The Partnership Approach, Advance for Hearing Practice

Transcription

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Teeny. Tiny
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Copyright © 2011 Siemens Hearing Instruments, Inc. All rights reserved. 2/11 SHI/11993-11
ITSTHATSOMETHINGXTRA
YOUGETWORKINGWITHAN
4!UDIGY#ERTIlED PRACTICE
ATANYSTAGEOFYOURCAREER
students, audiologists & owners—do you have it?
Learn the true power of Vision, Commitment and Execution.
The Members/Owners of Audigy Group invite you to explore a
partnership with them. Learn how they are, in many cases,
exceeding their personal, professional and financial goals.
Visit us at AudiologyNOW! 2011 booth 1035
International: see us at booth 1121
866.711.2026 • www.audigygroup.com
student
placement
Deanna & Stacey
Audigy Group met Stacey – a top audiology student – at AAA
in 2009, and quickly recognized that she and Deanna – owner
of a leading US audiology practice – shared similar personal,
professional and financial goals. Now they both are realizing their
goals together. It’s just
another example of Audigy
Group’s belief in Vision,
Commitment
and Execution.
What are you looking
for in an employer?
| Respected professional in the field
| Ability to support you as you grow in your career
| Compatibility of professional goals and values
| Experience mentoring employees
| Has established training protocol
| Will facilitate your continued learning
Come grow with us
Build your career, knowing you’re a member of a
group that has seen tremendous growth and success.
We'd love for you to join us as we continue to
improve the lives of employees around the country.
X 2009: 223rd fastest growing
private company in the U.S. (Inc. 500)
Deanna Frazier, Au.D., FAAA, Doctor of Audiology
Audigy Group member since 2008
Bluegrass Hearing Clinic, Richmond, KY
Stacey High, Au.D., CCC-A,
Doctor of Audiology
professional
placement
Nancy & Amit
Nancy and Amit – each with their own unique set of personal,
professional and financial goals – were introduced to each other
by Audigy Group in 2008. The Audigy Group business model
became the vehicle for each of them to not only achieve
their own goals, but also share a common set of goals
to significantly grow the
practice. That’s Audigy
Group’s Vision,
Commitment
and Execution
in action.
Nancy M. Bowen, M.S., CCC-A, Clinical Audiologist
Audigy Group member since 2007,
Audiology Clinic, Vancouver, WA
Amit Gosalia, Au.D., FAAA, Doctor of Audiology
Seeking to eventually own his own private practice
X 2010: 863rd fastest growing
private company in the U.S. (Inc. 500)
X 2010: Ranked #19 in the Fastest Growing
Companies (Portland Business Journal)
get yourapp
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aaa11/
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ketart.co
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Find it at m
march/april
Volume 13
l
Number 2
l
2011
This issue
On the Web site
www.advanceweb.com/hearing
Check Out the Top Ten
22
1
2
3
4
5
6
7
8
9
10
Explaining
Hearing Loss
Cover
22 Practice Profile: Kathy Mellott, AuD
Regrowing Hair Cells in
the Human Cochlea
By Rich Magda
Features
Starkey Introduces AMP,
an ‘Invisible’ Hearing Aid
ASK THE EXPERTS
20 Behind-the-Ear Hearing Aids:
What new technology/functionality is
becoming available in BTE hearing aids?
Selective Sound
Sensitivity Syndrome
The Ear and
the Eye
CORPORATE PROFILE
27 Widex
Thriving in the
‘New Normal’ Economy
HEARING TECHNOLOGY
28 Rethinking Accessory Devices
By Donald J. Schum, PhD
The Case for 2.4 GHz
Digital Wireless Technology
AUDOKU Hearing Aid
Acronyms
Hearing Loss Screening
Recommendations to be Updated
Patient Education
Handouts
40
BUSINESS
40 Achieving Success in 20 Questions
By Brian Taylor, AuD
RESOURCE DIRECTORY
44 The ADVANCE Guide to
Hearing Aid Accessories
Columns
6 Pediatric Pointers
8 Patient Education
10 Keys to Success
12 Private Practitioner
14 Tinnitus Topics
INDUSTRY INSIDER
34 Marketing and Business Strategies:
What are some innovative strategies to
market and operate a hearing practice?
16 The Bottom Line
SPECIAL SUPPLEMENT
35 Building Revenue: Practical
Strategies for Profitablity
Departments
18 Retail Strategies
46 Point of View
9 Ad Index
45 Career Opportunities
How to Reach Us
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• Information/Editorial: (610) 278-1400
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• Display Ad Fax: (610) 278-1421
• Calendar Fax: (610) 278-1422
• Recruitment Ad Fax: (610) 278-1420
• Subscriptions: 800-355-1088.
Copyright 2011 by Merion Matters. All rights reserved. Reproduction of any form is forbidden without written permission of publisher.
ADVANCE for Hearing Practice Management is published 6 times per year by Merion Publications Inc., 2900 Horizon Drive, P.O. Box 61556,
King of Prussia, PA 19406-0956. Postmaster: send address changes to Circulation, ADVANCE for Audiologists, Merion Matters, 2900 Horizon
Drive, P.O. Box 61556, King of Prussia, PA 19406-0956. Advance is a member of the National Association for Health Care Recruitment.
Subscriptions are free to qualified audiologists, hearing aid specialists, otolaryngologists, hearing aid manufacturers and others allied
to the field.
ADVANCE also serves the healthcare field with publications for Nursing, Rehabilitation, Imaging, Speech and Audiology, Respiratory Care,
Laboratory Medicine, Information Systems, Health Information, Long-Term Care Management, Nurse Practitioners, Physician Assistants,
and Age Management.
Advertising Policy
All advertisements sent to Merion Matters for publication must comply with all applicable laws and regulations. Recruitment ads that
discriminate against applicants based on sex, age, race, religion, marital status or any other protected class will not be accepted for publication.
The appearance of advertisements in ADVANCE Newsmagazines is not an endorsement of the advertiser or its products or services. Merion
Matters does not investigate the claims made by advertisers and is not responsible for their claims.
4
ADVance for Hearing Practice management
l
March/April 2011 w w w.advance web.com/hearing
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Quality of Sweden
By Johnnie Sexton, AuD
Pediatric Pointers
as language habilitation, auditory training,
speech reading, (lipreading), hearing evaluation, and speech conservation;
• Creation and administration of programs for prevention of hearing loss;
Over the years during my work with schools, children and families,
• Counseling and guidance of pupils,
windows of opportunity have allowed wonderful expansions of programs for parents, and teachers regarding hearing
audiology and HI services. In fact, at the end of each school year, my staff and I loss;
prepare a “wish list” for the school administrators in case there are any funds
• Determination of the child’s need for
available that must be used or lost.
group and individual amplification, selecting and fitting an appropriate aid, and
No matter what setting districts for which my practice provides evaluating the effectiveness of amplificayou are in as an audiolo- educational audiology services, the school tion;
gist, you may have before you a window of administrator and I collaborated and were
• Identification of children with audiopportunity to enhance services and tech- able to purchase $103,000 in new personal tory impairments, using at-risk criteria and
nology for schools in your local areas. If you FM devices for students. It is not unheard appropriate audiological screening techare employed as an educational audiologist, of for school administrators to “hold back” niques;
in private practice or in a medical/clini- on spending these funds until the last min• Determination of the range, nature, and
cal setting that provides pediatric services, ute. The administrators often are afraid that degree of hearing loss and communication
exploring the current status of “stimulus they will need the funds for some major functions, by use of audiologic evaluation
funds” could yield positive outcomes for all issue or emergency, so the money sits until procedures;
involved. For those of you in other audiol- the last six months or so. Then that “win• Referral for medical and other services
ogy settings, you could have an opportunity dow of opportunity” opens.
necessary for the habilitation or rehabilitato establish relationships with local school
As an audiologist, being prepared for this tion of an infant or toddler with a disability
opportunity means getting to know the who has an auditory impairment;
districts for expansion of services.
To explain the term “stimulus funds:” On
February 17, 2009, the American Recovery
An online library of all Pediatric Pointer columns is available in the columns
and Reinvestment Act of 2009 (ARRA) was
section at www.advanceweb.com/hearing.
signed into law. This legislation brought an
unprecedented $787 billion of appropria- local school district administrators and
• Provision of auditory training, aural
tions, with more than $100 billion in funds educating them on the mandate for audi- rehabilitation, speech reading and listening
dedicated to education. These funds were ology services in the schools as well as the device orientation and training, and other
to be distributed over a two-year period, technology available to assist students in services;
beginning in July 2009.
classrooms. Most importantly, audiologists
• Provision of services for the prevention
So what does this have to do with audi- need to make sure that they are educated of hearing loss; and
ology? There are some targeted areas for and up to speed on available technologies.
• Determination of a child’s need for
spending ARRA funds for projects within
These services, as outlined in IDEA parts individual amplification, including selectthe scope of the Individuals with Disabili- B and C, are to be provided by a licensed ing, fitting and dispensing of appropriate
ties Education Act (IDEA), including:
audiologist who is qualified and trained listening and vibrotactile devices, and evalin pediatric audiology and the fitting and uating the effectiveness of those devices.
• audiology services;
• technology for identification of hearing management of assistive technology. Any
So take the time to research the needs
disabilities (otoacoustic emissions, tym- other staff involved with this technology of local school districts, whether you are
panograms);
must be directly trained and supervised by employed by a school district or not. By
• technology for classroom use (FM, a licensed audiologist.
being proactive, your efforts may bring
sound field).
According to IDEA Part B-300.34 (c) (1) about a whole new era in service and techIn the next few months, all of these and Part C-300.13 (b) (2), audiology ser- nology availability for children in your area.
funds have to be spent. In one of the school vices include:
Step through this outstanding window of
• Identification of children with hearing opportunity! loss;
• Determination of the range, nature and
degree of hearing loss, including referral for Johnnie Sexton, AuD, is executive director of The
medical or other professional attention for CARE Project Inc., Wilmington, NC. For more information: [email protected], www.
the habilitation of hearing;
Information sponsored by Oticon Pediatrics Inc.
• Provision of habilitation activities, such thecareproject.me.
www.oticonusa.com
A Window of Opportunity
6
l
Oticon Safari
– built for a life of adventure
The Oticon Safari family is the
first truly dedicated family of
hearing instruments designed
specifically for children of all
ages and degrees of hearing loss. Safari comprises
three BTE models - 312, 13 and 13 Super Power - each
available at three price points to make it easier to
meet the needs of parents, too.
With Streamer and ConnectLine, Safari also gives
children from youngsters to teens new opportunities
to connect to TVs, PCs, mobile phones and mp3
players with far more ease than before.
Safari demonstrates true Child Friendly Hearing Care:
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t%FEJDBUFE1FEJBUSJDmUUJOHNPEF
t$PVOTFMJOHBOETVQQPSUNBUFSJBMTGPSQSPGFTTJPOBMT
parents, children, teens and teachers
Learn more about the Safari family at www.oticonusa.com, or contact
Oticon Pediatrics at 888-684-7331 or [email protected]
ADVANCE for Hearing Practice Managment_Safarifamily.indd 1
3/16/2011 12:51:44 PM
By Jonathan R. Brown, PhD, CCC-A, CED
Patient Education
Communication in
Noisy Conditions
Noise during communication exchanges between two people may be described
as any auditory or visual interference that impacts the quality and quantity of the transmission and/or the reception of information. Examples of noise that can interfere with
communication are machines operating, music playing, ongoing traffic noise, multiple
people talking, people moving, and distracting lights. The impact of noise may be most
apparent during day-to-day communication activities, such as face-to-face and telephone
conversations.
