Latest / Starkey Sound Bites: Hearing Aids, Tinnitus, and Hearing Healthcare / Strategies for a Thriving Hearing Care Practice feat. Dr. Gyl Kasewurm

Transcript

Strategies for a Thriving Hearing Care Practice feat. Dr. Gyl Kasewurm · Starkey Sound Bites: Hearing Aids, Tinnitus, and Hearing Healthcare

• 0:01
  SPEAKER_01: Welcome to Starkey Soundbites.
• 0:03
  SPEAKER_01: I'm Dave Fabry, the host of Soundbites and Starkey's Chief Hearing Health Officer.
• 0:08
  SPEAKER_01: Many listeners of this podcast are hearing care professionals who also own and operate a small business.
• 0:16
  SPEAKER_01: On top of helping people hear better, they also have the day-to-day demands that come with running a small business.
• 0:22
  SPEAKER_01: And I can think of no one better to have on this podcast than my good friend and colleague, Dr.
• 0:28
  SPEAKER_01: Jill Caseworm.
• 0:29
  SPEAKER_01: We've known each other longer than either of us cares to admit.
• 0:33
  SPEAKER_01: That is true.
• 0:34
  SPEAKER_01: And uh, you know, what comes to mind with me uh to me with Jill is, you know, we began our relationship back in the previous millennium, which sounds even farther ago than it is, but uh when we both uh had the opportunity to serve on some boards together.
• 0:49
  SPEAKER_01: Um we certainly uh our paths have crossed many times in uh professional organizations.
• 0:56
  SPEAKER_01: Uh I've even come and seen your practice, uh, which is so impressive numerous times, and even helped out a little bit.
• 1:03
  SPEAKER_01: But so it's it's just a little bit.
• 1:05
  SPEAKER_00: A little bit, he thought.
• 1:06
  SPEAKER_00: A little bit, a little bit.
• 1:07
  SPEAKER_01: Pleasure to have you on the podcast, Jill.
• 1:09
  SPEAKER_01: It's been a long time coming, and I'm glad we're finally getting the opportunity to sit down actually face to face.
• 1:15
  SPEAKER_00: Yeah, Dave, thank you so much.
• 1:16
  SPEAKER_00: You know, I listen to your sound bites, and I think there's such an opportunity to help people across the board that own their own practices.
• 1:24
  SPEAKER_00: Because as you know, to be a clinical provider and a business owner is quite exhausting to very different from each other.
• 1:31
  SPEAKER_01: I mean, you can think that you're at the top of your clinical uh uh best practice and all of that, but then in addition, there are business best practices.
• 1:38
  SPEAKER_01: And the thing that's most impressive for for me to you is you've owned your practice, you know, and owned that practice for over 30 years.
• 1:46
  SPEAKER_01: Oh, yeah.
• 1:46
  SPEAKER_01: Yeah.
• 1:47
  SPEAKER_01: In the town where you grew up, and you are, and and over that entire time, you're the dominant provider in that market.
• 1:56
  SPEAKER_01: And the way that you embedded in the community ran a best practice that rivals anyone in the world, but also the way that your cue in that community is just off the tops of the charts.
• 2:10
  SPEAKER_01: People recognize if they have hearing loss and they're looking for someone to receive care, they came to you.
• 2:16
  SPEAKER_00: Well, you know, Dave, at one point I formed an advisory board for the business and had people from all different walks of life.
• 2:23
  SPEAKER_00: And you know, you have a lot of people in your practices that are very smart and they still want to contribute.
• 2:28
  SPEAKER_00: And so one of them said to me when I was having lunch with them, You want to be the mayo clinic of the Midwest when it comes to hearing?
• 2:34
  SPEAKER_00: And I said, Yes, that is what I want to be.
• 2:36
  SPEAKER_00: And that's when we design that's when we designed our state-of-the-art office and our virtual reality office because I did want to be different.
• 2:44
  SPEAKER_00: You know, I used to hate when, you know, somebody would come in after they got hearing aids and you'd give them like a yellow notepad and say, write down everything you hate about these.
• 2:53
  SPEAKER_00: That made me crazy.
• 2:54
  SPEAKER_00: So there's so many scenarios now, especially with the new softwares and all of the tools and the softwares, where we can demonstrate different environments and really know before the patient ever leaves our offices that they're hearing as well as we think we can get them to hear.
• 3:10
  SPEAKER_00: And of course, then we can tweak it, but it's just I didn't want to start at the bottom.
• 3:14
  SPEAKER_00: I wanted to start at the top.
• 3:16
  SPEAKER_00: And that's how we became renowned in our community.
• 3:19
  SPEAKER_00: And of course, if you live in a small community, you have to be involved in that small community.
• 3:24
  SPEAKER_01: There's no getting around it.
• 3:26
  SPEAKER_01: And if you do a great job, that's one thing.
• 3:28
  SPEAKER_01: I mean, we've talked for a long time about when you make a patient happy, they tell their family members.
• 3:35
  SPEAKER_01: If you don't serve the needs of the patient well, they tell everyone.
• 3:39
  SPEAKER_01: And in a small town, that can absolutely torpedo your business if you're not serving people.
• 3:45
  SPEAKER_01: And that's why when you bring up Mayo Clinic, which is near and dear to my heart, uh, that's where I first learned you've got to keep the needs of the patient's interests at the top of the list.
• 3:55
  SPEAKER_01: They're really the only interests that matter are focusing on that need of the patient.
• 3:59
  SPEAKER_01: And I think that's what you established at the very beginning of your career.
• 4:04
  SPEAKER_01: And I want to do a deeper dive onto this.
• 4:06
  SPEAKER_01: How did you know when you established your business years ago that that's what you wanted to stand for?
• 4:13
  SPEAKER_01: How did you know?
• 4:14
  SPEAKER_01: Who do who did you have mentors?
• 4:16
  SPEAKER_01: Uh, did you go to classes?
• 4:17
  SPEAKER_01: Did you read any books?
• 4:18
  SPEAKER_01: What was it that that relative we'll both say, you know, now we were reflecting back on the years in there there weren't a lot of private practice mentors for you, which now you've interestingly become uh a mentor to so many practitioners.
