Becoming a Nonprofit Audiologist: Jill Sheehan, AuD

Dr. Sheehan is a licensed audiologist, holding a master’s degree (MS) from Purdue University and a doctoral degree (AuD) from Salus University. She has been practicing in the Fort Wayne, Indiana area for the past 20 years, specializing in pediatric and adult diagnostics and hearing aid fittings, including Auditory Processing Disorders. Dr. Sheehan started out as a volunteer audiologist with GiveHear, investing her talents in many of GiveHear’s patients since 2014. Building authentic relationships with her patients is at the core of her mission to change their lives.

1. At what point did you decide that you wanted to study Audiology?
I went to Purdue University and started my undergrad education in nuclear pharmacy. I quickly realized that sitting in a lab all day was not for me. I loved the science but also wanted to work with people, so my dorm counselor, who was in her masters in Speech Language Pathology, suggested that I try the intro to audiology class. I did and the rest is history.

2. What made you become involved in a nonprofit?
I have been an audiologist for almost 20 years. I started at a large ENT practice and was there for 12 years, and then I left to start a private practice.  While running my private practice, I met the founder of the non-profit where I am currently working. At that time, the organization had just begun and I was asked to volunteer one day a week seeing patients. As the non-profit very quickly grew,  they needed space to move into for an expanded three days/week clinic.  They moved to my private practice space and leased space from me and I saw patients for them three days a week. Again, we grew very quickly over the next three years and we realized that more space and time were going to be needed to care appropriately for the growing need in our community.  So, at the beginning of 2018, I was asked to come on full time with GiveHear and to be the Director of Audiology running the non-profit clinic.  I closed my private practice and moved to the non-profit full time.  Many questioned my motives and thought the big transition for me was because the private practice was not working out, but I decided to do this full-time because I am passionate about our mission and the unprecedented work I am able to be a part of for our community.

3. Where do you get your funding?
GiveHear is a 501(c)(3) nonprofit hearing center providing hearing healthcare to low-income adults and under-served children in our community. We rely on the support of our community through grants, donations, corporate sponsorship, and volunteers to make our programs sustainable.  In return, our unique Circle of Giving model gives our patients the opportunity to give back to the community through volunteer hours.  For every hearing aid our patients receives through GiveHear, they return a designated amount of volunteer hours to their community.  This is our way of saying “thank you” to the funders and donors that make it possible for our patients to receive the “Gift of Hearing”.

4. Do patients need to pay for the services or are they free of charge?
We are not a free clinic. We operate on a reduced fee, sliding scale basis to make hearing healthcare affordable. The sliding fee scale, based on income and household size, includes individuals from below the federal poverty level up to those families who are 250% above poverty level (for example, a family of four bringing in income of $62,750 or less would qualify for our services).  Our fees start at approximately 25% less than a private practice and decrease from there based on the sliding fee scale. For instance, if a hearing test is $75.00 for a full pay family that is at the top of the scale, that same testing would be $10.00 for a family at the lowest end of the scale. Hearing aids range from $800 down to $150 for the same hearing aid depending on the placement on the scale.  These hearing aids are equivalent to a Phonak V30 or V50 technology levels.  We also have a large donation program where we are able to recondition BTE or RIC aids donated to us and sell/fit them for $450 to $75 depending on the sliding fee scale placement. (These aids may be a high end hearing aid like Phonak B90 or Oticon Opn 1, just depending on what we have in the donated stock at that time, so patients are able to afford wonderful technology and not go without because of financing.)

5. What does your average day look like?
There is no average day in our clinic. Being that we provide such a variety in services, every day is different and I love it that way.  We do not schedule specific testing or services on a certain day, so I may have hearing aid fittings, cochlear implant activations, basic testing, BAHA evaluations, threshold ABRs, newborn hearing screenings… all on the same day. The next day may be all hearing testing or APD testing.  I never know how the schedule may look.  I could change that if I wanted to, as I am the Director of Audiology and set protocol for our clinic, but I truly like the variety of patients and schedule types.  I also enjoy the variety of ages and family types I am able to serve in my clinic.

