By Lolly Wigall
I was reading a professional magazine this morning while I was drinking my coffee. I have to admit that I generally do not read professional magazines. I see all the research articles with the wonderful graphs and statistics and my eyes glaze over. I may read the intro and the conclusion. But, reading the actual study does nothing for me. I just don’t see the relevance for my daily practical life as an audiologist. I want to know how this study impacts my life selling and fitting hearing aids. I am glad that some people like to do research. I am not one of them.
As I was reading, I recognized the names of the authors of the articles. I read several of the articles. They were enlightening. Some of the articles I found confusing. It would have been nice to have the author’s email address so I could send a message to them asking for clarification. A number of the articles were by leaders in the professional organization. I get it. It is the beginning of the year. Goals are articulated. New members are introduced. New people are running for national positions. Their biographical information and their philosophies were being shared. I am happy that some people have the time and interest for national professional unpaid positions. They take a lot of time, energy, thought, and emotion.
Professional Organizations
Over the years I have been involved in State professional organizations. When I lived in New Jersey I was the Audiologist on the Association Board. I met some wonderful people. When we moved to Massachusetts, I agreed to be Secretary for the Massachusetts Hearing Aid Society. I was co-chair of the New England Hearing Health Convention for three years. My husband, Steve, and I have been involved in National Presbyterian Marriage Encounter as the National Clergy Couple. That too was rewarding, but very time consuming.
In 1997 I was appointed by Massachusetts Governor Cellucci to be the Audiologist on the newly formed Hearing Instrument Specialists Board. I am still there.
Having been a leader of several organizations as well as a member of organizations, I understand that sometimes the goals clash. Or, maybe I should say they are on different trajectories. Sometimes we members do not take the time to talk to the leaders about our needs or goals. Sometimes we just don’t see the bigger picture. And, sometimes we are not given the opportunity to voice our opinions.
Last year one of our professional organizations (I admit I do not remember which one!) sent me a survey, which I dutifully completed. The organization said it was trying to “hear” from its members. But, the way the questions were asked, and the multiple choices offered had little to do with my interests or concerns.
The questions were selected by people who work in a university setting, hospital setting or ear, nose and throat setting. The questions had little to do with private practice.
To me the survey had more to say about the people who wrote the questions than about those of us who answered the survey.
Academia Often Clueless About Realities of Independent Practice
Being a good clinician doesn’t mean you are cut out to run a business. Image courtesy wv.gov
I am in private practice. I test hearing and sell hearing aids for a living. I do billing for my testing. I am a provider for most, if not all, insurance companies in my area. I do my own marketing, I train staff. I have a business to run. There are many skills I have needed over the years to make my business successful. The one main skill I needed from day one was being able to sell hearing aids.
One author I read this morning stated that many audiologists will enter the workforce either as independent practitioners or as clinic administrators in hospital settings. But, in the goals he listed there was no mention of selling hearing aids. Hmmm, I thought. I must be missing something. To be in private practice means selling hearing aids. To be a hospital administrator means having some business sense that includes marketing and selling.
No student I have supervised over the last 35 years has ever taken a class on selling hearing aids or marketing. If students are expected to enter the workforce as private practitioners, doesn’t this seem like a major oversight in the university curriculum? I talked to the director of the program about this very issue. She told me that there was “no room” in the curriculum for a class like that. I don’t know the professors at the local university except by name. I do not know if they have ever depended on their selling ability to earn a living.
Students Need Clinical (and Business) Skills
Beyond clinical skills, audiologists need to be trained in the basic principles of business. Image Courtesy ucdmc
This year I have taken a stand. I am insisting that every student who does a practicum in my office read books on selling and marketing. I have a number of books and podcasts that have influenced me. I purchased used books that I will loan to the students. I am determined to make the students develop a style that fits them so they can sell hearing aids by the end of the semester. If they are to make a living selling hearing aids, they need to learn this skill while they are in their doctoral program.
Over the years I have hired AuD students who were completing their externship. I had to teach them how to sell hearing aids too. Doing hearing tests, relating to patients, explaining test results, selling hearing aids, writing a contract, asking for thousands of dollars, fitting the hearing aids, explaining the care of the aids, and doing follow-ups need to be part of the university curriculum. By the time students are ready for their externship, they should be able to accomplish these tasks with ease. However, sadly, this is often not true.
That’s why many audiologists in private practice will not hire someone on their externship year.
My friends who own private practices often say, “The extern students cannot sell. And, they want too much money while they are learning to sell. It is too expensive.”
