Challenges and Rewards of Building a New Hearing Care Platform – Tuned Audiology Roundtable

Heather Malyuk 0:09
Welcome to This Week in hearing. I’m Heather Malyuk. And today I have with me Dr. Kathleen Wallace and Dr. Laura Sinnott. We are all audiologists who work part time with Tuned, a new tele audiology platform Tuned was designed to give access to true audiologic, expertise and care to those who otherwise might not seek it out or who are perhaps looking for a non traditional approach. Through the Tuned approach, we’re really aiming to empower audiologists to lean into their knowledge and expertise to demonstrate their value to patients without a sale attached. And in a bit we’ll discuss what tuned isn’t. But the real purpose of today’s podcast is to provide listeners with a chance to peek behind the curtain and see what three clinical audiologists have learned while helping develop such a platform. We all have unique experiences and backgrounds which have been formed this process and I’d love to offer any listeners the opportunity to hear the ups and downs, the surprises and of course the let downs of creating a modern tele audiology platform with as much transparency as we can give. So to start, I mentioned that my name is Heather Malyuk. I’m a clinical and research audiologist. I’ve been in the field 10 years, and I own sound check audiology. I like a lot of aspects of audiology, I work a lot in hearing conservation as it relates to musicians. And I really love telehealth that it allows me to connect with new people as well as my own patients no matter where they are in the world. So that’s a little bit about me, my role at tuned is head of Audiology. I’ve been with Tuned for about two years. We’re all part time here. And I’ve really appreciated the chance again to see behind the scenes, how a company like this is developed and how to look at different studies, look at the evidence, look at devices, etc, and kind of oversee everything. Laura, would you mind given your background and what you’re doing it tuned? Sure. Hi,

Laura Sinnott 2:06
everyone. I’m Laura Sinnott and I’ve I’ve been an audiologist for about five years only a career expanded in my mid 30s. Previously, I was an audio engineer or still am an audio engineer working in the film industry. And what I do it Tuned is mostly focused on vetting devices. And you’ll learn about this later. But one of the cool things about Tuned is we connect audiologists and provide education and knowledge about non traditional hearing aids we we embrace hearing aids too. But we also know that there are a plethora of devices out there in the consumer world. And some of them are pretty freaking awesome. And this is coming from the audio engineering side of me as well as the audiologist. So I’ve got the products, I run objective measurements on then subjective measurements. And then I kind of condense, write edit the information and try to present it in a way that helps audiologists figure out what devices are good enough to recommend to certain people. And then on the audiology side, I also very recently started a company called Sound Culture, which I have to give Heather props for naming my company. And it’s just getting off the ground, but I’m focusing on concierge audiology. I have seen orchestras and I see musicians mostly at this time

Heather Malyuk 3:28
Awesome. Thanks, Laura, Kathleen.

Kathleen Wallace 3:30
Hi, everyone. I’m Kathleen Wallace. I’m an audiologist here in New York City. With Tuned, I am the head of provider education. So I oversee a branch of what we call Tuniversity and we will get into more detail there. But it’s essentially the resource hub for audiologists on the Tuned platform, a lot of Continuing Education essentially and thought pieces and just questioning the standard care of Audiology. My experience up until this point has been in traditional medical models in end clinics or hospitals. So this is certainly a change of pace from that. And in addition, I’m also an adjunct professor at the CUNY Graduate Center, which is my alma mater and Laura’s alma mater. And what interests me in audiology is I love to analyze the profession of audiology itself and how to monitor modernize it. How to Improve audiology education and how to promote hearing healthcare and patient education

Heather Malyuk 4:38
awesome yeah, for anyone listening. If you don’t, if you’re not connected with Kathleen on LinkedIn, that’s a great place to see a lot of articles that are put out about this as well as some thoughts and really good conversations. I always enjoy following your posts Kathleen as a means to start I you know, I started with Tuned two years ago. Little over two years ago. And one of the things that struck me was this concept of brand agnosticism, and not having influence from the manufacturing side of things. And I really took to that right away, I thought it was really important because so often in the audio logic world, we see sort of the big manufacturers kind of owning the scene, in a way, they don’t own the whole scene, you know, but there’s, there’s a big influence there. And I decided, when I started that I really really wanted to maintain this brand agnosticism with Tuned. And I find that a lot of audiologists are surprised when they hear that we aren’t a pay to play platform, you know, they get on the site, and they see a product and they assume someone has paid to be there. That’s not the case, they’re there. Because myself or Laura, or Kathleen has talked to that company, we’ve tried something out, we’ve decided there’s a good reason for them to be there. The other thing is, I really wanted a space for audiologists to practice without having to focus on product sales. You know, I wanted a space where the audiologist could be elevated above that. Or they could be separated from the device and really be seen for their brains and their knowledge and their expertise. There is a statistic that 24 million people see an audiologist every year. So they’re seeking out some kind of care, many different reasons. But within that statistic, 81% of those potential patients leave the clinic without a solution. Without a care component. Maybe they need a device, maybe they don’t. And I think a lot of these individuals I’m seeing who have normal or mild hearing profiles, mild hearing loss are sort of left on the clinic floor. And so you know, being able to present them with more options, to not be tied to a certain manufacturer device or not even be tied to a device at all. Like I said, some people don’t need a device, they need an audiologist. So this was really important to me. And I you know, Kathleen, I’d love to know your thoughts on this aspect of what we do.

