Audiology Employment Trends: What Job Seekers and Clinic Owners Need to Know

All right, everybody, and welcome to another episode of This Week in hearing. I am very excited to be joined today by my good friend Shadi, owner of Staffing Proxy. I’ve had a few conversations with Shadi in the past on this show and on my podcast, FuturEar Radio about kind of the state of the market as she sees it, the, the state of the employment market within the hearing healthcare space. And she’s got some different image overlays to present today, some different maps of data but thought we would have a conversation kind of about the state of the hearing healthcare market from both an employee and a, or a prospective employee and an employer. So, Shadi, thanks so much for being here today. How you doing? Good, thank you, Dave. Thank you for having me again. It’s great to talk with you and go over some of the stuff and trends that we’re seeing. So yeah, as you said, you know, the whole thing is that we do recruiting and HR in hearing health only. So every single day, that’s all we’re dealing with. We’re looking for providers, front office, whatever you may looking for in this small, crazy industry. And even though there are lots of data and stats out there about the employment market, employer you know things that they should be doing, because this is such a specific a niche market, I often feel like the data that’s out there does nothing really correlate and represent what we’re seeing every day. So I’m excited to talk about that and go over some of the key takeovers that we have at least this year so far. Yeah, that’s perfect. Well, let’s do it. I wanted to really kind of dive into this because I do think, as you mentioned, things are changing. I think that today’s incoming professionals are being dealt a different hand that had been dealt previously which obviously impacts the. Their trajectory and sort of the way in which they’re going to evaluate their prospects and then, you know, in tandem today’s business owners, today’s employers are basically being met with totally different environment, a different job environment generational differences in what types of job expectations and benefits and types of things that prospective employees are seeking. So who better to talk to than you about all of this stuff? So why don’t we just dive right into it and let you kind of take us through what you’re seeing with the data you’re collecting at Staffing Proxy. Perfect. So you said a couple of things that are. I’m glad you brought them up, because I’m going to talk about them as well. So you talked about the generational difference and what candidates are looking for versus what. What employers are offering. So I want to include the class of 2024. So audiologists that are graduating this year have already graduated, and are looking for their first job as an audiologist, as a recruiter. Our perspective is that that first job as an audiologist is extremely important. It can build an individual and set them up for success as an audiologist, or it can easily set them down this path of really not enjoying what they’re doing. So what we have seen this year so far is that the same trend as it was last year. A lot of recent grads are looking for a first job that’s going to give them a large scope of responsibility and learning. In school, they’ve learned a couple of things, but they really want to experience everything in addition to the hearing aid side. So they want to do vestib, CI, peds, whatever it may be. They want to learn and grow. And when it comes to existing audiologists, so people that have two, three years and up ten year, it’s kind of the same thing, except that compensation is also really important to them. So they’ve started their first job, they’ve learned a few things they know they like, some things they don’t, and after two or three years, that’s when they’re like, you know, I am ready for the next thing. So why is that important as an employer? Is because you have to constantly look at what you’re providing, what you’re offering, not just compensation wise, but growth and development side to your employees. I’ll show this data at some point throughout our conversation to the days of having an employee, including provider, staying with you for three, four years. Those are long gone. There are options out there. One of the things that we keep track of is how many jobs per provider out there are available. So, as of right now, and again, our data is not 100% accurate because we can’t keep track of everything like it. Bureau of Labor Statistics. For every provider, there are 9 jobs. It may not be necessarily in your own backyard, but that’s just a breakdown. So what that means is that if I’m an employer, if I’m a private practice owner and I’m looking to hire an audiologist, the first question I need to ask is, what is so special and so different about my practice that someone would want to say, yes, I want to work for you. It doesn’t matter what it is, but you have to know what differentiates you. It cannot be patient care. Everyone says we provide great patient care, and I mean, I’ve yet to see an audiologist that says I went to school so I could do a bad job taking care of patients. That’s just the starting point. But quantifiable and measurable things. What is the reason that someone, or what are the reasons that someone. Would want to work for you. It can be compensation. You can see, you know what? I am just going to pay crazy amount of money, and that’s okay. You can find people