Innovative Models of Patient Care: Panel Session from FHH 2024 Conference

All right, everybody, and thanks for joining today for our panel discussion here at the Future of Hearing Healthcare conference. I will be moderating this panel. My name is David Kemp, and today I’m really excited to be joined by four very entrepreneurial audiologists going around the horn as I see it on my little the different boxes that I’m looking at here. I have Kathleen Wallace. I have Brandi Smiley, Amanda Levy, and Melanie Hecker. so I figured we’ll start by setting the stage and just saying that the topic of this panel will ultimately be about some of these really innovative businesses that these four individuals have created and how they’re sort of changing the nature of what it means to be a hearing healthcare professional in 2024 and the types of ways that you can provide patient care. so why don’t we just start with you, Kathleen if you’d be so kind to introduce yourself and share a little bit about your business and how you’ve sort of developed that, I guess, the genesis of it and why you decided to create your business. Sure. so thanks for having me, Dave. I’m happy to be here with all of you. I’m Kathleen Wallace. I’m an audiologist based in New York City. And I had been working in traditional healthcare settings for the first part of my career, and then decided after the pandemic, or towards the tail end of the pandemic, that it was time to get out of the traditional healthcare settings. I am working now with two companies. One is Tuned, Tuned Care. we are a virtual hearing health benefit. So I do all tele-audiology with members, and it is delivered as a benefit through someone’s employer. so that is a very exciting way to do audiology, and I’m the Head of Provider Education there. I also do in home hearing consultations with Anywhere Audiology. We cover all of New York City, all of the state of New Jersey, all of Long Island, and all of Westchester county. and that’s been really fun to do. I started that about a year ago. all of this was very important to me to put a little bit of a dent in the accessibility of audiologic services and for me personally, to just have some more flexibility, some creativity, some autonomy. and that’s really where I got to where I am today. Awesome. Well, thank you so much for being here. we’ll pass it over to you, Brandi. Hi, guys. My name is Dr. Brandi Smiley. I am a mobile audiologist in the state of Georgia. And I would say my journey is similar to Kathleen. I started in traditional starting in the VA medical center for about eight to nine years, and then I transitioned over to educational audiology. during that time, I started to do some humanitarian work. And what I saw was this common thread in all of those sectors, and that was lack of access to care, and it plagued me a lot. I would bring those ideas to the VA, would bring it to the school district, and there were barriers to kind of break towards what they knew audiology to be. So, like Kathleen during the pandemic, I had some time to sit with my dreams and my aspirations to decide, you know, am I going to stay in the education system at that time or kind of take a step of faith, a leap of faith, and do the things that I desire to do and use the gifts that I have been given. And it came to, I guess, ahead during midnight one night, I was looking at Tiny House Nation, and this was the episode with Little John, and he was building a tiny house, but also a studio that was a tiny house. And I saw a vocal booth in there. And so that’s where the idea was like, okay, we can possibly mobilize audiology in a tiny house hearing clinic on wheels. And it was crazy. I was looking up all ideas. Had someone done this before? Of course. I didn’t think I was the one that came up with this idea, but I said, of course, it’s been done before. but it had not. And so that left a canvas of utilizing this time and opportunity to figure out how to mobilize it, utilizing the expertise of architects, engineers, vendors, manufacturers, to see how we all could work together to make this a reality. And so the goal really was to help break those barriers to access. And so that’s just my little piece of what I’m doing here in the state of Georgia. That’s awesome. Well, thanks for being here today, Brandy. how about you, Amanda? Thank you so much for having me. Wow. I feel like I’m in just such amazing company, and I am so excited to hear what everyone else has to say. I am Amanda Levy. I am an audiologist based in San Diego, California. And I started my business, Levy Audiology, just about two years ago. So, July of 2022 and the focus of my practice is auditory processing disorder. So, throughout my career, starting with my externship I had the opportunity to be mentored by a fantastic audiologist who got me interested in her work that she was doing with auditory processing disorder and educational audiology through a nonprofit clinic that I did my externship at. And eventually she moved on to another clinic, and when I had finished my externship, suddenly I was the APD expert one year out of grad school and I learned on the job a lot of information about doing the testing for auditory processing disorder and working in an educational audiology setting which led me to a full time job as an educational audiologist, which I did for a couple of years. and then I wanted a change of pace, so I worked for a couple years in a private practice doing a lot of hearing aid dispensing. I created a pediatric audiology program for the clinic, and I started an auditory processing program in the clinic. But the one piece of the puzzle that was missing throughout this whole journey I had been on was that I would do all of this testing for auditory processing disorder. I would make a diagnosis, I would counsel the family and then I had nowhere to send them for therapy. So traditional wisdom says, okay, let’s refer to a speech language pathologist. Speech