Daily Updates, Future Ear Radio, Hearables, Hearing Healthcare, Podcasts

055 – “What are you looking forward to in 2021?” Part 2 (Hearing Health)

Dave Kemp

Part two of the end-of-year compilation, and the last Future Ear Radio episode of the year, features six hearing health industry leaders. While part one (released last week) featured guests with expertise and backgrounds in consumer hearables and voice technology, this week’s episode highlights the perspective of the hearing professional.

“What are you looking forward to in 2021, as it relates to hearing health, audiology, hearing technology, and/or innovation pertaining to this industry?”

This episode features:

Thank you to everyone who has tuned into Future Ear Radio this year and made this first year of podcasting so special and rewarding. I appreciate all of the support and feedback more than you all know. I can’t wait for year two and sharing all the great conversations I have planned in 2021!

-Thanks for Reading-
Dave

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EPISODE TRANSCRIPT

Dave Kemp:

All right. So, we have D’Anne Rudden here. D’Anne was on the podcast on episode 27 with Brian Urban back in April, right at the onset of the pandemic and we were talking about telehealth and how it can be implemented from this hearing professional standpoint. As an audiologist, it was awesome to hear your feedback on that and clearly, I think going to be a trend that will be with us well beyond the pandemic, I think telehealth is here to stay. But, wanted to bring you on just like I’ve brought everybody else here on this episode to get a sense of, what are you excited about as it relates to 2021 as we head into the new year. In your world, what are the things that are top of mind for you that you’re excited about as we go into next year?

D’Anne Rudden:

Well, I don’t know about you but I can’t help but have this phoenix rising energy. It feels like, that’s got to be a part of this next-

Dave Kemp:

I agree.

D’Anne Rudden:

… set of time. I think in some ways that’s always healthy. It’s like you have to burn down ways of being and ways of thinking to push you to create something new and to transform yourself. So I always love that energy at the end of the year, regardless. So setting the intention for what I want 2021 or whatever new year things to be but, I think for me, what’s been really interesting and what I’m looking forward to obviously is, I’m sure like everybody else, in-person connection.

Dave Kemp:

Yeah.

D’Anne Rudden:

This is great to be able to have still had a mechanism to continue to be connected with people. But man! I’m one of those people that I love in-person like-

Dave Kemp:

Same.

D’Anne Rudden:

I would have done terrible at online university, that would not have been my jam. I need that people connection and accountability from others, and to show up, to have to get off my butt and show up. So I’m really looking forward to that. I’m really interested to see, who’s been laying low and has been working on transforming, especially when I think about voices in the industry. It’s been interesting to see how this year has given people confidence to put themselves out there because there was no other thing to do. You had to make an effort to put yourself out there. You couldn’t hope that somebody noticed you, sitting at the soda counter, kind of thing. There’ve been a lot of new voices that I feel like has come on to the scene and been willing to share their expertise and vision. So I’m really excited to talk to those folks.

Dave Kemp:

I totally agree with you. I’ve noticed and I think you’re right. I think that the pandemic probably was the trigger for a lot of people to recognize that maybe that this was something that they’d been thinking about. But I’ve now noticed, there are more people in the industry that are taking it upon themselves to launch podcasts, YouTube channels, you name it. It just seems like we went from having a small handful to now, I think 10s, 20, 30, 40 people that I can think of off the top of my head, and a lot of them started this year. So, I totally agree.

Dave Kemp:

It’s really cool that, you have this new wave of people that are lending their expertise and the things that they know a whole lot about. I think just does the community justice because it… The more exposure in a lot of these popular online channels, the better. If there are number of popular YouTube channels that is promoting best practices and really starting to highlight the value of why you should see a hearing professional as opposed to trying to do it yourself, and just making people aware of what exactly it is that this profession does and why they’re so valuable for the millions of people that have hearing loss, so I totally agree. That’s cool that you mentioned that because it is something that I’ve recognized that, there’s been a ton of new people that it seems are now creating all this awesome new stuff and I’m all for it.

