Amber C. Rolfes, AuD, works at Piedmont ENT & Related Allergy in Atlanta, Georgia, as a clinical audiologist, where she provides diagnostic audiological evaluations for patients of all ages; balance, electrophysiology, and retrocochlear testing; hearing instrument selection, evaluation, and dispensing services; aural rehabilitation; cochlear implant and BAHA initial stimulations, mapping, troubleshooting and rehabilitation; and is contracted with QTC-VA for medical/disability evaluations.
Dr. Rolfes earned her bachelor’s degree in communication disorders from Appalachian State University in Boone, North Carolina, and her doctorate of audiology (AuD) from Auburn University in Auburn, Alabama. She served three third-year site rotations at Atlanta VAMC, Children’s Healthcare of Atlanta, and ENT Associates of Alabama (in Montgomery). Her prior work experience includes Auburn University Speech and Hearing Clinic, as well as Auburn University Montgomery Speech and Hearing Clinic. Dr. Rolfes is a member of the American Academy of Audiology, the American Speech Language and Hearing Association, and the Alabama Academy of Audiology, and previously served as student liaison for the American Board of Audiology, and vice president and event coordinator of the NAFDA. She’s been published in the American Journal of Audiology.
When did you first decide to become an audiologist? Why?
I was in the aural rehabilitation class at Appalachian State and my teacher read a quote from Helen Keller. She read, “Helen Keller was asked if she could have her sight or hearing back, which would she chose. Helen replied hearing, because sight separates you from objects and hearing separates you from people.” I have never forgotten that statement and it was one of the driving reasons for me going into audiology.
I worked for a couple of years after college doing a variety of things. I finally ended up working as an executive sales assistant, making tee times and dinner reservations. I was tired of working for someone else and wanted to have more of a career than a job. I began sending my applications in for graduate schools not long after beginning that job.
How/why did you choose the audiology school you went to?
I read a US News and World Report article about the best audiology schools, and Auburn was listed on it. I looked into their program, which was in the process of changing over from the master’s degree to the doctoral degree, and the first class would be beginning in August 2003. In truth my grades from undergrad were not so great, mostly due to the fun I had during my freshman year. I felt maybe I would have a better chance of getting into a beginning class versus an established program. I went and visited Auburn and loved it. However, when I got my letter saying I was “wait listed,” I was so upset. Only a few weeks later, I got a phone call from Dr. Johnson stating that they would like me to be apart of the first class. If I remember correctly, I screamed.
What surprised you the most about your audiology studies?
I was shocked at how much I enjoyed studying. I was never one to read or study in school. Grades always came fairly easy. But once in graduate school, I read what I was supposed to and enjoyed it. Don’t get me wrong! It was a lot of very hard work most of the time. I became a little bit of a rigid planner, which has continued into my life today. But the analytical thinking and problem solving was really interesting.
I have always thought about being in the medical profession; however, I do not like blood and often faint when dealing with it. About three months into school, I had a really hard time dealing with earwax, which is something audiologists always work with. I was second-guessing my career choice at this point. Now I have gotten over my fear of body fluids, for the most part, and enjoy being an audiologist very much.
If you had it to do all over again, would you still become an audiologist? (Why or why not? What would you have done instead?)
Of course! Though, I would probably have gone about it a different way. But if I had, then I would have handled graduate school very differently. I was much more mature at 26 starting school and this was considered a profession I was proud of. I don’t know that I had that same attitude at 23. I did find it was much harder to get back into school than going directly to graduate school. The most common questions in interviews were questioning my leaving school. But getting back into a doctoral level program was something I achieved and being hard fought for made it much sweeter.
I definitely would have tried to get more financial help with schooling or scholarship money. I did receive a couple of scholarships and a graduate assistantship; however, out of state tuition is extremely expensive. Also, I worked for four years in between schooling, and the incurred living costs during that time (such as car payment and credit card payment) made the bills even more. Working during graduate school was impossible being the first class at Auburn.
Has being an audiologist met your expectations? Why?
Yes! I would say that being an audiologist had exceeded my expectations. I enjoy what I do and feel I am knowledgeable and good at it. It is exciting to see some interesting cases or a sweet patient. It makes it much more enjoyable when the patients are kind, even when they are frustrated with something. I do have many patients that I look forward to seeing because we have built a personal relationship just in the office. Though there are always those one or two patients that make you want to go home sick when you see them on the schedule. But luckily they are not very often. Sometimes though, I wish the [other] physicians had more respect for the audiology profession.
What do you like most about being an audiologist?
I love working with my patients. I form very special bonds with some of the patients that I see. My patients are usually excited to see me and learn about my little guy, as many of them went through my pregnancy with me. I see some of my patients around town at Georgia Tech games or the grocery store. I love the personal relationships I have made with my patients.