Kathleen Wallace 7:04
Yeah, I think the brand agnosticism is it’s crucial for the success of Tuned. And it’s strange how this is sort of a an exception to the rule that the standard default is people are expecting there to be some relationship or role of industry. And I love that we’re not that. And absolutely the part about using your whole brain that you said, I am a huge endorser of all of us did not go to school for as long as we did to just become a glorified hearing instrument specialist or, you know, pick certain specialties and then not go beyond that. So I think it’s really important for patient trust, to have that independence. And then I’ve also have sort of shifted my thinking personally, with Tuned, is of viewing myself more as a Hearing and Communication Consultant, where I am just your resource, I will share all of my knowledge and educate you as much as you can and empower you to be an informed consumer. For you to use that information, however you see fit, whether it’s a device or auditory training, or tinnitus, management, whatever it is. And I think that’s a really exciting area of audiology and something that tuned actually absolutely enables and promotes.

Heather Malyuk 8:26
Yeah, the collaboration is really essential. And, Laura, I’d love to know your thoughts before I move on to the next topic, just what what you’ve seen really with this not being tied to a device or manufacturer and how that’s how you’re working with that. On the platform. Yeah,

Laura Sinnott 8:41
I think I mean, honestly, having recently been a student, again, I think five years or so, when you’re a student, you’re you’re becoming an expert, because you’re diving in so deeply into all of this knowledge and education. And then little by little, it’s like oh wait, we have to sell things. And I remember one textbook, or maybe it was a professor, they said, they said ENTs are medical ear doctors, but audiologists are experts in hearing, you know, more than than ENTs do about hearing. And that just sort of a light bulb went off because I’m like, oh, it’s true. Like nobody owns hearing better than audiologists, we are experts. But I think that we lose that over the years of practicing clinically, because of so much pressure to sell devices that a lot of times we don’t even feel the patient might need so yes, Tuned just seems like this ideal almost dream come true company. The where we can go back to being the experts. And I think about for a lot of people that’s intimidating because we’re not used to practice them like that because we all besides them. Focusing on this device sales. We also really focus on the audiogram right, it’s like there’s certain thing we always do with patients and with out those kind of two things to fall back on. And we’ll talk about the screeners that we have at Tuned in a moment, but you know, we don’t have the traditional pure tone audiogram with an audiometer. So sometimes people can feel like, Oh, well, wait, what do I do? But we are- We are the experts. We just have to kind of like, find that in ourselves again.

