From My Perspective: Thriving in the New Audiology Frontier In an unfamiliar landscape of competing interests, private practice audiologists must develop new strategies to keep upȔor risk being left behind. From My Perspective
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From My Perspective  |   January 01, 2014
From My Perspective: Thriving in the New Audiology Frontier
Author Notes
  • Robert R. Broeckert, MS, CCC-A, is a private-practice audiologist and co-owner of Hearing Clinics of Wisconsin. broeckertr@yahoo.com
    Robert R. Broeckert, MS, CCC-A, is a private-practice audiologist and co-owner of Hearing Clinics of Wisconsin. broeckertr@yahoo.com×
Article Information
Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Practice Management / Professional Issues & Training / From My Perspective
From My Perspective   |   January 01, 2014
From My Perspective: Thriving in the New Audiology Frontier
The ASHA Leader, January 2014, Vol. 19, 10-12. doi:10.1044/leader.FMP.19012014.10
The ASHA Leader, January 2014, Vol. 19, 10-12. doi:10.1044/leader.FMP.19012014.10
Thriving in the New Audiology Frontier
In an unfamiliar landscape of competing interests, private practice audiologists must develop new strategies to keep upȔor risk being left behind.
BY ROBERT R. BROECKERT
Recently I saw “Mrs. S.,” a longtime patient of mine who is 78 years old. Mrs. S. has moderate to severe hearing loss. Over the years, I had fitted her with and serviced two sets of high-end, behind-the-ear hearing aids. On this day, though, I noticed she was wearing different instruments. Mrs. S. told me, “My new insurance paid for all but about $400 per aid. They were so inexpensive, I felt I had to try them.”
But now that she had worn them for a month, she had nothing positive to say about them except that they were low cost. She complained that speech was not loud enough, so she was constantly adjusting her aids. She had returned to the nonaudiologist dispenser her insurance mandated several times. The dispenser offered her the three hearing aid options available through her plan, and gave her the strongest option—which, according to her audiogram, was appropriate for her loss.
She asked me, “Could you adjust these aids to make them work better? Or do you have any better options in the same price range?” It was a stark reminder of how much things have changed—and continue to change—for the profession of audiology.
These changes, and the new frontier that comes along with them, spur angst in many private practitioners and in the hearing aid industry in general—and it is justified. Patients have more hearing health care options than ever before. Recently, a few of those options are being offered through mega-retail and insurance heavyweights.
What we really offer—what separates us from any new competition—is our expertise in providing better hearing.
Add to that the direct-sale Internet competition and, indeed, much has changed over the last decade. In light of these changes, private practice audiologists have no choice but to develop new strategies to thrive—or inevitably be left outside looking in.
New frontiers need new strategies
I have been an audiologist for 24 years, all but two in private practice. I do not purport to be a practice management expert, but my practice is stable, growing and more profitable each year. That success is not exclusive to my efforts; my business partner and I have complimentary talents and share common goals that have allowed us to succeed. Part of our success is due not only to strategies we use to cope with the increased competition, but also to how we use new market forces to help grow and strengthen our practice. Let’s briefly examine a few of these strategies.
Internet hearing aid sales.
Some audiologists view all retail Internet hearing aid sales as a monolithic, negative entity—a path to purchasing hearing aids that leads local patients away from audiologists’ offices. But I see direct Internet sales as inevitable in today’s shop-at-home world. They fall into one of two categories: those that include local, professional service (good) and those that do not (bad).
For more than 10 years I have been a provider for multiple Internet retailers, who bundle typically one year of my professional services (for example, instrument selection, fitting, verification, counseling and maintenance) into their instrument prices. These patients were referred to me at no cost, and I would not likely have gotten their business otherwise. My reimbursement is reduced compared to hearing aids purchased directly from me, but that is why I charge for service after my one-year contract expires. We inform patients upfront that they are buying the device from the online retailer—not from my office—and, therefore, my included professional services are limited to the defined time period.
A well-placed business website is not the only way to generate significant revenue from increasingly Web-savvy consumers. If I do my job well and provide quality professional services, many remain with me for life. Some patients purchase subsequent devices directly from me. Over time, I have been able to show these patients that I am their hearing care expert—the Internet was just the tool that led them to me.
Patients who try to go it alone and purchase aids on the Web without local services are just that—on their own. When they call (and eventually they do) looking for help, I provide it if I can for a reasonable fee, and then offer a plan of follow-up care, including scheduled maintenance, real-ear verification, aural rehabilitation and so on. As an industry, we know that counseling and follow-up care increase a patient’s chance of successfully wearing hearing aids. If I can make their aid work better—proving my skills are worthwhile—they likely will look to me for advice on their next purchase.
hi HealthInnovations.