language pathologists don’t typically want to be involved in the auditory processing world. They are so busy and they have such huge caseloads and are doing such important work in what they’re doing that I just couldn’t find anywhere to send these kiddos who needed auditory training to improve their auditory processing. So I started my clinic to bridge that gap and not only provide the diagnostics, but also provide the therapy and the help for these kids and adults who wanted to improve their auditory processing. And I started out being 100% mobile, traveling to patients homes, traveling to their schools. I’ve rented an executive office once a week now where I can have some patients come to me, and it’s just ever evolving. so yeah, that’s my story. It’s so cool. I’m really excited to really jump in here with all of you. But last but not least, let’s hear about Melanie and your world. Thank you. Yeah, this is very cool. And I love hearing all the origin stories. I feel way less alone now. the entrepreneurial journey is really interesting. So I’m Dr. Melanie Hecker. I’m an audiologist based out of Seattle, Washington. And this Saturday will be one year live to market for my startup, BLUEMOTH Hearing. So I’m very excited about that. Thank you. I do also own traditional brick and mortar medical audiology clinics as well. but in 2017 was really where the impetus of BLUEMOTH began. and just like Kathleen and Brandi, COVID allowed me some extra time to let those percolate, marinate, and grow. So, essentially, how it started was seeing OTC rise through legislation in 2017 and its origin that was coming through at Washington state as a whole. And I was involved in our state organization at the time, and I saw it coming. I knew it was coming, and it was almost like a surfer seeing a wave and getting their surfboard waxed. so I knew OTC was coming. I knew that there were pros and cons to that. I actually believe that there’s a lot of beautiful things to OTC. I’ve been an advocate since the beginning. I also obviously own brick and mortar medical clinics, and I believe traditional audiology that has best practices and real ear measures is beautiful. And I think there’s pros and cons to everything. What I saw was a huge void in the middle. And I was thinking of my own consumeristic experience as someone who’s had a vision impairment my whole life. And the fact that I would go in and get visual exams once a year by a licensed provider, but then I would go on to 1-800 contacts or Warby Parker, things like that. And I saw that there was this huge void, that there was no fun, consumeristic experience with the safety guardrails of audiologic care that was really targeting Gen Xers who were early on in their hearing wellness journeys and also providing, to Brandi’s point and actually all of ours. Access – Right? like, accessibility, affordability greater ease of care. I really also wanted to make it a fun experience and an enjoyable experience to where it was helping break and shatter the stigma around hearing loss. People who are like, oh, that’s for older people, or, oh, that’s such a daunting process. You know, if you can turn it around and make it more of a consumeristic experience, it starts to change the mindset and consciousness around hearing healthcare. And I was hoping that that would help increase acceptance. Blue moth does do that. So we don’t do any testing. People have to come and bring their own active prescription within the last six months. It has to have all of the components that you need in order to be able to properly dispense. It’s only in states where we have licensure and coverage. But one of our claim to fames is our experience box, where we actually send out three different sets of premium technology so the consumer can test drive those in their real world. What’s been wild is our initial thought was we wanted to go after, you know, Gen Xers and be their first hearing tech. What we found is that for so many people, they’re attracted to us organically because they’ve very rarely been given the opportunity to be a part of that selection process. They say, oh, wow, like, I didn’t even know that there were multiple brands. That was never brought to my attention. I never got to test drive or demo beforehand and I definitely didn’t get to do it, you know, in my real world. So they’re seeing this as a compelling offering to be able to test drive multiple technologies and see what actually fits best for their lifestyle. So it’s been pretty exciting to see the responses and just like everything that you’re doing is finding voids and serving more people through that. We’ve also been getting some assisted living facilities because that access to getting back and forth is very challenging. And so there’s nursing care teams that are willing to assist with the plugging in and getting onto the remote care, and then we take it from there. So there’s all different kinds of ways with which mobile and tele audio have so many avenues to be able to provide greater ease and convenience and access for more people to get better hearing healthcare. So this whole topic just really excites me, as you can probably tell. Well, great. Well, thank you for being here as well. I think that it’s really cool that the four of you all sort of had some experience in this space. You had sort of seen opportunities and then you, through a different variety of reasons, all sort of decided to pursue the opportunity. Like you said, you found voids that you’re trying to fill. And I think that’s what’s really exciting to counter whatever kind of doom and gloom narrative there is that I think there’s a lot of really interesting and exciting opportunities that really didn’t exist that long ago. And I think that those barriers of entry and unlocking some of this with technology and stuff like that is really making things interesting. So the first kind of question that I would have and at this point, just feel free to start hopping on