Heather Malyuk 10:17
Yeah, I agree in looking beyond again, looking beyond hearing loss, looking at the patients who need us for conservation, general education. Kathleen, one of your specialties is third party disability looking at like the whole family how hearing loss impacts others. There’s, there’s so much more. And, Laura, you said something that is always on my mind, which is the hearing testing, I love to ask students, I asked a student who was with me today in the clinic, why do we test hearing? What’s the first thing you do when you see a patient? Why do you do it that way? And I think the safe zone for many audiologists is behind an audiometer. Like, that’s where they feel very comfortable. And one of the things that we did when looking at, you know, what do we need on the Tuned platform? And what do we not need? One of the big things was the hearing screener. Part of that was for the way we designed it was for the comfort of the audiologist. And what was interesting going into this, I had not had that much experience with looking into the actual companies who produce these things, and talking to them, and trying to talk to the engineers. And to be totally transparent here. I am not going to say names of any companies, but so many are not validated. And when we were trying to choose something, speaking to several of these companies and being on a meeting with them over zoom, or Google meets or whatever, and saying, Hey, can you send me some of your data? You know, I want to see comparisons with boot with in Booth testing, I want to know more about your validation process. And several said, Oh, we didn’t do anything like I don’t have anything to send you. Is that something that’s necessary. And these are tests that I’m seeing on other clinicians websites that I’m seeing used on websites of certain manufacturers, and nothing was done in the process? So, you know, that’s just something transparency wise, I think audiologists should know, they’re not all validated. And even when they are there are differences still in transducers. There’s a reason why they will probably maybe always, maybe not always, but they’re called screeners for a reason. So, you know, and I do want to get more into that in a moment, Laura, but I just want to say, you know, what we looked at was, okay, can we just have one type of screening? And the answer was no, it’s not enough. When someone walks into the clinic, I unless it’s just, you know, like an OSHA regulated hearing test, where I’m just doing pure tones at certain frequencies. I do a lot more than that. And I know you guys do as well as, as does every other audiologist. So we start with a questionnaire, the CEDRA questionnaire, which is the consumer ear disease risk assessment tool, which was validated through otolaryngology world, looking for medical red flags, to see does the patient need to see an ear, nose and throat physician? Are there medical issues here that need to be addressed? And then we go into a digital noise test. And then we thought we can’t stop there. We do a threshold test. And the reason for that I’ve had a question from audiologists of why do we have two different types of tests? In my mind, it was looking at sort of like a cross validation. And I know it’s not exactly the same, but I thought, well, in the clinic, we do a test and then we do SRT, there’s usually something else we’re looking for things to line up. We’re looking for reliability. And so I wanted something similar to that. And so that’s really where we started. And then Laura, you came on board. And I’m curious to know, your thoughts. I think you were not as surprised as me about the lack of validation, because you had been looking into this for longer?

Laura Sinnott 13:44
Well, I think I wasn’t surprised because it’s hard to validate because of all the calibration issues. And you know, talking about you said something earlier, Heather, this is an example of how are podcast today, we’re all about transparency. One of the reasons we have a pure tone screener is because it will make audiologist comfortable. They’re not, they’re not the end all be all, even the one that we have, which is I mean, it is one of the most validated screeners out there. Because we have we have listed them all. It’s still a pure tone screener. And it is incredibly difficult if not impossible, to get the same results on a pure tone screener, if it’s web based, every single time. But I think this is another really good example because we have the digital noise, we have the questionnaire. We have a pure tone screener pure tone threshold screener, I should say. And we’re gonna we help you understand how to audiologists how to, to interpret them, but you still have to, you know, put your thinking into your brain. Yeah. And make some judgments about the combination of results. So yeah, I think the digital noise is a great kind of cross check for the pure tone threshold screener because the threshold whether somebody passes or doesn’t pass is based off of a three frequency pure tone average. I think if it’s 40 DB, it’s a moderate carb reading. So again, we help you understand those things. But yeah, I should also say, we tried to develop our own pure tone, threshold screener, attuned. And that’s when I came on board about a year ago. And whether people liked it or not, I was I feel like I was the squeaky wheel. Like you guys. There’s a lot wrong with this. And we were trying to get a validated, we put lots of blood, sweat and tears. I know that we did even though I came on later, and we dropped it because it wasn’t good enough.

Heather Malyuk 15:36
Well, I think that’s why it’s really important to point out that clinical audiologists are needed in the development of these things. That’s the other thing that has surprised me about a lot of companies, we’ve got engineers, we’ve got MDs, this and that. And they’re creating tools and not consulting with audiologists. And when when you and I look at something or I do or Kathleen, and we say Hang on a second, this is not we can’t use this with a patient. This is not good enough. Someone has to say that. You know, that’s the only way to move the field forward? Well, exactly, exactly.

Laura Sinnott 16:09
And so nobody argued it. And that’s why I think that was the first month I was there. And basically like Danny, the co founder, and and everybody out there were like, You know what, you’re…this, this isn’t good enough? Let’s find something that is

Heather Malyuk 16:22
Well Because at the end of the day, if it doesn’t serve the patient, what’s the point? Right, you know, that just doesn’t make sense. So, so yeah, so the whole hearing screening process, and what was created was a big eye opener, I’m happy with where we are now. And what I’m really excited about, is looking into the future of this and seeing it, I do believe this will get better. And there are other things people can do you know, like after the screen, or if there is a red flag, well guess what that person might need to be seen in person, you know, that is where you refer. Or maybe they get an at home test kit. You know, it doesn’t stop there. You say, Oh, something looks wonky on the screen, or oh, sorry, we can’t do anything. That’s not the case at all, then you say, Okay, you need to come see me in the clinic, or let me help you find someone who’s near you. So really, the screening is to look for issues. The other thing is, and Laura, you can probably talk about this a little bit in terms of devices, a lot of the newer devices that are used for mild hearing loss, have a hearing test integrated, that have to do with those transducers. So on a screening online, if you can get an idea of fitting range, and again, any medical issues, anything like that, that person will be taking another screening over the device that was meant for the transducers they have on, correct?