Treating Hearing in
Noise Problems
For listeners with hearing in noise problems,
the following are a few options that an audiologist may recommend to a patient.
For listeners who wear hearing aids:
• Use two hearing aids rather than one
hearing aid. Normally hearing listeners use
The degree to which people have problems both ears to enhance listening to speech in
listening to speech in noise may be mea- noisy conditions.
• Use a hearing aid microphone that is
sured. Audiologists, after at least a basic
evaluation has been completed, have the highly directional. Directional microphones
knowledge and experience to test a person’s help to improve signal reception.
Testing for Hearing in
Noise Problems
If you are having trouble hearing speech in noisy conditions,
an audiologist can help you identify your problems and find
solutions to improve your quality of life.
hard of hearing provide communication
strategies, such as listening, watching and
positioning, that help listeners more fully
use conditional cues to enhance the reception of communication.
Living with Hearing in
Noise Problems
The first goal for a person having problems
hearing speech in noise is to seek help from
an audiologist. The second goal is to work
with the audiologist to identify the problems that a listener may have hearing and
discriminating speech in noisy conditions.
Lastly, the patient and audiologist work
together to find strategic and possibly electronic solutions to improve the quality of life
the listener deserves to enjoy.
ability to hear and discriminate speech in
• Use hearing aids with enhanced digital
noise. The testing used by audiologists signal processing. Digital processing helps
simulates excellent to poor listening con- to reduce the impact of some unwanted
ditions that a person may experience and sounds.
compares the patient’s responses in these
conditions to the responses from a random For anyone:
sample of normally hearing listeners. The
• Use an auditory training device dur- References
test results provide a measure of the types of ing controlled listening conditions. These 1. Communication Sciences and Disorders, The Pennproblems and the degree of problems a lis- devices are typically used in meetings, con- sylvania State University. Accessed online at http://csd.
tener is likely experiencing during everyday ferences and classrooms. The speaker wears hhdev.psu.edu/clinic/audiology.html.
listening conditions. Accurately identifying a transmitting device and the listener wears
listening problems is the first step in finding a receiving device.
the help that is needed to improve a person’s
• Use skills learned during auditory train- Jonathan R. Brown is a professor at Clarion
quality of life.
ing. Audiologists and teachers of the deaf/ University, Clarion, PA.
This patient handout is designed as a general guide to help patients better understand a condition or issue. For more specific information, patients should
consult a hearing healthcare professional. Look for more patient handouts about other hearing topics at www.advanceweb.com/hearing
jeff leeser
Even for normally hearing listeners, surrounding noise may cause communication
problems; however, for people who have a
hearing loss, listening to speech in noise is
likely the most problematic communication
condition they routinely experience.
Advertiser Index
ACT
NOW!
Support the companies that support your profession. The companies listed
below support the hearing profession by placing advertisements in Advance for
Hearing Practice Management. Their support keeps our publication coming to you free
of charge. Please contact these advertisers or visit their Web sites to learn more about
their products or services.
Advertiser
Phone or web address
Pg. #
ADVANCE Custom Promotions
www.advancecustompromotions.com
47
ADVANCE Healthcare Shop
www.advancehealthcareshop.com
29
American Hearing Aid Associates
www.ahaanavigator.com
31
Audigy Group LLC
www.audigygroup.com
2, 3
Auditdata
www.real-ear.com
33
Symfon®
www.bellman.se/us/audio
5
Discovery Hearing Aid Warranties
www.discoverywarranties.com
33
Hansaton
www.hansaton-usa.com
17
Harris Communications
www.harriscomm.com
42
Oticon Inc.
www.oticonusa.com
7, 19
ReSound
www.gnresound.com/remotemic
21
Rexton Inc.
www.rexton-online.com
13
Siemens Hearing Instruments Inc.
www.usa.siemens.com/aquaris
cover gatefold, 23
Sonic Innovations
www.sonici.com
24, 25
Sonus
www.sonus.com
11
TIMS® Software
www.timssoftware.com/audiology
26
Van B. Enterprises
www.hearingaidsweatband.com
42
VARTA Microbattery Inc.
www.powerone-batteries.com
insert
Westone®
www.westone.com
48
Weitbrecht Communications Inc.
www.weitbrecht.com
41
WhisperRoom Inc.
www.whisperroom.com
34
Widex®
www.widexPro.com
15
Williams Sound Corp.
www.williamssound.com
20
Bellman &
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9
By Kathy Foltner, AuD
keys to success
documents can be long and appear daunting, they are designed to protect franchisees
in that once the franchise agreement, which
is attached to the disclosure documents, is
signed it cannot be changed by the franchisor without the franchisee’s permission.
The importance of this restriction is readily
apparent to anyone who has done business
Across industries and as a general business rule, franchises with an entity under certain terms or condiallow businesses to remain independent while providing support systems tions only to find out those terms have been
that are otherwise not available to business owners. Starting a private unilaterally changed. As an example, in a
practice and owning a business are inherently risky, but owning a franchise franchise an exclusive territory is defined in
can provide access to business resources that can help to reduce that risk.1
the franchise agreement and, assuming the
franchisee complies with the terms of the
Audiologists who own a investment (ROI), owner compensation and franchise agreement, the territory belongs
private practice are well profit. A franchise is designed to provide a to the franchisee and cannot be unilaterally
aware of the many areas of business in which formal support structure that assists the new changed by the franchisor. That is not the
they must either be an expert or seek expert or experienced owner in making his or her case with buying groups or networks that
advice: marketing, generating referrals, business maximally successful.
are not regulated by the FTC.
operations, staff training and management,
Franchises offer multiple benefits, includAll audiologists should understand the
information technology including software, ing a built-in support system, a history in basics of business and audiology practice
and finance are just a few areas that all busi- the field, comprehensive training programs, management whether they own a practice or
ness owners must manage. The better these sample employee policies and procedures, are employed. Many audiologists have utilized
areas of business are managed, the greater established supply lines with improved the “learn as you go” method for practice manthe chances of success for any business, purchasing power, a recognized brand with agement, but a franchise can offer training
including audiology private practice.
Most audiologists have minimal formal
For more information on the benefits of franchises, view a summary chart that
training in business management, and this
compares franchise and non-affiliated audiology business practice issues in the
lack of experience or confidence in business
“Online Extras” section at www.advanceweb.com/hearing.
management often creates fear or uncertainty that stops them from entering private increased name recognition, marketing and support that reduce the chances of makpractice. Some audiologists took a leap of programs, an established market presence ing costly mistakes and therefore increase the
faith and entered private practice absent that with proven business strategy, lower unfore- participants’ chances for success. extensive business training, but the number seen costs, easier streamlined start-ups, a
of audiologist practice owners is relatively higher success rate and reduced risk.3,4 The References
small. According to a survey conducted by financial, management, training, human 1. International Franchise Organization; Frequently
the American Academy of Audiology, the resource, operations and marketing sup- Asked Questions About Franchising. Accessed Februmajority of audiologists (55 percent) reported port offered by a franchise can be extremely ary 2011 online at www.franchise.org/franchiseesecondary.
their primary job title as “staff audiologist” valuable to audiologists and can create the aspx?id=1008.
whereas only 14 percent of audiologists time and freedom for the audiologist owner 2. Sullivan, E. American Academy of Audiology Compenreported their primary job title as “owner.”2 to see more patients while at the same time sation and Benefits Survey 2007, Revised 2008. Precision
Additionally, formal analysis of many private expertly managing his or her business for Reports, LLC, Bainbridge Island, WA.
3. GlobalBX. Accessed December 2010 at www.globalbx.com.
practices often uncovers room for improve- maximum profit and success.
ment with important business variables such
The sale of franchises is regulated by federal 4. Gaebler Resources for Entrepreneurs. Accessed Decemas key performance indicators, cost of goods, and state laws. The laws are designed to pro- ber 2010 at www.gaebler.com.
processes, patient satisfaction measures, tect the prospective franchisee and to provide
practice efficiencies, marketing return on the prospective franchisee with information
that he or she may need to make an informed Kathy Foltner, AuD, is vice president of Sonus
decision about purchasing a franchise. The Franchise Sales–East. She has 35 years of indusFederal Trade Commission (FTC) requires a try experience and holds adjunct faculty status at
franchise provide each prospective franchisee Rush University Medical Center and Salus Univerwith
a disclosure document that specifies the sity. Contact her at [email protected]
Information sponsored by Sonus-USA Inc.
obligations and responsibilities of the fran- or 312-286-7888. Visit www.sonus.com for more
Minnesota Registration #F-1032,5000 Cheshire
Parkway North, Plymouth, MN 55446
chisor and the franchisee. Although these information.
Franchise: A New Model
for Audiology Practice Success
10
l
A New Model
for Success in
Hearing Care
Introducing the Sonus Franchise
Nearly 100 hearing care locations have already joined. Many more independent
hearing care practices have inquired about this unprecedented new opportunity.
In a changing hearing industry, the Sonus franchise
will support you in growing your business:
• A multi-talented marketing team to support your local efforts
with marketing programs that generates over 3:1 Return On
Investment (ROI)
• A completely automated Customer Relationship Management
(CRM) program to save your time and helping ensure repeat sales
and referrals with a 40:1 ROI
• First of its kind, National Call Center to answer all the calls
generated by marketing campaigns and book appointments
directly into your location through the Sonus Private Cloud
• Advanced IT systems integrated with QuickBooks that calculates
ROI for marketing activities, includes insurance billing and
management and much more
LOOKING TO ENTER,
EXPAND OR SELL YOUR
PRACTICE?
OR
DO YOU SIMPLY WANT
TO SPEND LESS TIME
RUNNING THE BUSINESS
AND MORE TIME WITH
PATIENTS?
Get all the facts. Call 877-879-0475
to schedule your private and confidential meeting with Kathy Foltner, Au.D.,
or Thomas Tedeschi, Au.D.
Whatever your goals, a Sonus franchise may be right for you!
Kathy Foltner, Au.D.
www.sonus.com
877-879-0475
By Angela Morris, AuD
private practitioner
Charitable Partnerships
Create Practice Promotion
During a brainstorming session at a weekly have been several tangible successes associteam meeting, my staff and I came up with ated with our program.
a unique “outside the box” idea that has
• The organizations that we partner with
been a service to our community as well as are able to do less work to raise more money
a service to our practice. We wanted to find (how many candy bars do you have to sell to
a way to donate to local community causes raise the same amount of money—and who
such as churches, high school bands, soft- has time?).
publicity,” and you don’t want your pracball teams, and charities, but we needed to
• The organization does all of the leg- tice to be associated with a disreputable
do it in a way that would not cost us a lot work in promoting the opportunity to their charity.
of money.
supporters and the general public—I don’t
• Even if there is limited participation
We developed a plan to donate a portion have to do anything to promote the dona- in a particular promotion, the effort is still
of each hearing aid sale to local charities,
while putting the charity to work as our
Get more strategies for private practice success, growth and profitability
sales force. It is the same dynamic transfer
in the online archive of this column at www.advanceweb.com/Hearing
PrivatePractitioner.
concept that many groups have used successfully to promote every type of product
and service, from restaurant dining to wrap- tions, but my practice gets the credit. For worthwhile. Everyone who sees the proping paper. The basic steps are simple:
example, one group had the newspaper motion will remember the name of your
• We developed a customizable flyer that publish an article about the program and practice when they are ready to see an audiwe use to describe the details of each chari- the fact that my practice was donating a ologist.
table promotion. Information includes how portion of hearing aid revenue to the charThis community outreach effort has been
much per hearing aid will be donated to the ity. That news story was free advertising for highly successful for my practice. It is easy
cause, a description of the charity and how us! Other groups put the flyers in the paper, to manage and truly has made a difference
place them in various businesses around to the organizations that I have supported.
supporters can participate.
