New Service Delivery Models in Hearing Care: Interview with Kim Fishman

Brian Taylor 0:10
Hi everyone, and welcome to another edition of This Week in Hearing. This is Brian Taylor. And I’m really happy this week that we have an audiologist with us with a long career in private practice. And that is Kim Fishman. And she’s with us today to talk about new business delivery models. Welcome to this edition of This Week in Hearing, Kim.

Kim Fishman 0:30
Hi, Brian, thank you for having me here.

Brian Taylor 0:32
That’s great for you. I’m glad you could take time out of your schedule to be with us. Before we talk about some of these new innovative business models that you’ve been involved with, I thought maybe you could kind of share with us some of the things you’ve done in your career as an audiologist.

Kim Fishman 0:49
So, um, my career is an audiologist, let’s see, it’s kind of been similar to probably other people’s careers where you’ve sort of jumped from place to place trying to find your your home. And I just want to back up a little bit to explain. My history is growing up in Minneapolis in a very sort of transparent area. My parents are both attorneys. One of, my mom is a.. worked for the attorney general. And she was always looking for like fraudulent things and, and charities and transparency. And my father is a civil rights attorney and also an immigration attorney. So I kind of grew up with this. Parents talking attorney stuff. And my mom always was saying, you know, you ought to be with people to help people. However you are you’re you like to be with people you like to help people. But instead, I rebelled. And I went into science. And I went, I was a biology major at the from the University of Minnesota. And I went to California and I started doing some organic chemistry and research and this kind of work. And I was terrible at it. I have to tell you, I almost blew up the lab a few times I and my my bosses who were 30 at the time would say ‘Kim, have you learned your lesson?’ and I would say I better not wear my good clothes, because I ruined my shoes that I had just gotten they were like fancy shoes, and I really liked fashion. So anyways, I decided to go back to school to become a speech pathologist like you because my my aunt was getting speech therapy because she had a stroke. And it was very fascinating. So I went to school in California to be a speech pathologist. And I met this professor who I probably we all had girl crushes on her, she was really neat, very powerful New Yorker professor. And she always would they say things like ‘it behooves you’. And ‘you need to empower yourself’ – things like that. And so she was really neat. So she had encouraged me to switch to audiology, which is what I did. So I have this, like science background with this, these parents that are always trying to discover transparency and things like that. And so that has kind of led me into where I’m at today. And so, as I work from place to place, I never really liked the models in which people were getting help. And my whole idea was always to help the people and I, I love helping people. And I love Pete working with people. So this is fine. This is a fine field to do so. But in the way in which we do it has been difficult for me.

Brian Taylor 3:42
That’s something we’ll talk about. I think as we move through, I think what I wanted to really focus on next, Kim was, I know, well, I’m in Minnesota, or in the Twin Cities, you’re in the Twin Cities. So I know that you’ve had a practice here. But what’s really, I think, what the reason I wanted to have you on our broadcast is that you now have this online store. And that looks like a really interesting model that combines and it’s it looks like your business or your practice combines in person care with online sales and service. So could you tell us a little bit about your current business venture and this combination of in person care and online sales?

Kim Fishman 4:20
Yes. So I have a little clinic in Hopkins, was in Minneapolis. Now it’s in Hopkins. And I’ve been trying to think of these delivery models of how to help best help people. So we have an online store, but it’s actually I started talking to people about it. It’s actually for everybody. So it’s not about me. So the goal is to its member, it’s a member base. So we thought about having it be a co op but you can’t have it as a co op because I want providers to come into it. So it’s both member based and provider base. So there’s going to be a network of providers as well. So that we can reach rural areas to help more people. And if it’s member based, we can get the prices more affordable and offer lots of different things. So whatever the customer needs, is, well, that’s what

Brian Taylor 5:18
I found really interesting is it looks like you have a combination of traditional hearing aids available on through the website, and also personal sound amplification products, PSAPs. So tell us about this combination of PSAPs and hearing aids available on your website.

Kim Fishman 5:40
about it? Well, it’s just trying to help people, wherever they’re at, so to speak. So I noticed that online – one thing that I want to say about the hearing aids and mostly we it’s not just hearing aids, we have everything like eartips, is that I noticed that people come into the clinic with tips stuck in their ears all the time, and the tips don’t even match the hearing aid that they have. So they go on to Amazon, and they buy tips that will fit their hearing aid. And so I thought let’s, they need to find the right pieces to go with their equipment. So that’s really where this was coming from is trying to help them find what they really need. Right. And so it kind of just took off from there. And then I I believe that people need us audiologists and hearing professionals, because they don’t really know what they’re doing in it. And as their becomes more PSAPs and over the counters and hearables need us to help them figure it out. And so that’s right.