and commenting on each other’s businesses or perspectives or whatever, but talking about making that plunge, I think that’s the first thing that comes to my mind, is what really kind of went into that. And what was that process like going from zero to getting the thing off the ground? Those very early successes maybe just trying to put it into those practical terms for the people that are listening that maybe are in similar positions that you all were a few years ago before you had made the plunge, speaking to that prospective person as to here are some of those really early first things that I had to overcome. maybe some things that were challenging initially. those kinds of things. I would be curious to kind of hear your take on that. So whoever wants to take a stab at that, go for it. I’ll start. this is Amanda. I agonized over the decision to start a business. I come from a long line of small business owners in my family, so the concept wasn’t new to me, but I had never done anything like this before. and it took me a long time, I think, to be confident in my independent skills as a clinician in order to have the confidence to start a business. I know there are people who graduate and the next day they hang up their shingle. I wasn’t ready to do that. Am really glad all the steps that I took to get here because I feel like everything prepared me. leading up to starting my business I started very small and I started with a safety net. So I had a part time job as an educational audiologist. When I started my business and started my business part time I did not take out a large loan to start my business. I literally grew organically. a friend of mine. This is a crazy story. A friend of mine was given at a garage sale, a Maico portable audiometer, and said, hey, that is crazy. I know. I got this free audiometer. Do you want it? so I have this, this free, like, antique Maico audiometer. I got it calibrated. It worked perfectly. That thing is built to last. and that was my first piece of equipment that I started with. So I carted it around by its little handle. Everywhere I needed to go. I had my otoscope. And that’s how I got started doing auditory processing, testing, doing hearing tests with my Maico. and slowly, as I started to build and my business generated a little bit of income, I was able to purchase a Tympanometer and some OAE equipment. And little by little, I have grown in baby steps completely organically. and I know it’s not what works for everybody, it’s definitely what worked for me. I read so many business books, so many books were recommended to me and I devoured every single one and nothing felt like it was the right path for me. I kind of had to march to the beat of my own drum in growing my business and doing what I was comfortable with. so, yeah, that’s how I got my start. Really small and working my way up little by little. Maico should pay you for that shout out, Maico. podcast is now sponsored by Maico. No, seriously, they make a. They make a good little MA-42. Okay, I’ll go next. So, unlike Amanda, I grew up in a household of educators, so they did not have the business savvy. and I remember in grad school, I had formulated my business plan to be not quite mobile, but to be just a smaller practice, more intimate. So I dusted it off, and I thought about everything that was coming into me. I did not have the funding. I knew that the likelihood of me getting approved for funding was just very low due to disparities. So I’m thinking, okay, what can I do to build this business and not have the resources? And I, you know, not to get too spiritual, I went to prayer, and the word that came to me was ask. I’m like, lord, ask who? And you know, about 30 people start coming to mind. So I went to my mother, my husband, about this word, this ask word, and we just were very proactive about taking that faith and activating it. So we asked the 30 people who became our donors, and the ask initially was, like, $75,000. And with a matter of two or maybe three months, it. Everything was just given. And then people were given, giving given. So we were able to raise above what the initial ask was, so that that goal to be debt free, could be met. and that’s not, you know, everyone’s story. I’m very grateful because I was able to build this with a community, with a village. And they were able to attach their purpose of giving with my purpose of wanting to give back to the community. So, for the most part, a lot of my equipment was able to be funded. so I’m very grateful for that. but, yeah, I would say if you are definitely a faith based person like myself definitely lean into that, because this is a hard journey. We all know this, right? we’re all out of the box thinkers. and it takes a special type of faith to kind of take that leap and build the clinic that you desire so you can have the freedom and autonomy. So that is the origin of how we funded the tiny house clinic. Love that. That’s so cool. It takes a village. I’ll go next. Brandi, thank you. That’s so inspiring. I love that I can’t believe how the community came around. That’s so amazing. as I mentioned, I started to have the conceptual idea in 2017, and at that time, I was actually in the process of purchasing my first brick and mortar clinic. And so I was like, cute idea. Don’t have time for that. and then in 2018, I went through some pretty intense personal issues. So, again, thank you. Good idea. Don’t have time for that. And then I was growing my first business, got a second location. We’re about to have four. So I was growing, you know, my organic, you know, my current business as it is. And it was one of those things where the idea just would not leave me alone. And kind of like, to Brandi’s story where she’s like, you know, this must already have been done, right. I just kept thinking, someone’s gonna do this. This is too obvious. Someone’s gonna do this and do it well. And it finally just got to a point where it’s