There are currently three practices:
· Ashgrove Specialist Medical Centre Suite 5a/21 Harry Street Ashgrove 4060.
· Thursday and Friday.
· 299 Boundary West End 4101 & Alexandra Level 1 201 Wickham Terrace Spring Hill 4000.
· All other days (including weekends).
· The telephone number is 0402 650 500
I am also available to conduct home visits, both to private dwellings as well as nursing homes and other institutions.
Scope of Practice
The business is a specialist service, devoted to the health of the ear. It is not meant to replace the G.P., ENT specialist or Audiologist out with this scope of practice..
The practitioner is specifically trained to:
· Assess the health of the ear canal.
· Promote and educate the patient in best practice for the health of their ear.
· Safely and effectively remove ear wax (Cerumen).
· Prepare the ear for intervention and fitting of hearing aids by an Audiologist.
· Report to Doctor or Audiologist
· No doctor's referral required.
A bonus that I see for this practice is that it relieves the G.P. and ENT specialist of having to clean the ear canal (external auditory meatus), a practice which can detract from their other work.
Unlike a G.P. or practice nurse who would only do this type of work intermittently, this service offers a stand-alone professional intervention by a practitioner who has made it their specialist career.
I understand that many G.P.s are now refusing to this type of intervention due to the time and risk of injury to the patient.
Offering a cheaper but specialist service to the patient without the additional cost an ENT specialist would incur, it also reduces the risk of a negative outcome to the patient as any procedure is carried out by a dedicated specialist.
The client does not require a referral from a doctor or other specialist and can simply call, either themselves or through a caregiver.
As some alternative therapies are available for rebate, I am hoping that this procedure, which is a clinical intervention, could gain the same credibility.
The current cost for treatment, which involves examination and any wax removal is $75.
The procedure takes approximately 30 minutes.
The treatment involves an initial Metabolic Study to determine a baseline physiological presentation. This involves taking base-line vital signs (Temperature, Pulse, Respiration and Blood pressure). Clients can present with a possible Otitis Externa or Otitis Media without realising. They can be referred to their G.P. for appropriate treatment before any procedure would take place by the Ear Hygienist.
The next step is an examination of both of the patient's ears.
This begins with an overall visual impression of the external ear (also known as the pinna or auricle).
Next, an examination of the ear canal is carried out.
Detailed, high definition photographs are taken via a Digital Otoscope. This records a permanent record of the ear canal at the time of the examination.
It is also used to compare the canal before and after any treatment.
Clients are offered the opportunity to have the photographs emailed to them, free of charge.
Method of Cleaning
I currently prefer using two techniques in my practice.
The first is the use of hand held instruments, wax curettes, also called Jobson Horne probes.
These are of different sizes and are used to manually remove ear wax from the ear canal.
The second is a Low Pressure Irrigation System.
This delivers water, at low pressure, through an applicator which is aimed towards the wall of the ear canal in order to gently remove wax which is too close to the Tympanic Membrane to remove manually.
Contrary to other practitioners, I do not use a Low Pressure Suction Method as a first line of treatment.
I have found the technique convenient but not as gentle as the irrigation method.
I have a machine available should I feel it to be clinically indicated.
Clinical indications can be; perforation of the tympanic membrane, a history of 'wall down' surgery or client preference and previous experience.
Clients who have impacted ear wax and/or where the tympanic membrane cannot be observed are offered softening agents to take home and use for a few days prior to having wax removed. They charged for one consultation and treatment only.
As part of the service, clients are taught the most effective methods for looking after their own health in respect to their ear hygiene.
The object of Total Ear Hygiene is not to create a dependent clientele but to offer people the ability to make informed decisions regarding their hearing.
This is in a relatively simple format and can be verbal, as well as, handouts or information pointing to valid resources found on the internet.
The maxim, ‘Do no Harm’ is a major philosophy with Total Ear Hygiene.
My intention is to:
· Relieve Suffering and Distress
· Aid in the Return of Function
· Promote Health and Hearing
· Offer Support
· Empower and Enlighten
· Referral to an Appropriate Service Provider.
Documentation and Reporting
A suite of documents are completed for the clinical pathway the client will navigate.
· Client Information (with Consent form)
· Case History
· Report to Referral Source
With the client’s permission, a report detailing assessment, treatment and outcome can be sent to any preferred health care provider or specialist. This can include G.P., Audiologist, ENT Specialist or Key Stakeholder.