Brian Taylor 6:44
No, I kind of I think, in we’ll talk more about how to people can access and look at your website. But it seems to me that one of the things you’re trying to do is allow people to kind of dabble or look at different devices, but then channel them to the professional to get the service that they might need. Exactly, which is great. Exactly. Yeah. Another question. Do you have any maybe offer some thoughts about if somebody came to your website? And was looking around somebody that maybe had never worn hearing aids and maybe needs need some type of device? What’s What are your thoughts on that? Yeah,

Kim Fishman 7:25
so let’s say they find our store, and they can fill out a contact, they can call us, they can email us. So there’s lots of ways to reach out to us. We’re going to be filling in. So I, I just like I said, I just started talking to other providers to fill in that service. So they could click the service and the consultation to that state that they’re in. So let’s say that they’re not in Minnesota. So they’re in Wisconsin, so we would have a Wisconsin provider there that they could click and talk to and and work with. And then that provider would help them whether they go in whether they have, you know, an online discussion like this, whatever is easiest for that customer.

Brian Taylor 8:12
Yeah, no, I think that’s great, because it’s another point of contact is one of the way to kind of encourage somebody to get the help that they need, may need. We know a lot of people out there need help, but they don’t, for whatever reason, don’t want to take the time to go in and make an in person visit. And maybe that first point of contact online makes it easier for them. And you also said something really interesting, I thought about serving rural communities, I just looked at some recent data that shows that a lot of people in rural areas are kind of underserved by audiology, with the help they need. So yeah, tell us tell us your thoughts on that.

Kim Fishman 8:47
Well my goal is is to start once we start getting providers in all the states is to reach out to or to do marketing in those areas, and then try to figure out how to help the rural areas. Whether we do tele audiology, or if somebody from Minnesota, let’s say they’re in Litchfield or someplace like

Brian Taylor 9:07
that, a small town in Minnesota, yeah,

Kim Fishman 9:10
maybe I would go maybe I would go there for a day and help them you know, so just kind of figuring out what they want. If they can’t come to us if we can’t fill in that gap out there. So that they don’t pay huge amounts of prices. For for a hearing aid that doesn’t really work for them. Right. I want to tell you about a person that I’ve been talking to in Tennessee, so we’re already meeting people all over the United States. It’s really fun. And there’s a lot of areas where even in like Maryland, there’s areas I was looking for somebody wanted a hearing aid in Maryland and the pricing was so crazy high. So I called around talking to people there and we just couldn’t find anybody. But there was this one man that reached started from Tennessee. And he wanted a Phonak piece. So I just started asking him, Oh, well, why do you need the Phonak piece? Do you have a severe hearing loss? What’s your hearing loss? He said, No. And I got this hearing, hearing device and I can’t hear at a table. And I asked, Well, can I see your audiogram? And can we talk a little bit and we talked, and it actually wasn’t the right product for him. And so we found a place for him to go to try something better for him because he has a PhD. And he’s a doctor, and he needs better hearing. And we just kind of were able to, you know, touch base with him and give him some expectations. And I like that I’m, I’m able to talk to people and give them expectation.

Brian Taylor 10:46
Yeah and i think it’s great, because if you think about over the counter, that’s something that’s probably going to become a reality in the next year or so yeah, you know there’ll be a lot of people out there that will want to self-direct and get their own products. But at some point, they’re going to need the expertise of someone like you. And we all know that a lot of people are not going to take the time to do an in person visit. But they will get on the computer. And if you’re readily available to help them in the virtual world. I think that’s great.

Kim Fishman 11:17
Yeah. So that we can give them expectations and kind of what they’re what they’re watching for. As long as we know, we know what is expected and what it is

Brian Taylor 11:27
exactly. I think that’s really cool that you’re able to offer service to offer your expertise without having somebody physically in the same room as you that you can do it virtually. And you’re making it. So you’re making it easier for the consumer ultimately, to still get the expert, the service and the expertise that they that they really deserve. So

Kim Fishman 11:49
and friends all over the United States, which is

Brian Taylor 11:51
Yeah, yeah. So you mentioned two different types of members on your website, one membership for professionals, and the other membership for consumers? Can you kind of unpack that a little bit? And tell us a little bit? You mean by that?

