Becoming an Interventional Audiologist: Lori Zitelli, AuD

Lori Zitelli began working for University of Pittsburgh Medical Center in 2012. She received her clinical doctorate in Audiology from the University of Pittsburgh. Her interests include amplification, tinnitus treatment, clinical education, clinical research, and interventional audiology. She is also a part-time lab instructor at the University of Pittsburgh and teaches a Clinical Procedures Lab for first-year AuD students. She is an active fellow of the American Academy of Audiology.

1. At what point did you realize you wanted to study audiology?
When I was a child, I had a lisp and had to attend many years of speech therapy. Partly because of this experience, I initially thought I wanted to be a speech-language pathologist. I ended up in an Introduction to Audiology course my freshman year of college in order to begin fulfilling the requirements for the University of Pittsburgh Communication Sciences and Disorders (CSD) program. I have since learned that I am one of many former Pitt CSD students who were swayed to join the audiology program by this course, which was taught by Dr. Elaine Mormer. She made it sound so fun and fulfilling – and she was right!

2. What is interventional audiology?
“Interventional audiology” is a term that was coined by Brian Taylor and Robert Tysoe. It focuses on preventing and treating hearing loss before it becomes a barrier to other treatments or leads to other health co-morbidities. It comes from the concept of interventional medicine, which is a branch that focuses on detecting and treating medical conditions that may lead to or exacerbate other conditions, with the ultimate goal of promoting a healthier lifestyle. There is a great article by Drs. Taylor and Tysoe in the November 2013 issue of The Hearing Review that outlines the purpose, importance, and goals of interventional audiology. It’s titled “Interventional Audiology: Partnering with Physicians to Deliver Integrative and Preventive Hearing Care.”

3. When and how did you decide that you wanted to take on the intervention role?
I have to give all the credit for this to my boss, Dr. Catherine Palmer. One of her visions for UPMC’s audiology department is to have a clear and important role within our medical center that focuses on bringing communication access to all of our patients – this includes both inpatients and outpatients, as well as their family members and visitors. Thanks to the Americans with Disabilities Act, patients are afforded the right to physically access to the care that they need (ramps, elevator doors that stay open a certain amount of time, etc). However, many providers do not consider communication access when they claim that their offices and clinics are accessible. This mission has become something that is very important to me as I continue to see firsthand all of the ways that poor communication with care providers can negatively impact our patients’ healthcare outcomes. Over the last three years, we have been able to integrate interventional audiology services into several different outpatient clinics within our medical system. Additionally, all of our UPMC hospitals have focused on providing inpatient audiology services in order to enhance these patients’ ability to communicate during their inpatient stay.

4. What does your average day look like?
It just depends on the day! In the majority of clinics where we provide interventional audiology services, my role is either clinical (seeing patients myself) or supervisory (overseeing students or an audiology assistant). Sometimes our role in the clinic is as simple as screening a patient’s hearing prior to their appointment with their Primary Care Provider and providing a non-custom headset amplifier to use if they have a significant hearing loss which may interfere with their communication. Sometimes, if patients are interested and willing, our role is expanded to include comprehensive testing, comprehensive hearing aid services, finding solutions for specific hearing problems such as hearing a pill reminder beep or hearing on the phone, removing cerumen, and counseling regarding the patient’s expectations and our recommendations.

5. What interprofessional/teamwork roles do you play?
In each clinic, we work with a variety of other care providers. The list currently includes physicians, social workers, behavioral health providers, nurses, medical assistants, physical therapists, occupational therapists, speech-language pathologists, pharmacists, dentists, nutritionists, palliative care, hospice, and students in each profession. We work hard in each setting to integrate ourselves into the clinic flow that already exists with minimal disruptions. Regardless of the setting, the goals are to intervene when necessary to improve the patient’s communication with their providers on the day of their appointment, provide the necessary resources for the patient to follow-up and receive audiologic care if it is warranted, and continue to promote awareness of our services with other care providers.

6. What drives you to be an audiologist? 
I love being able to see the differences that our services can make in patients’ lives. Sometimes it seems like we are investing a ton of time, energy, and effort into patients who don’t always immediately benefit from our services. When providing interventional audiology services, we’ve been able to see countless patients who appear to be cognitively impaired, demented, or delirious “perk up” and be able to participate in their care when appropriate amplification is applied – the instantaneous transformation is extremely gratifying!

7. Any advice for students considering the profession of audiology and/or interventional audiology?
Challenging yourself to think “outside the booth” is a great way to develop and apply interprofessional, problem-solving, and audiologic skills. If the combination of these skill sets is appealing to you, consider branching out into interventional audiology!

Alyson Ruotanen is a third-year AuD student at the University of Cincinnati. She is currently serving as a member of the SAA Communications Committee.