The variety of places an audiologist can work and the variety of testing just in one day is a positive. I work in an ENT practice and might see a couple of audio patients, then a hearing aid patient, then a vestibular patient all in one morning. I also like that I am able to see a variety of ear disorders. Every patient’s problem is a little different, so each solution has to be different. I love that moment when you have really fixed what the patient is in for and they are so satisfied. Those are the moments that make my week.
What do you like least about being an audiologist?
Dealing with the questions from the patients about online hearing aids and cost of hearing aids is a big issue. The practice I work for is in a fairly affluent neighborhood of Atlanta and our patients are educated and technologically savvy. They research the products very well and come in with well formulated questions. This can be challenging when looking at the Costco prices and trying to explain why they should spend more and get my expertise instead.
Also, audiology has been striving for autonomy in healthcare for several years. It is a slow process and difficult to get everybody on board. It seems many audiologists, who are not as involved in state or national academies, are afraid of the changes.
What was it like finding a job in your chosen career field? What were your options and why did you decide what you did?
I found it fairly easy to find a job in my field. During my time in school, I was able to try out different clinical settings on a short term basis. I personally planned my third-year clinical time to include one semester of a children’s hospital, one ENT clinic, and one geriatric clinic (the Atlanta VA). I found during this time that I enjoyed the fast pace of an ENT practice and variety of testing. I focused mostly on getting a fourth year externship at an ENT practice. I felt this would help me to hone my skills and really decide what I liked best about audiology. I had a little bit of a difficult time finding a fourth year externship, because we were the first class at Auburn and I really wanted to stay close to Atlanta. A couple of mentors called the places that were looking to hire and put in a good word for me. I completed my externship and was offered a full time audiology position at the same location. I have been fortunate enough to have held onto my position for over five years now.
Describe a typical day at work.
The days are very similar in that each day begins at 8 a.m. and ends at 5 p.m. Usually, I get into work and either attend to emails and phone messages, or more often there are patients ready and waiting. Each day is similar but still very different. The other audiologist and I split up the vestibular testing throughout the week. So, this makes it more enjoyable and no one is stuck in a dark room for five days. Mondays and Wednesdays are my vestibular days, and hearing aids and audio testing is fit in between these tests. The rest of the week is dedicated to implant patients, hearing aid evaluations, fits or check ups. The physicians will also work in hearing tests as needed. Most days we get lunch, but working for six providers can mean one or more might work through lunch one day in order to leave early or go into surgery. Luckily, I might have a little down time during the day to work on chart notes, letters to the patients, reports, or for work-in hearing aid checks. Not all patients are scheduled when working in an ENT environment, and we have to be ready for any patient who might come from the doctor or off the street. Around 4 p.m., things tend to wind down and most of the catch up is played at that time. By 5 p.m. we are usually on our way out the door and to our families. Then it all begins again the next morning. The testing is similar, but the problems, personalities, and challenges are almost always different.
Do you work with mid-level providers, and if so, what kind(s)?
It’s interesting you should ask this question. In the clinic that I work at, audiologist are considered the mid-level providers, though many audiologists would not consider themselves a mid-level provider. There are a multitude of different mid-level providers in our office currently and previously. In my five years at this office I have worked with physician assistants and audiology techs. Currently, I work with some really amazing and well trained hearing instrument specialists.
On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
My schedule at our office is from 8 a.m. to 5 p.m. We often times will work into or through lunch and occasionally have to stay late with a patient. On average I would say I work about 40 to 45 hours per week depending on the schedule. I personally have a small child and so sleep in our house is coveted. I like to get about eight hours of sleep if possible. I work better with a full night of sleep and don’t feel so dependant on coffee. Vacation is limited when working for someone in the healthcare industry. We get approximately a day per month for paid time off (PTO)/vacation. This includes all sick leave, personal days, and vacation. This adds up to not a lot of time off, approximately two and a half weeks, and it can be challenging to feel refreshed. Other offices may have more or less vacation. My family and I try to take vacations in conjunction with a holiday. This makes it easier to have a full week without having to take a full week of PTO.
Are you satisfied with your income?
Overall, yes! Sometimes I am not so satisfied with my debt, which is a whole other issue. I feel I make a competitive salary and I receive 15% commission on the net profit of devices. The commission varies between months. So, some months I am very satisfied with my income and some months not so much. The economy plays a big part in the commission. The benefits for our office are not great, unfortunately. I work five days a week and get little time off for the stress and hours put in each week. In our office there is no division between sick leave, vacation, or personal time. We get about six to seven holidays off per year, so that helps.
If you took out educational loans, is/was paying them back a financial strain?
Unfortunately, I was unable to work through graduate school due to the work load and clinic load. With the out of state tuition and living expenses, the student loans racked up tremendously high. Paying them back has been a huge financial strain. Luckily, my husband is an engineer and also makes a competitive salary. We work together to try paying down more than the monthly amount, but it takes a lot of discipline. But, we will probably being paying them back until our child goes to school.