like, okay, this was put inside of me. I’m going to nurture this concept. I’m going to make it a reality. It won’t leave me alone. Let’s make that happen. I was very fortunate in the fact that by the time I was ready to start conceptualizing this idea, I started putting together my business plan, competitive analysis, doing all my initial research, figuring out how would I go to market in 2020. I didn’t even launch the website, like I said, until May of last year. So that’s how much. It’s so funny when people are like, oh, wow. I’m like, that took three years before I even went on the Internet. You know what I mean? No one even knew my name. And even then, it was like, nothing. so just how much work and diligence and contemplation and intentionality goes behind it. but I was fortunate at that time that the housing market in Seattle blew up. And so. So I was priced out of anything. and so I’m like, you know what? I’m going to use my savings. I’m going to use my 401k And to date, I’ve been able to fully self finance this business and keep moving it forward. but that’s a risk that a lot of people aren’t able and willing to do, especially as a single mom. Like, I’m solely responsible for my son and me. but it was something where I took that leap of faith and I truly believed much like Brandi said, this idea is here. I was granted with it. I was given it. I’m going to, I’m going to make it happen. And so, so far that’s how, how it’s been going. Yep. These are all awesome. Yeah, very cool. I’m a I’m a different flavor of entrepreneur than all of you where I refer to myself as a freelance audiologist now because I like function of you know according to the IRS I work for myself. Right. but I have these contracts with Tuned and with Anywhere Audiology. The initial vision for full transparency was that I was going to work completely for myself. And I think it’s always a good sign and it’s a good thing to recognize when you meet good people in your life and there’s other people that you can partner with and to sort of not be too proud and to team up with other people that are like minded. And I was approached by Anywhere Audiology and by Tuned and this just all worked out very well for me. but I had the idea of I had the recurring thought in my old jobs, my traditional jobs that this can’t be it, you know, this can’t be audiology. and a little bit of like doom and gloom of I don’t know how I’m supposed to do this for another 30 years. so there was always a big itch to get out and to do something new. I started working for Tuned for free. It was a tiny little company at the time I was employee number six that signed on and I just did it on the side of my full time job that has built out and built out and I am now I’m there at least half of the week and then I was supposed to go back to my ENT job, my traditional job when my son was five months old and I didn’t go back and I was scheming that entire leave of what I was going to do and doing the in home visits and I launched. It was starting to get momentum and I was approached by anywhere audiology to connect with them and then we teamed up and sort of combined efforts. But I say as far as my mindset I was for sure naive. I didn’t know what I was getting into. I thought I had it all figured out and it has been a long road and a lot of learning on the fly. and I think in a certain way it was good that I You don’t know what you don’t know. And for me that worked to my favor in the beginning. Right. I mean, I think it, it’s always like a lot of the learning process is failing, unfortunately. what for some of you, like, were some of those. Again, I find this to be really interesting. When you take something from concept and then you’re actually like taking the plunge and then you’re executing on it. and I can imagine that it’s pretty lonely and that you celebrate small wins and, you know, just any kind of momentum that you can feel like, okay, maybe there’s actually something here. Do you all have a memorable sort of small win or a moment where you felt like your dream was actually something that you could materialize and that there was something to it and that, you know, there was something here. Did it happen right away, or was it something that it took time for it to, I guess, materialize? I don’t mind kicking this one off, but yeah I think one of the things, and I think I’m hearing this and appreciated about, you know, entrepreneurs and I’m seeing this with the four of us is like all the time I say I have no ego around this, you know what I mean? It’s like poke holes in the concept, tell me where things are not right, because I want to create a really healthy, strong business that’s, you know, going to be built to last and is going to satisfy the demands of people who are, you know, engaging. but one of the things was you get a lot of no’s and you get a lot of rejection, and especially when you’re building the business, you know, I needed products to go to market with. And so, I mean, there was one day I flew to New York on a red eye pitched for 5 hours. I called it the gauntlet because they were just coming at me with all these questions and packed myself up and flew back to the west coast. it was exhausting, and I had to do that with multiple manufacturers. And right before going to market, there were originally going to be five. two pulled out. one of them pulled out two weeks before we launched the website. And, you know, I just took it with grace. And I have a lot of just faith in general that, like, this is happening for me. Not to me, I don’t understand why yet, but, like, it just, maybe it’s just massive denial, I don’t know. But, but I truly do believe, like, everything’s happening for me and I’ll understand it later. But one of those wins, Dave, was when nine months into the business, the company that said no two weeks before, came back and said, we’ve been watching you. We love what you’re doing. Let’s figure out how to make this happen. And that