D’Anne Rudden:

Yeah, me too. And I think audiologists, and I’m going to speak very globally about this. We tend to want to highlight the people that we’re serving rather than ourselves. I don’t know. It seems there’s a humbleness to what we do, and I’m really glad [inaudible 00:05:14] being willing to say, “Hey world, look at what we do. Check us out.” We’ve got this going on and we’re here certainly to serve, but also to bring an element that I think we’ve been shy to put out there. I’m hopeful that from, again, that phoenix energy, from the ashes of what felt like, “Oh my God. We’re going to lose the profession, things are shut down.” To like, “Hey, we’re resilient.” And we actually do have the capacity to reach probably greater number of people than we even imagined this time last year. If we’d have had this conversation.

Dave Kemp:

Right. Yeah I know I agree with you. I’m thinking about your podcast too and I think that, what’s cool is I know that you’ve probably felt this too is that, the great thing about a podcast is just, serves as a great way to meet so many different people and help to span these chasms and understand who is super knowledgeable about what, and cross-pollinating ideas that way. And I really do think there’s been a big element of that this year. I feel like more than ever, I’ve noticed that the industry and all the different facets within it, are really, really communicating in a way that I hadn’t seen before, and I think that’s really positive is that, it seems like we’re all on the same page, more or less. Particularly, the professionals with a lot of this stuff and I think that’s going to be really important moving forward as well.

D’Anne Rudden:

I feel like in this year, I’ve been able to make connections with people in Australia, people in New Zealand, people in England that are doing incredible work. It’s nice that this time forced us to think bigger and to look further out for people to make connections with. The other thing that I’m hopeful for is, anytime you get knocked down a little bit, my hope always is that, you come back stronger. But also, maybe as a catalyst to fight a little bit harder for ourselves.

D’Anne Rudden:

This time last year, I remember feeling so energized from my time on Capitol Hill with ADA, and what that meant to me, to fight for my profession. And then it’s fast forward a couple of months, I felt like I’d been knocked right on my… I don’t know if I can say that word out loud, but knocked down. You start to get back up again and it’s like, “Whoa.” I hope that, this time of being knocked down and knocked around a little bit, has made us more willing to fight for ourselves.

Dave Kemp:

Yeah.

D’Anne Rudden:

And to stand up, and to use our voices in a way that perhaps we always felt like, oh, someone else will do that. Someone else will stand up and it’ll all be okay. Maybe now people are willing to say, “Hey, wait a minute.” And get out there and have a more collective voice.

Dave Kemp:

Yeah, I love that, the phoenix rising. That’s what I got from you is that, it’s definitely feeling like things got bad this year, but I think that it put a lot of things in perspective for people and a lot of what you just said there, this idea that, there’s a lot of value that this profession brings and I think that this idea that, maybe you got to take the ownership and put it upon yourself to, whether it is your contribution is going to be, you’re going to go to Capitol Hill and you’re going to help to lobby for things that are positive for the industry. Or you’re going to launch a YouTube channel, where you’re going to try to make the general public a little bit more aware of why they should maybe go see a hearing professional, and the various reasons why a hearing professional is so valuable to the hearing loss community. So, I loved all that. I think that was really, really good stuff.

D’Anne Rudden:

And don’t count out private practice. I’m telling you. We rumble with change every day. I think sometimes people feel like, “Oh my gosh! This is going to be the end of, the death of private practice.” On the contrary, I would say, be very careful because, we’ve been plotting and planning for how the next set of circumstances are going to go. And I think we’re going to come back stronger and better and more resilient than ever.

Dave Kemp:

Perfectly said. I love it. Thanks so much, D’Anne, for coming on here and I look forward to chatting again here in 2021.

D’Anne Rudden:

Thanks so much, Dave, and I appreciate your voice out there too. You bring on some really amazing people that I’ve gotten to hear, and I appreciate that from you.

Dave Kemp:

Thank you. I appreciate it. All right. So we got Kat Penno here on the podcast. Kat did a couple episodes with me this year. We had great conversations on episodes 47 and 38. A couple of talks with Andy Bellavia, like a little round table. Where we really looked at the emerging technology that’s occurring in the industry. I’ve always appreciated your perspective because, you’re obviously an audiologist. But you have this really digitally oriented mindset with the hearing collective and this idea of, there’s a lot of different online services that exist and different ways that you can be more accessible to patients in an online setting with some new technology. So, it’s fit right into the future, your wheelhouse and therefore I’ve always really enjoyed our conversation. So, I wanted to get your take on the things that you’re looking forward to as we head into 2021.