• We turn the f lyer over to the non- town, hand them out to congregations and I am confident that it could be a successful
profit organization for distribution. They local organizations—and they all feature strategy for any practice.
can make as many copies as they like and the name of my practice front and center.
distribute them in any manner that they
• Patients who come in through this offer This article was made possible by a partnerchoose.
typically establish long-term relationships ship between ADVANCE and the Academy
• Participants bring in the f lyer and with me and my staff, and we receive a tre- of Doctors of Audiology. For more informareceive the “per-aid” discount, which we mendous return on investment long after tion on ADA activities, educational offerings
donate to the organization. In actuality, the fundraising promotion ends.
and/or membership, visit the ADA website
the discount that we ordinarily would have
at www.audiologist.org or call ADA at 866given to the patient is simply transferred Fundraising Partnership Tips
493-5544.
to the charitable organization; the process
• Larger organizations, or those with
costs us nothing out of pocket.
several staff members or volunteers, are
generally able to spread the word more eas- Angela Morris, AuD, owns and operates Southeast Kentucky Audiology in Corbin, KY. She serves
Key Successes
ily to achieve better results.
In addition to the long-term goodwill that
• It is important to work with reputable a member at large on the Academy of Doctors of
charity relationships have generated, there organizations. There is such a thing as “bad Audiology Board of Directors.
12
l
kyle kielinski
Partnering with a non-profit organization can be an excellent way for an audiology
practice to garner positive publicity while supporting a great cause—and, as I have discovered,
you don’t have to spend an arm and a leg to do it successfully! My practice, located in Corbin, KY,
has developed meaningful non-profit partnerships to raise awareness about my services while
supporting worthy causes along the way. Here’s how we did it and how you can too.
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By Merideth Eldridge, MA
Tinnitus Topics
Some patients you never forget. Early in my audiology career,
I was confronted with an elderly woman who reported hearing
non-stop marching bands and show tunes. She insisted that the music
was so loud that I would be able to hear it coming out of her ears if
I came a little closer! As she tapped her finger and her head bounced
in rhythm with the tunes, my mind was swirling with questions: Is this
tinnitus? How will I explain this? Should I refer her?
Musical tinnitus can be exacerbated by professionals who are not knowledgeable about the
condition. Let patients know they are not alone
and reassure them that their symptoms are not
an indicator of mental illness.
Many years later and more experienced with tinnitus patients,
I have consistently heard a similar complaint from patients and
colleagues. The auditory perception of hearing music or singing
is reported in the literature and called musical tinnitus, auditory
imagery, musical ear syndrome or auditory hallucinations. Many
of these cases go unreported because patients are afraid that family, friends and professionals will think they have mental illness.
In fact, most patients have that underlying fear themselves, a fear
that may unnecessarily exacerbate their condition.
Although the definition for tinnitus and auditory hallucinations
are the same—phantom sensory phenomena in the absence of real
14
l
March/April 2011 Merideth Eldridge, MA, is a tinnitus consultant at Eldridge Consulting, LLC,
and a member of the Tinnitus Practitioners Association Board of Directors. For
more information or to find an audiologist in your area that specializes in tinnitus treatment: www.tinnituspractitioners.com.
w w w.advance web.com/hearing
kyle kielinski
When the Music
Never Stops
external sensory stimuli—using the term “hallucination” can be
detrimental because it elicits such negative emotions and reactions.
Most patients instinctively know that what they are experiencing,
whatever it is called, is “weird,” and they worry that they are “losing
their mind.” We can help them understand that there is a difference
between psychiatric auditory hallucinations that generally occur
with mental illness and non-psychiatric auditory hallucinations
that generally occur with hearing loss. People who experience
psychiatric auditory hallucinations generally hear voices which
speak clearly and directly to them. People who experience nonpsychiatric auditory hallucinations mostly hear music, singing or
unclear babbling.
Sometimes the condition is exacerbated by a professional who
is not knowledgeable about the condition or the neurophysiology
of tinnitus. Consider the woman who reported she heard a tenor
singing. It began while she was in the hospital. She thought she
was hearing Muzak but, when she went home, she could still hear
the singing at night. Although the music was soft and pleasant and
actually helped her sleep, she became very concerned when her
physician suggested that she see a psychiatrist. Following counseling from an experienced tinnitus specialist, she was relieved
and is doing fine.
Some patients report having non-bothersome typical tinnitus,
and then suddenly they experience a musical component that is
alarming and can be debilitating. This was the case with an elderly
man who experienced profound hearing loss in one ear, moderate
loss in the other ear and mild, non-bothersome tinnitus. Suddenly,
following a medication change, he noticed a very loud unending
sequence of six distinct songs. He became extremely distressed
and contacted his audiologist who referred him to a tinnitus specialist.
It is not clear what causes the more complex auditory perception
to occur, but lack of auditory stimuli due to damaged hair cells is
usually considered the main culprit. Stressful events, anxiety or
medications may be contributors. Generally, the condition is more
common in elderly hard-of-hearing patients. Therefore, consider
including music in your description of tinnitus (i.e., ringing, hissing, crickets, music, etc.) in your initial evaluation of hearing loss.
Often, the patient will feel “safe” about reporting the symptom if
you initiate the topic.
Let the patient know that this symptom has been reported by
others and they are not alone. Reassure them that it is not an indicator of mental illness and encourage a rich auditory environment.
If the patient is bothered by the symptom, consider referring to an
audiologist that specializes in tinnitus treatment. Most patients
are successfully treated with a combination of counseling and
sound therapy.
EVERYTHING
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By Granville Y. Brady Jr., AuD
Bottom Line
When It’s Time to Find
the Right Partner
Almost every successful audiology practice experiences a time
when additional staff is required. Adding personnel can be a response to increased market share, a desire to expand the scope of practice, the owner’s
burnout or a simple desire to share the professional load with a colleague that
can be trusted to continue the quality of services developed over the years.
Am I emotionally and financially suited
to accept a partner into my practice? Not
everyone can work well with others. An audiologist who has been used to “calling the
shots” for many years might be reluctant to
share decision making with someone else.
In cases where the practice owner cannot
give up control, the partnership rarely succeeds. When taking on a partner, unless the
new audiologist has an established patient
base, there will be a financial burden on
the practice. It takes time to break someone
in and time for patients to accept a new
16
associate, meaning it can take anywhere
from one to three years or more for the new
partner to “pay for himself.” In the interim,
funds must be available for the payroll and
associated personnel expenses even when
the partner is not fully productive.
Do I have the space and potential clientele
to succeed with another audiologist in the
office? If the practice has multiple offices,
this might not be a problem, but the own-
patients from the former office. A partner
who is bilingual can open up new markets
with different ethnic groups. Expansion
also may occur if the new partner has expertise in specialty areas such as vestibular testing, pediatrics or cochlear implant
mapping.
Am I willing to be flexible in helping the
partnership to succeed? Recognize that
buying into an existing practice may of-
Want to read more great advice from Dr. Brady? There are 16 of his excellent
Bottom Line columns available in our online library at www.advanceweb.com/
HearingBottomLine.
er should not expect a new partner simply
to take up the slack of leftover cases. If the
practice does not have a sufficient caseload to support a second clinician, time
and money will have to be spent developing additional clientele.
What skills am I looking for in a partner?
Practice owners that want clones of themselves will be disappointed. Not only will
a new partner bring a different skill set into the practice, any attempt by the owner
to restrict or control a new partner likely
will lead to disaster. We all like to feel that
we are indispensable, especially if we’ve
had a successful one-person show for
many years, but the truth is that nobody
is irreplaceable. The wise practice owner
will seek someone who can complement,
not reproduce, the services that already
have been established.
How can the partner improve business? In
some instances, a new partner may bring
l
March/April 2011 fer many challenges for a potential new
partner. Often a talented young audiologist does not have the capital to buy into
a business right away. A structured settlement where the new partner pays out over
time can be negotiated. If the prospective
partner is very talented with skills that
are in great demand, the practice owner
might offer a “sweat equity” arrangement
wherein a portion of the new partner’s
revenue is credited toward the purchase
price of the shares. When an existing
owner seeks a partner, creative financing
can be the difference between a successful relationship and one that is doomed
to failure.
However, the cardinal rule in establishing
a successful partnership is that both parties
are satisfied with the arrangement.
Granville Y. Brady Jr., AuD, owns a private audiology practice in Clifton and East Brunswick, NJ.
Contact him at [email protected].
jeff Leeser
An a lternative to hiring staff is to take on a
partner. A potential partner might be an
associate employee already with the practice
or a colleague that has similar interests but is
employed elsewhere. Occasionally, a gifted
student with a clinical doctorate might come
along at just the right time. Whatever the candidate’s background, the owner needs to look
at how he or she might be incorporated as a
partner into an already thriving practice.
Before seeking a partner, the owner should
take stock of what the practice now offers and
what services, if any, the additional colleague
might provide. For example, a dispensing
practice that has many requests for testing
children might seek an audiologist with pediatric experience. Likewise, vestibular testing is
somewhat specialized and can be a source of
revenue for the right practice. Furthermore,
vertiginous patients might be good candidates
for amplification since many geriatric cases
have both BPPV and hearing loss.
Before the practice owner begins the
search for a partner, he or she should consider several very important issues:
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By Tom Nelson, MBA
Retail Strategies
The Patient-Friendly Office
You have developed a marketing plan and prospective patients are
calling your office. What do they experience when they call your office or
walk through your door for the first time? When was the last time you looked
at your office from a patient’s perspective? Have you experienced calling your
office, setting up an appointment and waiting in your waiting room as if you
were new to your office, feeling the emotions of someone getting their hearing
evaluated for the first time? What do the look of your office and the actions
of your staff say about you and the care you will be giving someone? With all
you have to think about in a day sometimes these things can get overlooked.
