Why our waiting rooms are so empty, and what you can do to fill them up

Hearing Health & Technology Matters
June 4, 2013

By Brian Taylor

Brian Taylor

Brian Taylor

I really enjoyed Jerry Northern’s recent article posted on A.U Bankaitis’s blog. If you haven’t read it, I urge you to do so. As the title of his post suggests, it is indeed time for us to “wake up” and collectively embrace a future filled with disruptive innovations–many of which will undoubtedly force us to redefine the audiologist’s role in healthcare.

After reading Dr. Northern’s analysis, I gave myself a pat on the back because I had read most of the books he cited in his thoughtful piece. However, there is another recently published book that he didn’t mention that I think warrants your attention. I’m referring to The New Digital Age: Reshaping the Future of People, Nations, and Business. The authors are Eric Schmidt, former CEO of Google, and Jared Cohen, a Rhodes Scholar and senior fellow at the Council of Foreign Relations.

The New Digital Age provides a bird’s-eye view of how technology will shape our lives over the next decade. Although hearing health care professionals are never explicitly mentioned in their book, healthcare in general is a major focus of Schmidt and Cohen’s work. After reading it, I predict that you will conclude that audiologists must adapt or risk becoming obsolete or irrelevant.

Because audiologists are so deeply tied to technology (hearing instruments and diagnostic and fitting equipment), I would argue that as the cost of manufacturing and using this technology continues to decline, our current device-centric way of practicing will become unsustainable. In fact, being so device-centric makes our profession especially vulnerable to disruptive innovations on all fronts.

Believe it or not, the number of people in your waiting room is a good proxy for how disruptive innovations may already be affecting your practice. And, judging from the number of empty waiting rooms I’ve visited in the past few years, we may already be experiencing the early effects of following an unsustainable business model. (If your waiting room is constantly crowded and you have more business than you can handle, you’re in a fortunate minority.)



The question begs, why are so many waiting rooms so empty? In addition to the old clichés about the stigma and cost of hearing aids, another major reason is that the majority of hearing care practices are based on a paternalistic medical model of “fixing” individuals with moderate to severe hearing loss. We’ve built a reasonably efficient system for addressing the needs of a minority of people with hearing loss.
















Before going any further, let me say that the provocative title of this Hearing View is not meant to denigrate the skills of audiologists or hearing instrument specialists. It’s simply a vestige of a larger health care delivery system built on treating patients with infectious diseases–as this graph from a recent article in The Washington Post so aptly illustrates.

Along with the threats that disruptive innovations pose to our profession, they also offer us some real opportunities to tap into underpenetrated segments of the market. To do this, we need to select and use disruptive innovations to create a sustainable business model that captures a larger swath of people suffering from permanent hearing loss.

The key, I think, to understanding new business opportunities rests with more effective market segmentation efforts. Figure 1 (below) is a good first step into thinking about market segmentation for hearing care services in a new way. Delivering offerings to consumers around degree of hearing loss and “jobs our customers want or need us to perform” gives us the potential to unlock many capabilities that our profession can provide. Figure 1 shows how entrepreneurs could tap into a new markets along these two axes.

 Figure 1. Segmentation matrix with some of offerings consumers can receive from hearing healthcare professionals. Readers are encouraged to add more offerings to this matrix.

Figure 1. Segmentation matrix with some of the offerings consumers can receive from hearing healthcare professionals. Readers are encouraged to add more offerings to this matrix.

Notice in this segmentation model that service and rehabilitation, rather than a device, are at the center of the provider-consumer relationship. Doing this will require a two-pronged strategy, one that combines effective offense and defense.

Playing defense requires us to create some significant barriers to entry. These include establishing direct access for consumers to audiologists with limited-license status. It also means as fixing the loophole that allows “personal sound amplification products” (PSAPs)–essentially, crude hearing aids by another name) to be sold directly to consumers without any regulation or protection.

The Academy of Doctors of Audiology (ADA), despite its relatively small membership, deserves to be commended for having the vision and the courage to champion the monumental cause of direct access.  I urge everyone to support ADA’s 18×18 Initiative.

It is also imperative for audiologists to support higher standards in the training of new audiologists by backing the accreditation of AuD educational programs that is offered by the Accreditation Commission for Audiology Education (ACAE).



Just as it is risky in football to rely on a full-on zone quarterback blitz to win the game, it would be very dangerous for audiology to stake the outcome of the game on a defensive strategy, such as direct access. It is essential that audiology practices also play offense. Next week, I will discuss seven keys to an effective offense that will help repopulate those empty waiting rooms.


Brian Taylor, AuD, is Director of Practice Development and Clinical Affairs for Unitron. He is also Editor of Audiology Practices, the publication of the Academy of Doctors of Audiology, and the author of the book Consultative Selling Skills for Audiologists, published by Plural.



birdsong hearing benefits
  1. What a timely piece Brian! We are especially vulnerable to these disruptive technologies in our profession, precisely due to our reliance on technology, and we need to be on the offensive. Initiatives such as 18×18 are long overdue and I hope that all audiologists will take up the charge on this one.

    Consider this: had audiologists pushed for this years ago, we may be in the same position as Optometrists today–the primary authority for hearing and balance care, rather than consumers being constantly confused by advertising and bewildered by the various “hearing healthcare” professionals out there. With all due respect to hearing aid dispensers and technicians, it’s very frustrating to spend 8 years on a doctoral degree and have patients associate you as the same as the same type of ‘hearing healthcare’ professional down the street who has 1 year of post-high school education at best.

  2. Bravo, Brian – from a person with hearing loss who clamours for more client centred care that focuses on the real-life needs of people with hearing loss! Well said.

Leave a Reply