Students will begin looking for jobs soon. My advice is to learn to sell hearing aids in the next few months if you want to earn a living. Some books that have shaped my sales life have been “Top Performer” by Stephen Ludin. This book talks about creating a persona, which I find very helpful. “Guerrilla Marketing” by Jay Conrad Levinson was super helpful in finding inexpensive marketing methods. Recently I found “Seven Reasons why you suck at sales and what to do about it” by William Wyatt. It is pretty straightforward and blunt.
This morning I also read “Never Be Closing” by Tim Hurson and Tim Dunne. This book summed up that sales is about relationships and the process of getting things done. A podcast by Jeb Blount from Sales Gravy are five-minute talks about selling. I like to search the iTunes store for any sales podcasts. Sales are sales and I can learn from other professions.
These are some of the books on my list for the next student. I hope I can make a difference for the students passing my way. I want to help equip them for life after school.
*title image courtesy Wikimedia Commons
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I can see your viewpoint. Really, I can. Private practice is hard. I know. I cut my teeth in private practice before working in medical centers and then teaching in the university setting. However, I offer to you a new perspective to consider. Your post contains the word(s) “hearing aid sales” 9 times; “sell” 6 times; “sales” 3 times, and “marketing” once. Students surely need training in the business of running a practice, including marketing, billing, and how to relate to people, etc. However, when you take the 30,000 foot view, the only thing we should be “selling” is our professional expertise, our ability to carry out a thorough lifestyle-based hearing needs assessment, problem-solve, coach and come up with an individualized solution set of training and technology to meet the client’s hearing enhancement needs. What we are doing is trying to convince the client to accept a concept of what technologies and strategies can be employed to enhance hearing. Selling that idea is a lot different than simply “selling hearing aids.” If we can to that successfully, then the technology will sell itself. I also respect the need for some Dale Carnegie-type training because students do need to learn to relate to all kinds of people so that a trusted bond is formed so that the client will listen to advice. But, as a profession, it’s really time to stop being so hearing aid sales-centric and focus on hearing needs. Each person’s hearing needs inform technology choices, not the other way around. Maybe hearing aids are needed; maybe hearing aids plus remote microphones; maybe just a simple remote loudspeaker for the TV or a simple phone amplifier. What’s best depends on the hearing loss, cognition, budget, lifestyle, tech saaviness, and all the other factors we learned in grad school. We are not hearing aid fitters/sale persons. We are hearing enhancement coaches who team with our patients to solve their hearing issues. We had better embrace this new perspective or we will be out in the cold, thanks to the proliferation of apps and “hearables” and the marketplace now demanding accessible and affordable hearing health care. It’s time to unbundle and embrace a range of technologies and price points. We also need to lobby the insurance companies to pay for our time because part of best practices is taking the time to listen. It’s time to develop a standardized course sequence for training that addresses skills needed for business as well as needs assessment, selection, fitting, verification and validation of a whole host of technologies. We are definitely not there. One of my students presented research at AAA on a survey she did of almost 300 audiologists who had graduated no more than 5 years ago. Three-quarters of them reported that their undergraduate training in proper needs assessment and selection of hearing enhancement technologies beyond hearing aids was non-existent or poor at best. We need to change this via our accreditation programs. We also need to require national testing and perhaps board certification in this area until it becomes a standard part of the landscape. The audiologist of tomorrow will be recommending all kinds of technologies, both prescribed and OTC. If audiologists know how to do this properly, then consumer will learn to turn to us for their hearing enhancement needs. In the end, as Simon Sinek says, “people don’t buy what you do. They buy why you do it.” I like to believe that my colleges are in this game not to sell hearing aids but to “sell” hearing enhancement.
Brilliant
Re: “as a profession, it’s really time to stop being so hearing aid sales-centric and focus on hearing needs … inform technology choices”.
I think Cynthia has it right here, in that it’s the client’s NEEDS that NEED to be serviced. If that’s done, the sale will occur. As a hearing loop installer, I too often see it from the other side where e.g., a church full of people have hearing aids that can connect with almost any technology, except for the simplest one – because there’s no working telecoil. Why deny anyone full access to every technology? Maximize the multiple environmental listening utility (MELU) for everyone that walks through your door, through service that no one else (big box?) can match.
Like Bill, I come from a different side, that of a long time hearing aid user. I would certainly look forward to seeing the audiologist profession “stop being so hearing aid sales-centric and focus on hearing needs.” Too many of the audiologists that I have seen over the decades have functioned as little more than specialized salespeople, just fitting me with a hearing aid, collecting the big cash payment, and sending me out the door without another word of advice. I have had a severe hearing loss in both ears since childhood, but not one audiologist that I saw as a kid ever recommended that I take a class in speechreading, suggested that I try using an amplified telephone, or even mentioned any other hearing technology besides the expensive aids. Even now, after all my experience with hearing aids, I’m finding it difficult both to find local audiologists who will sell me an aid unbundled as well as to identify a health insurance company that will provide any coverage for hearing aids at all. I commend the idea of convincing insurance companies to provide coverage for regular compensation, such as a joint copayment for each visit, so that audiologists are not so highly dependent on the revenue from hearing aid sales alone (and hopefully would not need to charge such high margins when selling aids).