that are going to say, you know what? I’m going to spend four or five years just making good money, and then I’ll look for the next thing. There’s nothing wrong with that. Or it can be a great scope. If you have a full service practice that you’re offering everything, you should really talk about that and also incentivize employees for doing that. So that kind of goes, actually, with the compensation piece. I know selling is really a taboo word, but if you have a practice that you really need someone that’s going to dispense and fit and sell hearing it, it’s okay. Talk about it. Be upfront with the candidates. Don’t try to hide it and say, we have a full service clinical practice. We have vestib, CI, everything. But you’re only going to get paid a nice commission when you sell hearing aids. So if I’m a provider, why would I want to spend an hour dealing with other patients, with patient care, sure. But there’s no incentive in it. Then, of course, benefits, health benefits, retirement plan. We hear a lot that, oh, we’re a small employer, we can’t offer. There are ways to do it. You can always offer stipend. So And when we look at also the nine jobs that I mentioned, it’s not all large hospitals, it’s not all large organizations. There are a lot of small businesses that are looking to hire candidates. And I often hear this from employers that, oh, we provide autonomy to our employees. We’re not an ENT or whatever it may be, our employees are autonomous. They can do what they want, but they have to sell 25 hearing aids a month. So I would say the first thing to do is, before you start even looking for a provider, you have to have an honest conversation with yourself. Would you work for yourself? So yeah, that’s fascinating. Okay, so there’s a couple things I want to dive into here. And you can pull up the data at any point throughout this. But you know, the this whole part about, you know, kind of like, what the, you know, the graduate the graduate of 2024, like, what they’re looking for. And you said, you know, obviously, number one is going to typically be compensation. Like, that’s where the bar is being established. But, you know, when you’re talking about a market where there is clearly more demand than supply. You have nine job openings per you know, prospective employee. They’re free agent, and they have. They have options that they can really be evaluating here. And I think that, you know, kind of like personal growth, career growth those are like things that you would expect from a young person that’s ambitious. But, I mean, again, it’s kind of one of those things that. Sure, it’s a. It can be kind of a platitude, like you just. Say like yes I want career growth but the fact that that really does seem to be sort of second on the rung of the ladder after compensation speaks to I think maybe a little bit of an underlying awareness by this next generation that the future for them is going to be most secure by them really rounding out their experience and being more valuable to the market. More or less And I feel like I’ve seen that anecdotally at some of these like trade shows that I’ve gone to and talking to some of these incoming graduates is that it seems like there is a lot more. And again this could all just be relative or it’s cyclical, whatever, but at least what it feels like right now is that there is this collective awareness of like I need to be a very well rounded professional for my like future prospects. And so in one way I do think that’s very encouraging that you’re you know if the dynamic was inverted and there was only one job opening for that person then they might you know obviously have to put the their you know that being a priority for them, career growth because their limit, their options are limited. So you know in this current state where you do have a excess of demand and a shortage of supply in some ways I I think that one sort of silver lining to that is that at least it seems that this next generation is, is really looking at the future of this profession, at least on the audiology side as I have to be a very, very well rounded audiologist that can handle the various facets of audiology and you know basically practice to your full scope. Yeah You know as you were saying that I, and we’re talking about you know the recent grads and joining the workforce. It’s really important to also remember as an employer your reputation is very important. You’re dealing with a generation that cares about reputation, they want to be represented well. So if you are an employer that just does not have a good reputation among I don’t know manufacturers or your peers, they’ll know about it. And the same way that you go look at probably a potential candidate’s social media and judge them, they’re going to do the same thing and as they should. And when you’re in an industry that there aren’t enough providers, Gosh, you really need to take care of everything that represents and reflects you. And knowing that success means different to every different person. Just because you think having a high revenue generating practice, that success, that doesn’t mean the same for a potential candidate. Anyhow so let me tell you about what I’m showing. This is something that we keep track of. And it shows the movement of audiologists. Now, I don’t include. Hearing instrument specialists in the data because that gets a little messy. So this is first quarter of this year and it shows the percentage of providers that have that a state has gained or has lost. So essentially the