Kat Penno:

So let’s kick it off. You won’t hear it here first and before you’ve heard it all year round. But I think 2021, it’s going to be the year of the hearable. So a lot of factors play into that. First of all, an increase in ear-worn devices, an increase in audio content consumption, increased in improved Bluetooth connectivity. So, anything that’s got the ability to have Bluetooth, we’re going to connect to our ear-worn devices to it, and as a result of that, I’m hoping for an increased in hearing and hearing loss awareness and potentially reduction in stigma. The way I envision this, and I’ve described it a few times now, is that I see it as a spectrum.

Kat Penno:

People will come and they’ll start their hearing journey with perhaps hearables and then, as they notice their hearing changing over time, I hope they continue and then they go from hearables to hearing aids or implantable devices, depending on the severity. As part of this, the overarching banner that I say, I’m sitting on top of the hearables or hearing technology spaces client-centered care.

Kat Penno:

And want to really excited about in this case is in probably more from a consumer point of view rather than the hearing healthcare professional point of view. So let me explain that a little bit. What I think of and envision when I think of client centered care is that the locus of control management goes back to the client. So any as an end user with these hearables, I’ll be out to manage everything in an ecosystem in the palm of my hand or via wearable smartwatch to my ear-worn devices.

Kat Penno:

So these pieces of technology will be able to gather my personal, my data, my individual personalized data, be able to give me some recommendations of where to go. And for example, if your hearing is deteriorating, perhaps this is a red flag to go see a professional to manage it.

Kat Penno:

So that’s what I think of when I think of the year of the hearable. It’s the gateway to hearing health and improving your connections with your loved ones to the greater extent. And so professionally. So I’ve split into three categories, the year of the hearable, professionally and healthcare in general. Professionally with hearing collective. What I’m excited about is expanding, hearing healthcare services, perhaps bringing on a few more experts into the field.

Kat Penno:

I’m still figuring out how to apply audiology in a very modernized and relevant sense to the client. So I’m trying to figure out what does an audiologist look like in the year of 2021 and how can we apply that to our clients and walk alongside them to improve their hearing journey.

Kat Penno:

And lastly, when I think of 2021, I really envision a less siloed profession, what I mean by that is I am envisioning more co-locations of professionals. So we might go and co-locate in an office with a psychologist or a GP or a speech pathologist where we can immediately have that multidisciplinary team of client-centered care rather than, oh, I’ll just shoot an email to this professional or that professional and chat to them on the phone. So I see a lot more co-locations happening.

Kat Penno:

I also have envision the retail aspect from the consumer electronic in having a big part. And I do foresee professionals being able to consult in up-skill, I think as the healthcare profession changes. So does the retail aspect and in Australia, we’ve got stores like JB Hi-Fi, which I think in America might be the equivalent to Best Buys. I’m not really versed on the big electronic stores there, but-

Dave Kemp:

No, that’s right.

Kat Penno:

… I think, cool. I see that the retail aspect is still going to be quite prevalent in hearing health care as a blend of hearing technology exists. And as part of that, I think there’s a role for audiologists to upskill and educate retail assistants to understand products better rather than just saying, “Oh yeah, I like these headphones because they’re comfortable over my ear or in the ear.” So there’s that opportunity there and an opportunity for audiologists to that.

Kat Penno:

The client understands that we’re there to provide them with expert knowledge on the ear and the brain to a certain extent and how that can improve their quality of life. Yeah. So I hope that summarizes, and you can hear my excitement in the tone, in my time for the year of the hearable. There’s so many things going on in this space, but I really do think that hearing care, hearing health will be really pivotal in regards to an ecosystem.

Kat Penno:

I’m not sure how that would look. And I think you would agree with me on this and I’d be interested to hear your insights about Apple, for example, that they’ve been really smart with having the wearable watch with the sound level meter built into it, their iPods pros and all their hearing combinations that they’re putting into it, bringing their third-party apps to monitor hearing, and then having the health data center on their phones as well. So that’s building an ecosystem and I see more of that. I can envision more of that happening in this space with other tech companies coming in.