• 4:36
  SPEAKER_01: But where did you get that model?
• 4:38
  SPEAKER_01: How did you establish it?
• 4:40
  SPEAKER_00: Well, you know, Dave, in a small town, okay, I got married and I was in Sophomore College.
• 4:44
  SPEAKER_00: I had to work in addition to going to college and finishing my education.
• 4:48
  SPEAKER_00: And I always knew, I don't want this to sound funny, but I always knew I'd be successful at what I did because I'd do what it took to make it work.
• 4:56
  SPEAKER_00: There was no looking back, there was no safety net, you had to do what you had to do to make it work.
• 5:02
  SPEAKER_00: And so when I was, there were no real audiology jobs in my community.
• 5:07
  SPEAKER_00: So How big is St.
• 5:09
  SPEAKER_00: Joe?
• 5:09
  SPEAKER_00: 12,000 people.
• 5:11
  SPEAKER_00: And the whole county, 150,000.
• 5:14
  SPEAKER_00: But when I was starting, OSHA was coming out with their ruling that anyone, any manufacturer that had employees exposed to a time-weighted average of 85 decibels or above had to have their hearing, had to have their employees' hearing checked once a year.
• 5:30
  SPEAKER_00: So I went to the bank.
• 5:32
  SPEAKER_00: I didn't write a business plan or anything like that.
• 5:34
  SPEAKER_00: Said, I need$15,000.
• 5:36
  SPEAKER_00: Now they looked at me like I was nuts.
• 5:38
  SPEAKER_00: I was buying a big box on wheels to pull around with a truck that I did not own, doing business that I did not understand, but I knew I could do it.
• 5:47
  SPEAKER_00: And so they wouldn't give me the$15,000, but they gave it to David because he had worked at that bank.
• 5:52
  SPEAKER_00: Yeah, David.
• 5:53
  SPEAKER_01: And then wonderful man.
• 5:55
  SPEAKER_00: Wonderful man.
• 5:56
  SPEAKER_00: He's the saint, as some people say.
• 5:57
  SPEAKER_01: But they wouldn't give a female.
• 5:59
  SPEAKER_01: Is that really what it boiled down to?
• 6:01
  SPEAKER_01: That because it was a a woman, they wouldn't give you the money, but they would give it to David, who has trem uh added tremendous value to the practice.
• 6:11
  SPEAKER_01: You were the person that was really generating the pr the the the all of the revenue, let's just face it.
• 6:17
  SPEAKER_00: And so I knew what I had to do per week.
• 6:20
  SPEAKER_00: So I would sit, this was way back, Dave, no cell phones.
• 6:24
  SPEAKER_00: The phones were tethered to the wall, and I was still working two days a week in the um hearing impaired clinic, so I could get certified through Asha.
• 6:33
  SPEAKER_00: And the other three days I knew how much I had to make.
• 6:35
  SPEAKER_00: So I would sit on the floor of my kitchen because the phone was tethered to the wall, and I was surrounded with books of industries that I knew would need my services.
• 6:44
  SPEAKER_00: And I just I wouldn't let myself get off that floor until I'd made 50 cold calls every day.
• 6:49
  SPEAKER_01: Every day.
• 6:50
  SPEAKER_00: Every day.
• 6:50
  SPEAKER_00: And sometimes I got no appointments, sometimes I got a lot of appointments.
• 6:54
  SPEAKER_00: And of course, I was dealing with all men who were safety directors of these companies.
• 6:58
  SPEAKER_00: And so I would drive that box around on wheels with my father-in-law's truck.
• 7:04
  SPEAKER_00: People thought I was nuts.
• 7:05
  SPEAKER_00: They thought I would starve to death.
• 7:06
  SPEAKER_00: Well, that business took off, and then we bought another business just like it.
• 7:11
  SPEAKER_00: And then David, my husband, quit his job.
• 7:13
  SPEAKER_00: And then then I opened an office in a specialty clinic.
• 7:17
  SPEAKER_00: And so it just grew from there because my my motto was if you believe it, you can achieve it.
• 7:23
  SPEAKER_00: Anything is possible.
• 7:24
  SPEAKER_00: And I know that that's true.
• 7:28
  SPEAKER_00: And I also knew that I had what it took to survive.
• 7:31
  SPEAKER_00: And I was smart.
• 7:32
  SPEAKER_00: And so when I would go into these industries, there was no one more convinced at offering the services that I was offering than me.
• 7:39
  SPEAKER_00: And so I would say to them, You need this.
• 7:42
  SPEAKER_00: So I just had that, you know, being the youngest of four children, having three significantly older brothers.
• 7:49
  SPEAKER_00: I learned at a young age you don't back down.
• 7:51
  SPEAKER_00: Right.
• 7:52
  SPEAKER_01: I've never seen you back down from any challenge, any obstacle, any barrier.
• 7:57
  SPEAKER_01: You'll go plowing through it.
• 7:58
  SPEAKER_01: And it's interesting you bring up what sounds like a John Maxwell phrase.
• 8:02
  SPEAKER_01: If you can if you believe it, you can achieve it.
• 8:04
  SPEAKER_01: But also, he has another one that always sticks out in my head the dream is free and the journey is not.
• 8:09
  SPEAKER_00: Right.
• 8:09
  SPEAKER_01: And so those 50 cold calls every day, a lot of people don't see that.
• 8:14
  SPEAKER_01: They see the the the beautiful facility, professional hearing services, and that you've, you know, you you built over all of those years, and they think, I want that now, but they don't think about you sitting on the floor making 50 calls a day, hoping for one lead.
• 8:29
  SPEAKER_01: Right.
• 8:29
  SPEAKER_01: Um so the the the dream is free, the journey is not, and and I think your plowing through it is a testimony to your drive.
• 8:37
  SPEAKER_00: And I have to say one thing I learned.
• 8:38
  SPEAKER_00: I I went for my master's to Western Michigan University, and there was a woman who was always spoken very highly of by our professors who had started her own practice about 90 minutes away.