6. What are some of the challenges in working in a nonprofit setting?
The most challenging part of the non-profit as a whole is raising funding and all of the work that it takes to pursue grants and donations. It is all necessary to be able to provide the same level of care and technology at an affordable cost that a for-profit practice is able to do because of their higher pricing.  Fortunately, at GiveHear, I am not responsible for the funding, so I am able to see the patients and simply provide care for them.  We do have a specific intake process where all patients must provide us with financial documentation and getting them to do this and bring all the paperwork is difficult at times. It is necessary that we follow the same process for every person and not vary it because of our non-profit status and annual auditing that is completed. The only frustrations that I personally struggle with are our higher than average no-show rate due to some of the population we serve (many patients lack reliable transportation, etc.) and paying for interpreters that come to these appointments.  It is a requirement to provide interpreting services for patients who need them and this costs around $100 per appointment. We cannot bill insurance or patients for this service. It is a great expense for us to cover when it doesn’t directly provide hearing health services for a patient. I am grateful for the interpreting services available for our patients, they are all wonderful, it is just that the expenses incurred for the services are quite expensive for a non-profit.

7. Does your location provide balance testing also?
No, I am trained and enjoy doing every part of audiology except balance testing. I specialize in pediatrics, but I do see all ages. GiveHear completes all types of ABR and hearing testing from birth to geriatrics, hearing aids and after care, cochlear implants, BAHA, Auditory Processing Disorder evaluation and referrals for rehabilitation (being the only providers for this testing from central IN up to MI), offsite hearing screening, hearing testing and hearing aids for hospice care and cancer services.

8. What is your “Audiology Why”? What drives you to come into work everyday?
Passion. My desire is that no person is prevented from full participation in life due to hearing loss. I have been an audiologist for almost 20 years and have witnessed children struggling in school, families fighting, people isolating themselves, people thinking they have no value to anyone… all due to a hearing loss and not being able to afford care or not knowing that there is help for them. I want to be a small part of a process to build the self-worth of individuals by restoring their hearing potential and providing them with opportunities to engage with their communities through service to others. I want to show others that someone in the medical field can care about them and listen to their concerns, doing what I can to help them in any small way.  It is amazing to witness our patients feel they have value and can “do something” for others when they go out to complete their volunteer hours, or to watch a family laugh and participate in active communication again, or have a child come into the office excited to say their first words to me or let me know they are now on the honor roll because of getting help in a diagnosis of APD. I have always loved being an audiologist whether it was in the ENT setting I was at for 12 years or in my private practice for 7 years, but I never enjoyed taking so much money from people for their care or for hearing aids. I once cried with a family because they put a second mortgage on their home to get hearing aids for their daughter, and another family who used all their savings.  Now, I feel blessed to be doing the exact same services, providing high level evidenced-based care, and fitting the same quality hearing aids, but in a way that makes it all available to everyone, not just those who feel they can afford it.

9. Any advice for students considerating the profession of audiology and/or nonprofit audiology?
Make an intentional effort to call and schedule time to visit a wide range of types of places that provide audiology care. Watch the interactions that audiologists have with their patients in all the different ways we have been taught to care for people. See ALL ages of care and testing and rehab that audiologists are able to provide. If you are “scared” to do pediatrics, see it done anyway.Try it out and be surprised at what may become enjoyable to you in areas you never really thought about. Please do not pigeon hole yourself in only hearing aid fittings because there is so very much our field is able to do for those in our communities. Also, if you wish to be in private practice, realize that it IS possible to do medical audiology and diagnostics in a private practice as well as hearing aid fittings. The lights will stay on, you can make money, and you will be providing options for people to choose the type of place they wish to go for their hearing healthcare. I love the non-profit part of it all and we have a model of care that is new and not utilized but in about three places in the US. We teach others how to create the same model of care… doing any services in audiology that a provider decides they would like to do. Go into audiology because you care about people, look into your heart and ask WHY you may want to do audiology. Are you passionate about it, why are you thinking about getting into audiology, can you talk with and interact well with a variety of people? Our field is always changing and we have to keep up. It’s a lot of work at times and we should be doing it because we care about the people we will be serving, no matter what type of facility you end up working in or what type of services you would like to provide.