Dave Kemp:

Yeah, I think that that’s going to be one of the biggest question marks or it’s going to be really interesting to watch this unfold because on one hand you have the big box retailers that are not like at Costco where Costco is, they’re obviously very immersed in this channel and they’ve very clearly carved out a niche for themselves selling hearing aids. But I look at a company like Best Buy and I wonder what does their offering eventually look like? Because clearly one of the ways that they need to differentiate away from say Amazon is the in store experience. And I’ve always thought that not necessarily hearing aids, but I think something more like new Hara would be a really interesting in that type of product category where there is a little bit more of a sophistication.

Dave Kemp:

Yes, it can be just directly out of the box, but like what? Is it just going to be a Best Buy representative? Or is there more of a… Is it an opportunity for the world of audiology to make inroads with companies like a Best Buy so that their staff is trained on this in a more well-versed manner. You could say the same thing with Apple. I don’t know ultimately what Apple’s plans are. I don’t know if they’re looking to get into the hearing health market in a serious way, or if it’s more or less enabling the consumer products like iPods to have semblance of hearing technology embedded inside of it. And that more or less leads to being a gateway to more sophisticated solutions.

Dave Kemp:

So I don’t know what these major retailers are. I think that they have their own incentives for why they wouldn’t necessarily want to get into full blown hearing aid sales, but I could see there being more of an emphasis on especially as we’re seeing wearables as a broad category, like a whoop or the order ring, how these things are becoming more popular, this idea of having a real granular look at your data set, your physiology.

Dave Kemp:

I can see it translating over to, if there’s tons of different types of earbuds out there, maybe some of the on floor experience that you have with that wrap inside of Best Buy or the Apple Store goes beyond just here’s the product. Here you go. And you’re on your way. They’ll probably need to speak intelligently to these. And my question is, what does that experience look like? And is there an opportunity for the world of hearing health and the professionals that reside inside of it to be a liaison and look at this as like these people are probably going to go into this channel one way or another, and you have the opportunity to help to lead people to the fact that you can start here and then down the line, maybe it makes sense to come see a professional.

Dave Kemp:

So for me, I think that’s going to be one of the biggest question marks over the next few years is as these major retailers and manufacturers become a little bit… Are wading deeper and deeper into these waters, ultimately, what does that do to this industry? And what’s the impact that we as an industry can have to help shape that whole narrative?

Kat Penno:

Totally, just listening to you describe, I suppose, the potential that occur in these markets. It makes me super excited. And I think I should also add that as a professional who likes to try things out. I think that companies like Apple and you hear of their new partnership with HP, I think these guys are already ahead of the game with what they want to do. And again, I’m not a 100% sure where they want to go.

Kat Penno:

I’ve got an idea that they want to improve the user experience with the technology and some of the software that goes into it. But then what, so I definitely agree the retail aspect and the user experience there, and the customer experience there is going to look really different for all brands. And I definitely think there’s opportunities for hearing aid companies to, I suppose capitalize upon that and think about doing a co-lab or a co-located with these tech companies, so that you can share the information, the data you’ve got, because at the end of the day if we can maximize the data and the user experience for our clients, everybody wins because there’ll be [inaudible 00:21:47] somebody to some extent.

Kat Penno:

And then it’s an opportunity for the audiologists that you’re hearing healthcare professional to come in and educate and upskill and guide the client along their journey for life. Pretty much, it’s not just here, you’re hearing it really measurements see you in another six months or 12 months with the data that we can start to collect and analyze. We can have a better input over time. So, yeah, I’m just really looking forward to seeing how the hearing healthcare landscape evolves over the next five to seven years. I think if we’re happy to try new things out and even market ourselves to these big brands and say, “Hey, I know where I can add my value.” Then I think we’re going to do really well as professional in the long run.

Dave Kemp:

Yeah, I couldn’t agree more. I want to do an episode next year where we really break down this concept that you’ve laid out to me before. I don’t think we’ve ever fully fleshed it out about this idea of data health coaches and how that concept applies to hearing health professionals. Because the more I think about that, the more I’m really starting to buy into this idea, and it would make sense too, it ties into the whole narrative of these are your patients for life. And what does that relationship look like? It’s not something that’s just transactional. I fit you with a hearing aid and I fit you to the real ear measurements. That’s good, that’s important. But I think that in terms of where your real value I think will lie across the future is going to be in the true, this is a journey, this is a lifelong thing, and we’re going to guide you.