• 8:50
  SPEAKER_00: And so when I knew I was gonna start with industrial, because I didn't have a hope of getting a job near me, I was already married, my husband had a good job.
• 8:58
  SPEAKER_00: Um, I went and spoke with her.
• 9:00
  SPEAKER_00: And you know what she said to me after she'd done it herself?
• 9:03
  SPEAKER_00: She said, You can't do it.
• 9:05
  SPEAKER_00: You don't have enough experience, you're never gonna make it.
• 9:08
  SPEAKER_01: And that fueled you, I'm sure.
• 9:10
  SPEAKER_00: And that just really, yeah, it didn't break my heart.
• 9:13
  SPEAKER_00: It made me angry.
• 9:15
  SPEAKER_00: You did it, and now you're telling me I can't do it.
• 9:18
  SPEAKER_00: So I learned along the way to always be encouraging to other people.
• 9:23
  SPEAKER_00: And you may find some things that are obstacles, but also tell the person the opportunities because I still believe in this industry that hearing health care uh is a fabulous profession.
• 9:36
  SPEAKER_00: And there's so much opportunity, it's only growing.
• 9:39
  SPEAKER_00: Yeah.
• 9:39
  SPEAKER_00: So um, I did the right thing by kind of falling into a profession I didn't really know much about at the time, and it worked out for me very well.
• 9:46
  SPEAKER_00: And I still love it as much today as I did when I started all those years ago.
• 9:51
  SPEAKER_01: It's interesting you bring up that that example where someone said, Well, you know, I did it, but I don't think you can, so don't even bother to try.
• 10:00
  SPEAKER_01: I had a parallel experience where when I was receiving my master's degree from the University of Minnesota, one of my professors, as I was uh approaching graduation, said, You know, congratulations, but uh, you know, I really don't see much future for this profession.
• 10:18
  SPEAKER_01: And um I that just fueled me.
• 10:21
  SPEAKER_01: And uh in and the last thing I w I want to be, and and we're roughly the same age, is that person now sitting on the other end of the spectrum, which now I'm older than that professor who made that statement.
• 10:33
  SPEAKER_01: And I'm just as excited every day to get up and get at it.
• 10:37
  SPEAKER_01: Um I'm on a different side of, you know, how amazing is it that we both chose a discipline that lasted for 40 years and that we didn't have to pivot and change.
• 10:50
  SPEAKER_01: And you really, especially, I think, in building, confronting all kinds of challenges.
• 10:55
  SPEAKER_01: I think everyone feels now, students coming out of school, I know they have a lot more debt than we did.
• 11:00
  SPEAKER_01: Right.
• 11:01
  SPEAKER_01: But they feel like whether it's OTC or whether it's some other, you know, third-party pay, some other challenge, they feel like this is the worst challenges that this profession, this discipline, this business has ever faced.
• 11:15
  SPEAKER_01: Um, there have always been obstacles.
• 11:17
  SPEAKER_00: Always.
• 11:17
  SPEAKER_01: And and some people see obstacles, other people see opportunity.
• 11:20
  SPEAKER_00: So you know how people say now, like, OTCs, what do you think?
• 11:23
  SPEAKER_00: I think I've been through that three times in my life and it didn't kill me then.
• 11:26
  SPEAKER_00: And it's not gonna kill me now.
• 11:28
  SPEAKER_01: Cheap hearing aids, what a novel concept.
• 11:30
  SPEAKER_00: Oh, yeah.
• 11:30
  SPEAKER_00: Like I couldn't have seen those everywhere 20 years ago in a magazine or whatever.
• 11:34
  SPEAKER_00: They've always been out there, but when you do a job and you do it to the best of your ability and you promote that about yourself, you're always gonna have patience.
• 11:44
  SPEAKER_00: And if you try to delight your patience, they're always coming back and they're always telling others about you.
• 11:52
  SPEAKER_00: And that's the best word of mouth.
• 11:54
  SPEAKER_00: You can pay a ton of money into advertising.
• 11:57
  SPEAKER_00: But if you don't have that good word of mouth, especially in a small community like I grew up in, you know, when I would go to the grocery store, you had to be ready.
• 12:06
  SPEAKER_00: That if you saw somebody that was a patient, you had to be friendly.
• 12:10
  SPEAKER_00: Hi, how are you?
• 12:10
  SPEAKER_00: I never usually would remember their name, but I would just say, hi, how are you?
• 12:14
  SPEAKER_00: How things going?
• 12:15
  SPEAKER_00: That's part of it.
• 12:17
  SPEAKER_00: But it's just the icing on the cake because those relationships have been so great for my life.
• 12:23
  SPEAKER_00: I mean, I think about the people I've met over the years, as I'm sure you do, like meeting you, and some of the best and the brightest in my profession has only made me try to get better.
• 12:33
  SPEAKER_00: And so that's what I love.
• 12:34
  SPEAKER_00: I might tell somebody I'm working with, well, yeah, these are a couple obstacles, but let's look at the opportunities too.
• 12:41
  SPEAKER_00: Because business is just business, no matter what business you're in, and it's not rocket science.
• 12:47
  SPEAKER_00: So if people in business adhere to those basic principles, they're gonna do well.
• 12:51
  SPEAKER_00: But most of the time people get mired down in all the day-to-day activities that they don't have time to do that.
• 12:58
  SPEAKER_00: And that's the mistake that practice owners make.
• 13:00
  SPEAKER_00: They don't have enough time to work on their business as well as in their business.
• 13:04
  SPEAKER_00: Yes.
• 13:05
  SPEAKER_01: And I'm so glad you brought up delight, because that's the that's the bookend to the statement I made early about if you in a small town, if you aim for satisfaction, you're always turn it to 11.
• 13:17
  SPEAKER_01: But if you aim for satisfaction, they tell a handful of people.
• 13:20
  SPEAKER_01: As you said, if you can aim for delight, they'll tell more people in a positive way than those dissatisfied patients tell others.
• 13:28
  SPEAKER_01: And and that's really aiming for delight, not just you, you're you talking about fabulous, um, and aiming to be fabulous rather than good enough, is what really I think has been your secret sauce and your energy and your passion and your discipline to focus on measuring your results, trying to do better.