movement across the country for audiologists, what’s important to see is that there are a couple of states that are bleeding. Now I don’t live in any of those states, so I don’t know exactly what the reason is. But we’ll talk about that a little more and then you’ll see the states that are just, you know, green and they’re flat. So that means that they are not gaining any more providers and they’re not losing any more providers. When we talk about losing, it’s a combination of providers retiring, moving to work in a non clinical setting, non patient setting, so doing something remote, working for manufacturers. And the other thing is moving across the states, to other parts of the country for personal reasons. So let’s go to the second quarter. Now, the second quarter, the numbers look a little bit different because we have the fourth years that have accepted the job and they have decided to move to a different place, excluding of course, the Pacific side. As you see, Idaho, you know, is flat. They’ve gained some providers and we have a handful of states that are green. So people are moving to those states and they’re gaining providers. And then let me show you comparing them quarter over quarter. So the red states are the scary part. So these are the states that are losing providers. And I think this is really, really insightful to take a look at. And if I’m, let’s just say I am an employer in Texas, it’s going to be a little bit harder because people are leaving the state, so. Or are leaving the profession in that state. So let me stop here and see if you have any questions. Dave, before I go to the next. I think it’s really interesting to obviously have like a visual flow of where people are moving to and from. It looks like and obviously you have, like you said, people retiring. And I wonder if that’s more concentrated in certain areas and the fourth year programs. It would be fascinating to be able to specifically see where the next crop of professionals are moving into what states are doing a good job of appealing to that next generation, I think. And then obviously drilling down into a more specific level of granularity to see where specifically is that what type of settings are attracting. New audiologists. So anyway, I find this to be very, very insightful of like, okay, so we can kind of geographically see more or less like where the employment growth is. Yeah, yeah. So from my point of view, it would be really interesting to look at third quarter and fourth quarter once, you know, all the programs are done and see if some of the red states are turning yellow or whatever and see if it flats out and we’ll be able to take a look at that. So when you talked about what type of organizations or institutes employees or providers are joining, let me show you this next slide. I’ll change it to. So this shows the tenure. So the length of a time that a provider stays with an employer. Red is good, that means that’s high. And the lighter it is, that’s cold, that’s not good. So the tenure goes anywhere from about a year to actually less than a year, to states that are close to six or seven years. Interestingly, just say Alaska, you have really high tenure, but they’re not also gaining new providers. So whoever is there that’s staying there, they haven’t had anyone new joining. And then. Right, so like maybe those are, maybe that’s a state that there’s a high level of retirement because, you know, people are You know, it’s kind of like you can make assumptions off this data in some different directions, but you know, maybe it’s like Alaska has a hard time of attracting new employee new employees, but once you, once they do, they retain them well, that kind of thing. Yes, and I. It’s interesting that you say that, because the data that you’re seeing is for all audiologists, I don’t have it broken down to just dispensing audiologist, clinical, pediatric, any of those things. But the interesting point is that traditional audiologists, so someone that’s really solely focused on hearing aid side, tenure is about 1.8 years. What that means is that if you’re an employer and that’s the kind of environment you have, after a year and a half or so, you should be looking, you should know that there’s a chance that your employee is going to go and look for something else, and that something else is most likely a position that’s going to give them more scope of responsibilities. They get to learn and do other things. Now, when the position becomes clinical audiologist, which typically means, you know, you are doing also vestib, CI, a whole bunch of other things, tenure increases to about three years. So people stay longer when they are doing more than just hearing aids. And then the highest and best employee tenure in audiology is pediatric audiologist. So pediatric audiologist, tenure is about 6.2, which to me it’s surprising because I thought, you know, I don’t know, dealing with kids every day could be hard, but it seems like, first of all, they get employed in organizations that are large, so the employee really gets to embrace what they’re working and the service that they’re providing as a pediatric audiologist, and then it’s a more secure position, it’s more specialized. So to me, that is a huge takeaway. So knowing that there are at least nine jobs for every audiologist out there, and if I’m a private practice owner and my services are hearing aids and maybe tinnitus, gosh, it’s going to be really hard, because as an audiologist, I’m going to be limited to what I’m doing. I’m