Kim Fishman 12:05
Yeah. So okay, so the membership is strictly for the consumer. So we started out with just let’s just talk about the consumer, we just want to take care of them. So we built that out. And then I have a partner, his name is George, and he, he’s the money guy. So luckily, I have somebody because I don’t really, I just like to spend it, you know, he’s like, Hey, we got to do this, we got to figure out this and see if we can even make money. So we started with the consumers. And that’s what I’m good at. Okay, so I’m talking to consumers. And we have two types of memberships for them. Now, on the other side, it’s called the network, we’re going to call it the referral network provider, okay? There’s going to be two types of members for that two types of providers that are going to come in the first provider will just be a provider that’s going to come in and get referrals from us. Okay. And I have the legal paperwork now, which I just got all done. And I’m ready to go back out and talk to people again about it. So they would just sign in to become a referral partner. And they’re gonna abide by our, what we’re saying is legally, right. Okay. And I can tell you about that next. But the second type of provider is going to be a want to say executive or, like a premium provider. And those guys are, those providers are going to kind of be a little bit more in the helping us in the game. And they’re going to get profit sharing. Okay, this is not about me to get rich, I’m, I’m thinking at some point, this will come a nonprofit, and org or something like that. It’s about the consumer. And it’s about my ideas, trying to make it a little bit better for everybody. So that we can get rid of all these I get, we’re all going to have biases, but but I want people but I want our providers to share their biases. And, and and talk about transparency,

Brian Taylor 14:08
well transparency is the name of the game. And that’s something that we’ll get at in a minute. I just had one. I’m curious about the membership for consumers. Tell us more about that. What what does the consumer get if they become a member of your co op?

Kim Fishman 14:23
So I’m excited about that. They get discounts, rewards, there’s a forum on the website where they can go and sell their used or gently used or refurbished products. The consumer can talk to us the consumer can talk to other consumers. There’s referrals so that if they made a referral, they get reward. So everything is loaded in this website. I mean, there’s stuff like TV streamers and tips and batteries and whatever, you know, just to be part of the the game and it’s all about hearing and in ear cleaning pieces. And so they would get all access to all of that.

Brian Taylor 15:05
No, I think it’s great because you think about when you talk about Bluetooth streaming, all the all the gadgets that go around to hearing aid, there’s a lot of information. So what I think is really, what’s great about what you’re doing is you’re making it sort of a one stop shop for information.

Kim Fishman 15:21
And I’ll just say one more thing. That’s also I’m really into and I was telling you about my past with research is, I’m really research based. And so we I have on my team, Karen, she’s an awesome writer, I suck at writing, but I like to write. So we do all the blogs, I want to put out real research based I don’t want to put out stuff like, um, biases, like, oh, the best, the best hearing aid you can get, is this hearing aid. It’s actually going to be research based.

Brian Taylor 15:53
Well, I think, I think what you’re saying is, and I’ve seen that been on your website, so I see this, it’s bedded information, it’s been, you know, you’ve looked at it, you’ve evaluated it. And now you’re kind of weighing in with your expert opinion about how how this research might be helpful to somebody who wears hearing aids, or might be in the market for hearing aids, something like that. So reviewing

Kim Fishman 16:14
what somebody else has put out so that we can say this is what this group found. And that’s what’s important. Yeah,

Brian Taylor 16:22
the next thing I wanted to ask you about Kim was, you mentioned the lack of transparency, you have this legacy of social justice that comes from your parents. Yeah. Tell us, give us your take on the on transparency within the industry. I know you’ve done some videos on this. And I think it’s important for you to maybe elaborate on what you mean by a lack of transparency within the industry.

Kim Fishman 16:50
Without hurting anybody’s feelings or naming any names. This is a problem. A huge problem in our field, to the point where my consumers are coming in and saying, Who owns you? What brand are you going to push? Things like that? Why..and it’s the sort of like, why are you doing what you’re doing? And is it a bias? Or is it a business venture? And it’s hard to really understand that as a consumer. And I put myself as the consumer, so when I go in someplace, so let’s say we want to go in and buy something. We know if we walk into a Toyota dealership, or a pearl vision dealership, we know where we’re at. It’s labeled, it’s clear for us, right. But how do you know when you walk into a clinic and they don’t have ‘owned by’… Um, it’s, it’s not good?