Laura Sinnott 17:36
Yeah, most of the devices, yes. And a lot of them are using the Mimi hearing test, which I think a lot of audiologists are familiar with. And that’s just an example of how I think it’s really great that the consumer world is getting involved because the Mimi hearing test is a super threshold screener. Or test I have to Is it a tester a screener? Well, I think I would call a screener- it’s super threshold. So it’s, it’s just cool. It’s like there are ways we can modernize audiology, but no one seems to have the resources to do it. So now consumer companies are coming in. And that is one of the great benefits of, of those other industries getting involved. So that’s very exciting to me. And I’m sure 10 years down the road, maybe 20, we’re going to have some amazing web based diagnostic tools, because companies are trying to figure it out. There’s no question about it. And Oh, one last thing about that, yes, most of these consumer devices do but I should just mention the Bose SoundControl hearing aids, which I think are going to be there, they’re under the umbrella of Lexie now…but they don’t actually require a hearing test. And I have spent hours vetting that that device, objective measurements, I’ve had people try them who have hearing loss. It is an amazing device. And it doesn’t even require a hearing test. So and there’s lots of validation behind it. I couldn’t get into it now, but I won’t.

Heather Malyuk 19:00
We only have so much time. But this is stuff. This I will point out as we go in to kind of the next topic, I wanted to talk about focusing on the audiologists in terms of empowering them, educating them, etc. I think that what you just raises a good point who has time, just quite frankly, who has time to do everything you’re doing with all these devices. And that’s one of the things we’re trying to do here is provide resources to lift all audiologists up. We have about 130 on the platform right now. And we’re continuing to grow. And the idea here is that everyone becomes an expert, because we’re providing the resources needed. So there’s no hierarchy. There’s no elitism. It’s just, hey, we’re taking the time to do this to help you diversify and expand your clinic. And Kathleen, I kind of want to pull you back in here. Can you talk about the focus on audiologists? why that’s so important and how it relates to education and things like that. Yeah, and

Kathleen Wallace 19:57
I think what you both were just discussing about the creation of our screening and how critical we have been. And really being very cautious. Everything that we do, it’s very obvious that there are audiologists behind the scene like that we are very much we’re toeing the line of modernization along with very being very rooted in best practices and evidence based practice and making sure that we are making very informed decisions about what we implement and how we are counseling people on it. And so there is a lot of provider education there, which is where tune diversity comes in. That’s essentially our resource hub of everything, you need to use the tune platform itself to conduct virtual appointments, how to interpret the screener along with how to how to approach the devices, and really make sure that your understanding you feel comfortable with the recommendations you are making. There is a lot of resources going in and a lot of effort, to be honest, a whole lot of manpower going in to really producing very digestible resources for audiologists, because we want to do right by our patient. And part of that is that we have to be well informed and really own this expertise. And a lot of people that maybe have been practicing a fraction of our scope of practice, have interest in expanding but they don’t have the opportunities to do so. And to University is a great place for people to sort of dip their toe into learning from other professionals that might have different specialties, you know, audiologists with different specialties, or knowledge base, like I’ve learned a ton from both of you, with working together and to university really fosters that collaborative environment and really learning from each other. So we ultimately do right by our patient, and everything is above board and audiologists are comfortable with it.

Heather Malyuk 21:58
Yeah, and the other thing is, you know, we the education, I think is really important because again, the focus on is on keeping the audiologist independent. And again, a question that I often get from audiologists when they’re looking at Tuned or joining is, am I employed by Tuned? And whose patients are they? And the answer is No -and they’re your patients. So the education is important because you are not just some cog in a wheel, working for an employer being told to do things a certain way. The idea is that every audiologist is independent, has their own thoughts has every patient they have is their patient, Tuned as a benefit for employers so employees can get on the website be connected with an audiologist in their state and get care. That’s that’s their patient. And so the idea of the education Kathleen, what you’re curating with Tuniversity, is that there’s no need for them to not be confident with patients that they’re maybe not used to seeing, because Tuned is not in charge tonight is not in charge of their clinic, we are here to handhold a little bit, you know, we’ve given guides and you know, things like that. But the idea is that they learn enough that they enter that meeting with their own knowledge, their own confidence, and they raise the bar for themselves and their colleagues.

