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20 Questions: Laura Assante Johnston, AuD

Created January 6, 2013 by Juliet Farmer
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Dr. Laura Assante Johnston is the director of Sacramento Ear Nose & Throat (SENT) Hearing Aid Center and Sacramento ENT Diagnostic Audiology Department in Sacramento, Calif. She earned a bachelor’s degree in communicative disorders and a master’s degree in audiology from California State University, Northridge, in 1987. She went on to receive her Doctor of Audiology (AuD) from Arizona School of Health Sciences at A.T. Still University in 2002 and completed a fellowship year at the House Ear Institute in Los Angeles, where she performed diagnostic audiology, pediatric cochlear implants, hearing aid evaluations, pediatric evaluations, ABRs, pediatric ABRs, aural rehabilitation with children, facial nerve monitoring exposure, and research.

Dr. Johnston joined Sacramento Ear, Nose, & Throat in 1988, where, as supervisor of diagnostics, she has provided clinical training and supervision. She spent years as a commissioner for the State of California for the Hearing Aid Dispensing Examination, presented research papers at various conferences and was published in Advance for Audiology. She has worked with school districts to implement Aural Rehabilitation programs, and has been a guest on various local T.V. and news programs providing hearing advice. Dr. Johnston is an American Academy of Audiology Fellow and a member of both the Academy of Dispensing Audiologists/Academy of Doctors of Audiology, and the American Speech and Hearing Association. She also serves as a medical advisor for Blue Shield.

When did you first decide to become an audiologist? Why?
I started out a pre-med major. I was taking a basic science class at the University of Nevada, Reno in the School of Medicine building. Someone came into my class and asked if anyone knew sign language and could interpret for a patient in the basement. I had three college semesters of sign language while I was in high school so I volunteered. When I finished, I looked around the basement clinic and asked, “What is this place?” I was quickly handed a brochure for Audiology majors and strongly advised to take a couple of classes the next semester. After two classes, I was hooked. I also found the six-year program appealing, and I was impressed by my instructors who were intelligent, enthusiastic, and had great clothes.

How/why did you choose the audiology school you went to?
I transferred three times in three years for my undergraduate. I completed my last two years at California State University, Northridge. CSU Northridge had some great professors and was located near many wonderful Los Angeles clinics that provided versatile opportunities for internships. I was also attracted to the proximity to Malibu beach. For graduate school, I considered my options, but CSU Northridge made me a financial offer I just couldn’t refuse.

What surprised you the most about your audiology studies?
The more Audiology courses I took, the more I loved the major. I loved that I could become extremely knowledgeable in this area of study. As soon as I started my internships, I could see myself in the role of Audiologist and knew I would look forward to going to work each day.

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?)
This is a tricky question because now the field requires a four-year Doctorate program versus a two-year Masters program. Knowing now that I thoroughly enjoy this field, I would choose Audiology all over again; however, given the choice as an undergraduate without any knowledge of the field, I think I may have chosen a four-year medical program or something else. I would have certainly had to weigh the cost benefit factor.

Has being an audiologist met your expectations? Why?
Audiology has completely met my expectations. I look forward to going to work everyday, seeing my patients, and helping people hear better. I am in a field that continues to grow and change and continues to stimulate my mind. I work directly with patients everyday, but also am lucky enough to have the challenges of running a business. I get to utilize my creative skills, organizational skills, business skills, scientific skills and social skills. I have been able to balance a fulfilling career with raising children. It has completely met my expectations.

What do you like most about being an audiologist?
I love hearing aid technology. I love that it continuously changes. I love to listen to my patients’ needs and help them choose the optimal instrument and utilize program strategies for successful fittings. I enjoy being able to fit a baby and see him graduate 18 years later. I enjoy my senior patients and am thrilled to hear the stories of their lives. It is wonderful to have the opportunity to provide patients with the ability to hear better, and I enjoy the challenge of trying to provide them with something better each time I fit them.