Brian Taylor 17:51
Yeah. Now you bring up a really important point, I think this lack of transparency, the importance of ethical practice, practice practicing and practicing in an ethical way, the importance of disclosures. So maybe, you know, shed some light on for consumers and for professionals, what are some ways that they can practice in a way that’s more transparent?

Kim Fishman 18:20
Exactly. And I think if people were just transparent, I believe the consumer would be super happy with that. Because if I, I think what we’ve learned is that we have to share where we’re coming from, so that people can understand and understand the consumer, where they’re coming from. So if you can share as a, as a provider, where you’re coming from, why your biases this way, I share mine all the time. Sometimes people don’t like it. And some people, some people do, right. But I think if you could label on your door, I think that would be the best way to do it. Is that you? Or in your clinic, when they walk in that says this is sponsored by blah, blah, so that they understand it’s simple. And then and then the person can say, Okay, well, why did you choose that? And they can then say, I believe this is the best product. And that’s why I’m doing it. Now. I am, I don’t, I don’t have one best product. And the way that I do it is in my consumer likes at my patient is that I offer all different products. And so it takes forever for people to go through and try different things. And that’s the gimmick that I was telling you about which we can talk about later. But that transparency of I’m not I don’t think anyone best product fits one person, right? And I started getting really annoyed, watching and disturbed, watching some videos where they’re saying these are the best things you can do. And I don’t believe that that person or Are these people know that it should be based on the research? Right? I feel like we have a disconnect between the universities and the clinicians. And I’ve always felt that way because I was in a doctoral program for a while. And I felt like when I came out of the doctoral program and started working in clinical, and I did not get the doctorate by the way, but when I came out, there was this huge, they’re not supporting, this is not supporting and so there’s a lack of transparency to the student, as well as the professors not doing the research that helps the consumer. And it’s just so and maybe that’s across all different fields. I only I only know this field,

Brian Taylor 20:42
right. Well, I think that what you’re saying really reminded should remind everybody that it’s important to revisit your what you know about ethics, and ethical standards within your profession.

Kim Fishman 20:56
Everybody,

Brian Taylor 20:57
you know, the name of the game is really disclosure that people need to know, your potential biases and how they might be influencing your recommendations or your clinical opinions and decision making process. So I think woody Yeah, exactly. But I think it’s important, just have to be upfront about it. And and so what I really appreciate about you, Kim, is that you’re actually kind of reminding everybody that there is this lack of transparency in many places, and that you have to disclose what your biases might be,

Kim Fishman 21:30
or who’s giving you money?

Brian Taylor 21:31
Exactly. So thank you for reminding everybody that that’s an important part of ethical practice. So I see that our time is kind of I don’t want to take up any more of your time. So maybe we could kind of wrap things up. Some final thoughts that you have about the future of audiology, about the future of hearing care, the talk maybe and how that relates to your, your new practice venture.

Kim Fishman 21:54
So people are going to be seeing more of me, we’re still working on like I said, I have some legal documents that I’m getting through that people are going to be signing to be but to share their biases and their transparencies with the consumer. To the consumer, I want to say out, feel free to ask people. Don’t be afraid of asking somewhere where you go in Why are you doing why are you why are you giving me this? Why is this this? Why is it this way? And then I also want to say to anybody who’s interested, please reach out to me to start getting involved, we’re still working on some things. And I think it’s going to be a great thing. I’m optimistic and our goals are, are high. We’d I didn’t tell you my ultimate goal. But that’s for another talk.

Brian Taylor 22:43
Well, we’ll have to have you back on after you get this up and running and 100% speed that Kim, tell us the website where people can find you.

Kim Fishman 22:51
Oh, it’s hearshearingandhearables.

Brian Taylor 22:54
Hearshearingandhearables. I think we’ll probably put that on the bottom of the screen here so that people can see it. But if anybody has any questions, what’s that website again? If they want to contact you,

Kim Fishman 23:05
hears hearing and hearables but they can email me to please share if you don’t mind email at [email protected]. I’m always looking for more help. I’ve talked to other people in the industry who have a couple people who want to help us because it’s again, not about me. It’s about the customer, right about our people.

Brian Taylor 23:27
Well, I can’t thank you enough. Kim. Thank you, Kim Fishman, private practice audiologist who definitely keeps the consumer at the forefront, a true consumer advocate. We’re really happy that you were able to take some time out of your busy schedule to be with us. And on behalf of everybody at This Week in Hearing. We wish you all the success in the world.

Kim Fishman 23:51
Thank you, you too.

Brian Taylor 23:52
Thanks for being on the broadcast Kim