Kathleen Wallace 23:21
Yeah, and that’s the beauty of tune is that you can use it however you want. And you know, at the end of the day, it’s your patients and you’re the provider, you’re it’s your appointment, so you can conduct it however you want. We’re just giving you all the tools and empowering you to maybe diversify a little bit or serve, make sure you’re serving those patients as best you can with a more modern approach to audiology, because a lot has changed since we all graduated from our AuD programs. And it’s very hard to find the kind of resources that we’ve been making it whether it’s, you know, comparing Bluetooth stethoscopes or tinnitus apps or Laura doing very detailed vetting videos of these devices that where you can actually hear the samples, you’re not getting this anywhere else. But it’s crucial information for audiologist to feel comfortable with the care they’re providing.

Heather Malyuk 24:15
Yeah, I mean, on Tuniversity today, I put up some resources, I read on EMF radiation and air pods because I’ve had questions from patients who are young, you know, people who, again, maybe wouldn’t walk into an audiology office, but they’re going to have a screening and a wellness appointment because it’s through their employer. And they’re asking these kind of questions and saying, well, the audiologist should know, this is something that goes in my ears and I’m like, oh, gosh, I don’t I don’t know. I need to read about that. So yeah, there’s there’s a lot going into this new era. I think of hearing care where there’s just so much to learn and especially with the products and Laura just to I want to get an idea from you, I guess in your words because you’re doing this all the time, reviewing products. What Why is this important? I mean, I have my idea of why it’s important. But why do you think it’s important? And then can you give sort of a brief synopsis of what like, what’s your process? Basically with a product

Laura Sinnott 25:10
Sure. I’m gonna do something that is hypocritical because I, I really value the act of listening. And there are lots of people who are in the wisdom practices world, who will tell you like when you’re actively listening, or you having a conversation, most people aren’t listening. They’re thinking about the thing they’re going to say next. And I was totally just doing that with you have here because we were talking about when Oh, when you mentioned young people, so yeah, right now, you know, if we’re gonna, I’m in this mood of God, Tuned is amazing, like, hallelujah. So something last week, I think at our audiology meeting, we learned about how much we’re putting, Tuned is putting a lot of money into marketing, and advertising. And really, what’s so cool is that it’s helping to elevate and build awareness for hearing. So we always talk about audiology, how audiologists don’t do a really good job about advertising our own profession, compared to dentists. And that’s why one reason why society at large doesn’t value their hearing, because nobody’s telling them that they should value their hearing. So again, it’s just like another plug for why I love to Tuned so much because, you know, we’re spending our own money. But really, it’s it’s to try to also get these young people to come and see audiologists, because we know it’s important, and again, serving people who don’t necessarily need need hearing aids, but they need hearing healthcare. So yeah,

Heather Malyuk 26:40
yeah. Which I want to get to into in a minute, because I want to talk about some, like the types of patients we’re seeing. And yeah, so you know, how, how that’s working, but

Laura Sinnott 26:49
do you want me to talk about the devices?

Heather Malyuk 26:51
I do. I do. But I want to preface it by saying like, if you’re, if you’re an audiologist listening to this, and you’re thinking, okay, all I’ve heard is that, like products are bad, like anything that’s not hearing aid is bad. And the other thing is, what an overwhelming thing to get into. Because if you try to search any kind of earpiece, or headphone or whatever, even on Amazon, you’re gonna come up with so many options. And again, who has the time to sift through these. And so I know that you are sifting through them, which is why I want you to talk about your process. And part of why I want you to talk about your processes, this is not a proprietary thing. This is something anyone can do in their clinic, if they have the resources. This is not a secret. It’s just it takes a long time. So So why do you think it’s important? And how are you going about it? And how is it helping clinicians?