The Front Line of the Office
feel important and that they will not be introduce practice staff by providing short
Your receptionist and front-office staff are forgotten. Address patients using formal bios, credentials and images. A waiting area
the front line in your practice’s interaction titles, such as Mr. Brown or Mrs. Smith. also offers a great opportunity to use a flatwith patients. Unfortunately, patients may Many older patients feel that they deserve screen TV to run educational videos; you
judge you and your practice by that front this level of respect until they become more could include looped clips from manufacline, even as early as when they first call to familiar with you and ask you to call them turers highlighting new products or offer
make an appointment. It’s very important by their first name.
educational presentations on hearing, the
for your staff to be friendly, courteous and
causes of hearing loss and how today’s techclear as they interact with patients both in The Waiting Room:
nology can help people return to the family,
Not Just a Place to Wait
person and on the phone.
friends and lifestyle activities they may have
When patients call, one simple way to All too often we think that it will take a been missing.
make them feel more comfortable is by large investment to update a room in our
Outside of the waiting room, try to difasking questions in a friendly and nonintrusive manner. It has been found that
Retail Strategies is a new column in ADVANCE for Hearing Practice Management.
questions starting with “what” can generate
It is featured on the homepage of our website, www.advanceweb.com/hearing,
where we also maintain an online archive of all columns that appear in
stress. It may have taken seven to 10 years
the magazine.
for a person with a hearing loss to call your
practice to schedule a hearing test. Therefore, your receptionist needs to understand homes. Sometimes freshening up a room ferentiate the areas of the office depending
the situation and do everything possible to is as easy as a fresh coat of paint, moving on the activities taking place, such as
lower the anxiety level during a patient’s some furniture and eliminating clutter; testing, counseling or fitting. Each area
first interaction. Try questions that begin it’s the same for your practice. The waiting should reflect the activity taking place in
with “May I,” for example: “May I have area can create a lasting impression of your the space. Reposition furniture to create
your name?” All staff members should be practice. Is it clean and organized? Does a more conversational consultation area
trained to speak slowly and clearly, keeping it feel up-to-date? You can freshen up the if there is enough space in your fitting
in mind that most of your patients have a space by painting the walls or even a single rooms, or add a comfortable armchair
hearing loss.
accent wall with a warm color of paint or and a table. Even the simple act of moving
When patients enter the office, make simply by adding fresh plants and a new furniture can give the office a new look at
sure someone on the staff acknowledges welcome mat.
no cost.
them. We all want to feel as if we matter
In addition to providing a pleasant, comThese simple steps can help ensure that
and that our time is valuable. Greeting fortable area for patients to relax while once you attract new patients to your pracpatients as they enter helps to make them awaiting their appointments, the waiting tice they will feel comfortable and welcome.
room also can be a place to educate and Your efforts will help ease any initial fears
motivate them. Make sure brochures, edu- and plant the idea that you are someone they
cational materials and product displays are can trust.
in inviting areas that are easy for patients
to access. You might use the waiting area
to inform and educate your patients on Tom Nelson, MBA, is channel manager at Oticon
Information sponsored by Oticon Inc.
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all the services you offer, or you might Inc. in Somerset, NJ.
18
l
People are our Starting Point
Innovation is our Means
Empowering people is our Shared Goal
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Jerry L. Yanz, PhD
Director
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Hansaton
Acoustics
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As a standard and power BTE in
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Vice President,
Alera line. The ability to reconfigAudiology &
ure the hearing instrument allows
Professional
the same physical device to be used
Relations
for a wide range of hearing losses.
Oticon Inc.
Reconfiguration between open
RISE is the first and closed fittings and power levhearing device platform devel- els is easily accomplished through
oped with wireless connectivity the fitting software and an earbuilt in at the chip level. Oticon hook change. The result: a large
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20
l
March/April 2011
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Practice profile
By Rich Magda
Dr. Kathy Mellot operates three offices in Washington D. C. suburbs and
sees patients from infants to the elderly. She believes that good business
is a matter of building good relationships, not only with patients but with
other healthcare providers.
The Partnership Approach
well. So Dr. Mellott decided to call—early
on a Wednesday afternoon, when she knew
he would be free—to see if she could use
his office to help her get started in private
practice.
“I was very honest with him,” Dr. Mellott
says. “I told him that I was just starting out
and didn’t want the rent and other overhead
that would come with having my own office.
I asked if I could sublet some of his office
space on Wednesday afternoons, and he
said, ‘Sure, let’s try it.’”
When Kathy Mellott, AuD, decided to
start a private practice, she harkened
back to her high school days. She recalled
working as a medical secretary at a radiology
practice in Silver Spring, MD. She thought of
the otolaryngologist who worked across the
hall. She remembered his name—Dr. Robert
Baumgartner—and that he didn’t have an audiologist on staff. She also remembered that his
office closed on Wednesday afternoons.
22
The First Steps
Dr. Mellott and Dr. Baumgartner drew up a
contract specifying the terms of the agreement. In addition to subletting the office
l
▲
Dr. Mellott figured Dr. Baumgartner would
remember her. They had worked together
quite often back then, on radiology referrals for his practice. He had been a referral
source when she worked as an audiologist
in hospitals in the Washington D.C. area as
space, she would rent his equipment and use
his staff to manage appointments. It was an
ideal arrangement on almost every front, for
both parties, and the beginning of Audiology Unlimited LLC—Dr. Mellott’s private
practice enterprise.
While Dr. Mellott was enjoying the perks
of running a private practice absent many of
the operational costs, this approach would
present its own set of challenges. At first,
for instance, Dr. Baumgartner would stick
around on Wednesday afternoons, during
Dr. Mellott’s time in the office. “I was seeing some of his patients, and they were just
getting to know me, so I think he wanted
to see how I handled them,” Dr. Mellott
says. “The patients gave him good feedback
advance
Kathy Mellott, AuD, built her private practice on relationships
with allied health providers.
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Practice profile
on my services, and after a month or two MD, Public Schools, where she served for six Pennsylvania College of Optometry (PCO),
he realized that I’m certified and licensed months as a speech therapist and three years now Salus University. The connection was
and good at what I do. One day he handed as an audiologist. In 1981, Dr. Mellott was with an optometrist who saw an opportunity
me the keys and said, ‘Lock up when selected for a year-long residency in medical to bolster his practice by offering hearing
you leave.’”
audiology at Duke University Medical Cen- aid services. He opened College Park HearEarning Dr. Baumgartner’s confidence ter in Durham, NC. She then worked at The ing Services with another audiologist, who
would go a long way toward helping Dr. Denver Children’s Hospital before moving left to open her own private practice. After
Mellott clear another hurdle—getting her back to the Washington D.C. area to develop she left, he called Dr. Mellott to fill in as he
patients to understand that she was an inde- the Neurotology Unit at Suburban Hospital in cycled through CFYs.
pendent practitioner, not a technician. “They Bethesda, MD. In 1986, she accepted a faculty
“Every time a CFY left, he called me,”
called me ‘girl,’” she recalls. “Whenever I position in the Otolaryngology Department Dr. Mellott said. “I would name my price,
saw a patient, especially for a hearing aid, I at Georgetown University Medical Center. because I was helping him out. After about
would have to reiterate that it was my own Now, imagine starting a private practice after two years of that, he said he wanted me to
practice—that Dr. Baumgartner and I were all of that and being called “girl.”
come on as the audiologist and asked what
colleagues sharing office space. That was one
“Thankfully, Dr. Baumgartner deferred to it would take to get me there. We drew up
of the hardest things.”
me every time on issues regarding hearing a contract and now I provide services there
One look at Dr. Mellott’s experience at that aids,” Dr. Mellott said. “That helped a lot. as College Park Hearing Services. I’m there
time helps to explain why this was so difficult. And I can also tell you that getting the AuD two days a week, and I use his staff. They do
After receiving a bachelor’s degree in speech after my name helped a lot, too. Patients all the scheduling and fax it to me.”
and hearing from the University of Mary- think of me as the doctor that I am.”
When Dr. Mellott took over College Park
land in 1976 and developing a deep interest
Hearing Services in 1997, she was working
in instrumentation, she earned her master’s Branching Out
three days a week as an audiologist—Mondegree in audiology from Towson University, The next venture of Audiology Unlim- days and Fridays there and Wednesdays at
near Baltimore. Her clinical fellowship was ited stemmed from a connection Dr. Dr. Baumgartner’s office. Also at that time,
obtained through the Washington County, Mellott made while earning her AuD at the she and her husband, Pat, closed a maternity
Practice profile
well. This arrangement worked well for a few Spreading the Word
years, but when the associate left to open her The three offices of Audiology Unlimited
own private practice, Dr. Mellott decided to are situated in the northern and eastern
scale back at Upper Marlboro, opening only suburbs of Washington D.C. In such a
on Tuesdays, allowing her to focus more on highly populated area, the 10 miles between
the Silver Spring office, which continued the Silver Spring and College Park offices,
to grow.
and the 20-plus miles between them and
“That’s where we are today,” Dr. Mellott the Upper Marlboro office, are dotted with
says. “We forward our phones and our fax many distinct and diverse communities.
from Upper Marlboro to our cell phones and Although this location is advantageous
Internet fax, so I never miss a call. Patients for the growth of her business—due to
know that if they call me, I will either answer the sheer number of potential patients—it
or call them right back. And I tell them, nine also forces Dr. Mellott to get creative with
out of 10 times problems with new hearing marketing.
A regional periodical titled Your Health
aids are simple problems and I may be able
to answer questions over the phone. If not, Magazine is one of the most successful ways
we’ll schedule an appointment. They may Dr. Mellott spreads the word about hearhave to meet me at a different office, but they ing health and the services she offers. Dr.
are happy with it.”
Mellott pays to publish a self-written article
Two of Dr. Mellott’s offices open at 9 a.m., in each issue of the monthly publication,
and the Silver Spring office opens earlier. accompanied by her headshot and an adverShe works through lunch and closes at 2 tisement for her practice.
p.m. because, in her words, “I start to lose
“The article is a great way to reach potenmomentum in the afternoon, and some peo- tial clients,” Dr. Mellott says. “I’ve written
ple want to come on their lunch hour.”
about everything from advances in hearing
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and children’s consignment shop that they
had operated as a side business for six years.
With two days a week now open, Dr. Mellott
was looking to put more time into her private practice. Serendipity struck when she
received a phone call from a dentist who was
looking for an audiologist to practice at his
office in Upper Marlboro, MD.
“I asked how he got my name and he said
he was just going through the phonebook
and calling people with audiology listings,”
Dr. Mellott said. “He had been sharing
space with an optometrist, but then the
optometrist retired. He explained that he
had an office, that we would share the waiting room and that our services areas would
be separate.”
Dr. Mellott and her husband met with the
dentist at his office and were intrigued by
the opportunity. They conducted some market research and found that she would be the
only audiologist in the Upper Marlboro area.
Dr. Mellott signed on, and her husband did,
too—as office manager. To help manage the
caseload, Dr. Mellott hired an associate as
Practice profile
aid technology to noise exposure and stress-related hearing issues.
Whatever it is, the readers really respond. They appreciate that I’m
See a photo slideshow of Dr. Mellott's
practice in the "From Print" section on
providing educational articles and they call about my services. It’s
been very good for me.”
Dr. Mellott and her husband also participate in area health fairs
and annually promote hearing protection at the Mid-Atlantic Flute clients have custom-fitted earplugs. She also sells a less expensive
Fair by fitting musicians with specialized earplugs. Their involve- “ready fit” model.
ment in the flute fair dates back five years, to when their daughter
“Before the musicians leave my table, I show them how to tell right
was in the Mid-Atlantic High School Flute Choir. As Dr. Mellott from left, how to clean them, how to insert them, how to contact
was waiting for practice to finish up one day, she noticed how loud me, etc.,” she says. “In five years, I haven’t had anyone call to say
it was in the exhibit hall. She then approached an organizer and anything but nice things.”
asked how much it would cost to have a display at the fair.
Most recently, Dr. Mellott was invited to have a display at the
“They said the table would be $75,” Dr. Mellott says. “I decided to annual meeting of the Maryland Music Educators Association.
promote musician’s earplugs, and I’ve been doing it ever since.”
She was unable to attend due to a scheduling conflict, but her
Dr. Mellott makes impressions onsite, at the fair, and sends them extern—Jill McClelland, a fourth-year AuD student at Bloomsto Emtech Laboratories, her ear-mold provider. Within a week, her burg University in northeastern Pennsylvania—went on her behalf.
Ms. McClelland returned to report that many visitors asked if Dr.
Mellott would have a display at the upcoming Music Educator’s
National Conference (MENC) Eastern Regional Conference in
Baltimore.
“I didn’t know anything about the regional conference, so I looked
into it and found out it would cost $750 for a booth,” Dr. Mellott says.
“I sent a letter [to MENC] saying that I feel this is a public service,
that I really don’t make a lot of money doing it, and that I’d like to
be there to get the word out to musicians and music educators from
all over the East Coast.”
