By Angela Loavenbruck, Ed.D.
This week I thought I would reflect a bit about the audiology culture I tried to create in my own private practice. It certainly is a culture that evolved over time, but there were essential kernels present from the very beginning. The “beginning” was sometime in early 1975.
I left a teaching position at Catholic University to return to my alma mater, Teachers College-Columbia University as Director of the Audiology Clinic and Assistant Professor. My audiology practice experience at that time included a position as Director of the Speech and Hearing Department at a community center that provided rehabilitation services to physically handicapped children.
My time at the center coincided with the rubella epidemic in the 70’s, so I had a lot of experience testing babies and young children and evaluating them for hearing aids, which their families then purchased from local hearing aid dispensers. The children returned to us for fitting and for therapy.
Any adults who came to the center were also evaluated and then sent to a dispenser for fitting. We typically never saw the adult again and generally had no idea whether the hearing aids we had recommended worked well for them or not.
It was that experience, along with my involvement with the Ralph Nader publication “Paying Through the Ear”{{1}}[[1]]Ralph Nader’s Retired Professional Action Group (RPAG) in 1973 released Paying Through the Ear: a report on hearing health care problems. This report documented a number of unscrupulous practices occurring in the hearing aid industry at that time. [[1]], which convinced me that audiologists had to become directly involved with dispensing.
Looking Back
When I think back to the early conversations with my first two partners (Dennis Hampton and Richard Cortez), I always think of Judy Garland and Mickey Rooney movies where someone says: “Hey, I know, let’s do a musical show in the garage and the big movie producer will come.” By which I mean, we were totally naïve about what we were trying to do.
None of us had business experience, audiologists had not dispensed hearing aids before, and there was no one to give us advice.
I am always amazed that the practice succeeded in spite of our naïvete.
In the role of a private practice audiologist, I developed a way of listening to people talk about their communication difficulties and of talking to them about their hearing that would help lead them to solutions. Every patient’s story was a puzzle to solve. Hearing aids were often part of the solution. I never thought of myself as a salesperson and I certainly did not think of my practice as a retail operation.
Understanding the Fundamentals
I started to read about marketing and tried to develop a marketing plan that emphasized the professional services provided, and the difference between our practice and retail operations. Then, as now, the marketing was designed to emphasize that solving the problems caused by hearing loss demands the professionalism, education and skills of an audiologist, and that hearing aids are one part of the solution.
Early on, our marketing plan was heavily geared toward public relations, rather than advertising activities. In recent years, however, we became part of a management group (Audigy).
I often wish the collective practice management/marketing/budgeting skills which suddenly became available to me had been available years ago.
We have been able to develop a comprehensive marketing plan, including advertising, which fits the culture of our office and emphasizes the value that our training as audiologists brings to patients. And, most critically, we’ve learned to make our entire office staff part of the value we bring to patients.
We still use a bundled pricing structure, although we are working hard to develop a fee structure for each aspect of the professional services we provide so that we are more agile in today’s hearing health environment.
Preserving Private Practice’s Future
The point of all of this is that I believe that the culture and structure of this type of private practice can protect audiologists from commoditization. Price and products are never marketed.
We market our education, our expertise, our services and the value they add to the hearing healthcare process. We will not participate in any marketing that makes the hearing aid the center of that process. We try to make sure that we are identified as “experts” about all aspects of hearing healthcare, and we identify ourselves as audiologists – NOT as anonymous hearing health professionals.
The second point is that I believe that the problem with audiology education is not that students are not taught to sell. The problem, in my view, is that students are not being taught how to discuss diagnostic test results with patients in a structured way that might lead to the purchase of products as part of the solution to the communication difficulty the patients describe. They are not being taught to see audiologists as central to this process.
Selling, I believe, is a very narrow and loaded word to describe a successful interaction between audiologists and patients.
