Assessing tinnitus clinicians

[Steve]

Talk on another thread lead to an interesting question.

Say there were a resource, a professional organisation maybe, for tinnitus clinicians. What do you think the criteria should be before we deem them competent to treat tinnitus patients?

Maybe a certain amount of time specialising in tinnitus, completed a series of courses to learn to properly treat tinnitus, experience in at least 3 treatment techniques, continued training in tinnitus every 3 months?

What are your thoughts?

 

[cullenbohannon]

I would've thought the ATA would have some guidelines or list regarding this. Is that not the case?

 

[Steve]

They actually have a register, on the page they state:

The individuals on the following pages have indicated to ATA that they are interested in providing services and treatments to tinnitus patients.

Remember to ask any potential hearing health care provider about their experience with tinnitus evaluations and treatments. Because there are many different tinnitus treatment strategies, knowing what to do if you have tinnitus can be confusing. Make sure you turn to health care professionals who provide support, care, and compassion- and who know about and understand tinnitus.

And they have some questions to ask them here: http://www.ata.org/resources/questions-for-dr

 

[RaZaH]

First requirement > Having tinnitus.
Not really , but still.

 

[MattK]

Well this might sound funny, but I would almost want to say that they have had to have suffered from bothersome tinnitus themselves. I truly believe that unless one actually experiences bothersome tinnitus, then one cannot truly understand how devastating it can be. I'm not even talking about those instances where a doctor looks into your ear and says, "Ah, you have an ear infection, that's why you have tinnitus... it'll go away once the infection is gone." I'm talking about it bothers the heck out of you, and you go to a doctor and the doctor says, "Everything checks out, I don't have a clue. You might have to learn to live with it for the rest of your life. Too bad you're only 20/30 and not 99... because it's going to be a long, long time." When someone has experienced that, then I think they are prepared from an emotional level to relate to tinnitus patients.

And of course, proper qualifications academically are important too.

 

[JohnG]

A good background and training in neurology and can understand the etiology and science of how the nerves send aberrant signals to the brain.

 

[Kimbo Slice]

Doctors are pretty much useless here, so I think I'll have to go with scientist/researcher, broad with blonde hair blue eyes and a nice body who knows how to signal my notch.

 

[Littlebailey]

Well this might sound funny, but I would almost want to say that they have had to have suffered from bothersome tinnitus themselves. I truly believe that unless one actually experiences bothersome tinnitus, then one cannot truly understand how devastating it can be. I'm not even talking about those instances where a doctor looks into your ear and says, "Ah, you have an ear infection, that's why you have tinnitus... it'll go away once the infection is gone." I'm talking about it bothers the heck out of you, and you go to a doctor and the doctor says, "Everything checks out, I don't have a clue. You might have to learn to live with it for the rest of your life. Too bad you're only 20/30 and not 99... because it's going to be a long, long time." When someone has experienced that, then I think they are prepared from an emotional level to relate to tinnitus patients.

And of course, proper qualifications academically are important too.

That's what I'm afraid. I've had it for a week now, and I feel like I'm quite conversant on the subject with just several hours doodling the internet under my belt. And yet, that's what I'm bracing myself for in about a month's time when I see an ENT.

Though I will admit, I'm holding out some hope that I have an ear infection, or blocked tubes or wax buildup. That would be awesome, provided it really becomes gone.

 

[MattK]

That's what I'm afraid. I've had it for a week now, and I feel like I'm quite conversant on the subject with just several hours doodling the internet under my belt. And yet, that's what I'm bracing myself for in about a month's time when I see an ENT.

Though I will admit, I'm holding out some hope that I have an ear infection, or blocked tubes or wax buildup. That would be awesome, provided it really becomes gone.

And there is a chance that the ENT will find a very treatble cause. It happens. Although if I were you, I'd go to an urgent care and be seen today. Even a regular MD will be able to rule things out like ear wax or eustachian tube dysfunction. Besides, what if it's something treatable now but if you wait a month it turns into a much bigger problem?

 

[cullenbohannon]

Steve I think those are good ideas I just have trouble imagining how we could actually enforce or put something like that into place. I have a hard time imaging t clinicians would want to follow guidelines we set for them. I think at least to start we could list them by location country, city or state etc, then what type of services they provide. Be it TRT, neuromnics or what ever other treatments we have available. Maybe have a rating system where we as patients if we were treated by them can comment on the experience and rate them which would be very subjective of course.