not advocating that everyone should add ancillary services. Absolutely not. But what I’m saying is that you just have to be aware of the challenges that you’re facing. Yeah, I mean, there’s so many different, like, ways to interpret this data that are really interesting. I mean I think, like, you know, to your point there about you kind of have the spectrum of you know, the provider, and on one side you have, like, the very, very, very clinical you know, pediatric audiology, you know, is kind of the epitome of that, right? Like, they’re really not focused on anything other that really is patient care, I think. I mean, it’s primarily patients. And like, your whole M.O, day to day is like, basically the singular focus is like, the patients that you’re going to see that day, which is the same for the other side of the spectrum. But the difference is that the way in which you’re being compensated and your incentives are much more aligned with that of a salesperson. Again, not to be a taboo thing, but when you talk about, like, the tenure, this sure seems to track to a traditional salesperson is every year and a half, two, three years, you’re weighing your prospects. And so, again, I think that this is a, what we’re seeing is like a labor market that is, there is like, the advantage right now, I think, is held by the employee because they have more prospects. They can really weigh their decision. And so as the employer, you really have to understand, like, you’re competing with all of these different you know, all of these other employers, and now in today’s world, you know, I think you’re also competing across state lines in ways where with remote work and the emergence of telehealth and some of these different ways that. So again, what I feel we’re seeing with all this is if you really zoom out and you take the big sort of macro perspective, is we’re just seeing the. Market demands being met in a different way. So your, your supply and demand equation is just shifting in a big way where I think ultimately what you’re going to see is like the you know, you start to put these pieces together and it’s like, okay, so what do these prospective employees want? They want, they want upward mobility. They want to future proof themselves. They want to really secure their future by diversifying and rounding out their talents because that makes them more valuable to the market. And, you know, now with remote work and all that, you also now have the ability to take your talents and port them into wherever you see fit if that’s going to be the kind of professional that you’re going to be. So there’s a new dynamic to the, the whole way in which the labor itself is being facilitated. So all of that is to say that, like, as an employer, you really need to be aware of the current environment and ultimately the competitive landscape that exists and what you need to do to set yourself apart in the eyes of these employees particularly the younger generations. When you talk about as an employer, you need to know and find a way to set yourself apart. It’s, gosh, there are times that we have really hard jobs in a very tough environment, tough city. It’s just really a hard job to fill. And you know, we find one candidate that says, yes, I’m interested. I’m going to pack my bags and move across the country. As an employer, if and when you come across a candidate that is interested in your job and you have done a good job doing a reflection on your position in your practice, you should really utilize your great sales skills and try to sell your position to this candidate. It’s a sales. Everyone is selling to each other. So it kills me that we have candidates and we connect them with the employer, and the employer is like, I’m going to look for someone else. And there’s no quantifiable reason. It’s just typically, it’s like they’re not a culture fit. Well, how are you going to measure and define culture if the reason is because you don’t think they’re going to be able to sell, just say that. Let’s just be honest with each other. And I use this example that drives my team crazy. It’s like you’re in a desert, there’s no water, and someone comes across with a glass of water, and you’re like, do you happen to have sparkly water? It’s. That’s just how crazy it is. It’s Yeah. So, well, and that, I think, is the reality of it is that things have changed. And I think the equations flipped. I think it was. I’d be really curious to know what that number is of where, you know, today there’s 9 job openings for every, for every audiologist. Like, what did that. What was that 10 years ago? You know what? And because I feel like so much of this industry is anchored to the past and. That, that is one of the things that kind of worries me the most about this, is that it feels like if change were to happen suddenly, that a lot of people would be very blindsided by it. And so, you know, I’m almost hoping for gradual change. But what it feels like is happening is, like, again, if you look at it from the market demands, like, what are in any given metro, like, how many people are actively seeking this type of service? And, you know, I just think that the days of just saying like, like, we’re the only shop in town and so they’re forced to have to go to you. That’s changed so dramatically with the Internet and with the way in which people are educating themselves on, like, the kind of clinical service that they want and the kind of provider that they’re seeking. And so, anyway, I just look at this and I say, it’s going to