The conference organizers replied, offering a booth at a reduced
price, as a public service.
“I’m very excited,” Dr. Mellott says. “It’s a great opportunity to
talk about hearing health with people who are regularly exposed
to high-volume music. That’s my main thing. I don’t lose money, I
feel good doing it, and I meet all kinds of fascinating people who
tell me about their experiences.”
Dr. Mellott leverages the Internet as a business driver, as well. Her
website, audiology.homestead.com, provides a brief but thorough
history of the practice, biographical information, a list of services
and accepted insurance providers, links to her articles from Your
Health and links to upcoming community health events. It also
includes photo galleries from the community health events and a
contact page with information and a map for each office.
“The website has pulled in a few clients,” Dr. Mellott says. “I’m
directing more and more patients there as I add links and information on hearing health. Web design is something I taught myself,
Please visit us at AAA-Audiology NOW! 2011 Booth #1766
so it’s a work in progress.”
More than anything, though, Dr. Mellott relies on good-faith,
word-of-mouth advertising. She promises a one-week turnaround
on all hearing aid orders and repairs and takes calls throughout the
day, even after business hours. Good business, she says, is a matter
of building good relationships. Being certified by the American
Board of Audiology also has been good for referrals. Several patients
recently have said they came to Audiology Unlimited because Dr.
Mellott is Board Certified.
“I have a great connection with my clients,” Dr. Mellott says. “And
they all know my slogan: Hear Better, Live Better.”
Rich Magda is senior associate editor at ADVANCE.
26
l
corporate profile
WIDEX
Widex, a family-owned company since its inception in 1956, is celebrating its 55th anniversary in 2011. The parent company in Denmark recently completed construction of a new
“green” headquarters and also has assumed responsibility for U.S. operations. Through originality, perseverance and reliability, the company’s mission is to develop high-quality hearing
aids that give people with a hearing loss the same opportunities for communication as those
with normal hearing.
"My biggest goal is to increase
our distribution channel and
service our clients on
a broader scale."
"High technology is our biggest
strength. We will continue
to bring on new technology
to help people hear better."
"When we introduce new
functionalities, they must not
only work well but also offer
true benefits."
—Jake Haycock, new president
of Widex USA
—Jan Topholm, CEO of Widex A/S
—Soren Ernstsen, vice president
of marketing, Widex A/S
Year Founded: 1956
Number of employees: More than 3,000
worldwide
Headquarters: Widex A/S: Lynge, Denmark;
Widex USA: Long Island City, NY
Countries of operation: More than 100
countries worldwide
History/Milestones:
1956—Widex is founded in Denmark by Christian Topholm and Erik Westermann and they
produce their first hearing aid—the “561.”
1988—With the Widex QUATTRO, four different personalized hearing aid programs are
able to be stored and accessed by the wearer
via a credit-card-sized remote control.
1995—Widex announces the first fully digital in-the-ear hearing aid—the SENSO—and
helps change the hearing aid industry.
1997—The SENSO CIC is displayed in the
Smithsonian Institution as an example of how
far hearing technology has come.
1999—SENSO Super Power digital hearing
aids are featured in an ongoing storyline on
the No.1-rated TV show, ER.
2003—Widex introduces CAMISHA laser-fit
technology, which uses computer modeling and
laser technology that has a profound impact on
how hearing aids are manufactured.
2004—Widex hearing aids receive extensive
w w w. a d van c e we b. c om / he ar in g "We see Widex not just as
a Danish company but as
a global company."
—Mike Dittmann, vice
president of sales, Widex A/S
media exposure, with appearances on Good
Morning America and Extreme Makeover on
the same day.
2005—Widex hearing aids are featured on
Larry King Live and other national programs,
and CNN recognizes SENSO Diva as a hightech hearing instrument that embodies one of
the top 25 innovations of the past 25 years.
2006—Inteo by Widex introduces Audibility
Extender and a tailor-made sound experience.
2009—Mind by Widex introduces the highly
original Zen program.
2010—Widex BABY440, a hearing aid
designed specifically for babies, is introduced. A clinical study at the University of California at San Francisco finds that hearing aids
with the Widex-patented Zen Program are
promising sound therapy tools for tinnitus
management. Erik Westermann receives the
Hear for Life Award from the trade journals
Audioinfos and Otology, paying tribute to the
Widex founder for his decades-long efforts in
helping people with hearing loss. Widex A/S
purchases its U.S. distributor, the Widex Hearing Aid Company, and assumes responsibility
for U.S. operations as Widex USA.
Ma rc h /A p r i l 2 011
l
12. 2011—Television actor Ron Rifkin proudly
shows off his real-life Widex Passion440
hearing aids on an episode of the prime time
ABC-TV show Brothers and Sisters.
Products and Services: Widex is the world’s
sixth largest manufacturer of hearing aids.
Latest Innovations: Clear440; Mind440, 330,
220; Passion440; Zen Program for relaxation and tinnitus management.
Future Plans: Widex continues to seek solutions to individual hearing loss. The company is proud
that its advanced To hear interviews
products also of- with Widex execufer relief from tin- tives, visit the
multimedia section
nitus and plans to
at www.advance
continue to con- web.com
centrate just as
much on the design and comfort of hearing
aids as the technology inside them.
Corporate Citizenship/Humanitarian Efforts:
Its new, entirely CO2-neutral headquarters
in Denmark is a major statement about the
Widex commitment to good corporate citizenship. Company officials hope that their
environmental efforts will be an inspiration to others. In many countries around
the world, when it comes to humanitarian
causes, Widex continues a history of being
discreetly yet actively involved, generous
and compassionate.
Contact Information: Widex USA, 35-53 24th
St., Long Island City, NY 11106, 800-221-0188,
www.widexPro.com, www.widexusa.com
a DVa n c e fo r H e a r ing P r ac t i c e m a n ag em en t
27
hearing Technology
By Donald J. Schum, PhD
Rethinking Accessory Devices
Additional technology can
increase hearing aid benefit.
28
l
▲
There is no doubt that modern hearing aids go a long way toward
solving the communication difficulties of our patients. However, for
basically any patient, there are going to be some communication situations where hearing aids alone will not meet all hearing challenges. For
many years, accessory devices have existed to supplement the benefit
provided by hearing aids. With the new age of wireless connectivity in
hearing aids, the effectiveness, simplicity and seamless integration of
these devices have improved dramatically. This new technology has
challenged professionals in our field to take a new look at how acces- Candidacy
sory devices can fit into modern patient care.
As hearing loss becomes more prevalent, it is logical that the situational limitations of personal amplification will increase as well. With that being stated,
The Role of Accessory Devices
however, nearly any person with hearing loss will run into situations where
Accessory devices always have been of two major types: those that additional technology may increase benefit and satisfaction. A wide range of
connect through personal hearing aids (such as FM receivers, compan- hearing aid users most often report problems in three situations: telephone
ion microphones, electromagnetic phone signals) and those that are use, television viewing and conversations in particularly noisy situations.
independent of hearing aids (such as enhanced alarm clocks, doorbells, These situations can pose a problem even for those with mild to moderate
smoke alarms). Both hearing aid manufacturers and independent hearing loss, and all three of these situations have been addressed by a variety
companies have developed many different devices over the years to of manufacturers using the new age of wireless technologies.
solve specific listening needs that are not completely addressed via
Telephone use: Historically, hearing aid users have used telephones
hearing aids alone. Accessory devices that are independent of hearing in one of three ways: direct acoustic coupling to the microphone,
aids have continued to develop and play an important role in the lives via the T-coil magnetic and magnetic transmission and by simply
of those with hearing loss. But the new connectivity landscape has taking the hearing aids out. Despite these options, Kochkin reports
greatly changed those devices that connect through hearing aids.
that phone use continues to vex hearing aid users.1 The frustration
One of the major historical limitations to using accessory devices only has increased with the widespread availability of cell phones,
that connect through hearing aids is getting the signal in a form that as those with hearing loss feel like they are falling farther behind.
the hearing aid could use while at the same time protecting signal Although home phone use is not without its challenges for those
integrity. Until a few years ago, hearing aids only could receive sig- with hearing loss, the gap between the performance of mobile
nals either acoustically through the microphone, electromagnetically phones for those with normal hearing and those with hearing loss is
through the T-coil or via a direct, hardwired electronic connection even greater due to two reasons. First, in the home environment, the
Jeff Leeser
(DAI or FM boot). Signals of interest in the environment had to be
delivered via one of those three pathways. If the signal could not be
delivered appropriately via the acoustic pathways, then the signal had
to be converted and delivered to the hearing aid. That conversion and
delivery process required specific equipment and, even when available,
did not always provide optimal performance for the user (phone use
of T-coils being the most common example).
With the widespread availability of wireless Bluetooth® signals from
mobile phones, there was a natural push for hearing aid manufacturers
to find a way to capture these signals and provide them to the hearing
aid. Bluetooth, however, is not necessarily a good technology for hearing aids, since the size of its componentry and its power requirements
make it impossible to integrate Bluetooth receivers directly into hearing aids. Over the past four years, many different manufacturers have
introduced connectivity solutions, initially designed to capture and
deliver Bluetooth signals. Two major approaches have been developed
using intermediary devices to convert the Bluetooth signal to either
a near field magnetic induction (NFMI) signal or a radio frequency
(RF) signal. Very quickly, the manufacturers also expanded their
connectivity offerings to include capture and delivery of signals arising from sources such as home phones, televisions, computers and
navigation systems. Now, for essentially any device that creates an
audio signal, there is a solution to get that signal into hearing aids at
a high level of sound quality.
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hearing Technology
acoustics are somewhat controlled by the person with hearing loss television viewing may significantly enhance the viewing experience,
whereas mobile phone use can occur in a wider range of environ- especially for previously difficult-to-understand material.3
ments, many of which include significant competing noise signals.
Face-to-face conversations in noise: Hearing aid technologies
Secondly, not all cell phones that are commercially available have designed to improve speech understanding in noise, especially
good M and T ratings.
directionality, have come a long way over the past couple of decades.
If a patient does not spontaneously indicate difficulties with home or However, there always will be situations where hearing aids alone
cell phone use, do not assume that all is well. It may simply be that the will not completely overcome background noise even for face-toperson has given up trying to use the phone as much as they would prefer, face conversations. Patients say they typically face challenges in
perhaps not realizing that new connectivity options exist.
environments like noisy, reverberant restaurants and while riding in
Television viewing: At first pass, it would seem that special help the car. Wireless companion microphones, designed to supplement
with television viewing should not be necessary for a person wearing the benefit provided by ear level amplification, have been developed
hearing aids since, if the volume is too low coming from the tele- (Figure 1). These devices piggyback on the new connectivity soluvision, the hearing aid volume control can be used to compensate. tions that currently exist and can provide improvements in the
However, the facts tell us that television viewing still causes diffi- signal-to-noise ratio similar to that of FM. Their discreet size and
culties for hearing aid users.1 Remember, though, that it is not just seamless integration into total connectivity solutions for patients
about sound volume. A variety of other acoustic factors can affect make them popular new problem solvers.
the ability to hear and enjoy the signals coming from the television, such as room acoustics, environmental sounds in the home, Initiating the Discussion
distance, or other people talking. Turning up the volume on the Providing connectivity options along with newly fit hearing aids
television to compensate is typically not an option if other persons is growing in popularity. However, the pattern of behavior amongst
with normal hearing also are watching or in the vicinity.
professionals tells an interesting story. Examination of professional
Again, if patients are not immediately reporting television issues, ordering patterns indicates that some dispensers are providing conthat is no guarantee that all is well. Further, the role of television in nectivity devices to a large proportion of their patients whereas others
the life of an older person is different than for a younger adult; TV is are offering very few devices. This pattern suggests that one segment
an important connection to society that can be used to compensate of the professional community has decided that connectivity is an
for the increasing isolation that is often an inevitable part of the important supplement to the benefit provided by personal hearing aids
aging process.2 The new connectivity options that are designed for and that there are options that make sense for many patients. Another
segment seems to have adopted a more conservative approach and is
using connectivity only as a special-needs solution.