was one of those moments where I’m just like, I’m so glad I was gracious and that I kept the door open and that we had a really great rapport and that I just kept leading forward with all integrity and authenticity and doing the next right thing. Did it take the wind out of me a bit when I got those no’s? Yeah, but then you adjust and it’s a lot of that. It’s a very fast, deep learning curve. It’s incredibly exhausting. but it takes a large amount of resilience and yeah, just kind of like keeping yourself going to that next step. Focus on the next step. yeah, and that’s That says a lot, Mel, right. That they were watching you, that they had you on your radar, you on radar, and they decided that they liked what they were seeing. That that has to feel really good. for me, it was just like the little moment. Well, at the time, a very big moment of, like, the first booking. I just couldn’t believe. I’m like, this might work. I got. I convinced one person to do this and that was like, a big deal. Big day, getting the website up, you know, like, there were little things that I really try to I can be very hard on myself. I try to celebrate the little wins and just being able to actually pull it off and make sure that it all worked the first time around, that gave me a lot of confidence moving forward that, okay, in home hearing, healthcare could work. there’s no obvious glitches in the system. As of now, this is workable and doable. I had an interesting thing happen my very first APD therapy patient, this sweet little boy. we’d been working so hard. We had done his whole round of auditory training. I’d been going to his house which I was assured would be very quiet. He had two siblings that were like, coming home from school and making all kinds of. It was like, we got through it, we got through it, we did great. He was doing fabulous. so this is my first therapy patient. I’m like, okay, it’s all writing on this. I do his re-test. At the end of his first round of therapy, he bombed it. Like, bombed it. It was like, worse than his pre-test. And I’m like, oh, my gosh, how am I going to explain this to the family? What have I done? What am I doing with my life? I can’t help anyone. later that night, he confessed to his dad that he failed it on purpose because he didn’t want to stop working with me. So I was able to stop having a midlife crisis about my career choice and retested him, and he did great. So, you know, that was when I knew, like, this isn’t going to be easy, but I’m on the right track. I can do this, I can help people. And now I know another thing I got to look out for. I’m going to keep mine very short. I had to just kind of take a step back because I’m still kind of decompressing from an event that I had this weekend, and I’m celebrating those wins, so I hope I don’t cry. but every time I take the tiny house clinic to an underserved community and, oh, God, I’m such a sap, but it’s the kids that come in, right? The adults really go crazy about it. But there was this little African American boy that you could tell just has had a rough life. And when he came and just sat down for me to just talk to him, get to know him, and he was like, can I just live here? You know, just, you know. And so that’s the point of it. You want to build something beautiful, to go to these communities that are not used to seeing something like that. They don’t know that they, too deserve this. Equal access, y’all. I’m gonna cry. that was a pattern this weekend. These kids in these underserved communities just grateful to have a clinic that maybe looked to them like it belonged in a different neighborhood. And one kid before I left said, thank you for coming to my neighborhood. Those are the things such as that. Those are the things that keep me going. Right. and so those are my wins. The community, when the community’s happy, when I’ve helped someone feel a little bit better about their day and help their hearing, of course, then those are the things that help me celebrate. That’s amazing. I just think it’s really cool that the four of you had different visions. You took the plunge. It was scary initially. but you’ve been validated all in different ways more times than it sounds like you can count. And I just find this to be so interesting because, you know, when you really do sort of, you realize that, you know, when you have the professional and they’re empowered, that’s kind of the recurring theme that I kept thinking when the four of you talked, is like, you’re so empowered now that you can go and do this, you know? And in the past, maybe there were a lot of obstacles that were in the way, but now it’s. That, to me, is so exciting, is that you really can sort of be the master of your own destiny here, to a large extent. it’s really a matter of how you want to shape your impact. And I think that this is so cool to hear these different variations of that, of kind of this realization that the notion of audiology doesn’t need to be limited to the traditional brick and mortar setting. Like, you can take it into somebody’s home, a mobile house, that you take into all these different areas within the state of Georgia, giving back to your community, giving people a way to see hearing healthcare in a totally different light than it’s ever been before. that was, I think what I was really hoping to get with this talk was just to hear these different versions of this because I think it is, it’s really emblematic of 2024 and the exciting side of the two sided coin. Yes, there are lots of external threats and pressures and stuff like that, but on the same side of that coin, you’re more empowered to be able to do this in the way that you want to do it, more so than ever. So I find that to be probably the most exciting thing about the current state of things. okay, so, shifting gears a little bit, let’s talk about where you see your services moving into the future. I think it sounds like you all have pretty nascent businesses