• 13:48
  SPEAKER_01: We're gonna do a deeper dive on what are some of those performance indicators that you really focused on as you were growing your business at an early stage.
• 13:56
  SPEAKER_01: And and then also I just you interestingly, you mentioned because I similarly have been a full-time clinician in a smaller community, a little bigger than than the one, you know, St.
• 14:07
  SPEAKER_01: Joe.
• 14:07
  SPEAKER_01: But how many times early on, 30, 40 years ago, you'd bump into your patients socially and either their hearing aids would be hanging out of their ear or worse, they wouldn't have them.
• 14:17
  SPEAKER_01: And then sheepishly, I know, like like me, I'm sure you were kind of looking around eyeball and see if they were wearing their devices out in public.
• 14:25
  SPEAKER_01: Talk about the differences in technology today versus those 30 years ago, and that interaction was awkward when you know I was giving them my best effort, and they say, Oh, I forgot them, or this or that, or the other thing.
• 14:37
  SPEAKER_01: But talk a little bit about the changes.
• 14:39
  SPEAKER_00: Well, you know, I remember when the first small hearing aids came out, 1994, Starkey tympanets.
• 14:48
  SPEAKER_00: And I loved those things, and all they had was a potentiometer, you know.
• 14:53
  SPEAKER_00: I think it had two potentiometers.
• 14:55
  SPEAKER_00: One was for volume and one was for lows versus highs.
• 14:58
  SPEAKER_00: Now, if we really measured that, Dave, did that really do anything?
• 15:01
  SPEAKER_00: Not much, but we thought we were doing a lot.
• 15:04
  SPEAKER_00: And when you tell the patient what you're doing and you involve them in the testing, now real ear has been out since I was in grad school.
• 15:11
  SPEAKER_00: I would never think of doing a fitting without real ear.
• 15:14
  SPEAKER_00: And the other thing I absolutely love, so I had an extern.
• 15:17
  SPEAKER_00: Um, and all of our all of the rooms in our clinic have video odoscopes, real ear measurements.
• 15:23
  SPEAKER_00: We try to make every fitting room, every adjustment room exactly the same so that we could walk into anyone.
• 15:30
  SPEAKER_00: And it just made it easier.
• 15:32
  SPEAKER_00: And this extern was working on this person who I knew had already been in twice.
• 15:36
  SPEAKER_00: They were now in for their third time of saying this isn't right.
• 15:41
  SPEAKER_00: And a lot of times people just make a tiny little adjustment, you know, and they'll say, come back if it's not right.
• 15:46
  SPEAKER_00: And that makes me absolutely crazy.
• 15:48
  SPEAKER_00: So we have all the surround sound and the things to really make adjustments and do it in a more measured way.
• 15:56
  SPEAKER_00: Sure.
• 15:57
  SPEAKER_00: And so he was having trouble.
• 15:58
  SPEAKER_00: I said, This per I know this person, they've been here, this is their third time.
• 16:01
  SPEAKER_00: Well, I know you get three chances with somebody, and then you're out.
• 16:05
  SPEAKER_00: And so I went in and I said, Hey, I'm gonna come help you do this.
• 16:08
  SPEAKER_00: And I turned on, I was asking what the problems were.
• 16:10
  SPEAKER_00: I turned on the surround sound.
• 16:12
  SPEAKER_00: We were doing aided discrim with, you know, the speaker like three feet in front of the patient with recorded discrim, and I knew what their optimal discrim was.
• 16:19
  SPEAKER_00: And I said, now we're gonna make some adjustments, and we did it with noise and without noise.
• 16:24
  SPEAKER_00: And when the guy left, he said, you know, Jill, this is really better.
• 16:28
  SPEAKER_00: And the extern said to me, I've never seen that done before.
• 16:31
  SPEAKER_00: Right.
• 16:32
  SPEAKER_00: And I thought, isn't that a shame?
• 16:33
  SPEAKER_00: I said, This is the art behind what we do.
• 16:37
  SPEAKER_00: This is what makes one clinician better than another.
• 16:40
  SPEAKER_00: Really going that extra mile, and when the patient leaves feeling like I've done my very best.
• 16:46
  SPEAKER_00: And you can only do that with best practices.
• 16:49
  SPEAKER_00: And it's makes such a difference.
• 16:50
  SPEAKER_00: You know, like I would never think of doing a so we always do discrim in the booth.
• 16:56
  SPEAKER_00: That's optimal.
• 16:57
  SPEAKER_00: Okay.
• 16:58
  SPEAKER_00: How often do you have a patient go in the booth and they say, Well, I heard everything in there, how could I have a hearing loss?
• 17:03
  SPEAKER_00: Right.
• 17:03
  SPEAKER_00: So we say, we're gonna measure your potential in the soundproof booth.
• 17:07
  SPEAKER_00: Of course, you know that's not as good as it gets.
• 17:10
  SPEAKER_00: That's what we would like you to hear like.
• 17:13
  SPEAKER_00: And then we're gonna do discrim outside the booth or in whatever at 40 dBHL for normal situations.
• 17:21
  SPEAKER_00: And it's amazing the things that you'll find.
• 17:23
  SPEAKER_00: And you'll say, No, that that wasn't lump, that was jump.
• 17:26
  SPEAKER_00: And the person will say, Oh, really?
• 17:28
  SPEAKER_00: So you can correct them right there to help them understand and really experience what they're missing, and then put the demos on them to show them how they should be hearing.
• 17:38
  SPEAKER_00: It's really impactful.
• 17:39
  SPEAKER_00: I love doing that.
• 17:40
  SPEAKER_00: I just because I feel like that's really what's making a difference that big box stores can't do.
• 17:45
  SPEAKER_01: Right.
• 17:46
  SPEAKER_01: Right.
• 17:46
  SPEAKER_01: Yeah.
• 17:46
  SPEAKER_01: And then and then testing in those more realistic environments, trying to simulate that with background noise.
• 17:51
  SPEAKER_01: I mean, we've been preaching that.
• 17:52
  SPEAKER_01: There are tests that can be done unaided or aided that use speech and noise testing, and yet it's never really people say, Oh, yeah, I should be doing that.