It is important to recognize that the role of the professional is to present the very best recommendation to the patient. We all acknowledge
that, no matter how far hearing aids have come, there still are areas
where patients struggle. Modern, advanced technology amplification
can be effectively supplemented by the new age of connectivity options.
It is important that the professional not fall into the more traditional
mindset that accessory technology is an option that is utilized only
when specific patient needs are reported. There is strong enough eviMARCH 2011
dence that connectivity can enhance the perceived benefit provided by
amplification, and a strong case can be made that it should be discussed
with every patient at some point in the fitting process.
Q Finding and Leasing Space for
Some professionals are wary of discussing connectivity with a firstHealthcare Practices and Clinics
time user due to financial concerns; if the patient already is concerned
Thursday, March 31, 2011 • 5:00 PM EDT
about the expense of hearing aids, how will he/she respond to the
Speaker: Mike Moloney
additional expense of connectivity options? However, it is not the
responsibility of the professional to make financial decisions for the
This practical webinar will bring you up to speed on how to
patient. Again, the professional’s responsibility is to provide recomfind space and a good location for your practice or clinic.
mendations as to the most effective treatment options. Further, the
Topics will include: where NOT to look; ideal locations and
pricing of connectivity technologies tends to be a fraction of the total
why they are ideal; how much rent to pay; how to find space
cost of hearing aids. Given the effectiveness of wireless connectivity at
without losing too much of your time; major pitfalls to avoid.
enhancing communication in important situations such as telephone
use, television viewing and one-to-one communication in highly noisy
environments, increasing the total patient cost by 5 to 10 percent should
be kept in perspective.
FREE WEBINAR
FROM ADVANCE
Choosing a System
Sign up online for these FREE events!
There are a variety of hearing aid manufacturers that now provide
wireless connectivity product lines. The professional who is ready to
30
l
March/April 2011
hearing Technology
situations are reported by the patient after
the initial fitting. However, the significant
technical advances in new wireless devices
offer alternative, proactive options. A preemptive mindset has the potential to bring
both a higher level of benefit to almost every
patient and to enhance the health of the professional’s practice. References
1. Kochkin, S. (2010). MarkeTrak VIII: Consumer satisfaction
with hearing aids is slowly increasing. Hearing Journal; 63(1):
19, 20, 22, 24, 26, 28 30-32.
2. Schum, D & Sjolander, L. (2011). The Impact of Connectivity
for the Older Patient. The Hearing Review. In press.
3. Kreisman, B. (2010). Connectivity and Quality of Life Of
Elderly Hearing Aid Users; Paper presented at Audiology
Now, San Diego, April.
Donald J. Schum, PhD, is Vice President, Audiology & Professional Relations, at Oticon
Figure 1. A wireless microphone designed to
overcome high levels of background noise during
face-to-face conversations. In this configuration,
the talkers signal is picked up by a small, body worn
microphone (A) with active noise control (B) and converted to a Bluetooth® signal. The Bluetooth signal
is sent (C) to a body-worn gateway device, converted
to a digital magnetic (NFMI) signal and sent (D) to the
hearing aids.
embrace this new era of technology is faced
with the task of choosing a supplier that
makes best sense. Here are some questions to
ask when considering which system to use:
• Is the system designed for easy use by the
patient, especially older individuals?
• Does the system integrate seamlessly with
hearing aids without a high level of patient
manipulation?
• Does the system protect sound quality?
• How many different connections are possible? Can they be available and operational
at the same time?
• What accessory devices will the patient
have to wear/use?
• Can multiple connectivity devices be
used easily?
• How will connectivity affect battery life
in the hearing aid?
• Is the system robust, both in terms of
wear and tear and also in terms of connection stability?
• Does the use of connectivity allow for full
access to important hearing aid technologies,
or does the choice of connectivity supplier
limit hearing aid choices?
Total Patient Care
Although the primary treatment option for
hearing loss is hearing aids, there always
is going to be the need to supplement personal, ear-level devices. The professional
can continue to treat accessory devices as
special-use solutions only when difficult
ALL THE
RIGHT
THINGS
2%:
17%:
Hearing aid industry’s rate of growth
through the third quarter of 2010*
AHAA’s core group of Associates’ rate
of growth in 2010, and 16% in 2009
7KRVH¿JXUHVDUHQRWW\SRVDQGFHUWDLQO\GLGQ¶WKDSSHQE\
DFFLGHQW:KHQ$+$$ZRUNVFORVHO\ZLWKSUDFWLFHVWRHQVXUHWKDW
WKHLUVWDIIFRQVLVWHQWO\DFFRPSOLVKHVAll The Right ThingsWKH\
WKULYHIt’s that simple.
3UDFWLFHVRIHYHU\VL]HDQGORFDWLRQKDYHEHHQEHQH¿WWLQJIURP
VLPSO\LPSOHPHQWLQJWKHSURYHQEXVLQHVVWDFWLFVWKDW$+$$KDV
GHYHORSHGRYHUWKHODVW\HDUV²QRPDWWHUWKHVWDWHRIRXU
QDWLRQ¶VHFRQRP\
&OHDUO\WKHUHVXOWVVSHDNIRUWKHPVHOYHV&RQWDFWXVWRGD\WR
EHJLQ\RXUMRXUQH\WRZDUGVdouble digit growth.
*Excludes Veteran’s Administration
LEARN MORE @
31
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hearing Technology
for 20 days and professionals can monitor
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audifon
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Oticon Inc.
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audifon introduces via, a wireless CROS/
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with CROS/BiCROS indication.
www.audifon.com, contact.audifon@audi
fon.com
Krown Manufacturing carries a wide variety of assistive technology for use with and
without hearing aids. The Krown StarPlus-45 amplified telephone with caller
ID offers the latest in telecommunication
technology. The StarPlus-45 not only amplifies the incoming voice by 53db gain, its
advanced circuit design and its electronic
Oticon’s Amigo FM system, including the
tamper-proof, light and slim Amigo R12
ear-level receiver, is easily paired with
anti-feedback filter make every word clearer Oticon ConnectLine™
and easier to understand without any feed- Oticon ConnectLine connects wirelessly to
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and dialing ease.
on the hearing instruFor more information: 800-366-9950, ments’ companion
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Neurotone Inc.
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LACE - Listening and Communication
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LACE 4 is an interactive, adaptive, aural conversation wirelessly to the user’s hearing
rehabilitation program designed for home instruments. ConnectLine solutions optior clinic use, now available on both PC mize the wireless capabilities of Oticon’s
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For more information: www.oticonusa.
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Bellman & Symfon
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32
Safari hearing instruments for an additional boost in classrooms where noise, echo
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hearing Technology
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March/April 2011
l
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advanceweb.com/hearing.
33
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StereoSound provide excellent
sound quality. True plug-andplay and one-step set-up make
it ready to go in less than 60
seconds. Used with the iCom,
one-button control makes it
an extremely simple streaming
device.
phonakpro.com
www.discoverywarranties.com
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5(DG$GYDQFH0DULQGG
industry Insider
Marketing and
Business Strategies
What are some innovative strategies to
market and operate a hearing practice?
For more information: 800984-3272, www.ahaanavigator.
com, TMcLaughlin@AHAAnet.
com
Rick Zaccaria
President
Active Ear
Hearing
& Audiology
cially trained.
AHAA’s focus is on offering
its network members compreOur business
hensive training programs that
strateg y is
In addition to providing expert emphasize activities and pro- based entirely on a patient-cencare, a key focus of a success- cesses designed to foster business tric approach. As result, we spend
growth and organizational more time counseling and fitting
development. Our program, patients and we focus on offer“All the Right Things,” serves ing products and services that
practice employees in every role, will enhance our patient’s entire
including audiologists, office listening experience. The Smart
ful hearing aid practice should personnel and telemarketers. Alert System from Unitron is a
be the experience it provides its It is this systematic method of great example of a solution we
patients. The ability to provide a performing essential business can offer patients to ensure they
good experience takes effective practices and creating good are more aware of their environbusiness and marketing planning patient experiences that drives ment. The Smart Alert System
and a motivated staff that is spe- success.
enables household alerts such as
the telephone, door bell or smoke
alarm to communicate directly
with hearing instruments. For our
patients and their families, this
means peace of mind day and
night.
Unitron’s Smart Alert System
is developed in partnership with
Bellman & Symfon.
For more information: 855327-7767, www.actionear.com,
[email protected]
Thomas McLaughlin
Sr. Vice President
American Hearing Aid
Associates (AHAA)
Tom Robbins
Senior Manager
of Audiology
Business
Development
Computers
Unlimited
Innovations such as a presence
on social media websites are
extremely popular; however,
nothing takes the place of knowing your current and potential
customers. Changing the way
you collect and analyze customer
data is not only innovative, but
highly profitable. Beyond tested/
not sold mailings, targeting direct
34
l
March/April 2011 mail to current customers produces quality opportunities at a
fraction of the cost. The key to
successful marketing is collecting
all customer data electronically at
the time of service, in a structured
manner, for future reference. A
well maintained database will
continue to produce new revenue
far into the future.
For more information: 800763-0308, www.timssoftware.
com/audiology, [email protected]
Nancy Palmere
Senior
Marketing
Manager
Oticon Inc.
Not innovative,
but certainly
a proven strategy: Take advantage of marketing/business
support provided by hearing
care manufacturers. At Oticon,
our business support provides
access to the newest marketing/business strategies to help
practitioners differentiate their
practices, increase positive client outcomes and improve the
bottom line. We recognize that
practitioners have very different needs depending on their
practice settings, and we have
identified the specific needs of
different customer groups and
developed marketing programs
and customized solutions most
effective and appropriate for
each. Business development is
the focus of Oticon’s knowledgesharing initiatives, including
marketing meetings for retailoriented practitioners and more
medically focused forums for clinicians working in hospitals and
ENT clinics. We also offer Blueprint Solutions, Healthy Hearing
and other practice management
tools to help practitioners stay in
touch with their patient base via
direct mail and other marketing/
promotion strategies.
oticonusa.com
SPONSORED BY
BUILDING YOUR PRACTICE
THROUGH EDUCATIONAL SEMINARS
ducational seminars are an effective way to increase
awareness of hearing loss and hearing solutions in a way
that positions you and your practice as authoritative and
caring community resources. Educational seminars appeal to
people beginning to explore options for addressing their hearing
loss and to those who are not ready or still considering what actions to take. These information-sharing events are a non-threatening way to learn about hearing loss without the pressure to
act immediately that some might feel in a one-on-one consultation. The information you provide can be the catalyst to motivate
those with untreated hearing loss to finally take action.
A seminar also lets you support current hearing instrument
users with tips and suggestions to improve communication. It is
a great forum to inform them of new technology, such as wireless
connectivity, that can make a positive difference in their lives.
BECOME THE EXPERT
No matter where you hold a seminar —your office, a retirement
community, local restaurant, community center or other facility
— you become the expert in hearing and hearing health care.