Cary
Oh my. I am so sorry that no one audiologist has looked at you as a whole person with other needs than just a hearing aid wearer. It is common place in my office for us to offer to fill out paperwork for free amplified phones and CaptionCall phones that are also free. There are now some insurance companies that are offering hearing aid benefits — some benefits and programs are better than others. Some insurance companies limit you on your choices, — and the choices they offer may not be in your best interest. Check with your human resource person at the company where you work. EVERY plan can be negotiated by the company to include or exclude different benefits. Talk to your boss. There are also some support groups in my area for hard of hearing individuals. Lolly
Hi Bill
I am a pastor’s wife so I get it about churches. And, I find it frustrating that churches will not even investigate loops. There is a committee at church and I have given them information and information etc etc. No, we are spending money on a new screen so people can see prayers and songs. Frustrating because I know a number of people in the congregation who I have fit with aids, and they still have a hard time — sometimes. I am happy to activate any t-coil when my patient has a need for it. easy fix. Most want the bluetooth to pair with their cell phones.
Lolly
Cynthia
Thanks for your response. I mentioned selling so many times because I believe we audiologists do not like the word. We instead like to say we “dispense” or ” we enhance their lifestyle” or we have a doctorate degree so we know best.
I believe students coming out with the AuD should have some business training. But, the big elephant in the room that no one wants to address is teaching students how to sell hearing aids. It is “safer” to teach business practices, or ethics. Many audiologists view “selling” as a dirty word.
Selling is listening, evaluating, and selling the correct product to meet the client’s needs.
Marketing is one of personal loves and I will write some posts on that. But, I wanted to express one of frustrations with the AuD degrees. When I earned my Master’s degree there was no talk of business or selling, since it was unethical at the time. I designed a dispensing program in the hospital in New Jersey as soon as ASHA said it was ethical now. That program is still going on…. all these years later.
I have owned my private practice for 25 years and I have had to learn about business on my own.
Selling hearing enhancement is a cop-out. I guess selling hearing aids is too blunt and direct. Saying we sell hearing enhancement is like saying saying we help people hear better. We help their quality of life. All these statements are true, but I would like us to address the fact that we sell hearing aids. In most private practices the sale of hearing aids is what pays the bills. Oh, it is nice to say we can sell the OTC items but overall that does not pay for all the factors that go into running a profitable business.
You didn’t mention Sales, selling, sell enough!!
I started the opposite of Cynthia. In the military and working with ENT’s then in private organizations where selling wasn’t what it was really about. Now the last 15 yrs or so it is all about the sales. I you can call it what you want but we are selling.
We sell everything including our services. You can provide all day and suggest or recommend enhancements all day BUT that piece of paper on the wall doesn’t give you their trust and confidence. It is the selling of yourself to your patients which brings the trust and confidence. So you keep providing and I’ll keep selling because I will not placate it by another softer sounding phrase. I sell me first and then sell what is appropriate for the patient. I’m not even sure I am not sell time to them. Oh, wait a minute I’m doing that to. Whether it’s bundled or unbundled still its all about sales in all we do. And the students who haven’t been in sales before their education will have a long hard learning curve if they are not at least taught the basics of sales and marketing.
Educators, you’re dropping the ball by saying there isn’t enough time. There should be a choice of courses on sales and marketing and are usually found in the business area of the facilities you work at. You don’t need to reinvent the wheel again its already been done.
Richard Well said. We definitely are selling ourselves, our practices, our products, our services, our expertise, etc. We are “selling” an experience to the patient. We are taking care of business. If we don’t make money and write that contract we will not be here to “help” that person hear better.
Lets face it. Honestly, nothing happens until we ‘sell’ that patient in front of us on the need to follow our recommendations.
Another ugly fact. The tools we use, those things we fit, those audioprosthetics have to be acquired, or in some manner traded for. That makes us all ‘Hearing Aid Dealers’.
But, how you go about it is what makes all the difference.
I DO NOT SELL the hearing aid. I sell the benefits that it can provide. There is a huge difference. Benefits cross labels and manufacturers. I AM NOT vested in either.
My allegiance is to that patient in front of me.
By selling the benefits of the recommendations that I am making, and not the particular hardware involved, it is very easy to move from one piece to another, should that first recommendation trip their Alderman’s nerve and induce gagging.