Laura Sinnott 27:41
Sure. And you’re absolutely right, Heather, and for those really nerdy people out there like myself, if you have you want to review post it to Tuniversity, we would love that we love it, I would say that, you can definitely, I can definitely Judge, I think we all could, to a certain degree just off of a company’s website, if they’re worth trying to even get the device in your hands in in your ears and listen to it, if they have zero specs, or if they don’t have many specs on the device, if there doesn’t seem to be any company history, all of those things. So for devices that do sound compelling, and interesting, once we do get them in our hands, my process is I really try not to watch other people’s reviews. Because I try to remain as unbiased as possible, I will try to learn about the company, I will try to see if there’s published research and for some devices there are for some there are not. So I will do my own background and research on it. But without watching reviews. And then I typically perform first, I just subjectively listen to it. And I have a minimum of 10 hours, I need to listen at least for 10 hours in different situations. And then I will run the objective measurements that might be Verifit2 or using my audio engineering tools to do so because some of the devices, you can’t use the Verifit2 with it. And we make recordings binaural recordings of most of the devices. And that is very cool. Because again, you can listen to samples of how they sound. They’re not, you know, perfect KEMAR laboratory types of assessments, but they give you somewhat of an idea, which is really nice. And sometimes I use those recordings to help me make objective analyses on the devices. And then once I have all of that information, I start scripting, scripting together a tutorial that’s geared towards audiologists and that is another process of deciding what’s the most important information because in the beginning, I wanted to put all the information in there and then I’m like, wait, Laura, these are audiologists nobody has time. I’ll be lucky if they actually even watch half of the video. So yeah, it’s deciding what is the most important information in then we produce the video and That’s a whole other story. But

Heather Malyuk 30:02
it’s a lot of work. And I like the way you do some of the things like I, there’s a video on Tuniversity of you doing a cartwheel and a set of devices to see if you’ll stay in your ears. I mean, these are, it’s funny, because these are things that patients might ask about, you know, and it’s like, okay, well, every audiologist doesn’t have time to try every device. But we do have something called Listening Club, which Kathleen This is in your area as well. I don’t know if you want to describe it, but where they can listen to any product that we have listed. They can rent it, correct?

Kathleen Wallace 30:34
Yeah. So this is a very nice supplement to what Laura offers, you know, Laura does the technical detail of you know, the objective measurements along with some subjective feedback. And then, ultimately, audiologists need to feel comfortable with actually, you know, holding and feeling and feeling it in their ears and, and hearing it and what does it sound like in different settings, these different devices that none of us have ever had exposure to like before I got involved with too, and I had never had hands on experience with any devices other than hearing aids or cochlear implants or BAHAs. So it is a very unknown realm. So how are they supposed to get comfortable with recommending it if they have never even tried it themselves? So we have listening club, it’s available to all audiologists on the tune platform. It’s in partnership with Oaktree Products. And it’s essentially a device rental library where we have partnerships with all these manufacturers with the purpose of audiologists getting their hands on these devices. So you can vet it yourself. And then we’re going to sort of gather all of that feedback. So we have subjective measurements and rankings and ratings along with what Laura’s offering from the technical side.

Heather Malyuk 31:55
Yeah, I think it’s really helpful to do it that way. So it’s not just so it’s sort of like a community effort. And I think that’s nice. And, you know, to just say about devices, audiologist do tend to be device focused, right. But I know a lot of the people I’m seeing on the platform don’t really need a new device, maybe they have something, and they just need to learn how to use it properly, or perhaps it’s something else. So we’ve brought up APD, a couple of times we’ve you know, tinnitus, things like that. They’re also things being looked at different apps, for example, there’ll be a couple of webinars with App creators. Looking at tinnitus apps, we’re about to roll out a pediatric department, you know, looking at, can we can we start finding kids who maybe are not being found through school screenings or whatever. And so there’s, again, there’s a lot more to this than someone with hearing loss being seen for a device fitting. And I think that’s the other thing to point out here is looking at this holistically. So speaking of people’s needs, I kind of wanted to mention who I’m seeing over tuned, because I find that when I speak to sort of a classic or traditional audiologist, they, they might not be aware of, of like who telehealth is actually reaching. The average age groups I’m seeing are between 22. And I think the trying to think of the age span here, where how high I’ve got up mid 50s, maybe? you know, and again, people who are maybe working from home, and they don’t necessarily want to walk into an audio aisle, excuse me, audiology office, or they feel like they don’t have time. They basically want a wellness check. They want to learn how to use earpieces safely. I’ve seen people over the platform who are using earpieces, 8 to 10 hours a day, on calls. And then on top of that they’re exercising for an hour with them. And they have something in their ears all day. And they want to know about safe listening levels, you know, and I teach them about things like binaural summation and how to choose what’s appropriate for them, or maybe using something during meetings if they if they do need a little boost something like a sonic cloud app or, you know, whatever. And it’s really cool to see these people learn about their hearing, and get really excited and say, oh my gosh, I can’t believe I haven’t seen an audiologist before. So that’s, you know, from the patient side, it’s really really cool to see this demographic, we know there’s like 700 million ears in our country. There’s only 11,000-odd full time audiologists. And so many are focused on moderate to severe hearing loss. And and we’re we’re missing out. We’re missing out on really good relationships with people who, who need us so so that’s what I’m seeing from the patient side. I was curious what you guys are seeing in terms of the audiologist side. What you think about who we’re seeing join Tuned.