This is an ideal opportunity to talk about how you practice hearing care and what makes your practice unique. Highlight the
services you offer and explain what patients might expect when
they are in your care.
The friendly setting allows you to make a connection to the
participants and begin to build a bond that can extend beyond
the seminar session. Enlist a current patient to share his or her
story to show the potential of modern hearing solutions to empower people to engage more fully in life.
Make your guests feel welcome, comfortable and glad they
came. Capture the name, address and email of everyone who attends. This will enable you to maintain the connection through
thank-you notes and follow-up mailings to the attendees.
Ensure everyone can hear the speaker and see the slide show.
If the seminar includes a demonstration, the presenter should
still talk to each participant and answer questions. Have your
appointment book handy. Make an effort to meet with each attendee, and ask whether they would like to book an appointment
based on what they have learned at the seminar.
MARKETING THE EVENT
Seminars are a cost-effective way to conduct new patient outreach. Depending on the location, advertising your event can be
as simple as posting flyers or posters at a community center or
clubhouse.
For some seminars, advertising in the local newspaper enables
you to reach a larger audience of potential clients. If the seminar
is held in a public forum such as a local library or community
center, you may be able to promote your seminar in the events
calendar of the local newspaper or on the community website.
Use your website, your newsletter and emails to inform current patients of the event and ask them to invite a friend who
may need amplification.
Oticon developed Success Tips for Planning Your Patient Educational Seminar to help you plan and conduct effective educational
seminars. This easy-to-follow guide helps you set objectives for
your seminar and walks you through the steps of holding a seminar, from planning to follow up to measuring your success. There
are practical tips, places for notes and checklists.
Oticon Sales Representatives are also available to discuss the
logistics and benefits of conducting an educational seminar. For
information and to request your copy of the Success Tips brochure, contact your Oticon representative today. Q
2 BUILDING REVENUE | ADVANCE FOR HEARING PRACTICE MANAGEMENT | MARCH/APRIL 2011
Turning Insights
Into Action
When selecting
hearing instruments,
there is no such thing
as one size fits all.
Through enduser insights, Oticon has learned that it isn’t just about the
peripheral hearing system we are supporting: it’s the whole person. A holistic
approach to audiology recognizes that patients’ auditory abilities and cognitive
skills differ and the key to true client satisfaction lies in treating the person as
an individual.
The Oticon product portfolio empowers people to communicate freely,
interact naturally and participate actively.
PERFORMANCE
PREMIUM
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ADVANCED
Acto
ESSENTIAL
Ino
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POWER
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Chili
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Learn more at oticonusa.com or call 1.800.526.3921
BUSINESS STRATEGIES
FOR SUCCESS
>> BY RONALD GLEITMAN, PHD, DIRECTOR, PRACTICE MANAGEMENT, SIEMENS HEARING INSTRUMENTS, INC.
earning practice management skills is essential to keeping
your practice on track. It’s a big subject, but I can share
with you some of my favorite rules of thumb.
KEY PERFORMANCE INDICATORS
The numbers don’t lie.Your systems should track your key performance indicators, a key aspect of performance management
and an objective measure of your practice’s success. These indicators include: new patient acquisition, call to appointment
ratio, cost of patient acquisition, close rate, binaural rate, ASP
(average selling price), return rate, and your marketing return
on investment.
THE BUSINESS PLAN
The business plan serves as a road map to implement change
or manage your practice. It permits analysis of all aspects of the
business such as projected income, expenses, marketing, staffing issues, patient management, competition and goal setting.
The business plan helps you to stay competitive, measure your
practice, and set goals.
Leg one is internal marketing, which is centered around
communication with your patient database to keep them coming back. Ask yourself what you want to communicate and how
frequently. The primary goal of internal marketing is to take
your patient out of the market place where your competitors
are marketing.
Leg two is external advertising, which will help you get new
potential end-users into your practice. This includes internet,
television, radio, and newspaper advertising as well as direct
mail, billboards, and other print advertising.
Leg three tackles how you are going to get more physician
referrals. First, internal physician marketing involves increasing referrals from the physicians of your current patients. Then,
external physician marketing lets primary care physicians know
who you are, where you are and why you exist. Build a list of the
area physicians you want to target with your market and a strategy on how you are going to get into their referral system.
For information on Siemens services that can help you make
the most of your business, contact your Siemens Sales Representative at (800) 766-4500. Q
OPTIMIZING YOUR PATIENT DATABASE
Optimizing your patient database consists of retaining current
user base through various communications such as telemarketing, direct mail, and face to face office visits.
WHERE YOUR PRACTICE STANDS
Take the SWOT approach to evaluating your business. Identify
your Strengths (what does your practice do well), Weaknesses
(what need improvement at your practice), Opportunities
(where do you see your practice in the future), and Threats (how
are you threatened in your practice?) to manage your practice
successfully.
SETTING SMART GOALS
Make sure your goals are SMART: Specific, Measurable, Actionoriented, Realistic, and Time-bound. As an example, “I will raise
my average selling price to $2,100 per device utilizing Top Down
Selling and the Client Oriented Scale of Improvement (COSI) by
the end of the second quarter of this fiscal year.” All goals need
to be reviewed regularly.
THREE-PRONGED APPROACH TO MARKETING
Divide your marketing efforts into what I call a Marketing
Tri-Pod.
4 BUILDING REVENUE | ADVANCE FOR HEARING PRACTICE MANAGEMENT | MARCH/APRIL 2011
Why miss a decibel
of life?
Introducing Siemens iMini™.
There’s CIC, and then there’s the invisible iMini.
Advanced hearing technology in its tiniest and most colorful form.
www.usa.siemens.com/imini
Answers for life.
practice management
By Brian Taylor, AuD
Achieving Success
in 20 Questions
If you grew up in the 1950s, you might remember the popular television game show “20 Questions,” in which one player chose a subject
and the others had to try to guess what it was by asking up to 20 yes-orno questions. Today, the 21st century equivalent of the game is simply
called 20Q and, like many activities, is available to be played online.
Besides being entertaining, the 20Q concept encourages creativity
and deductive reasoning. The 20 questions posed below are intended
to get you more engaged in the nuts and bolts of running a practice
and enable you to think more strategically about your business.
Implement the tactics suggested for each question, and you have
an excellent chance to “win” in your practice.
1. Do you know what you want your practice to be known for? This
question allows you to determine your unique selling proposition (USP)—that distinct, appealing idea that sets your practice
apart from your competitors as well as other related businesses
where customers can choose to spend their hard-earned dollars.
For example, as a potential customer is deciding how to spend
discretionary income, cosmetic surgery or hiring a personal
trainer may be competing with the idea of getting hearing aids.
Your USP is likely to revolve around just five possibilities: price,
product, technology, customer service, or memorable patient experience. It’s up to you to determine which of these five dimensions
is your USP and to design your practice’s goals, objectives and
marketing tactics around the dimension for which you want to
be known.
nesses, opportunities, and threats to your business is a proven way
to get started on long-range planning.
4. Do you have a plan with specific, measureable objectives? Once
you have established a long-range plan and set goals, you need
3. Do you have a long-range plan for growth? If you have not planned to make sure your staff understands their job assignments with
or thought about your long-range plans for success, you could be enough detail so there are no misunderstandings as to what is
moving in the wrong direction and not know it until it is too late. expected of them each day. The key to this point is to provide clear
Opportunities to generate profits may be lost.
communication and coaching in order for each employee to know
Develop a long-range planning procedure and review this plan how their efforts contribute to the success of the organization.
periodically. You may need to modify it as the economy or your com- Conducting weekly one-on-one meetings with each member of
petitive landscape changes. Long-range planning often starts with a your staff to review their projects and tasks is a great way to build
strengths, weaknesses, opportunities, and threats (SWOT) analysis. a personal relationship with them as well as ensure things are getBrainstorming with your staff and identifying the strengths, weak- ting done.
40
l
Jeff Leeser
2. Do you have specific business goals? Many practice managers are so busy taking care of their patients that they don’t have
the time to plan. In short, planning means you are setting some
clear performance goals for your practice. These goals typically
revolve around raising the bar on either productivity (seeing
more patients, dispensing more hearing aids) or quality (taking
better care of patients or operating more efficiently).
practice management
J\\=fi
Pflij\c]
allow you to foster a deeper
bond with patients. In addition, taking the time to incorporate these tests as well as
other more cutting-edge proFigure 1. Adding value in the margin cedures, like speech mapping
will ensure loyal patients.
and computer-based auditory
training, add value to your offerings. As Figure 1 suggests,
5. Do you set clear expecta- there is no better way to feel
tions? Based on years of experi- good about the retail prices
ence we know that owners and you charge than adding value
managers who take the time to by providing innovative serplan and set goals often have vices and tests during your ina far greater chance of being teraction with patients.
successful. After setting goals,
be sure to clearly communicate 8. Do you have a selling proyour expectations for accom- cess? It’s surprising how many
plishing your goals.
clinicians leave the consultation
with the patient up to chance. Tak6. Do you have an of fice ing the time to develop a formal
management system? In ad- consultation process will make it
dition to either a web-based likely that you move the patient
:XgK\c:Xgk`fe\[K\c\g_fe\
Add value to the patient's experience by
bundling warranties, batteries and office visits
into the price of hearing aids.
or stand-alone office management system, you need a
process in which you book appointments, schedule recall
visits and mine your existing
database as part of a systematic patient retention program.
Paying attention to your patient pipeline through diligent
management of it will ensure
you have a steady supply of
patients coming through your
doors.
March/April 2011
l
9. Do you add value to the
patient’s experience in your
office? One way to add value
is to bundle warranties, batteries and office visits into the
price of the hearing aids. Any
time you are bundling goods
and services into the price, it
enables the customer to look
at the long-term value of your
offering.
You a lso ca n conduct a
patient experience audit. Start
by recording all the points of
contact you have with a typical
patient, such as shown in Figure 2. Once you have recorded
all these points of contact, ask
yourself, “What does my staff
need to do in order to make the
experience for the patient memorable and engaging?”
41
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7. Are you relying on the tests
and procedures you learned in
graduate school to make clinical decisions? Based on MarkeTrak VIII data, there is a relationship between pre-fitting
test protocol execution and
patient satisfaction. Taking the
time to implement more engaging pre-fitting tests like the
Quick SIN, Acceptable Noise
Level and TELEGRAM will
from one point to the next and
that you ask them to do business
with you.
practice management
Figure 2. The various patient points of contact, along with optimum time of
appointment. Those listed on the bottom of the line are in-direct points of contact
with your practice, such as visits to your website.
set at least part of the agenda
10. Do you generate and track is a great way to build mutuword-of-mouth referrals? Be- al trust. After all, it is largely
cause word-of-mouth referrals trust that allows you to focus
add virtually no extra cost to on what you do best while your
your bottom line, it makes staff completes other imporperfect sense to try and get tant daily tasks. During your
as many of them as possible. weekly sessions, be sure to set
There are several ways you can aside time for each member
generate more word-of-mouth of your staff to bring up items
referrals; all of them rely on they want to discuss.
your ability to work your patient retention plan.