that are just still getting started. It’d be really interesting to hear between when you started it and where you are now. Maybe some of those realizations that you had of, like, oh, there’s opportunity over here. Amanda, it sounds like you’re predominantly focused on APD, but it would be very interesting to kind of hear, like, what that process has been like and has it evolved in ways. Melanie, with you in your business, how has that changed in light of the current state of the market versus where it was when you started? Kathleen, with both Tuned and Anywhere Audiology, and then just this idea of changing the whole notion of the way in which you facilitate care. I know in our conversations things have changed quite a bit from when you first took the plunge, but I think you’re a total testament of, like, once you just kind of get started, things start to fall into place and opportunities emerge. and same thing with you, Brandi. I mean, I know that when we first talked and you had just started the tiny house, I mean, now it seems like you found a lot of really interesting and exciting areas of growth as well. So if anybody wants to talk about, I guess call it from step one was launching the business, and then now where you’ve kind of established it and where you see it going from here and maybe some of those aha moments that you’ve had from the beginning of it and to where you are now. So since starting my business, I’ve had a couple of interesting things come up that are areas that I can expand into. the first one is I started out just doing auditory processing testing and therapy. But out of the blue, I think it happened from. I’d send a report to a pediatrician about a kiddo who I tested. out of the blue, I started getting a couple of referrals for pediatric audiology testing, like diagnostic, regular audiology testing, which I wasn’t expecting. And the fact that I can do it in a flexible setting is really helpful for a lot of families. So that’s an area that I am expanding into. Another one is in working. so there’s a gap in my area, at least for auditory verbal therapy services for adults who received cochlear implants. there’s fabulous resources for kids, for ABT, but the training that I do, Buffalo model auditory training, has been shown to be really helpful at improving speech discrimination for people with cochlear implants and hearing aids and even auditory brainstem implants. I just started working with my very first adult cochlear implant recipient for therapy, and we are doing it virtually. and she’s streaming through her CI and it’s just this really cool thing that I get to do. I get to help someone improve their speech discrim through their CI. And that’s a neat way that I can apply these skills that I’ve learned with APD therapy into a whole other area. I want to just kind of stick on this real quick. did these opportunities arise largely just by sort of being existing? You know, if I, if I will, like, just sort of like, you become well known in your community, and then the opportunities emerge because people you would just be amazed at, like, the kinds of things that get referred your way. Is that how it’s been for you? Is largely just, you do a really good job, you, you treat these different people, and then some way, somehow the referrals start to come in? Yes. It’s largely been word of mouth referrals that I’ve been getting. I had some relationships with the local school districts from when I used to be a full time educational audiologist. So those connections have helped me tremendously. And then for my private patients who I’ve seen they’ve told their friends and they’ve told their friends, like, I have a couple friend groups of kids who I’m seeing and then from, I haven’t done any direct to physician marketing, just sending my reporting. I’ve gotten some really nice emails from physicians saying like, hey, I’ve never seen a report like this before. This was really thorough. can I send more kids your way? And I say, absolutely. same with a few like local psychologists, neuropsychologists, the same thing. So it’s largely been word of mouth. Brandi, you’re nodding your head. Is that kind of how it’s been for you as well or you want to share what your experience has been like? It has. I feel like I’m similar to Kathleen, where a lot of my duties are based on contractual relationships. So like Amanda, I had relationships with the school district. And so early intervention approached me about being their first contracted audiology audiologist through department of health. so that opened up a whole world of doing follow ups for newborn hearing screens via ABR. Now that I have a system in OAE’s with head start, word of mouth. And so you start with one region. So right now I started with about, I think 13 in Augusta area. This was an area that I wasn’t even going to service, but they had a neat. And so just providing good quality hearing healthcare and follow up and having that good relationship and rapport trickle down to another region. I’m to the point now I really need some help. So we’ll get to that goal of hiring someone else because you don’t want to leave a situation where you’re burned down only to build your own practice and burn yourself out. And so, yeah, but yeah, it’s very organically just these opportunities kind of chase you down. And I feel that we’re all pretty blessed in that regard to have that. Do you want to go next, Kathleen? Or I guess I can just, I’ll go. I’m unmuted. so for us, I mean, really what it’s boiling down to is kind of two different routes. Either information from, you know, end users themselves stating where certain ease of services would be. for example, things like, okay, well, if I’m going to go get a hearing test, and I know I have a set of devices where I have custom ear molds, what would you talk me through in my consultation first? So it’s like, okay, well, while you’re getting your hearing test, let’s go ahead and have your