UnitedHealthcare’s recent leap into the hearing industry seemed a little shaky at first. With the do-it-yourself online hearing test and self-service initial delivery, the rollout of their plan had—in my view—some significant flaws. But over time the company has made at least some marginal improvements. The company removed the do-it-yourself hearing test and now recommends that patients see a professional for testing; established locations where patients can go for testing and programming; and continues to look for additional professionals (audiologists and nonaudiologist dispensers) willing to serve customers wearing hi HealthInnovations devices for a set fee-for-service rate.
Obviously, low prices are what hi HealthInnovations has to offer the consumer. Mass marketing this program to its subscribers has highlighted the low-cost device as a viable alternative to traditionally higher-priced instruments but, unfortunately, includes no mention of the professional services audiologists provide. Predictably, however, from my experience seeing patients wearing these devices—other than some users who have mild hearing loss— most experienced users found the hi HealthInnovations devices not meeting their expectations. These experienced hearing aid users, who have the benefit of previously listening to modern hearing aid technology such as
wireless streaming and adaptive directional microphones, can tell the difference. In my experience, hi HealthInnovations’ products appeal to new, price-conscious users, but will leave the majority seeking better performance elsewhere.
So how can audiologists benefit from hi HealthInnovations’ products? Certainly, keeping current on the latest product features in devices we offer gives us the chance to demonstrate these advances to customers who ask to hear the difference. hi HealthInnovations’ devices no doubt will increase the number of people wearing hearing aids. Consequently, audiologists will have the opportunity to educate more patients on why devices sold at our offices cost more—namely, because they are prescribed with the latest features appropriate for their specific problems and include all-important professional components (such as loss-specific selection, counseling, fine-tuning, verification measures, aural rehabilitation and troubleshooting) vital to successful long-term hearing aid use.
Big-box retail. Mega-retail stores selling hearing aids is a relatively new concept. What’s different is that this competition sells some of the same brands traditionally sold only in our offices. But in the big-box store—like everything else—they are discounted.
Routinely, I tell new patients that the cost to best solve their hearing problem includes me—my accurate assessment, recommendation of the best option for their problem based on my knowledge of available products, device programming, problem solving, counseling, and expertise—for, likely, the next five to seven years. I point out that whomever they choose to purchase hearing aids from, they are “signing up” with them and trusting them to make the hearing aids work.
Solving hearing problems is not like buying paper products. I don’t care where I buy a 100-roll package of toilet paper, as long as it is cheap. But where I get my health care advice does matter. We all know hearing health is complicated and requires professional services. Even quality hearing aids don’t work well unless they are programmed properly. Some consumers will choose to buy hearing aids from aisle 13—next to the garden hoses— from someone with unknown qualifications. But most seek out a professional approach.
Private practice’s best asset is … you
Ask some audiologists what they offer, and they will tell you they sell hearing aids. These audiologists are the ones most worried about the new frontier. What we really offer—what separates us from any new competition—is our expertise in providing better hearing. Our skills as clinicians and hearing “rehabilitationalists” separate us from the competition. Our ability to achieve each customer’s best hearing is the product we should sell. To do that, we need to keep up with changing hearing aid technology from more than one manufacturer!
To help each patient achieve the best hearing, we need access to varied technology used by no single manufacturer. We need a toolbox that includes comfort and expertise using multiple products, recognition of the need for other assistive devices, benefit and patient-performance measuring tools, patience and counseling skills to guide customers on the journey to their best hearing. If we strive to give each patient his or her best hearing, we have to learn how to do it better than the competition. Our audiology degrees only get us started; how much we continue to hone our skills has everything to do with our future success.
All roads lead to me
Continued success in private practice also means not only satisfying current patients’ hearing needs and retaining them in our practices, but also a steady supply of new customers. My approach to that is having all roads lead to me. Patients often comment that they looked into several discount pathways and I was a choice on all of them!
Too many of us rely heavily on one or two referral sources to fill our waiting rooms. We need to look constantly for new ways to get patients through our doors and make them lifelong customers. Not all discount networks or referral sources are equal—they need to let us use products that allow us do our job well. So again, we need to do our homework and choose networks that we can live with successfully. If we do not continually add new patient streams, the new frontier will indeed be a scary place for us.
Too many of us rely heavily on one or two referral sources to fill our waiting rooms. We need to look constantly for new ways to get patients through our doors and make them lifelong customers.
As for Mrs. S., when she asked if there were any similar aids I could offer for $400 … I simply said, “No.” The devices I had chosen for her in the past had multiple features necessary for her best hearing—and therefore cost more.
I offered her this analogy: It was as though she desired to live in a beautiful home with a wooded lot and two-car garage, but was only willing to pay a mobile home’s price. “Both are places people choose to live,” I said, “but they are quite different.” She thanked me for my time and left.
Two weeks later, Mrs. S. called and left a message to let me know that I had not lost a customer. She had returned what she called her “insurance aids.” Within a month, she was back and started a trial with me with appropriate new devices that provide her with her best hearing—not just the cheapest. Image Not Available
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January 2014
Volume 19, Issue 1