13. Do you provide your staff
with constant feedback? As
11. Does your staff have a clear the practice owner or manunderstanding of what is ex- ager, one of your primary repected of them? What seems sponsibilities is to lead your
obvious to you may not be so staff and to expect them to be
for your staff. Employees have a continually improving at their
strong desire to know how their job. One way to let them know
time and efforts contribute to how they are performing, both
the success of the practice. You what they are doing well and
can start by asking members what needs improvement, is to
of your staff how they create bathe them in constant feedvalue and how they rank their back about their performance.
daily priorities. Once you gain
agreement on what their pri- 14. Do you provide coaching to
orities should be, you can dis- your staff? Beyond providing
cuss exactly how their efforts feedback, you need to make
are intended to contribute to sure your staff is continually
the practice’s success, such as improving or taking on greater
shown in Figure 3. If you’re not responsibilities. By directing
sure of the answer, ask your them to the appropriate restaff to answer this question.
sources you can be sure they
continue to fine-tune or im12. Do you have weekly one-on- prove their skills.
one meetings with your staff?
In order to build an effective 15. Do you have an obsession
business relationship with with quality? Quality is that
each member of your staff, difficult-to-define term that can
it’s important to get to know be a huge competitive advanthem as a person. During your tage and ensure that you comweekly, one-on-one meetings mand an above-average selling
(Question 4), letting your staff price for your products and
42
l
March/April 2011
practice management
Figure 3. All staff need know how they contribute to at least one of these three variables. Weekly
meetings, feedback and coaching all revolve around
striving to improve these three dimensions of practice productivity.
services. In short, customers rave about Start by knowing how you want to price
quality when they experience it. As shown products; do you want to be the low-end or
in Figure 4, there are three dimensions to high-end player in your market, or do you
quality: effectiveness, which is your ability want to play in the middle ground?
to execute evidence-based clinical procedures; efficiency, which is your ability to 19. Do you have a marketing strategy? Most
work patients through your process in a business owners agree that at least 10 perthorough manner; and emphasis on re- cent of annual revenue needs to be reinsults. By taking the time to measure hear- vested into marketing. Once you have esing aid outcome as well as several aspects tablished a marketing budget, the next step
of your interaction with the patient, you is to create a plan. Typically, owners like to
are more likely to become the provider of devise a monthly calendar that plans out
choice in your area.
the entire year. In addition to pre-planning
an entire year, it’s important to use a wide
16. Do you have a passion for the mundane range of marketing tactics and measure the
details, such as fixed costs and margins? return on investment for each.
It’s not enough to look at the final results
on a monthly basis. Successful business 20. Do you get a sense of accomplishment
managers know the details of their busi- from managing your business? In today’s
ness. Knowing about your variable and incredibly hectic world of business, the
fixed costs, cash flow and accounts pay- ability to simplify and find small, increable and receivable on a daily basis is mental areas to improve in your practice
important to success. For example, fixed is the key to finding long-term success. In
Give yourself the competitive advantage of quality by being
effective, efficient and emphasizing results.
Figure 4. The 3 Es of quality
Figure 5. The Pyramid of Success shows the things
it takes to be successful in a hearing aid dispensing
practice.
w w w.advance web.com/hearing costs are those that you accrue even his long and very successful career, John
when you are not dispensing hearing aids. Wooden, the coach of the UCLA men’s
When left unchecked, fixed costs can have basketball team, won 14 national chama devastating consequence to the bottom pionships. Much of Wooden’s unprecline of your practice. Review this data of- edented success was not the direct result
ten and update your budget as needed.
of his ability to recruit top talent or coach
during the game. Rather, he attributed
17. Do you have an annualized budget with his success to being an effective teacher
revenue and product mix objectives? In and leader. During his tenure, he creorder to maintain a vision for your com- ated the “Pyramid of Success” (Figure 5),
pany (Question 1) you need to align costs, which schematically shows the essential
revenue and margins with your vision. characteristics and behaviors needed to
A budget serves as a template for your be successful.
The concept of the Pyramid of Success
monthly revenue and unit targets.
has great utility for managers and owners
18. Do you have a retail pricing strategy? of audiology practices and can provide a
There are a couple of reasons it is absolute- foundation for long-term success. As you
ly critical to have a clear pricing strategy. move up your pyramid, the skills required
Without one, it’s easy to fall into the trap to be successful become more complex and
of providing discounts (cutting a deal) finally culminate in your ability to identify
with every customer that comes through areas of improvement and simplify essential
your door. A pricing strategy also helps processes. Asking yourself and your staff
you build a budget. If you are able to main- the 20 questions posed above will help you
tain a precise retail price, you can plug get to the top.
that number into a monthly or annual
unit forecast that will enable you to project
revenue over the course of a year. You sim- Brian Taylor, AuD, is director of practice developply cannot do this without stable pricing. ment and clinical affairs for Unitron US.
March/April 2011
l
43
resource directory
optimal hygiene
maintenance.
These kits may be
helpful to clients
in reducing buildup of harmful bacteria,
fungi and viruses, preventing eczema and
needed. Nine sizes in 17
ear infection and promoting well-functioncolors are available for
ing hearing instruments. There are two kits
all makes and models
available for purchase: one for Standard
of BTE devices. Made
Tubing/Earmolds and one for ITE/Slim/
in USA.
micro Tubes.
For more information:
For more information: www.phonakpro.
866-644-2500, www.hearingaidsweatband. com
com, [email protected]
Advance Guide to
Hearing Aid Accessories
Discovery Warranties and Repair
Discovery Warranties offers comprehensive service warranties on all makes and
models of hearing aids. Discovery compensates dispensers
for t hei r t i me
and efforts with
a rebate on each
w a r r a nt y s old
or renewed, and
the user-friendly system requires minimal
paperwork with a streamlined process to file
claims. Discovery Repair is a rapid-response,
full-service, all-make repair company offering the advantage of experience in repairing
older and newer instruments.
www.discoverywarranties.com, www.dis
coveryrepair.com, discoverywarranties@
discoverieswarranties.com
VARTA
Designed for people on the go, power one
Established in 1976, Hearing Technologies ACCU plus rechargeable batteries and
International Inc. is a leading designer of
cordless chargers
hearing aid care products that are designed
are quickly gainfrom the hearing aid
ing popularity for
wearer’s point of view.
reliability and conIts products are disvenience. Made in
Germa ny, t hese
tributed by many of
batteries contain
the world ’s leading
0 percent mercury
manufacturers and
distributors includ- and are manufactured according to strict
ing Hal-Hen (AAA booth 1358), Oaktree environmental and quality standards.
Ear Gear
Products (AAA booth 1760), and Warner Available in all popular sizes, rechargeable
Ear Gear hearing instrument armor is an Tech-Care Products (AAA booth 1254).
batteries require little sales effort and can
acoustically transparent, water-resistant,
For more information: 800-553-6003, www. result in dependable profits. Power one sales
d o u b l e - w a l l hearingtech.com, [email protected]
deliver continuous revenue, high profit margins and the opportunity to interact with
spandex nylon
sleeve that proyour customers more often.
tects hearing Pehratek Products
For more information: 800-468-2782, ext.
i n s t r u m e n t s AID-GRIP offers a revolutionary new way 203, www.powerone-batteries.com
from dirt, sweat, to securely grip open ear devices onto the
moisture and
ear to prevent loss
loss. At AudiologyNOW!, Ear Gear will
and improve wear- Warner Tech Care Products Inc.
have all of its models on display, from those
ing comfort. It offers Located in Roseville, MN, Warner Tech Care
that fit the smallest RIC to those for cochlear
a double-backed Products Inc. stocks and provides an everimplants. The company also will introduce
adhesive cushioned increasing line of hearing aid accessories.
retention pad that has Warner prides itself on being a single-source
its latest model, Ear Gear ITE.
For more information: 888-766-1838, been specifically designed for miniature OTE supplier that helps audiologists provide
www.gearforears.com, AAA booth 1463
devices to secure them to the back of the ear better hearing. Accessory products can
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Hearing Technologies International Inc.
l
also
s.
s
s
you.
elone
may
ew
ay
of
he
has
know
ause
ouch
good
rage
w.
g
even
MOUNTAIN
of students require amplified oral
Audiologists measure classroom
instruction on any given day.
acoustics and ambient noise and help
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p. 45
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Sound field amplification in the
To keep
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In the Mainstream Amplification
SOUTHWEST
not use
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placing excessive
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Tell your patients that they also
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Evaluating Fitting
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Sound Field
There
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2 criteria for
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TO RENEW
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Evaluating Fitting
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Determine if the software is
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have a volume of materialsMarch/April
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45
career opportunities
can
uable
nize
hires
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diff
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cou
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By Barry Freeman, PhD
Point of view
Educating the Public
The National Council for Better Hearing (NCBH) was founded
in 2010 with a mission to provide the public with educational and professional resources so people can live with healthy hearing. The NCBH Board
of Directors is comprised of leading hearing healthcare educators and
providers who are dedicated to bringing broader access to and understanding of current hearing care options including the diagnosis, prevention,
management and treatment of hearing loss. The ultimate goal is to
ensure that consumers get the quality care and guidance they need to make
informed decisions about hearing healthcare.
The board believes that if consumers are mation on hearing loss and hearing aids.
provided with the right knowledge, they Despite still being in its infancy, the site
will be empowered to better deal with the has moved to the top of most search engines
causes, complications and treatments of and is averaging more than 38,000 conhearing loss. To that end, NCBH is dedi- sumer contacts per month.
cated to educating and helping people
Among the most frequently visited
achieve the healthiest hearing lives pos- portions of the site is the “Your Hearing
sible, and the NCBH Board is focused on Journal” section. Here, consumers can build
providing the most current and relevant personal journals and libraries of informainformation about hearing healthcare and tion on hearing loss and hearing aids. As
extending connections to hearing professionals who can guide patients in their
journeys to healthier hearing.
loss can severely and negatively impact one's
ability to communicate, acquire economic
prosperity and enjoy life. As research and
technology rapidly advance, there already
have been dramatic improvements in the
understanding and treatment of hearing
loss. Without question, these advancements will continue, and it is incumbent
on the hearing profession to maintain a
The values of NCBH include:
• Dedication to improving the overall
hearing health and wellbeing of those dealing with hearing loss;
• Working with leading hearing care professionals and other key partners to expand
access to educational materials to help people acquire the care they need;
• Supporting the hearing professional and
patient relationship by empowering people
with information, guidance and tools so
they can make the hearing health decisions
that are personally right for them.
As more people with hearing loss gain
access to the Internet, they are searching for
a credible and neutral third party that can
provide them with information on management and treatment of hearing loss. To
accomplish this goal, NCBH sponsors the
new consumer hearing education website,
www.Hearing-Aid.com. Since it went live
in September 2010, this site has gained a
reputation as a valuable resource for infor-
they read an article or find information rel- well-informed public. NCBH accepts a role
evant to their personal hearing needs, they in the dissemination of information to the
can save the information to their journal public by helping people better understand
for future reference. Without question, hearing loss and the advances in hearing
today’s consumer has more access to infor- aid technologies, as well as professional
mation than ever before. NCBH, through care options through sponsorship of HearHearing-Aid.com, compiles and organizes ing-Aid.com.
this information for the consumer. Of
course, as Hawkins notes, as consumers Reference
gain this information, they will push the 1. Hawkins, DB. (2010). Perspectives. “Best practice”
limits of practitioners and demand qual- and the well-informed hearing aid patient: Are you
ity services that adhere to best practice ready? Audiology Today, 22(5): 64-65.
guidelines.1
Hearing loss currently affects more than
36 million people in the U.S. and an esti- Barry Freeman, PhD, is board chair of the National
mated 650 million globally—a number Council for Better Hearing and senior director of
projected to increase in the next several audiology at Starkey Laboratories. Contact him at
decades. Left untreated, even mild hearing [email protected].
46
l
Outreach
CELEBRATE BETTER HEARING
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