Dr. Dornhoffer has found that telephone conversations can be problematic. “Before texting became so common, referrals done over the phone were difficult, as other physicians often didn’t want to give details to a nurse or send a letter with patient information,” he said. “Today it is very easy to e-mail details or to speak through instant messages. I can type almost as quickly as I can speak.”
Explore This Issue
May 2015Paul E. Hammerschlag, MD, a clinical associate professor of otolaryngology at New York University Langone Medical Center who has had a hearing impairment since birth, received a cochlear implant in July 2014 after his hearing seriously deteriorated over the previous four years. “The change was very dramatic, and a little emotional,” he said. “I was oblivious to what I wasn’t hearing, so it has been a real transition. I still struggle with hearing over noise. In the end, though, when my hearing loss increased, I could not hear properly over the phone, and it is much easier to be in conversation now.”
Surgery
DHoH physicians who perform surgery as part of their specialty must contend with loss of lip reading as an aid to communication. “I am a surgeon, and being in the operating room [OR] is difficult because I cannot read lips due to the surgical mask,” said Dr. Dornhoffer. “Carrying on a significant conversation is impossible for me.”
Dr. Hammerschlag agreed. “I am a superb lip reader, but in the operating room, masks get in the way. If medical supply companies could make a transparent-material mask, it would solve the problem.”
Effective communication is achievable, however, said Dr. Moreland. “For example, I receive a lot of questions about surgery rotation from students, and I let them know there are several good options—there is no one-size-fits-all solution that will be successful for everyone,” he said. “I worked with interpreters as a medical student; sometimes they would scrub in because we both needed to be close to the surgical field. I know of one physician who used CART [computer assisted real-time captioning] on a screen, which was an iPad that is enclosed in a sleeve to remain sterile; a typist transcribed what was being said in the OR, and it appeared instantly on the screen.”
Medical Technology
Assistive medical technology for DHoH practitioners, such as electronic and visual stethoscopes, has been available for years. “Any challenges with these would most likely be technological,” said Dr. Moreland. “’How do I adapt my cochlear implant to the electronic stethoscope?’ or ‘How do I use the display from the visual stethoscope?’ Ultrasound is an amazing tool that can be extremely helpful for DHoH physicians—it does not replace the stethoscope, but it can provide a great deal of supplemental information in a visual way. DHoH physicians, like anyhone else, would need to spend increased time to determine how best to use it technically.”