Talk on another thread lead to an interesting question.

Say there were a resource, a professional organisation maybe, for tinnitus clinicians. What do you think the criteria should be before we deem them competent to treat tinnitus patients?

Maybe a certain amount of time specialising in tinnitus, completed a series of courses to learn to properly treat tinnitus, experience in at least 3 treatment techniques, continued training in tinnitus every 3 months?

What are your thoughts?

 

[Littlebailey]

And there is a chance that the ENT will find a very treatble cause. It happens. Although if I were you, I'd go to an urgent care and be seen today. Even a regular MD will be able to rule things out like ear wax or eustachian tube dysfunction. Besides, what if it's something treatable now but if you wait a month it turns into a much bigger problem?

Thank you for this post. I think I will do that. Because now that you mention it, that is something that is kind of shocking about our health care system. Generally speaking, acute or at least distinct medical conditions get worse with time, and don't remain static. And waiting two weeks or a month or longer to get something examined could totally miss the boat, and something that was fixable could become non-fixable precisely because you had to wait in line for six weeks. And it really shouldn't be that way. Thanks for the tip. I'm going to look into that right now.

My ears were definitely kind of screwy in terms of crinkling all the time and sort of gently burping and doing odd, non-normal things, which I could definitely see as being blocked or malfunctioning tubes, or something like that. They definitely seemed clogged in some way. And that was well before this ringing started. Thanks again

 

[MattK]

Thank you for this post. I think I will do that. Because now that you mention it, that is something that is kind of shocking about our health care system. Generally speaking, acute or at least distinct medical conditions get worse with time, and don't remain static. And waiting two weeks or a month or longer to get something examined could totally miss the boat, and something that was fixable could become non-fixable precisely because you had to wait in line for six weeks. And it really shouldn't be that way.

Yep. Generally speaking, the reason we set up appointments with medical specialists is because we have a need that needs to be treated. But when you're suffering from something, it can be a nightmare to have to wait a month for it. I mean, a lot of people have a hard enough time facing one day at a time with tinnitus, but to go a month without any type of help would be frustrating.

I hope your appointment went well and you found out that it wasn't anything to be worried about.

 

[Steve]

Incidentally, I'm not proposing that we develop a register.

Just interested in what people think is a good benchmark for a competent clinician, what they should have before they treat tinnitus patients.

 

[Dr. Nagler]

Right. And it seems that folks are all over the page on it. That's a small taste of the challenges you will be facing as you move forward with the TN. I wish you well with it.

Stephen

 

[daedalus]

I think this is what the TRI is willing to do, standardize tinnitus treatment amongst clinicians: http://www.tinnitusresearch.org/en/consensus/consensus_en.php

They are not describing what a clinician should be, rather what a team of clinicians should do.

 

[Steve]

Right. And it seems that folks are all over the page on it. That's a small taste of the challenges you will be facing as you move forward with the TN. I wish you well with it.

Stephen

Certain tasks are above us, this would definitely be one of them.

Only a recognised body (I'm a member of 2 in my professional life) can impose criteria and decide with their members what is an accepted standard.

 

[Steve]

I think this is what the TRI is willing to do, standardize tinnitus treatment amongst clinicians: http://www.tinnitusresearch.org/en/consensus/consensus_en.php

They are not describing what a clinician should be, rather what a team of clinicians should do.

That is excellent work by the TRI. Very much needed too.

There are other movements for transparency and stricter control of research / trials, but this will be incredibly useful as a framework for future tinnitus research.

It's one hell of a task though, trying to get all researchers and centres to comply with a standardised practice when they have their own established systems.

 

[jchinnis]

The first question to ask is what we want. If it is a cure, then no clinicians should be approved at all.

If it is to feel better, then I think psychologists and a few physicians and audiologists might be on the approved list.

Seems to me that most people who develop tinnitus should get good audiology and medical evaluations first. Virtually any decent audiologist and board-certified ENT should be adequate for that. For 99+% of patients, there will be nothing to be done of a medical nature after the initial evaluation.

What is next for the patient is deciding whether to pursue something to help with psychological distress. I would put TRT and anything that assists habituation in that category, though others wouldn't.