An Audiologist’s Guide to Responding to Professional Threats

by Kim Cavitt, AuD

Many audiology practice owners are concerned about the future.  The perceived threats to private practice, such as third-party administrators/provider networks, over the counter/direct to consumer hearing aids, big box retailers, and insurance policies and reimbursement appear to paralyze many and instill anger in others.  

There are opportunities that can emerge from even the darkest of situations. Here are some options to help you be successful in this changing landscape: 

1. Do not let the disruptive force outperform your practice.

The evidence time and time again supports the efficacy and positive patient outcomes of pre and post treatment inventories, such as the Hearing Handicap Inventory (HHI), Client Oriented Scale of Improvement (COSI), and Abbreviated Profile of Hearing Aid Benefit (APHAB), and the use of real-ear measurement and live speech mapping. This is not debatable.

These services are often offered by our competition, even those in more retail settings.  Every practice needs to implement these tools into their repertoire. Audiologists need to consistently practice to the fullest extent of the evidence. Costco should not provide care you do not provide. Period. 

2. Offer all of the care not available from the disruptive entities.

We have to become more to the patient than merely a device. Disruptive entities, especially direct to consumer retailers, cannot or do not provide cerumen management, comprehensive diagnostic audiologic evaluations (when medically necessary), vestibular, tinnitus, auditory prosthetic device, and auditory processing evaluation and management, hearing conservation and ear protection, or basic health screenings surrounding cognition, depression, or speech/language (as allowed by state licensure laws).

Expand your practice to include these services, which can have a huge impact on the patient’s overall health and quality of life. It can also have a significant impact on your bottom line. It is time for audiology to illustrate our value and positive impacts on individual’s overall health and well-being. 

Also, consider alternative hours (offer a late night and a weekend option, at least monthly) and concierge care (where you go to the patient).  Accessibility to many is just as important as price and some are willing to pay a premium for convenience. Also, wouldn’t it be nice for you to have an occasional late start (noon to 8PM) or afternoon off during the week (because you had a Saturday clinic instead).

We are all consumers; what would you like to see your healthcare providers offer you? If you dream it, do it in your own world. 

3. Know your needs and your value. 

Every practice, regardless of setting, needs to know their breakeven financial needs.  In other words, what does each revenue generating provider need to bring in each hour for your practice to financially breakeven?

Usual and customary fees need to reflect these needs as well as offer the ability to make a profit. We need to stop providing free care as it devalues our position in healthcare and shows the patient that we are nothing more than a retailer/purveyor of a product. 

We also need to use this data on your financial needs to determine if participation in managed care, whether it is third-party administrator plans, provider network offerings, Medicaid or traditional insurance, is feasible and sustainable for your practice situation.

For some, participation makes sense because the allowable rates are within their financial requirements for the time being spent and it draws patients to their practice with little marketing expense. For others, whose financial requirements are greater, participation can be a losing proposition. You need to make the business decisions that is best for you and your practice. 

4. Consider alternative delivery and pricing models. 

A bundled, “one size fits all” hearing aid delivery is not the right option for everyone, especially existing users, snowbirds or patients who are price conscience. Consider unbundling, value based options, over the counter/off the shelf alternatives, rental or leasing programs, and care memberships.

It’s time to think outside of the box and offer numerous alternatives to access your care and your amplification offerings on their terms. Make it hard for folks to choose you competition. 

5. Listen to your patients. 

Despite what many audiologists often believe, no one knows more about experiencing hearing loss than a hard of hearing individual. We do not always know what they feel and the impact of their hearing loss. So, we need to ask.

Have your patients complete case histories and pre and post fit inventories. Find out how their hearing loss impacts their daily life and offer comprehensive options, such as hearing aids, telecoils, implants, assistive listening devices, FM systems, and aural rehabilitation to best meet those listening and communicative needs. And, most importantly, actively listen! 

There is a light at the end of the tunnel and a future which is bright.  It is just going to require a reboot of our profession and our approach to patient care and amplification. Change is hard but the outcomes of change can be monumental and exciting! 

Kim Cavitt, AuD was a clinical audiologist and preceptor at The Ohio State University and Northwestern University for the first ten years of her career.  Since 2001, Dr. Cavitt has operated her own Audiology consulting firm, Audiology Resources, Inc. Audiology Resources, Inc. provides comprehensive operational, compliance and reimbursement consulting services to hearing healthcare providers. She is a Past President of the Academy of Doctors of Audiology (ADA), serves as the Chair of the State of Illinois Speech Pathology and Audiology Licensure Board, and serves on committees through ADA , ASHA and AAA.  Dr. Cavitt is an Adjunct Lecturer at Northwestern University and the managing audiologist of the Think Audiology initiative.