
Life in the year 2020 is certainly different – and healthcare is different, too.
With the Covid-19 pandemic, nonessential surgeries and procedures were suddenly postponed, office visits shifted from in person to virtual, access for visitors and interpreters was restricted, and everyone is now wearing face masks! So many new barriers for people with hearing loss — for patients, families and health care professionals, too. It is understandable that many have avoided non-emergency healthcare due to these challenges along with pandemic-related stress and fear. But, in fact, NOW is a great time to get that physical exam or schedule screening tests and routine appointments to take care of yourself and your family.
As health care professionals who use bilateral cochlear implants and manage our respective family’s health, we live with these challenges every day. We know how difficult and exhausting it can be to try to navigate the healthcare system, especially during these times; but it is also critical to take care of your health.
Why NOW is a great time to get medical care
Medical and dental practices and hospitals are taking extensive safety precautions. Patients and staff are screened for symptoms of Covid-19, and rooms and surfaces are cleaned thoroughly between visits. Despite this, in the last two months, 40% of people report avoiding or postponing medical care even if they have symptoms. Screening tests for cancer and heart disease have declined by 65%. It’s important to get checked, since early diagnosis and treatment often lead to better outcomes; uncontrolled chronic conditions such as high blood pressure and diabetes, can have serious long-term consequences. Although the pandemic presents additional challenges to those of us with hearing loss, there are also unique opportunities. It’s all about choosing the best options for you and preparing in advance! Here are some tools and strategies to try.
Effective communication strategies
How to access the healthcare TEAM and find your medical ALLY
Healthcare is a TEAM sport! Like all teams, medical professionals have different roles and work together to create comprehensive care. Look beyond the doctor. Many practices and hospitals have Physician Associates (PA) and Advanced Practice Nurses (Nurse Practitioners) in addition to registered and licensed nurses and medical assistants. These members of the team are often easier to reach, can handle many issues and have regular check-ins with the doctor.
It’s especially helpful if you can identify a medical ALLY – someone in the office or hospital who understands your needs and can make things go as smoothly as possible. This person may be the practice manager, an assistant or a medical navigator, for example. It is a good idea to ask who can best assist you with communication issues and contact that person prior to your visit. You may also want to connect with a medical TEAM member to arrange necessary accommodations and to answer any questions. These contacts can be done electronically, using a patient portal or email, if available, or by telephone or virtual (video) visit.
How to choose and use in-person vs. virtual visits (or both!)
With hearing loss, it’s important to find out what to expect for the different types of visits. For example, will the clinician be wearing a mask? Will it be video or by telephone? Are translation services (including interpreters and captioning) available? Can you use your own technology?
Sometimes you can choose the type of visit and sometimes in-person visits may be needed (for example when an examination, test or procedure is planned). Virtual visits are new to many patients and providers, and we are all trying to make them work better. You can request that someone contact you prior to the virtual visit to assist with technical details and discuss any assistive devices or other accommodations you may want to use. There is also the option of a virtual visit with video and assistive devices in addition to being in-person for tests or procedures. Let’s think about a medical visit not as a single event in time but include what happens before and after. Before the visit, contact a TEAM member to arrange necessary accommodations and to answer any questions. A virtual visit with a healthcare TEAM member after your visit can help to cross check details, confirm your understanding and give you another opportunity to connect.
Exploring technology options
Here’s where we get creative! A variety of practical tools including patient portal messaging, speech to text apps, videoconferencing (including family and interpreters), assistive listening devices, clear masks and others can help. See below for a list of these tools and links for more information. We encourage you to give them a try.
What to do when it does not go as expected and how to pivot
Ultimately communication is a two way street. Remember to set the tone, be kind, find common goals and try to be as flexible as possible. Work through the barriers and the unexpected with your medical ALLY and TEAM and include interpreters and family members (virtually if not in person). Consider a real-time pivot and even a complete reset if needed. There is always another opportunity to connect after the visit and technology can help.
CHC’s September 30th webinar
We enjoyed preparing for and participating in CHC’s webinar Health Care, Hearing Loss and Communication Challenges: Taking Charge in 2020 and Beyond. For those who joined us for the live webinar, we hope you found the “behind-the-scenes” view interesting and that you will try some of the practical strategies and tools we discussed to optimize real-time communication at the point of care. We know this is a trying time and hope our suggestions can make it all a little easier for you.
The webinar video will be available here very soon. Please stay tuned.
Survey for webinar participants
Those of you who attended the live webinar on September 30th and have not yet taken our brief survey are invited to do so now. We appreciate your feedback.
We’re pleased to share the following list of resources (with links for more information) to help you get the most out of your visits with health care providers. Click the links below to learn more about these products and resources and to get the most up-to-date contact information.
Click here for our Tip Sheet for Individuals with Hearing Loss about how to prepare for and manage health care visits and communication.
Click here for our Tip Sheet for Your Medical Team that we encourage you to share with your health care providers. We suggest you add individual details about your hearing loss, how you prefer to communicate and the tools you would like to use at the visit.
Click here to view the webinar presentation deck.
Where to buy clear masks
Safe’N’Clear » (FDA approved)
The Clear Mask » (FDA cleared)
Many other clear mask options are available online.
Telephone relay services (TRS) for captioning
The following captioning phones and apps can be integrated with videoconferencing platforms used for virtual health visits.
InnoCaption’s DeskView » (Links with all videoconferencing platforms)
Videoconferencing platform with embedded captions
Big Note app
Video relay services for sign language
The following can be used with videoconferencing/televisits
Assistive listening devices
For guidance on which assistive listening devices are best suited for your hearing loss and/or your hearing aids or cochlear implants, please discuss with your audiologist. Click here to learn more about assistive technology.
Personal sound amplifiers (PSAPs)
Personal sound amplifiers can offer assistance to people with hearing loss who do not use a hearing aid. Acoustical benefit will vary by individual and degree and type of hearing loss. Two PSAP manufacturers to consider are:
Live Listen App and AirPod Pros
Sound Amplifier App by Google
HLAA health care and communication guide
This excellent resource from the Hearing Loss Association of America was developed by Toni Iacolucci and Jody Prysock.
Nancy J. Rennert, MD
Dr Nancy J. Rennert is System Chief of Diabetes Care, Nuvance Health, Chief of Endocrinology and Diabetes, Norwalk Hospital and Associate Clinical Professor of Medicine at Yale School of Medicine and The University of Vermont Larner College of Medicine. Her leadership of the multi-hospital Glycemic Care Team, which aligns clinical care with quality improvement, has been recognized nationally. Dr Rennert has extensive experience in medical school admissions, fellowship, residency and medical student training and mentorship for quality improvement and clinical research. She has a longstanding, deep commitment to care for the underserved and marginalized at a Federally Qualified Community Health Center in Connecticut. While pregnant with her third child, Dr Rennert experienced sudden and profound bilateral deafness and uses two cochlear implants. She has been a member of the Association of Medical Professionals with Hearing Loss (AMPHL) since its founding, published on stethoscope use and mentors aspiring and early career hearing impaired medical professionals. She is passionate about health care access, quality and equity and is looking forward to sharing insights from her professional and personal experiences.
Carolyn Stern, MBA
Carolyn Ginsburg Stern is the assistant director of outreach and strategic initiatives at the Center for Hearing and Communication (CHC). As a bilateral cochlear implant user, she helps others hear and connect better with tips, technical information and support and is passionate about the role of healthy hearing in helping people lead productive and connected lives. Carolyn earned her BA from Northwestern University and MBA from Columbia University’s School of Business.