Dave Kemp:

And that might mean that it’s going to be through different types of solutions along the way, different devices and the evolution of these devices and keeping them abreast with all of the different functionality. We are really at the just surface level of what I think these wearable devices are going to be capable of. And so I think that there’s going to be a tremendous opportunity for all types of medical professionals to be a guide as to what that device is capturing and the data sets that are being created, that I’m not sure if just like the patient will be able to really interpret in a meaningful way. Maybe that will be part of the big opportunity for professionals is to help to really break down what’s going on, what they’re looking at. And so I think that would make for an awesome episode for you and I to do in 2021.

Kat Penno:

Totally. And on that front also one on service deliveries and how that’s changing in our landscape, but the greater health care landscape as well. I think there’s some really interesting things happening, it would be awesome to get a third and fourth guest on to discuss their points of views in this areas as well.

Dave Kemp:

Love it. Definitely got to do it. Well, Kat, thank you so much for joining me. Thanks for sharing your thoughts. Thanks for being on the podcast. I look forward to continuing our conversations in 2021.

Kat Penno:

Awesome. Thank you so much for your time. Hope you have a good career, right. And I look forward to 2021 with you.

Dave Kemp:

Cheers. Okay, cool. So we got Nick Reed here, Nick, you were on episode 42 back in August. We had an awesome conversation talking about some of the great work that you all are doing at Johns Hopkins, in the epidemiology department, under Franklin, the achieved trial, I continue to think is one of the most important areas of research as it pertains to really the hearing healthcare industry in general. So definitely go take a listen to that. If you’re at all interested in this speaking your interest, but wanted to bring you on Nick as we approach 2021, and just get a sense from you. What are the things that you’re excited about heading into next year? What are some things that we should have keep an eye on and as it relates to being on your radar?

Nick Reed:

Sure. Well, thanks for having me back on. August feels like a lifetime ago, in this pandemic world. I guess, going into 2021, for me, what I’m personally most excited about actually is the potential for the

FDA to release the over-the-counter hearing aid regulations. I think that that is such a first step game changer that puts a lot of pressure on the entire marketplace to start changing delivery models, start perhaps changing aspects of costs, and really how we actually define those costs whether it’s bundled models or unbundled models. I think it’s just sort of a real shakeup and I personally believe the hearing industry has already been shooken up just by the prospect of it. I’m just of the ilk that once it becomes reality we might see even more start to change and I think that’s very exciting for audiology. I think it also adds a lot of awareness to audiology when the FDA makes this big shakeup and then perhaps new companies enter the market. So I think that’s tops for me.

Nick Reed:

I’m also cautiously optimistic about the idea of Medicare making real inroads into hearing coverage. And I know that there’s no real reason for me to be optimistic necessarily, but there’s been a lot of bills lately that have been out there. Our team has built out part of our website to build fact sheets and policy sheets and have started actively engaging various stakeholders in Congress to think about this. And I also just think that we’re starting to reach perhaps a peak. I always thought that that peak would come after the ACHIEVE trial was over, but I just feel like so many people have an interest in hearing, hearing care, and the research that’s come out lately and sort of the explosion of public health hearing research, because our team does it but the truth is all over the world I think you’re seeing more and more of it. And I think you’re seeing stronger interests globally in funding hearing research.

Nick Reed:

And you can look to the NIDCD here. You can look to the recent announcement in Australia that was led by the NAL group, I believe, where they’ve got the government to commit to something like $30 million Australian for hearing research. And I think that that adds a snowball effect and we might see, particularly in a more liberal controlled Congress, a liberal White House, I don’t know what’s going to happen with the Senate, but you may see actual expansion of Medicare and all signs would point to hearing being included in that.