Kathleen Wallace 34:51
I think that the conversations that I’ve had or what I’ve seen of people signing up on on Tuned, people are falling into a couple of different buckets. And it’s pretty interesting the the different kinds of use cases because again, tuned, you can use however you want to use it. It’s not the greatest analogy, but I have compared it before to like Etsy, you know, you’re running your business through Tuned, you can do whatever you want with it can be whatever kind of story you want it to be. So we have people that are well established in private practice, and they just want to open up a virtual branch of their practice. And maybe they’re using it with their current patients or expanding to their whole state. The next category, I think, we’re seeing people that are doing this more as like a night owl kind of gig of it’s a side job to supplement what their full time job is, maybe they’re not fully fulfilled with what they’re doing during the day, or they want to just like diversify and keep their options open. And then lastly, we’re seeing people that are actually starting fully virtual clinics through Tuned, which is super cool. And because it is a turnkey solution, it’s the whole infrastructure. But in general, I would say people within the first 10 years of their, of their practice is probably the bulk of it. People that move often that don’t want to be held to an office job that maybe are burnt out after COVID, we’re seeing a lot of different trends pop up, which is, which is great. I think this is this, having another kind of audiology, a way to practice audiology. It just makes sense for people, their lives changed after COVID. And this meets a lot of audiologists, where they’re at to it’s not just a patient centered approach. It’s also sort of a provider centered platform.

Heather Malyuk 36:39
Yeah. And what’s really cool about this is I’ve never worked in a situation where I’ve gotten to meet so many audiologists, and I really love our field, because they’re everyone’s really passionate about what they do and their burnout, for whatever reason, see this as an aspect of freedom or something new to learn, which is really fun. But everyone’s really passionate about hearing healthcare, which has been it’s been a real joy to see. As we wrap this up, the last thing I wanted to ask as a question for us are, what are our biggest challenges right now? challenges right now in our field, and what we’re doing, and what we’re seeing with audiologists, and just to start, you know, seeing this patient base, and audiologist saying, Well, how do I access them? You know, audiologists want new patients, they want net new, they want to see more people, they want to reach more people and help more people. So that would be first and you know, maybe they’re not sure where to find them. And then you know, kind of marketing and how to go about that I know with me, I of course I’ve had my clinic for a number of years now. And this wasn’t too big of a stretch for me to start doing. And I think that’s one of the reasons why I was asked to be head of audiology, because I’ve been working in this kind of URL-IRL fashion for quite some time, really, I think like since 2016. And it’s not new in audiology, we’ve got people who’ve been working in telehealth since the 90s. Like this is not a new thing. But I think the patient population is sort of new. So you know, in terms of what, how those people are accessed with tuned, and I mentioned about it being a benefit, you know, through employers. But then I’m also curious about, you know, both of you with, with what you’re doing like Laura with your clinic, or Kathleen with, you know, you wear several hats in your audiology life, how you’re going about marketing or seeing patients in this way.

Laura Sinnott 38:41
What I wanted to say as well is Tuned. The other cool thing I were at a meeting the other day, and I think it was Danny again, or might have been Kate the other co founder. But they said something like, Tuned, we’re you know, we’re serving patients, obviously, we’re also serving audiologists, and we’re also serving these employers like these companies that we’re signing contracts with that have 10s of thousands of employees, that will now have a benefit of speaking with an audiologist. And again, that is just something that is so in the people in tune. You know, there’s a whole group of people who work with to and other than the three of us, right, and their roles are so diverse that I’ve worked in startups before but not in this kind of capacity. And the talent that is behind getting these contracts and essentially selling hearing the importance of hearing help to these big companies that we’re we’re partnering with. That’s just so exciting. So the the challenge, I would say and this is more of a personal challenge I can take myself outside of tuned in as somebody who’s just started their own baby private practice. Yeah, like how we’re how are we how are we going to make money? How are we going to see patients over the platform? How do we convince people, it’s worth spending the money to have a session with us over the computer. And Tuned is doing amazing work to communicate the importance of that to kind of society at large. But then we have to do that individually as well. And yeah, it’s challenging. That’s always challenging. But again, we do provide resources to try to help that. I think that Kathleen, maybe you can talk about your SEO experiments that you’re you’re doing, but yeah, that’s it’s challenging. But it’s, it’s happening slowly for me as a new private practice owner.