• 18:02
  SPEAKER_01: And yet many don't test in more real-world situations because they're afraid that in some way the technology won't support it or that they won't be able to meet the need.
• 18:12
  SPEAKER_01: But you just hit on it.
• 18:14
  SPEAKER_01: Patients will say, you know, that's the first time anyone's ever done that for me, or the the the extern has.
• 18:19
  SPEAKER_01: And we've we haven't really translated from an education point, best practice into best practice in real-world environments.
• 18:28
  SPEAKER_01: And we shouldn't be afraid of that because that's where the patients live, and that's where they need to get benefit, is in noisy environments.
• 18:35
  SPEAKER_01: And being testing that way only makes only makes the best practice sense.
• 18:40
  SPEAKER_00: Dave, you know, you're a clinician like we talked about too.
• 18:43
  SPEAKER_00: Haven't you had those people that their optimal discriminant is 96%?
• 18:47
  SPEAKER_00: And then they come in and they're back and they're back and they're back.
• 18:50
  SPEAKER_00: I'm not hearing a noise, I'm not hearing a noise.
• 18:52
  SPEAKER_00: And then you measure speech and noise and say, Well, really, your speech and noise really is not good at all, and that's why you're having all these troubles.
• 18:59
  SPEAKER_00: Well, you can't go at the back end of something.
• 19:01
  SPEAKER_00: That destroys your credibility.
• 19:03
  SPEAKER_00: That destroys patients' confidence in you.
• 19:06
  SPEAKER_00: You got to do that in the front end, and then if they do have a really poor signal-to-noise ratio, you gotta say to them, now this is what you can expect.
• 19:13
  SPEAKER_00: Trevor Burrus, Jr.
• 19:14
  SPEAKER_00: Right.
• 19:14
  SPEAKER_01: And this technology is what you should consider and all that.
• 19:18
  SPEAKER_01: It it drives the rest of that conversation.
• 19:20
  SPEAKER_01: Best practice isn't a checkbox that you want to just say, yes, I did the test, but you have to think about what it is that you're doing with those test measures that translate, as you said earlier, to patient benefit.
• 19:31
  SPEAKER_00: You know, and I I hate my phrase that I love too is always underpromise and over-deliver.
• 19:39
  SPEAKER_00: So let's say if you really somebody says they have to have their aids by Thursday, you'll say, Well, I'll do my best.
• 19:46
  SPEAKER_00: And then if you call them on Wednesday and say your hearing aids are here, they think you're all that in a bag of chips.
• 19:51
  SPEAKER_00: So the thing is you want to give patients realistic expectations so that they don't have returns for credit.
• 19:58
  SPEAKER_00: And we have goals for all those things because I feel like if, you know, 24% of my patients are coming back with their hearing aids saying they want to exchange them or they want to return them, I'm not doing a very good job.
• 20:10
  SPEAKER_01: It's a lot of wasted effort.
• 20:11
  SPEAKER_00: A lot.
• 20:12
  SPEAKER_00: And then the person walks around without help.
• 20:15
  SPEAKER_00: And I know now, I'll tell you what, my husband sustained a hearing loss 30 years ago, suddenly, and you got him in the mail clinic right away.
• 20:23
  SPEAKER_00: We never really figured it out and then found out it was it was really heredity.
• 20:27
  SPEAKER_00: Yeah.
• 20:28
  SPEAKER_00: And but now David's 30 years older, doesn't process as fast, and he has gotten a lot more hearing loss.
• 20:36
  SPEAKER_00: Hearing aids have gotten much better, but there still are times when I have to know to look at him in a noisy environment.
• 20:41
  SPEAKER_00: He sits in a certain place.
• 20:43
  SPEAKER_00: And so I want to be able to give patients, okay, this is what you can expect.
• 20:47
  SPEAKER_00: We're gonna work with you on this, and it's gonna get better, but you got to get used to him, you got to put him in every day, and you have to be part of this process.
• 20:55
  SPEAKER_00: I can't do everything for you.
• 20:57
  SPEAKER_00: Right.
• 20:57
  SPEAKER_00: And so that's and it's so rewarding when patients come back and say, you know what, this really does help me.
• 21:03
  unknown: Yeah.
• 21:03
  SPEAKER_00: And I'm happy.
• 21:04
  SPEAKER_01: I it makes my day when patients say that, particularly those reluctant first-time users who um, you know, wait seven to ten years, they finally, they finally make the decision to take the plunge, and then they actually come back and say, you know, I I I wish I'd done this sooner.
• 21:22
  SPEAKER_01: That it makes my day.
• 21:23
  SPEAKER_00: But in, you know, in Florida, we're living in Florida six months now, every restaurant is so noisy and not conducive to good hearing.
• 21:30
  SPEAKER_00: Right.
• 21:31
  SPEAKER_00: And so David will get out his phone and he's adjusting it, and then he's participating more.
• 21:35
  SPEAKER_00: You know, it's nothing I hate more than looking over at this man that I love for so many years, and he's got that blank look on his face, and you know he has no idea the conversation.
• 21:45
  SPEAKER_00: Or he'll jump in with something, you're like, no, honey, that's not what they're talking about.
• 21:50
  SPEAKER_00: Not only does it make me look bad, but it makes him look old.
• 21:53
  unknown: Yeah.
• 21:54
  SPEAKER_00: So the technology today is so fabulous.
• 21:56
  SPEAKER_00: But then again, Dave, we have to have the time or The assistance to be able to adjust that technology and educate people on how to do it themselves because a lot of people just aren't that tech savvy.
• 22:09
  SPEAKER_00: It's not hard to learn, but you have to take the time to teach that.
• 22:13
  SPEAKER_00: And then it makes all the difference in the world.
• 22:15
  SPEAKER_00: Well, you know, all those studies that say increasing functionality with the hearing aids makes people so much more satisfied.
• 22:22
  SPEAKER_01: For sure.
• 22:22
  SPEAKER_00: And that's what we want.
• 22:23
  SPEAKER_01: For sure.