Nick Reed:

I like to point back to what seems, again, like a lifetime ago but it’s only, I think, six months or so ago when during the Democratic primaries they were debating Medicare expansion and you heard hearing being included in the expansion. And I think that’s a really, really important sign that we’re seeing on the biggest stage, hearing being a part of the conversation of the expansion. So I don’t know, I’m super excited about seeing what’s to come in 2021. I think there’s potential for another major sort of earth shattering event for audiology. I don’t mean earth shattering in a negative way. I know it’s got a negative connotation. I think it’s a good thing.

Dave Kemp:

Yeah, no, I agree. I think that there are a lot of signs pointing to that and I think it’s interesting, kind of the theme of all three of those things is just more accessibility to devices and access to hearing solutions which ultimately, I think, is a big net positive. I think the more people that are exposed to the types of solutions that exist and I think it’s really important to point out how good some of these emerging solutions are that maybe are non-traditional devices or they’re coming from these non-traditional players in the space, I think that competition’s a really healthy thing and the more options that I think people have the better.

Dave Kemp:

And also the other thing that the more options whole equation does is I think it puts more demand on the professional because I think that as the market gets saturated with options, that increases the demand for somebody to help navigate those options. So that’s what gets me really excited about this idea that a whole lot more people are going to kind of join into this funnel and I think they’re going to be presented with a whole host of new options. So I think that those two things in tandem are really, really exciting. The more people that kind of start to partake in treating their hearing loss, obviously the better.

Nick Reed:

Yeah. I agree a hundred percent. It’s interesting for hearing care, right, and for people like you who are content creators in this area where we’ve been talking about OTC now for three years. The bill passed three years ago.

Dave Kemp:

Literally three years ago.

Nick Reed:

We are now at a point where we might actually see the effect of the bill because, I mean, it’s pretty crazy when you actually stop and think about it. Just the prospect of over the counter hearing care has already transformed the face of audiology, right?

Dave Kemp:

Yes.

Nick Reed:

I mean, if you think back to 10 years ago or even just five years ago, you did not see the same content at the major conferences, and now every single conference has a whole section of how do you unbundle, how do you market yourself? How do you think about OTC? How does that affect your business practice? We’re just seeing sort of a total transformation and I’m sure that people will always sort of be against it. And I also always point out to people, there will always be room for multiple models of care. You want to continue down the traditional bundled route? I actually think there are more than enough people out there who want that. They want to just pay something and hands-off for the rest of it.

Dave Kemp:

One hundred percent.

Nick Reed:

But I’m excited to see really what happens once we have a real defined area for OTC. On a personal level, I’m also just curious at what’s sort of taking so long? And a lot of people have speculated what it’s going to look like and now I’m starting to wonder if we’re all going to get sort of a major curve ball, and if there’s going to be something in there that we just weren’t expecting as a field. And that has really piqued my curiosity lately.

Dave Kemp:

Yeah, yeah. The other thing too I’ll say as it relates to you is, I’ve talked about this before, but going off of what you just said about the different type of content that’s been in the industry really over the last 10 years or so, a big focus on different delivery models and business models and what have you. But the other thing is just the prominence that hearing health is starting to take, I think, in more mainstream publications. And I would say a lot of that is a testament to a lot of the research that folks like you guys have been doing where it’s now being well understood that it’s way, way more severe and daunting than just the fact that you have this broad swath of people that might be declining in their ability to hear the world.

Dave Kemp:

I mean, there’s obviously all these comorbidities that are linked to it and I think that that’s ultimately been a big reason why there’s now, I think, a lot more attention to the need to treat at-scale hearing loss and avoid all of the just downstream problems that I think we would have if this just goes unchecked.

Nick Reed:

I can’t agree more. It’s interesting, a piece that I have sort of internally been talking about with our team for awhile is… And for your listeners, if someone else is in research and they want to do this, by all means please do it. I actually think an interesting piece would be to look at, just within the research literature, how many papers on a hearing topic, either as the exposure or the outcome even, have moved outside of the traditional audiology literature? And so what I mean is let’s actually tally up the gerontology, internal medicine, general public health, number of hearing loss papers over the past 10 years and I think you would see a exponential growth curve of papers just exploding outside of the traditional hearing literature.

Dave Kemp:

For sure.

Nick Reed:

And that’s not to say that the traditional hearing literature is bad or anything like that. I think it’s just amazing that we’ve reached a new audience. More people care than ever.