Heather Malyuk 40:33
Yeah, I think something to point out that maybe we didn’t mention is there’s an hourly rate that the clinician sets. So like, whatever your hourly rate is, that’s what you set on the platform wherever you want it to be. And we do provide a direct referral link. So I mentioned earlier that when someone gets on the platform, they see audiologists in their state, well say you’re emailing with someone, and they’re asking you questions, and you’ve done enough emailing back and forth, and you say, Okay, you can schedule a consultation with me, I do that quite often. And I send them my Tuned link, so that rather than seeing every audiologist in Ohio, they go straight to me. So that’s the other thing people might be wondering, well, how, like, how would someone get to me, you know, through this platform, there’s, there’s a link for that, where they can get directly to you. And I think with something like with a hybrid approach to working one job, and then, you know, doing the Moonlighting, and things like that I’m seeing some really cool things, some really creative marketing come out of that with some of the audiologists we’re working with. And, Kathleen, I know that you work really closely with some of the audiologists, but seen the cool social media posts, and people’s websites. And I know we were talking about this earlier with a couple of the audiologists, I won’t name names, but just how creative they’re getting. And have you been particularly impressed or has something left a lasting impression on you in terms of the marketing scene where we’re finding?

Kathleen Wallace 42:00
Yeah, I, I think, Laura, back to what you were saying the the marketing and the messaging has been surprising. And we know this about audiology, that conveying the importance of hearing healthcare has always plagued audiology, and it’s, you know, progress forward. And that is absolutely true. It’s been more complicated than I expected to accurately convey what tuned is both for providers and for potential patients, for consumers. Partially because, you know, to patients, you were doing a lot of patient education of why Hearing Healthcare Matters. And then for the providers, it’s just a very different approach. So really making it crystal clear that this is just, it’s it’s the infrastructure, it’s a skeleton, to allow you to do whatever you want, it frees up your time. But ultimately, it’s it’s been a maybe people are a little paranoid.

Heather Malyuk 43:03
It’s not that we call that audiology, PTSD.

Kathleen Wallace 43:07
Yeah, it is, you know, they, they, they expect there to be these weird caveats or whatever. But really, like Laura was saying, the, the, whether it’s the intentional purpose of Tuned or not, you can’t ignore the fact that it is very pro-audiology, and it is doing a tremendous amount of work to promote the value of hearing health care. And it’s doing so by keeping the audiologist like, Paramount, it’s all about the audiologist and their expertise. Yes, maybe it’s trickling down to devices. But that’s not really the goal. And it’s been, it’s been tricky, to be honest, to really make sure that that message is coming across, both to patients and to provider. So the marketing has been interesting. I think there is a lot of potential and innovation that’s happening behind the scenes with audiologists. And I think we’re going to sort of create this pretty amazing blueprint of how you can launch a fully virtual practice, minimal overhead, you know, and really just make it about you and your expertise. And that’s going to be so powerful for Audiology to have moving forward.

Heather Malyuk 44:17
I agree. I feel we’re kind of like in this period of almost an industrial revolution and audiology, like things are really getting shaken up. And we’re going to see what happens and what gets created down the road. Like when we’re when we’re retired. And we’re sitting back and we see all the young uns like taken over this blueprint and how amazing it’s going to be in the future. I I think there’s a lot of doom and gloom about audiology, but then when I speak with audiologists, a lot of them are secretly really excited, but they’re afraid to say it, you know, because it’s like maybe not the cool thing right now to talk about modern types of care or alternative amplification or whatever. But I think our field is blossoming in this way and I’m really proud used, that we are all helping, you know, move this forward in an ethical evidence based way. And thank you guys so much for spending time, you know, to peek behind the curtain if anyone is interested in talking to us to give an opinion or to say, Hey, I didn’t like what you guys said about whatever, we’re very happy to field everything, because that’s how we learn and that’s how our field moves forward. So our email addresses are our first names. I’m Heather, we have Kathleen and Laura. It’s just first name @tunedcare.com. And if you want to take a peek at what we’re doing, go to TunedCare.com You can sign up as an audiologist or just poke around the website. It’s free to join. But please talk to us and again, thank you guys so much