{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/audiologists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Audiologists",
    "soc_code": "29-1181",
    "category": "Healthcare",
    "us_employment": 13660,
    "median_annual_wage": 95780
  },
  "verdict": "SAFE",
  "risk_resistance": 71,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 12,
    "embodiment": 14,
    "liability_shield": 16,
    "trust_premium": 15,
    "judgment_accountability": 14
  },
  "reasoning": {
    "task_resistance": "Automated pure-tone audiometry, tablet-based screening, and self-fitting OTC aids genuinely absorb the routine air/bone threshold-and-fit visit that fills a large share of a community clinic's schedule, and AI drafts audiogram interpretations and tympanogram reads well enough to be useful — but ABR/ASSR on a sedated infant, VNG with caloric irrigation, cerumen removal under otoscopy, and real-ear probe-tube verification still require a clinician at the chair, which is what holds this at 12 rather than the mid-teens.",
    "embodiment": "Practically every billable procedure involves your hands in or on a patient's head — inserting foam tips and probe tubes, syringing or curetting wax, injecting silicone for earmold impressions, placing electrodes for ABR, strapping a patient into a rotary chair — in noisy schools, NICUs, nursing homes, and sound booths rather than a fixed lab bench, which is why this sits at 14 and not the 8-10 of a screen-plus-occasional-exam role.",
    "liability_shield": "Every state licenses audiologists, and the AuD holder personally signs the diagnostic report, owns the decision to refer red flags like unilateral asymmetry, sudden sensorineural loss, or retrocochlear findings to ENT, and is the billing provider of record for CPT 92557/92585 — the 16 rather than 19 reflects that OTC hearing aids and expanding telehealth rules have already carved routine amplification out from under that licence.",
    "trust_premium": "Hearing-aid outcomes depend on months of return visits, counseling a resistant spouse, and adjusting to a patient's own reported experience in restaurants and church, so patients follow their audiologist between practices — but a good share of the caseload is one-off diagnostic and newborn screening referrals where the relationship never forms, keeping this at 15.",
    "judgment_accountability": "Deciding whether an asymmetric threshold pattern warrants MRI, whether a 2-year-old's inconsistent behavioral responses are real thresholds or fatigue, whether to trust a VNG result that contradicts the patient's history, and whether a cochlear implant candidate will actually benefit — all made on ambiguous data with the consequence of a missed acoustic neuroma or a lost year of language development."
  },
  "rationale": "Audiologists spend their days placing probes and inserts in real ears, performing otoscopy and cerumen management, running real-ear verification on hearing aids, taking earmold impressions, and running vestibular and ABR testing on patients who can't always cooperate — none of which a language model touches. Automated audiometry, tablet-based screening, and self-fitting OTC hearing aids do erode the routine pure-tone-and-sell tier, and AI already drafts reports and reads tympanograms competently. The AuD license, state scope-of-practice rules, and personal liability for diagnosis and referral (acoustic neuroma, sudden hearing loss) keep the human in the chair — a regulatory shield that could narrow if OTC and telehealth rules loosen further.",
  "outlook": "Employment holds or grows with an aging population, but revenue shifts from device sales toward billable diagnostic and rehabilitative procedures as OTC hearing aids and automated audiometry take the simple cases.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State boards or FDA guidance requiring a licensed audiologist to review and sign off on outputs from OTC self-fitting hearing aids and app-based audiometry when a red-flag condition (unilateral loss, sudden loss, otalgia, drainage) is flagged — i.e. mandatory referral gatekeeping written into the OTC rule rather than left as a consumer checkbox. Also cochlear implant candidacy and programming remaining an explicitly licensed act in state scope-of-practice statutes, and Medicare's move toward direct-access audiology (proposed MAAIA / Medicare Audiology Access Improvement Act) which would place diagnostic responsibility squarely on the AuD rather than a referring physician.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift: as automated pure-tone screening and OTC fitting absorb the simple sensorineural-loss-and-amplification tier, the remaining caseload concentrates in vestibular assessment (VNG, vHIT, VEMP), ABR/ASSR on infants and non-cooperative patients, tinnitus and hyperacusis management, cochlear implant mapping, and intraoperative neuromonitoring — all requiring physical probe placement, patient conditioning, and real-time interpretation. Universal newborn hearing screening referrals and expanding CI eligibility criteria feed this tier directly.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "embodiment",
        "change": "Growth in the share of work that is procedural: cerumen management under video otoscopy, earmold and custom impression taking, intraoperative monitoring in the OR, and CI device troubleshooting on the patient. If state scope expands to include more cerumen removal and minor procedures (as several states have done), the physical-manipulation fraction of the day rises.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "Ownership of the differential-diagnosis call under ambiguity — deciding whether an asymmetric threshold pattern warrants urgent MRI for acoustic neuroma or same-week steroids for sudden sensorineural loss. If direct-access billing removes the physician intermediary, the audiologist becomes the sole accountable decision-maker for that referral, and missed-diagnosis malpractice exposure attaches to them.",
        "plausibility": "plausible",
        "would_add": 2
      }
    ],
    "ceiling_note": "Trust premium has no strong upward route: hearing aid purchasing is increasingly price-driven and retail/big-box and OTC channels compete on convenience, not on wanting a human. The pediatric and vestibular segments already carry whatever premium exists."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 12020,
        "wage": 75920
      },
      {
        "y": 2018,
        "emp": 13300,
        "wage": 75920
      },
      {
        "y": 2019,
        "emp": 13590,
        "wage": 77600
      },
      {
        "y": 2020,
        "emp": 13300,
        "wage": 81030
      },
      {
        "y": 2021,
        "emp": 13240,
        "wage": 78950
      },
      {
        "y": 2022,
        "emp": 13940,
        "wage": 82680
      },
      {
        "y": 2023,
        "emp": 13880,
        "wage": 87740
      },
      {
        "y": 2024,
        "emp": 14730,
        "wage": 92120
      },
      {
        "y": 2025,
        "emp": 13660,
        "wage": 95780
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 13.6,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}