• 22:24
  SPEAKER_01: And as a both of us are members of the boomer generation, and we've had several okay boomer moments in the in this little preamble, but I'm less stigmatized by hearing loss and the use of hearing aids, and I know David is too, but I have higher expectations for what hearing aids should do for me.
• 22:41
  SPEAKER_01: So with all of that, by way of preamble, I think, you know, we're sitting in 2024, and we've we've come out of the pandemic, we've come out of some challenging business times with uh increase in third-party pay, OTC, all of that.
• 22:57
  SPEAKER_01: A lot of the professionals who are listening to this podcast look to you for guidance.
• 23:02
  SPEAKER_01: They're feeling stressed, they're feeling burned out.
• 23:06
  SPEAKER_01: Let's take a look under the hood a little bit and talk a little bit about what it is that you think are the essential ingredients to running a practice successfully.
• 23:16
  SPEAKER_01: What sorts of things, you know, w when you first began uh backing into things, as you said, literally and figuratively.
• 23:23
  SPEAKER_00: Yeah, literally.
• 23:24
  SPEAKER_01: And uh, you know, uh looking for a refresh, what are what are some of the things that you do focus on?
• 23:30
  SPEAKER_01: You mentioned return for credit is something that if you see return for credit rates creeping up, um, that you're that's that's gonna be something you're gonna figure out your partner.
• 23:41
  SPEAKER_01: I mean, are are they providing you with technology that's got the leading edge, you know, providing the benefits to the patients?
• 23:47
  SPEAKER_01: Are they dependable?
• 23:48
  SPEAKER_01: Are they durable, et cetera?
• 23:50
  SPEAKER_01: What are key performance indicators that you're monitoring to ensure that you're doing the very best that you can for your patients and for your business?
• 24:01
  SPEAKER_00: Number one, number one for anybody, whether they're in private practice or not, is measuring what I call your help rate.
• 24:09
  SPEAKER_00: So we know that if a hundred people come in and have a loss that can benefit from hearing aids, less than 50 are walking out with help.
• 24:16
  SPEAKER_00: Right.
• 24:17
  SPEAKER_00: And I don't understand why that's not a number we focus more on because think about how our numbers would grow and numbers tell a story, but most importantly, how the help that we give our patients would be so much better.
• 24:31
  SPEAKER_00: So I've never been intimidated by measuring that and making everybody in the practice measure that because it's the number one thing that'll change a business and that will change our patients' lives.
• 24:43
  SPEAKER_00: These people come to us for help.
• 24:45
  SPEAKER_00: It's taken them eight years or so to get in front of us.
• 24:49
  SPEAKER_00: And then half more than half walk out without help that they need and deserve, and they're gonna wait more years before they go to somebody else who's maybe not as good as us or as qualified.
• 25:00
  SPEAKER_00: So I don't back away from that.
• 25:02
  SPEAKER_01: So so if if the industry average is half, um, what is a reasonable number that you focused on?
• 25:09
  SPEAKER_01: And how did you differentiate yourself?
• 25:12
  SPEAKER_01: How did you do that without irritating, annoying patients, make them feel like you're pressuring them versus their partner on that journey to raise that help rate?
• 25:22
  SPEAKER_01: But what is a reasonable help rate number for private practitioners listening?
• 25:26
  SPEAKER_01: Uh and how do you achieve that?
• 25:28
  SPEAKER_00: Well, I think reasonable, okay?
• 25:31
  SPEAKER_00: And you can't count programs where people aren't paying anything.
• 25:33
  SPEAKER_00: Right.
• 25:34
  SPEAKER_00: So if it's Medicaid or they're not paying anything, you just yeah.
• 25:38
  SPEAKER_00: So I would say 70% is very reasonable.
• 25:41
  SPEAKER_00: But you have to start with the interview.
• 25:44
  SPEAKER_00: So let's say a patient comes in.
• 25:46
  SPEAKER_00: You know, I'm like, I've been doing this a long time, I know how to do things.
• 25:49
  SPEAKER_00: Let's go, let's go, let's take you down this road that I want you to go.
• 25:53
  SPEAKER_00: But you have to start by being a little bit familiar with the patient, saying, Tell me what brought you here today.
• 26:00
  SPEAKER_00: And they say, Well, my wife says this, my wife says that, and hopefully the wife's or the spouse is there.
• 26:06
  SPEAKER_00: And you say, Well, do you think that's right?
• 26:08
  SPEAKER_00: Well, yeah, I do miss a little, you know, and I do miss hearing my grandchild.
• 26:12
  SPEAKER_00: And then you can say, Well, that's pretty important, isn't it?
• 26:15
  SPEAKER_00: I mean, isn't that important to you?
• 26:16
  SPEAKER_00: Yes, it is.
• 26:17
  SPEAKER_00: So if I can help you hear your grandchild, is that the help you're looking for from me today?
• 26:23
  SPEAKER_00: And if they say, No, then you can say, Well, what are you looking for from me today?
• 26:28
  SPEAKER_00: And you can cater that interview toward the patient and not to you.
• 26:32
  SPEAKER_00: Sure.
• 26:33
  SPEAKER_00: And then if they say, Well, I just need to hear in a restaurant or whatever, you make sure you do those tests and you demonstrate that they can hear better.
• 26:39
  SPEAKER_00: But you have to make it all about the patient and not about you.
• 26:43
  SPEAKER_00: And when they say, Well, but I don't want hearing aids, you say, Okay, then why did you come here today?
• 26:50
  SPEAKER_00: So you have to get comfortable enough with your presentation.
• 26:53
  SPEAKER_00: Now we're comfortable, we've been doing this a long time, but newbies, they're not comfortable.
• 26:58
  SPEAKER_00: How do you get it?
• 26:59
  SPEAKER_01: Well, I think part of it is uh in in when you're coming straight out of school or out of your training and preparation, you're interested in telling the patient and and and demonstrating all that you know.
• 27:11
  SPEAKER_01: Exactly.
• 27:12
  SPEAKER_01: In fact, that's really not what the patient needs.
• 27:14
  SPEAKER_01: They don't they don't care how much you know until they know how much you care.
• 27:18
  SPEAKER_00: Right.