What do you like least about being an audiologist?
I have always disliked ABRs (auditory brain response testing). I always feel like there is something more I should be doing than sitting in a dark little room. Fortunately, I am in a position to pick and choose my schedule.

What was it like finding a job in your chosen career field? What were your options and why did you decide what you did?
As a student, I saw a news clip on the House Ear Institute, and I said, “That will be my first job.” After a grueling phone interview and an all day in-person interview, I was hired for my clinical fellowship year. It was an incredibly wonderful place, and I worked with some of the most talented people in my field. Since this was such a strong training site, I was offered numerous jobs at the end of my fellowship. I chose a private practice setting to gain some business experience, which led me to my current job of 23 years. After years of hard work and dedication, I moved from staff audiologist to supervisor of audiology to director and part owner.

Describe a typical day at work.
I see patients from 8:30 a.m. to 2:30 p.m. and through the lunch hour. This schedule permits me to drop off and pick up my child from school. During those hours, I see hearing aid patients, tinnitus patients, and patients with vestibular disorders. I work with newborns to seniors. I fit, program and adjust hearing instruments. Administrative duties such as hiring, training and dealing with staff issues occurs during that time as well. I start and end my day answering emails from home, and I complete the business aspect of my job such as interviewing, ordering supplies, marketing, writing newsletters, maintaining a website, contracting and reviewing issues with accounts payable and receivable from home in the evenings and on weekends.

Do you work with mid-level providers, and if so, what kind(s)?
I work with NPs, PAs, med students and PTs (for Vestibular Therapy) on a regular basis.

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?
I work a 30 hours a week and sleep eight hours a night. However, I do all marketing and business related administrative tasks on the sidelines of soccer games in a soccer chair. I take one day a month off for a spa day or a visit to the yoga farm. I take one week off every season to vacation with my family.

Are you satisfied with your income?
I am very satisfied with my income. I have been able to raise two children, cover private school plus the cost of college, and we have been fortunate enough to have nice vacations.

If you took out educational loans, is/was paying them back a financial strain?
I was lucky enough to receive scholastic scholarships and did not need loans. I spent the last three years of my education working as a live-in nanny, which covered room and board in a very nice home.

In your position now, knowing what you do – what would you say to yourself 10 years ago?
I would say, “Don’t worry about the small things. Be patient with your colleagues and enjoy every patient.”

What information/advice do you wish you had known when you were beginning audiology studies?
I wish I would have taken more business classes or health administration courses as electives. Classes on billing and codes would have been helpful.

From your perspective, what is the biggest problem in health care today?
The biggest problem in health care is the constant changes with insurance benefits, contracts, and reimbursements as well as ambiguity of an insurance company’s definition for reimbursement as “usual and customary.” Patients want to know their benefits for hearing aids; providers want to know reimbursement amounts. When a patient’s insurance benefits state something like “50% of usual and customary charges,” neither the patient nor the provider has a clear understanding of what to expect.

Where do you see audiology in 10 years?
I worry about the future of audiology. A four-year graduate program is expensive and I question whether we will have enough intelligent students choose it over other options. If reimbursement for diagnostic aspects continues to decrease, we may see audiologists in roles of supervising more technicians for basic testing.

What types of outreach/volunteer work do you do, if any?
I volunteer at various events at my child’s school. I have done everything from school hearing screenings, to fund raising to sports events. I also volunteer to teach medical residents basic audiology and I do various lectures in our community on hearing health care.

Do you have family? If so, do you have enough time to spend with them?
I have a husband, two kids and two dogs. I spend the afternoons helping with homework, driving to sports practices and attending games. My hobby is cooking so my family gets a wonderful meal every night. My husband and I walk the dogs together and have date night at least once a week.

Do you have any final piece of advice for students interested in pursuing audiology as a career?
Choose a school you can afford. Don’t go into debt with an expensive program if you can not afford it. Good audiologists are also ones that make good financial decisions. When it comes time to choosing a fourth year placement, chose the best one you can get, even if the salary is less. A top fourth year placement with exceptional experience is priceless.

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