In your position now, knowing what you do – what would you say to yourself 10 years ago?
Ten years ago I was still in the process of trying to get into graduate school. I was very disheartened about my rejection letters from other schools and my poor GRE scores. I would tell myself to keep trying. You will get into school and love being an audiologist. Save as much as you can and maybe even get a second job to help pay for schooling, preferably not the one at Pier 1 where you spent all your money. Get going on the scholarship applications. It is a lot of work but well worth the money when you get it. And also, that cute guy you found in the gym, stay away from him and focus on studies. Your future husband is someone you already know and lives 400 miles away.
What information/advice do you wish you had known when you were beginning audiology studies?
This is a tough question. About a month after starting graduate school, my classmates and I were studying at a local hot spot. One Auburn alum came up and was talking about her experience in the master’s level program. She repeatedly spoke about how she never thought she would make it through and how difficult it was. These comments made me a bit nervous and I second guessed my decision for quite awhile. This is a piece of advice that I wish I had NOT gotten.
As for information that would have been useful, I wish I had been more aware from the start the problems of beginning a graduate program. I also wish Auburn had been better prepared for the first class of AuD students. I know now that with every program there will be problems that arise and you have to have those problems arise to be able to fix them. However, it seemed every week there was something else in the program that needed to be straightened out. Obviously, over the past five classes things have “smoothed” out a bit. But, it was challenging being the first class of a new program.
From your perspective, what is the biggest problem in healthcare today?
In my opinion the biggest problem in healthcare today is the insurance companies, the increasing costs, and cutting the reimbursements for services. Insurance companies are getting more intrusive in the care of patients. The insurance companies seem to be dictating what tests a patient can have, not the doctor who needs certain testing for a diagnosis or from a legal aspect. We see that in audiology with hearing aid “coverage.” Most companies are considering the hearing aids as a service. What they do not understand is that a hearing aid is durable medical equipment. An insurance company cannot just send part of the money for a hearing aid and say write off the rest please. Most audiology practices would go under if all insurance companies did this. Offering a “benefit” is a better help for hearing aids and allows the patient the chance to upgrade if they choose and pay the difference. Getting insurance companies to pay for hearing tests without having to have a referral would be a huge step for our autonomy, as well.
Where do you see audiology in 10 years?
I would like to see audiology as completely autonomous and the entry point for hearing healthcare. I would love to see the majority of audiologists in private practice and working in conjunction with ENT doctors, not for them. Something also needs to be done about internet hearing aid sales. Currently, the view of the public is that buying a hearing aid is like buying a television. But it is a medical device. Would you buy an artificial leg from Costco or Best Buy or the internet? Probably not! Why would you treat your hearing that way? However, changing the perspective of the patients is important before the internet sales really can be limited.
What types of outreach/volunteer work do you do, if any?
Who has time for outreach with a small child and full time five day per week job? I have, unfortunately, not been as involved as I once hoped. My husband and I are active in our church. But most importantly we want to be active in our family and son’s life. Most of our family (Moms, Dads and siblings) live hours away. We travel to see them and keep involved in their lives. I feel there will be a time for audiology outreach in a few years, probably after completing our family and all our children are in school.
Do you have family? If so, do you have enough time to spend with them?
Yes, I have a wonderful and supportive husband and a one year old son. I don’t think anybody who works a career really spends as much time as they really want with their families. I was 26 years old when I decided to return to school. The idea of a career and graduate degree sounded great to me. I had no boyfriend, no prospects for a husband or family. I met my husband in my last year of school and we were married nine months after graduation. We make the most of our time we do have, whether in the evenings for several hours or the weekends. But, with student loans and the price of daycare, I have to work and use my ridiculously expensive degree. I do love being an audiologist and would not go back. If times were right, I would work part time. Maybe someday!
Do you have any final piece of advice for students interested in pursuing audiology as a career?
I would highly recommend figuring out the financial aspect of paying for graduate school first. I love audiology and what it brings to my life. With that being said, I am not a fan of feeling trapped in a job. I would have liked to have more freedom in my occupation and that is what I loved about audiology. You can work a few days a week and make a decent salary. Or you can own your own practice and have more vacation time. If you really like to work, you can always work in a hospital setting. But having the amount of student loans that I have forces me to get up five days a week and be away from my family. Our lives change and shift constantly. And where you are at in life when deciding to be an audiologist will change once you’re out of school. Make life easier on the other side of school by paying off tuition as you can. Look into schools which are in-state, where options for assistantships are plentiful, and look into every avenue for scholarships. Some hearing aid companies help and there are online websites dedicated to helping students pay for school. And if this is not available and you are still interested in being an audiologist, then keep the passion for it. It will make paying for the debt much more enjoyable.