There are a lot of good comments on this board, so I do not need to repeat what has been said. I would like, however, to provide my personal experience with cerumen management.

I have been a licensed audiologist in Virginia since 1997. I initially practiced in an ENT setting, and was trained in cerumen mangement by a Ph.D. audiologist as well as the physicians. The physicians were more than happy to have me take care of the less complicated cases. I performed cerumen management initially via curettage through an articulating otoscope, and over time developed skills with aspiration and lavage. As part of my Au.D. curriculum, I took a course in cerumen management. 

Currently, my cerumen management skills (and equipment) exceed those of any nurse or physician I know of in the area (excluding otolaryngologists). Many of my patients report that if cerumen management was necessary at their PCP's office, they were handed off to a nurse (LPN, RN) for a lavage. It infuriates me that someone with less than 2 years of medical training, and no formal training in cerumen management can perform these services in a physician's office, but a doctor of audiology in her own practice cannot. 

I perform cerumen management skillfully, quickly, and painlessly on my patients. I am comfortable with my skills, and also know my limitations. I refer to ENT as necessary. It would a disservice to my patients to refer them out based on the restrictions the board has presented. Many of my patients will be greatly dissatisfied if I have to refuse them my cerumen management services.  Many of them remark that I am very good at it, and would not like to be forced to have someone with less experience and training perform these services. I do not charge them for it, it is included as part of their hearing evaluation. With the new restrictions, I will need to refer many of my patients out, forcing them to pay co-pays to their physician, take off more time from work, get another ride, etc. 

An anecdote about foreign body removal restriction: a patient of mind had a rubber dome from a hearing aid stuck in his canal. It was over the weekend, so he went to urgent care. Nurse #1 said there was nothing in his ear (although it was completely occluding his canal) . Nurse #2 identified it and attempted to remove it. It resulted in extreme pain, and still not removed. He decided to leave and just wait until Monday to see me. On Monday I strapped on my headlamp and popped out the dome with forceps almost immediately. I gave him my cellphone number and told him to call me next time if it happens over the weekend. 

These are MY patients, some of them I have been treating for close to 18 years. Many of my patients fall into the new restrictive categories, and I would be forced to turn them away from a service I can skillfully provide.