Dave Kemp:

I know. I think that would be a fascinating study because I think there’s two sides of it. I think there’s the academic side that you’re seeing the cross-pollination that you just mentioned there, but even on the technology side, I can attest 100% that I have seen more articles in the last two years talking about hearing aids and kind of marveling at just the kind of modern wonder that they are, being able to cram the level of technology more or less into such a small device. I think that there’s been a major shift over the last few years where it was something that it was just kind of this thing that was over in the corner and nobody really talked about it.

Dave Kemp:

Now with the emergence of consumer wearables and what have you, people I think are starting to recognize that this is actually the most sophisticated of them all. And I’ve just totally noticed a totally new shift in the way that people talk about the technology and I would imagine that it’s the same for a lot of the actual science that goes behind it around the medicine and everything that you mentioned there. Because it is, it’s something that it’s kind of reaching the broader psyche, I think, and that’s new in my opinion.

Nick Reed:

I think you’re absolutely right. A few years ago, the first time they did it, what always strikes me and I’m sure you’ve read these pieces because they’ve updated it at least two or three times by now, but when Wirecutter started doing hearing devices… Wirecutter is basically like a Consumer Reports except, I don’t know, more savvy, trending towards a different audience slightly. They also do a lot of hands-on stuff that they report on and when you see Wirecutter covering hearing devices, it really changes the attitude from hearing loss and hearing aids being this stuffy, I don’t know, somewhere in the medical field, stigma-related thing to this is just something that is part of everyday life and it can be targeted towards audiences of almost any age.

Nick Reed:

I don’t know, it really speaks to the way we view it and the way the public media or the popular media, even, covers it now so I think you’re absolutely right. It’s a real change and it’s exciting to see. It’s exciting to see the growth. I think it’s exciting to see what’s going to happen next because we’re all sitting here so excited and we’ve seen so many changes, but let’s totally be honest. If we get outside of our relatively small networks and you start talking to people, like you talk to your neighbors that don’t know anything about hearing and don’t do anything in this area, don’t care, they’re like, “What are you talking about?” There’s still this massively open area for us to expand into and start to see things.

Dave Kemp:

Yeah, and I think that that can actually be viewed as a really positive opportunity is that there’s a gigantic opportunity that’s still sitting out there that all of these folks that are interested in trying to capitalize on it in some way, shape or form, I think that opportunity exists. So I’m in agreement with you. I think that this kind of new broader awareness of what exists and what’s possible in combination to some of the different accessibility improvements that I think are going happen over the next year or so are definitely really exciting.

Dave Kemp:

So, Nick, thanks so much for coming on and joining me this year on the podcast. Definitely need to get you back on in 2021 to catch up and just continue the conversation.

Dave Kemp:

Okay. So we’ve got Geoff Cooling here. Geoff was on the sixth episode, actually one of my all time favorite episodes, A Tsunami of Change Heading Toward Hearing Healthcare. You were also on the conversation that I had with Giles Tongue of ChatableApps So you’ve been on twice. You’re one of the contributing editors at Hearing Aid Know, so one of the big publications in the industry but I just think that you’re very, very well versed in hearing technology, hearing healthcare as a whole. Always really appreciate your perspective and your opinion so wanted to make sure I got yours. So as we head into 2021, Geoff, what are the things that stand out to you that you’re looking forward to, the things that are kind of on your radar heading into next year?

Geoff Cooling:

Hi Dave, thanks for having me on again. So I think for me in 2021, first of all, I think I’m just glad to see the end of 2020, and I think many of us will be. When it comes to the industry as well as the technology, I think the big thing that I’m looking forward to in 2021 is Bluetooth LE Audio, the arrival of that in a more widespread manner. And I’m really interested in seeing what the hearing aid manufacturers do with Bluetooth LE Audio. But on top of that I’m actually fascinated what outside manufacturers outside the industry or associate manufacturers with our industry, what they might do.

Geoff Cooling:

I recently did a review on a device called a Sound Selector. It’s a remote microphone made by a company called Nuance Hearing. They’re an Israeli company and they worked actually with Starkey to produce the Starkey table mic that was introduced for the Livio Edge. And these guys know an awful lot about signal process and they know an awful lot about microphones so they’ve designed this device and I really liked it. It was, as well as an ideal device for somebody with a milder hearing loss who wants a situational device, so they’ve aimed it kind of at the education sector but I think it’d be an ideal tool for consumers.