ear mold impressions made. Here’s the shipping label. So will custom products or custom solutions or custom hearing protection be down the road for us? That’s something on our roadmap, which is exciting. I also think that there’s more people coming into the market from like 3D ear scanning. that’s a little bit easier to be portable that could possibly be sent to homes so things can be done more easily, remotely. there was a company from Scandinavia that I had a meeting with just last week who’s having my brick and mortars beta their new 3D ear scanner. So that’s interesting in my mind additionally, is it something where we want to be more full service and have all of the aspects taken care of, where we can actually send testing equipment to them, get into remote testing as well? That’s potentially something we’re looking at. And then looking at strategic partnerships as well, you know, where does the BLUEMOTH model strategically make sense to assist more people, you know, from that remote tele audiology and blend the two businesses to get the best of both of what we’re trying to accomplish. so, yeah, so a few things, I think from the consumeristic standpoint, they’re saying, you know, oh, I wish I could have this, you know, can you do this? And it’s always that thing, well, can I? Is it worth it? You know, does that make sense? You know, I think it’s also, don’t get distracted by too many shiny things. Also, like staying true to what you were trying to do, but also being open minded enough to see if there’s a place that makes sense and that you can do it well and appropriately and that it’s actually of like a high medical caliber, so you’re actually serving people appropriate. and then the others from the business side, you know, different people from manufacturing, etcetera, they’re constantly having inputs and ideas. And it’s also really interesting too. It’s so funny. And this might be similar to you, but when you’re so new, sometimes I’m still like, how do you even know who I am? How did you hear about me? But I’ll get notes all the time from Australia and UK in particular. When will you be available? So there’s definitely a strong pull for international access to BLUEMOTH. And I’m like, I haven’t even gotten the US totally under control yet. Let me figure that out. So those things are always there. But I think it’s one of those things we have to make sure. Let’s make sure what my core purpose in business is, doing that well and then layering on things one at a time well, and that’s the hardest part. to me with audiology is like, all I see is so much opportunity. And that’s why the doom and gloom stuff really bothers me because I see a lot of bright, shiny objects that could be great to chase. And I just don’t understand why there’s this feeling of competition or like stealing business when it’s, there is so much to do. and both Tuned and Anywhere Audiology, there’s been a lot of evolution over the years of what we’re doing Tuned going into the benefits space is very fascinating. Hitting a very different market. the consultations I do on that platform are unlike any other consultation I’ve done. They’re just very different. They’re people that would never be seen in a brick and mortar clinic. they are very, it’s very entry level. a lot of emphasis on prevention which is really fun to be more proactive with your hearing healthcare. And I think that’s a big opportunity of doing that. I think that there’s a lot of opportunity and we’re seeing it with the in home visits of You know, a lot of people think of that with senior living facilities. we have seen a lot of success with concierge medicine, of partnering with different concierge doctors or executive health programs. and then OSHA is a giant opportunity as well. And when you look at all of the numbers of those populations, I just. There’s, there’s so much business to be had and we’re like barely, you know, we’re, we’re barely scratching the surface of it which is super exciting to see. Yeah, I just I think that’s really interesting that, you know, you all have, I think, some really interesting prospects. And you know, the reoccurring theme, I think Melanie said it really well, like these voids. and that to me is, you know, every single one of you sort of have a different take on that. You know, Brandi, you’re really servicing a part of the country and the world that is totally a desert that hasn’t really had any of this. And so that’s a total addressable market right there. that you’re providing access to this. And I think I could go with each of you about how you’re basically unlocking parts of this ecosystem that haven’t ever really been tailored to before. And that to me is like it’s, we all know in this industry how pervasive hearing loss and all of the like adjacent disorders are. And yet it’s one of those things that on the surface it’s like in the traditional model there’s only what, 15,000, you know, give or take audiologists. And so it’s like if you have a population of 350 million plus people that are only limited to 15,000 workers, that we want to be providing this really high standard of care, how do you appropriately match the supply and the demand? I think that what’s really exciting is that as the supply becomes more empowered to treat larger swaths of that untreated population, you’re unlocking huge swaths of demand. And that is what I think we’re going to continue to see into the future is like, what does APD look like? What is auditory training look like when you can start to really leverage the power of the Internet and somebody that’s entirely focused on this as an attachment to existing clinics, you can contract with them. There’s a ton there. I think there’s like the whole OTC market and going after different demographics that you would traditionally see in a brick and mortar location. Ton of opportunity there. You know, the whole notion of like what’s going on with telehealth. I’ve mentioned this before, but I was