Knowing who you work for, and what you are actually selling makes achieving that sought after compliance much easier than selling any particular piece of hardware.
But, make no mistake, if you are to be successful in helping more people achieve better lives, you’d best come to embrace those ugly truths.
Nothing happens until you sell the idea.
We are all hearing aid dealers, they are the tools of our trade, and if we don’t deal, or trade to acquire them, we must work for the V.A.
Just be clear on what you are selling, and who your really work for.
Now, go Be the difference in someone’s life. Sell them on the benefits of better hearing, through complying with your recommendations.
Best Wishes,
Dan……
Dan
Thanks for the thoughtful comments. I too “sell” the benefits, but I unless you write a contract, and ask for the money, no one is helped. I have found that audiologists are taught in school that private practice is “shady”. It is not openly said, but I have asked recent grads, and that is what they say. I believe that the professors are unsure about their selling ability and are very uncomfortable with the idea. Some recent grads have told me that private practice audiologists are likened to “car salesmen”… Really, I want to say??? Upsetting since I have been selling hearing aids — and their benefits since 1977. Lolly
As I read this in the Hearing Review I began growing concerned your sales tangent could be convincing, until I read a local AuD program director informed you there “was ‘no room’ in the curriculum for a class like that”. That right there tells you the focus of academia for audiology. The field is moving forward in bettering itself, moving away from the stigma of “used car dealers” hocking a product to true hearing healthcare professionals. I get the economics that hearing aid sales are necessary for a private practice to exist and function. Sales should not be, and based on current progression of the field to AuD, will not be the focus of audiology. No one (in his/her right mind) is going to pay for a doctoral degree in selling hearing aids. Somehow dispensers still exist to fill that purely hearing aid sales role. I took a small business class during my AuD program because I knew I had an interest in private practice. I have classmates and colleagues from AuD programs, where no hearing aid sales classes are part of the curriculum, who are very successful in private practice. Some of whom own/run their own practice. In any profession, often many years of experience can be beneficial; other times it can be a hindrance when bad habits and antiquated ideology has taken hold. Folks should join the movement to support audiology and audiologists as healthcare providers, NOT sales people!
Good afternoon. I appreciate you taking the time to write. In my private practice I do a lot of educating the physicians, and public. I view myself as a professional healthcare provider. But, I have found that the students who do time in my practice do not even know how to adequately explain an audiogram so a patient can understand their hearing loss. If a person can’t understand their hearing loss, it is difficult to make a decision to enhance their quality of life. The article was purposely designed to “increase” the discussion. If we continue to just educate the public but never sell/dispense hearing aids we are doing nothing to improve someone’s quality of life and their families lives. When I graduated from my Master’s Degree program it was unethical to dispense hearing aids. We have come a long way since then.
My experience with audiologists “selling hearing aids” is that the “selling” aspect seems to take overwhelming priority over ethics. Here is my experience:
I am a LONG time user of hearing aids, starting with analog aids in the mid-1980’s. Due to a geographic relocation, I was forced to find a new audiologist. As the analog aids were aging, she recommended Siemens digital aids, which I bought. Since I have one non-functional aid, instead of buying a pair of aids (one for each ear), I spend the same money and buy two aids for the working ear. The aids work well. Time passes, and those aids are aging. One aid has an earmold failure (cracked plastic). So I go to my audiologist to get it fixed, as the internal electronics are perfectly functional. She tells me that the aid is “non-repairable” (actually Siemens simply refuses to repair older aids), and proceeds to try to sell me an upgrade. I am actually in the process of buying the upgrade, but I am trying to get more complete information about the different aids, of which she was not forthcoming. I expressed my dis-satisfaction in a phone call to her office manager. Next thing I know, she has dumped me from her practice.
So, I find a new audiologist In the meantime, research on the internet reveals the existence of independent repair facilities that will fix any aid, so I ask the new audiologist about that with the end result that my broken earmold is replaced and the aid restored to full function.
But I still want newer aids, so take my latest hearing test to Costco and buy two new digital aids, which have worked (and are working) perfectly. The hearing aid technician (not audiologist) was completely forthcoming of information about all the different aids. She was FAR more “professional” than my “licensed audiologist”.
So IMO, audiologists are far more like used car salesmen than licensed professionals.
What I “should” have done is to report my original audiologist to both the Better Business Bureau and to any state licensing organization for audiologists, but I didn’t think of doing that until a good deal of time had passed.
The situation is that hearing aid companies (or at least Siemens) is guilty of restraint of trade, and lack of ethics, colluding with greedy audiologists to sell more (and more expensive) aids.