For years, cochlear implant programs have relied on established protocols for candidacy evaluations, programming, and long-term follow-up. But national data now show wide variation in how that care is delivered. So what should every clinic standardize, and where should clinicians retain the flexibility to respond to individual patients? Meet Meredith Holcomb, AuD, Professor and Director of the Hearing Implant Program at the University of Miami and past chair of the American Cochlear Implant Alliance. Dr. Holcomb has led a major redesign of cochlear implant care at Miami, including a de-escalated postoperative protocol, fewer routine visits for established adult CI users, and greater use of remote care and industry support. She also co-authored a national survey revealing how widely CI audiology practices vary across institutions, work settings, and patient populations. What You'll Hear: The Standardization Question: Why cochlear implant care needs a clear minimum standard without forcing every patient, clinician, and program into the same rigid workflow. Changing an Established Program: How Dr. Holcomb introduced new care models, earned team support, and used feedback and data to guide the process. Fewer Visits, Comparable Outcomes: What happened when the University of Miami reduced routine postoperative appointments and stopped automatically scheduling annual visits for stable adult CI users. The Real Cost of Routine Follow-Up: How repeated appointments can require patients to miss work, remove children from school, arrange transportation or childcare, and travel for visits that may not provide meaningful clinical value. What the National Data Revealed: Why some patients wait two weeks for a cochlear implant evaluation while others wait as long as six months, and how access, staffing, equipment, and clinical capabilities differ across programs. Personalizing the Care Pathway: Why older adults, patients with technology challenges, and people who are not progressing as expected may need additional support, even when most stable patients can follow a reduced schedule. The “More Is Better” Myth: Why some patients associate more appointments with better care, even when additional programming does not improve outcomes. Using the Entire Care Team: How telehealth, remote programming, manufacturer representatives, coordinators, and support staff can expand care without placing every responsibility on the audiologist. Finding the Root Cause: Why programs should identify their most important access or workflow problem before changing protocols or investing limited resources. Protecting Evidence-Based Care: Why efficiency cannot mean forcing complex CI appointments into unrealistic time slots that prevent audiologists from providing appropriate care. Dr. Holcomb makes the case that the future of cochlear implant care is not complete uniformity. It is a stronger foundation of evidence-based standards, combined with enough flexibility to account for patient needs, local resources, geography, language, technology, and clinical setting. Who should listen? Audiologists, otologists, neurotologists, cochlear implant teams, hearing healthcare professionals, program directors, clinic managers, hospital administrators, private practice owners, students, residents, fellows, researchers, and anyone responsible for improving access, efficiency, and outcomes in hearing implant care. If your clinic is relying on the same follow-up schedule for every patient, this episode asks an important question: Which parts of the care pathway are truly necessary, and which are simply being continued because that is how they have always been done? Stay up to date with us on LinkedIn, Facebook, and Instagram @MedAudPro. Want to learn more about FCOM?https://FCOMnow.com Join the MedAudPro Provider Community:https://medaudpro.com/join This episode is sponsored by Envoy Medical.