• 27:18
  SPEAKER_01: And using those two ears and one mouth, how how do you how do you how do you ensure that you're not falling into that trap of trying to present yourself as an expert by talking rather than by listening?
• 27:32
  SPEAKER_00: Well, number one, you measure it.
• 27:34
  SPEAKER_00: Simple as, you know, you can do it in most softwares, but it can be as simple as a scrap of paper next to your audiometer, needed help, got help, and then really watch it, but you also record what you say to people.
• 27:46
  SPEAKER_00: You know, I remember when I first got out of school, I drithered on about the audiogram and sensory hearing loss.
• 27:53
  SPEAKER_00: Nobody wants to hear that.
• 27:55
  SPEAKER_00: I mean, there was a focus group by Hearing Industries a few years ago, and they asked patients, what do you want from your professional?
• 28:02
  SPEAKER_00: We want a strong recommendation and we want a good reason we should do it.
• 28:06
  SPEAKER_00: And then you say nothing until they think about it.
• 28:09
  SPEAKER_00: But think about how with the technology today, there's so many things.
• 28:13
  SPEAKER_00: And you know, it can be so great.
• 28:15
  SPEAKER_00: So you'll you'll say, Well, oh my gosh, we could do this, or oh, maybe I'll want a table mic.
• 28:19
  SPEAKER_00: Oh, oh, well, really, we could hook this up in your car, or we could hook this up with your phone.
• 28:23
  SPEAKER_00: And by then the patient's sitting there drooling, going, Yeah, I think I want to think about it.
• 28:29
  SPEAKER_00: It's one thing.
• 28:31
  SPEAKER_00: One thing.
• 28:31
  SPEAKER_00: And then you focus on that, and then when you say, These are the results I found, this is the benefit you can derive, and this is what I think you ought to do, that's it.
• 28:42
  SPEAKER_00: Don't say anything else.
• 28:43
  SPEAKER_01: And then stop.
• 28:44
  SPEAKER_00: And then stop.
• 28:45
  SPEAKER_01: Yeah.
• 28:45
  SPEAKER_00: And then let the patient talk next.
• 28:47
  SPEAKER_00: But let's face it, you know, when you're telling people, and the other thing is we should never say that the hearing aids cost this much.
• 28:55
  SPEAKER_00: This is a plan, an enhancement plan.
• 28:59
  SPEAKER_00: This is what's involved in the plan.
• 29:01
  SPEAKER_00: It's not just the hearing aids.
• 29:03
  SPEAKER_00: That's where we've gone wrong for so long, Dave.
• 29:06
  SPEAKER_00: It's not the hearing aids they're buying.
• 29:07
  SPEAKER_00: They're buying us and our staff and our equipment and our expertise.
• 29:12
  SPEAKER_00: And every study has shown that when you get a professional involved, patients do better and are more satisfied.
• 29:19
  SPEAKER_00: So we have to stress that.
• 29:20
  SPEAKER_00: This is what you get, and this is what it's worth.
• 29:23
  SPEAKER_00: It's not just hearing aids.
• 29:26
  SPEAKER_00: When I went to an orthodontist years ago, he didn't just put wires on my teeth.
• 29:30
  SPEAKER_00: What were those worth?
• 29:31
  SPEAKER_00: Not much.
• 29:32
  SPEAKER_00: It was him and his expertise that really made a difference to my beautiful smile.
• 29:37
  SPEAKER_00: And I wasn't buying braces, I was buying a beautiful smile.
• 29:42
  SPEAKER_01: A beautiful smile.
• 29:42
  SPEAKER_00: Thank you.
• 29:43
  SPEAKER_00: And so that's what we have to focus on.
• 29:45
  SPEAKER_00: But I think, you know, you have to believe it.
• 29:48
  SPEAKER_01: Yeah.
• 29:48
  SPEAKER_01: And when you talk about again, then going from 50 or less than 50 to 70 percent on the help help rate.
• 29:55
  SPEAKER_01: Have you found have you used as best practice, if there are family members with the individual with hearing loss to encourage or or require is best practice to bring in a family member with the patient?
• 30:11
  SPEAKER_00: Absolutely.
• 30:12
  SPEAKER_00: You know, communication is a two-way street.
• 30:15
  SPEAKER_00: And so, you know, even with my husband, I had to understand his hearing loss.
• 30:20
  SPEAKER_00: I had to understand what he missed.
• 30:22
  SPEAKER_00: And, you know, in the great softwares today, you actually play for the family member what a sentence sounds like.
• 30:29
  SPEAKER_00: This is what your voice sounds like to him or to her.
• 30:33
  SPEAKER_00: And they go, wow, I didn't realize that he hears, but that's why he doesn't understand because all the consonant sounds are missing.
• 30:41
  SPEAKER_00: And so because of this, you still have to get his, you still have to get his attention.
• 30:45
  SPEAKER_00: Yeah.
• 30:45
  SPEAKER_00: You have to look at him.
• 30:46
  SPEAKER_00: And if and if he doesn't get it right, say it in a different manner.
• 30:50
  SPEAKER_00: Don't just restate the same thing over and over and over.
• 30:53
  SPEAKER_01: Yeah, and you're helping to educate that family member, the loved ones that come in to that they they can't just assume because you're fitting them with amplification that they're going to get everything so that they can have their back turned from the next room, poor lighting, and hear everything.
• 31:06
  SPEAKER_01: You're educating them about uh using good communication strategies that hold up whether they're using amplification or not.
• 31:16
  SPEAKER_00: Exactly.
• 31:16
  SPEAKER_00: And that's like, you know, how many times have you like put hearing aids on someone for the first time and the wife or husband walks around?
• 31:23
  SPEAKER_00: You know, they walk three rooms down and they talk, and I say, okay, now I'm gonna talk to you three rooms away and see if you can hear it.
• 31:30
  SPEAKER_00: The answer is they can't.
• 31:32
  SPEAKER_00: And I'll tell you something, you know, I've never been one that has the greatest patience.
• 31:37
  SPEAKER_00: Hearing loss requires patience, yeah.
• 31:39
  SPEAKER_00: But it's worth it.
• 31:41
  unknown: Yeah.