have to require if you want to do well as an owner, I think you’re going to really have to understand this, and then you’re going to have to adapt to it. And so one example of this would be, okay, so we know that, number one, you got to make sure that the employee is getting a competitive offer from a compensation standpoint. But if the number two thing they want is experience, how can you foster that? And if you look at, like, kind of the existing market and the types of small businesses that exist, again, if you kind of think about everything being anchored to the past, it wasn’t that long ago that you could have a very, very successful practice that was, you know, almost entirely focused around hearing aids and the revenue that’s associated with that. And, like, you never really had an incentive to diversify your services. And as time goes on, I can totally imagine how it becomes more and more daunting to think that I’m gonna introduce a vestibular portion of my clinic, I’m gonna introduce a CI, whatever it might be, all of these things that you hear other people doing in the industry, and you’re like, that’s not really something that I’m, that would be a good fit for me. And for my, for my practice or whatever. Like, okay, fine, I sympathize with that. But how then, you know, when you start to really map out, like, what’s gonna set yourself apart in the market, you know, if the real reason why you’re not pursuing those ancillary services is actually really because you and your team isn’t equipped to be able to handle that, then maybe the opportunity here would be for you to kind of carve this thing out and bring somebody in that’s got this wherewithal to be the person that’s going to fill that role. That isn’t an easy fix. It’s going to take a lot of effort to facilitate that kind of thing, but that’s what the market is asking for right now. It’s those kinds of things. Yeah. Gosh, you are 100% spot on, Dave. When we have positions that the employer is like, I want to set myself apart from all the other practices in the area. Plus, there’s not a non-compete anymore, so people can go around different businesses. Very true. That’s a very important ruling. Yes. So how am I going to set myself apart? And knowing that it requires investment, if you’re going to add balance to your practice, you’re not going to immediately have people lined up. It requires investment. So at that point, you go and find a provider that is on the same page with you. They want to learn and grow, and they want to take ownership of that portion of the business, and they have a vested interest in your business succeeding. Because if the vestib side doesn’t have growth, guess what? You’re going to shut it down. We’ve seen that with APD. Gosh, people are like, “no, I can’t do that. We don’t have enough patients.” But we’ve had a couple of clients that are like, you know, I’m going to make this an APD only audiologist, and we’re going to make it happen. And it’s amazing to see how many people are like, I want to do that. I will do anything. I will pack my bags and move from Maine to California for the job because it is something that would differentiate me, and it’s not. It’s true patient care at that point, you’re not just saying patient care and getting paid 10% of gross hearing aid revenue, whatever it may be. So, yeah, I find this to be you know, it’s just the brutal reality of it, you know, if you’re really struggling to find somebody that I can’t find a provider, you know, because I live in this, maybe I live in an area that isn’t the most ideal, you know, kind of spot that people are chomping at the bit to move to. But, like, I guess the questions that you have to start asking yourself is like, how are you going to attract that type of person? And that’s the reality of it, is that, frankly it’s a, it’s like, you know, a sports analogy. It’s like the free agency market is really, you know, it’s very much skewed toward the players right now, and the players have all the control. They can choose where they want to go, play and all that. And so you have to create a scenario for them as to why they should want to seek your services out. And again, like, if you look at, like, the macro level picture, it’s like, that’s clearly where the future generations want to be moving towards. So that’s, you know, skating to where the puck is. And not to mention that a lot of the practices today could use those kinds of ways to differentiate themselves. So it really is kind of a mutual win-win, but it’s on the onus is on the owner. I think to then really put it upon themselves. Like you said, it’s an investment. So you have to, like, you have to really carve out like, what the job expectations are, what your goals are going to be for this thing, and set them up to succeed. But, but it solves a lot of different problems for you if you can think about it. And it doesn’t necessarily have to be like ancillary services, but I think you really need to be cognizant of. They want to be able to inherit and constantly be surrounded with new experiences that are really growing them. And then also they want that level of, like, ownership. And they want to feel like there is an incentive for me to stay more than a year and a half because it’s not a stepping stone to something past this career. You need to be thinking about and put yourself in their position and say, well, what would I be thinking if I was 24 years old, just getting started in my career? Am I a stepping stone for this person? Or can I be something a little