blown away when I was at the EDHI conference recently and people are talking about tele-ABR diagnostics and I’m thinking to myself, you know, it wasn’t that long ago when I thought that was the furthest thing away from what you could do via telehealth, yet it’s totally feasible today. And then, you know, I just find all this to be super, super interesting. So as we come to the close here, closing thoughts Again, for the people that are maybe in a similar position as you were a few years ago Just words of wisdom as to what you would tell your past self, I guess, before you made the plunge. So feel free. Whoever wants to volunteer here to wrap it up, go for it, Kathleen. I’ll start us off. So for me there’s two big things. So the first is, I always think it’s a good thing to ask. Why? Like, why do you do something the way you do it? why has it always been done that way? Why is this the standard? And usually when you start, that’s how you poke holes in things, and that can lead to a lot of innovation. And I think there’s a lot of audiologists that work in places that they don’t always align with the why or the how. And which leads me to the second one. You don’t always have to ask permission. Like, there’s actually. I think a lot of people are waiting to be given the opportunity to do something. That was probably the biggest lesson I learned is, like, oh, you really could just file for you could open a business, you could just file the paperwork, and you just do it because you are a licensed audiologist. Like, you can, you have all the permission to do that. and you don’t have to get that permission from anyone else. those were two things that, like, have always been bouncing around in my head and are certainly two big things that I think are good to remind people that might be feeling like they’re not doing exactly what they want to be doing at the moment. My thing is to find your people. Right. So a lot of us started, and we didn’t have that village of audiologists to bounce ideas off of. Well, now you see us doing panels, you see us having this conversation. So if you are that student or that early audiologist that wants to take that leap of faith, you’re not alone. finding those people to bounce ideas off of, finding people who are smarter than you, that may be a little bit more business savvy, you know, that can lead you to books and resources to help you kind of get you know, more attainment in that area. just do it afraid, but do it prepare, you know, and that’s my thing, is you don’t have to know everything. There are people who know it but just do it because there are people who are waiting for everything that you’re hoarding inside. Love that. Yeah, I think my biggest one, I’m pretty big about, like, I want a high fun factor. So if something’s not fun, I get bored pretty easily, and I love a challenge. And, like, one of blue moss core, you know, two of our core visions that I think are most important is, like, stay curious and rebellious thinking. And so you know, I’m not here to, like, chaos for a cause is, like, our thing. Like, you know, not here to just, like, destroy things or uproot the system for no reason. But I think it’s so important. And this kind of echoes Kathleen’s. Why it’s like, yeah, almost like be that three, four year old, like, well, why are we doing it this way? Is that actually the best way? And also meeting people where they’re at? there’s pros and cons to everything. yes, there’s obviously best practices and best standards and there’s so few people who are getting reached. Our biggest competition is not the person on the next corner. Our biggest competition, in my mind is how few people who have hearing loss are reaching out to get hearing healthcare. So why is that happening? How can we make that more enjoyable of experience? How can we have more access? there’s so many things there. and so I think the biggest thing is to be a little rebellious, to ask questions and to make it playful and fun. You know what I mean? so that way it’s enjoyable along the way. And I think that was one of the biggest things with BLUEMOTH. I was fortunate that I had a job. I was decently, financially secure. So this was my playground, this was creating something fun for me and it’s just fortunate that it’s taken off. so, yeah, ditto to what everyone else has said. Such a wise, wise people in this, wise audiologists in this Zoom, I would say, don’t let fear hold you back from doing something that you want to do. Don’t let perfection get in the way of progress. So I had this idea in my mind for so long that I had to have a plan. I had to have everything set in stone. I had to know exactly what I was going to do before I started a business. that’s probably why it took me so long, honestly. but you don’t have to have everything planned out exactly. You’re going to learn new things along the way that are going to make your business so much better. And you wouldn’t have had those opportunities unless you got started. so I called it throwing confetti up in the air to see what lands at the beginning of my business. I didn’t say no to anything. I said yes to every opportunity that came my way and quickly learned I really like doing this, I don’t really like doing that. I’m going to do more of this stuff and less of that stuff. So if you are dreaming of starting a business, I’d say go for it, make it work on your terms. And it doesn’t have to be perfect to exist to get started. Fantastic. Awesome. Well, I really appreciate you for coming on today to talk about this. I thought this was an awesome panel and so much insight, experience wisdom here. it’s just cool to hear about what some of these new, innovative models look like in businesses that are being started here, I guess post pandemic you know, or in the past five years or so. So thank you so much for everybody who tuned in here to this panel. Thank you to our panelists and enjoy the rest of the Future of Hearing Healthcare conference.