• 31:41
  SPEAKER_00: And hearing aids today do so much more for patients.
• 31:45
  SPEAKER_00: I mean, have you listened to any old hearing aids lately?
• 31:48
  SPEAKER_00: The ones that just had a volume control and no directionality and none of this connectivity.
• 31:54
  SPEAKER_00: It was amazing how much worse they sounded than today.
• 31:57
  SPEAKER_00: They're good today.
• 31:58
  SPEAKER_00: I I love going on the phone and going from regular to edge mode and listening to what it does because it does, it makes a huge difference.
• 32:06
  SPEAKER_00: But if we don't take the time to explain that and educate the patients on that, they won't get that benefit.
• 32:12
  SPEAKER_00: And the family members.
• 32:13
  SPEAKER_00: Exactly.
• 32:14
  SPEAKER_00: I mean, technology is cool today.
• 32:16
  SPEAKER_00: Yeah.
• 32:17
  SPEAKER_01: Well, and and you bring up the technology piece.
• 32:19
  SPEAKER_01: So in your practice, for for young practitioners who are establishing their business and their practice, um, how many manufacturing partners throughout your career at a time?
• 32:31
  SPEAKER_01: I mean, obviously you've always had someone or a group of people, but what how many different manufacturers are necessary in order to serve the needs of your patient the very best?
• 32:43
  SPEAKER_00: Well, I'll tell you something, Dave.
• 32:44
  SPEAKER_00: With today's technology, I don't personally believe you can have more than two manufacturers and really do it well.
• 32:54
  SPEAKER_00: Because think about it.
• 32:54
  SPEAKER_00: Think how much time it takes to download new software, educate the staff on new software, um, get different parts for different technologies.
• 33:03
  SPEAKER_00: It's too much.
• 33:05
  SPEAKER_00: You know, if I want to be an expert at something, I feel like I have to put 90% of my eggs into one basket and 10% in an alternate.
• 33:12
  SPEAKER_00: Sure.
• 33:12
  SPEAKER_00: Because look at all the technologies and what you can do.
• 33:15
  SPEAKER_00: You can take any technology and fit it to almost any hearing loss.
• 33:19
  SPEAKER_00: So I've done it before, you know, where something new comes out and everybody says, oh, this is so fabulous.
• 33:25
  SPEAKER_00: And I'll say, well, let's give that a try.
• 33:27
  SPEAKER_00: Six months later, the person comes in and I have no idea what I'm doing because I haven't looked at that technology for six months.
• 33:34
  SPEAKER_00: So, and in the era of hopefully people using assistance, you need everybody on that staff to be as qualified as you are at adjusting it.
• 33:43
  SPEAKER_00: And so that takes a lot of time and effort.
• 33:46
  SPEAKER_00: And you got to be an expert at that technology.
• 33:49
  SPEAKER_00: And I think too, is probably as many as anybody needs.
• 33:53
  SPEAKER_00: And I don't see anything wrong with that.
• 33:55
  SPEAKER_00: I think it's actually doing a better job for our patients by being a real expert at technology.
• 34:00
  SPEAKER_01: Yeah, you really want to know how the software works, user apps, we'll get to that maybe too, you know, because that's how the patient interfaces with the technology.
• 34:09
  SPEAKER_01: It's not just the hardware behind the ear anymore, it's also the user app.
• 34:13
  SPEAKER_01: And to familiarize yourself with a full, you know, five, six uh different technology, sometimes it can be difficult to stay up to speed.
• 34:24
  SPEAKER_01: And then it's a question, it also you you haven't touched on, it can erode your profitability too if you have too many partners and you're not getting profitable.
• 34:32
  SPEAKER_00: You know, in today's world, when we talk about KPIs, I mean, cost of goods shouldn't be any more, in my opinion, than 30%.
• 34:39
  SPEAKER_00: And obviously, the less it is, the more the profitability.
• 34:42
  SPEAKER_00: And when you look at practices today, we need to be profitable.
• 34:48
  SPEAKER_00: People need to keep an eye on their businesses because the businesses, if they're going to be successful, they have to be profitable.
• 34:55
  SPEAKER_00: Too many business owners don't look at that, they have no idea where they're at.
• 35:00
  SPEAKER_00: Numbers tell a story and it tells where your business is going.
• 35:03
  SPEAKER_00: It's either going forward or it's going back.
• 35:06
  SPEAKER_00: And that was always so important to me.
• 35:08
  SPEAKER_00: But you know, sometimes people get overwhelmed by numbers.
• 35:11
  SPEAKER_00: I love them.
• 35:12
  SPEAKER_00: I just love them.
• 35:13
  SPEAKER_00: And now there are in the softwares, you get lots of information.
• 35:17
  SPEAKER_00: You don't even have to track that stuff yourself.
• 35:20
  SPEAKER_01: Yeah.
• 35:20
  SPEAKER_01: I mean, and we'll we'll come to that on the technology side a little bit later.
• 35:23
  SPEAKER_01: But I'm gonna have another okay boomer moment and say and take a page from uh the old Dick Cavit show that I grew up with in the 70s.
• 35:31
  SPEAKER_00: Um I grew up with that too.
• 35:33
  SPEAKER_01: Yeah, and one time I remember he had uh Yoko Ono and John Lennon on, and they had such an engaging conversation that they decided to do another episode.
• 35:44
  SPEAKER_01: So today, Jill, you're my Yoko Ono, and I think this is a good place to end this part of the discussion.
• 35:50
  SPEAKER_01: But the good news is that we're gonna continue over into a second podcast now.
• 35:55
  SPEAKER_01: So for our listeners, uh stay tuned.
• 35:58
  SPEAKER_01: And for the second half of this engaging, enthralling, I'll say, conversation with Dr.
• 36:03
  SPEAKER_01: Jill Caseworm about all things business and practice.
• 36:08
  SPEAKER_01: And if you like this uh episode, please like us, rate us, share it with your friends, and uh then tune in because we're gonna have a second continuation of this.
• 36:18
  SPEAKER_00: Awesome, I'm ready.
• 36:19
  SPEAKER_01: All right, thanks.