bit more significant? Yeah, gosh, I feel like I should print that, put on a t shirt. I’m going to come apply. To work at Staffing Proxy. Yeah. So it’s really interesting. Every year I keep thinking, oh, this year things are going to be less challenging, but the challenges are just evolving. And it’s because of different generation of workforce and their expectations, what they want. And we just have to learn to adapt. You just have to learn to adapt and change and be quick because there are options out there for every audiologist. Yeah So how about we close here? Can you give us a, maybe an example of a positive case study, if you will? Somebody that came to you said, I really need help to find a good fit. You know, you don’t have to say names or anything like that, but just to kind of close with, like, here’s a real world example of someone that you know, sort of maybe initially went to market and said, you know, hiring and nobody really took them up on it or they failed in some capacity and then they, they changed courses and they figured out how do you actually obtain talent today? Yeah, I’m not going to say name, but Small private practice in Midwest, in small towns. So hearing aids only. That can be a tough sell. So you. Our target audience is typically for a situation like that a tenured audiologist that they know what they want and what they don’t want. That didn’t work out. And the employer compensation was median. 74,000 is a median for us and no health benefit. What’s so amazing about this person, a she, she was able to sit down and figure out how to differentiate herself and what she needs to offer to attract younger recent grads generation and same as older audiologists. First thing, first compensation, let’s change that. Let’s remove the bonus component out of the equation. And for the first year, you’re going to say, you know, I’m going to pay you $85,000 just making up that number, but every single month I’m going to show you the potential of commission that you could have made. It’s up to you. If you want to be salary only, be salary only if you want to be commissioned, this is the amount you. This is what you would have gotten. Smart. So what that did, it opened up the door to both recent grads and also tenured audiologists. Because if I’m an audiologist and my salary is already 80k and you’re telling me I can make 120k working for you, but my salary is going to be 75k the rest is bonus. It’s really risky for me to make that transition and move, so this eliminated that. And on the, sorry, benefit side, that’s just stipend. There’s so many different ways. As a small employer, you can contribute to employees salary or the health benefit without having to be part of a small group. So it was just the branding, figuring out what the compensation is going to be and why someone should work for you. Because as an employer you understand the challenges in the market and you’re able to, you’re willing to adapt and invest in your employees and hoping that employees will realize that and in return do that. So that position is filled and we still have people reaching out to us asking, hey, you remember, whatever job you reached out to me, are they still hiring? No, not anymore. Now there’s a waiting. That’s a great way to close this out. I mean, I think I always enjoy your perspective. What you’re seeing, I mean, it’s, you’re truly on the front lines of like the employment landscape, which is so obviously important to the future of the profession and everybody that’s in this industry. But I think it’s also fascinating right now because I really do feel like we’re kind of in the midst of like a real sea change in this industry. And I think that it’s interesting that, and it makes sense that like the young sort of next wave of employment recognizes this. I think that they really do see the writing on the wall and say it is a risky endeavor for me to put all my eggs in the basket of just kind of like solely focusing on being a dispensing audiologist, better off making sure that I am as well rounded as possible. And obviously that’s a generalization. Like some, some of these young professionals are going to really specialize and they’re going to have their one thing. But I do feel like that is sort of maybe a little bit of a difference from generations past, is that in many ways the market itself is forcing this change is kind of, I think making people aware of like, you know, if you’re going to take on this debt to get this degree, then surely you need to be able to kind of like ensure your own sustainability into the future regardless of what happens with the primary source of revenue that many practices operate off of today. Yeah, yeah. Well said. Thank you. I appreciate you giving me a few minutes. It’s always great talking to you. It is. It’s always a lot of fun. So where can people connect with you? For those that are in this boat, employer or prospective employee, how can they link up with you and staffing proxy? Our website is staffingproxy.com dot. You can email us, it’s hello@staffingproxy. Or just pick up the phone and call us. Were here to help both employees, employers and we try to give honest, transparent advice to people. Sometimes they may not like it, but brutally honest. Yes, that should be our motto. Thats hilarious. Brutally honest. Well, as always, Shadi, thank you so much for coming on and sharing your thoughts and your wisdom with everybody. Really appreciate it. Thanks for everybody who tuned in here to the end. We will chat with you next time.