Employ Audiology Assistants to Grow Your Practice In a recent live ASHA chat, audiologist Gyl Kasewurm makes the case for using audiology assistants for a more productive practice. Overheard
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Overheard  |   March 01, 2018
Employ Audiology Assistants to Grow Your Practice
Author Notes
  • Gyl Kasewurm, AuD, is the owner and operator of Professional Hearing Services in St. Joseph, Michigan. gyl@prohear.net
    Gyl Kasewurm, AuD, is the owner and operator of Professional Hearing Services in St. Joseph, Michigan. gyl@prohear.net×
Article Information
Hearing Disorders / ASHA News & Member Stories / Overheard
Overheard   |   March 01, 2018
Employ Audiology Assistants to Grow Your Practice
The ASHA Leader, March 2018, Vol. 23, online only. doi:10.1044/leader.OV.23032018.np
The ASHA Leader, March 2018, Vol. 23, online only. doi:10.1044/leader.OV.23032018.np
Participant: What do you think is the biggest hurdle to relying on support personnel more?
Gyl Kasewurm: I think we are the biggest hurdle to utilizing support personnel. The idea [of using assistants] has been endorsed by every professional organization for the past 40 years! The climate is changing, reimbursement is being reduced, and we can’t afford to spend our time completing tasks that don’t require our education and expertise.
Participant: Are you asking an audiology assistant to do other duties or only work with hearing aids?
Kasewurm: If you haven’t used an assistant, you would be amazed at how much more productive you can be as an audiologist. An assistant is instrumental in helping with patient care: cleaning hearing aids, doing paperwork, ordering supplies, calling on orders, keeping rooms stocked and helping with tests. They also screen hearing, modify ear molds, repair aids, order spare parts and the list goes on and on. Audiologists should spend the majority of their time on tasks that generate revenue. And an assistant is paid about half of what an average audiologist is, so we [audiologists] can see twice as many patients.

Audiologists should spend the majority of their time on tasks that generate revenue.

Participant: What specific nonclerical tasks would you assign to an audiology assistant working under your supervision?
Kasewurm: Calibration, of course. Hearing screening is allowed in my state and my assistants are also CAOHC (Council for Accreditation in Occupational Hearing Conservation) certified. They screen to see if thresholds have changed on annual evaluations. We have protocols so there is always a flow chart of what to do when, and the audiologist is involved. Assistants never make referrals, and they don’t diagnose.
I recommend that everyone do a time study of their daily tasks in 15-minute increments for a week. The time study will be eye-opening on how you spend your time on tasks that don’t require your education and expertise. Most audiologists spend more than 50 percent of their time completing tasks that audiologists really don’t need to do. Most audiologists feel like their patients only want to see them during appointments, but I have never really found that to be true. Patients want their problems solved in an efficient and effective manner, and they don’t really care who completes the tasks.
Just let your patients know what the chain of command is. For instance, my patients don’t expect me to ever help with a service issue—just like most of us would never expect our dentists to clean our teeth. The professional is the decision-maker and we are ultimately in charge of patient care. We just don’t complete every aspect of every task.
Participant: What do you think about recruiting experienced audiologists as assistants?
Kasewurm: I would never recruit an experienced audiologist as an assistant. Doesn’t matter if they work full time or part time, it’s about being efficient and effective. The point is, I can pay an assistant $16–$18 an hour, and I would pay an audiologist twice that much or more. The real issue is which tasks need to be completed. If it’s a diagnostic role (testing, counseling, referring, fitting aids) then I would need an audiologist. If it’s a service or support role (cleaning aids, ordering, paperwork, screening hearing), then I would hire an assistant.
Participant: What type of education would you look for in your assistants?
Kasewurm: I would love an associate’s degree but I don’t always find that. You can look for people who are trained in the medical field as assistants: chiropractic assistants, nursing assistants, optometry assistants, etc. We have had the most luck with on-the-job training. I like CAOHC (The Council for Accreditation for Occupational Hearing Conservation) for teaching assistants to test hearing. Then we send the employees to our manufacturing partners for training on hearing aids.
Participant: Please tell us more about how you’ve seen an audiology assistant help specifically in an ENT [otolaryngology] office situation.
Kasewurm: I haven’t worked with ENTs for years, but I would look at how oto-techs are used in this setting and convert them to audiology assistants because audiology assistants have to have an audiologist as a supervisor—so we are in control of what happens. You could certainly use an assistant in an ENT setting for cleaning hearing aids, ordering supplies, placing orders and calling patients to see if they are happy, or helping with testing children, record-keeping, transcribing reports, etc. This is where it would help to keep track of what you are doing and analyze what you could delegate to an assistant. However, if you aren’t getting support from the ENT staff, I can imagine it would be difficult to convince the ENTs to hire an assistant for you. You would have to be able to prove the cost-effectiveness on paper.
Participant: Are there patients who insist on seeing the audiologist rather than the assistant?
Kasewurm: I have used assistants for 32 years, and patients don’t complain if they know what to expect. Last year, the assistants completed 56 percent of all the patient visits and our patient satisfaction is 98 percent. We tell patients up front when they will see audiologists and when they will see assistants and they are thrilled with our customer service!
People have to get over the fear of using an assistant. Patients don’t tell us what to do or how to run our practices. We tell them. If a patient wants to see the audiologist, of course they are scheduled. But if they walk in or have a service issue, they see an assistant. It’s worked for 32 years. The truth is, audiologists can’t afford to do everything themselves if they want to make money or grow the business. What other doctor do you know of that does everything themselves?
Participant: What is the minimum educational requirement for audiology assistants?
Kasewurm: The minimum educational requirement depends on the state laws. ASHA has a great website with educational requirements listed by state.

Audiologists can’t afford to do everything themselves if they want to make money or grow the business. What other doctor do you know of that does everything themselves?

Participant: What are your thoughts on a formal audiology assistant diploma vs being CAOCH-certified?
Kasewurm: Again, that depends on the state. It would be nice to have a universal audiology assistants program. The most important part is that the audiologist regularly participates in training of assistants. We have a meeting once every two weeks to do chart reviews and to discuss quality control of patient care to make sure assistants are following protocols.
Participant: How do you support aural rehabilitation (AR) services that may not directly generate revenue?
Kasewurm: We have courses on AR for patients and we recommend apps and more extensive training like clEAR (customized learning: Exercises for Aural Rehabilitation). Assistants investigate whether the patient is completing the training and share the patient’s progress with audiologists.
Participant: Does it require a lot of your time to train the assistant?
Kasewurm: Unfortunately, training does take time. We have a structured timeline when an assistant starts with specific outcomes notes. It is work, but it is worth the effort. I would say it takes a good six months for the assistant to be independent, but they are completing certain tasks independently before that time. It may be that we start with learning how to clean aids, stock rooms, complete orders and order supplies first.
Participant: If audiology assistants perform screenings, and then a complete audiologic evaluation is indicated, will the patient’s insurance pay for both the screening and the evaluation?
Kasewurm: I don’t know of any insurances that pay for screening. It’s usually a charge to the patient or included in a bundled model of hearing aid care.
Participant: If an audiologist has never used assistants, which steps would you recommend in hiring that first assistant?
Kasewurm: Find the right person. I would definitely do an assessment to see if the personality is appropriate to be an assistant.
Participant: Would you be willing to share the form that you use to survey patient satisfaction? How do you use the results with the assistants and other staff?
Kasewurm: If you follow me at DrGyl.com, you can request our surveys by email. We review the results monthly and if patients are dissatisfied, we make certain to follow up to try to satisfy the patient.
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March 2018
Volume 23, Issue 3