Geoff Cooling:

You use it at the moment with a set of headphones and it’s pretty cheap. I think it works out at like it’s no more than $300 anyway, and I think that device coupled with Bluetooth LE Audio would really be a ground shaker because it works exceptionally well. I was really, really impressed with how well it works and Bluetooth LE Audio added to it would allow it to do that and stream its audio to any hearing aid that was equipped with Bluetooth LE Audio. And I think that there’s a load of, I would say, possibilities delivered by that ability and I’d imagine Nuance Hearing probably isn’t the only people thinking about it, or even thinking about how they may integrate, who knows, marketing messages with Bluetooth LE Audio transmission and that fascinates me. I think that’s going to be really, really, exciting probably over the next couple of years, but we’re going to see the start of it in the next year, I would imagine.

Geoff Cooling:

So, yeah, I’m really interested in that and I think for consumers I think it’s just fantastic because can you imagine a hearing aid user walking into a museum somewhere and having the ability to simply pick up the museum audio as they move from exhibit to exhibit. Bluetooth LE Audio transmission gives you that ability. It gives the ability for countless devices to be connected to the one transmission in an easy simplistic way. So yeah, that kind of has me stoked.

Dave Kemp:

I think that just going off of that point, obviously this industry’s really well acquainted with telecoils and telecoils are great, but the problem that telecoils have always run into is that you’re only looking at a really small subset of potential users. Granted they’re the users that need it the most, but it’s designed for folks that more or less are wearing a t-coil enabled device which tends to be a hearing aid. So with Bluetooth LE Audio and this broadcast capability, you can cater that to the masses. So that type of functionality that you’re describing, that could appeal to the hundred million pairs of AirPods that are out there and, oh, by the way, folks with hearing aids that are operating on Bluetooth LE Audio get to take advantage of that as well.

Dave Kemp:

So again, it’s another one of these examples where these mainstream functionality and features that are built out on the incentive of the consumers, more or less, the mainstream users, it’s another example of how I think hearing aid wearers are going to get to really benefit by reaping a lot of these byproducts. They’re not necessarily designed specifically for them, but they’re the subset of users that get the most, I think, out of those features. And so I fully agree with you. I think that’s what’s so exciting about Bluetooth audio is that we’re going to see a lot of amazing capabilities that are built for everybody that has Bluetooth LE Audio earbuds that, oh, by the way, the hearing aid wearers get to take advantage of. There’s a lot of exciting things coming in that vein, I think.

Geoff Cooling:

Yeah, and you touched on a really good point there about LE Audio it’s much wider, much more mainstream than just hearing aid users. I mean, that’s a really good thing because it’s a normalization of something that hearing aid users use and there’s real psychological implications to that in that this is a normalization, it’s a normal process.

Dave Kemp:

One hundred per cent.

Geoff Cooling:

It makes us just like them, kind of thing. And I think that that’s really important. Unfortunately, we still live in an era where there seems to be some stigma in relation to the use of hearing aids. People aren’t adopting them, and of course cash, finance, money does play a part in that, right?

Dave Kemp:

Yep.

Geoff Cooling:

We do know that stigma, discretion, et cetera, et cetera, also play a psychological part in the impediment, I suppose, to adoption of devices that will help. Funnily enough, that brings me to the second thing I’m really stoked about. So I’ve been doing a bit of work recently on kind of understanding adoption rates and the length of time from awareness to action with hearing loss. And while I was doing that, I was doing some research on consumers as well, and I had a bit of a light bulb moment when I was undertaking that research and it made me think differently about how we communicate to consumers. Up to now, even now, so our consumer communication has changed over the last few years. Instead of talking about features we should be talking about solutions, solutions to problems.

Geoff Cooling:

And I would have been, “Yeah, yeah, yeah, solutions to problems,” because you’re kind of touching the consumer where they live when you talk about a solution to a problem, right? But I was thinking about that and I suppose at a higher level than just a solution to a problem, what are consumers looking for? So what are older consumers looking for now? Our prospect consumers have changed dramatically. They want to stay healthy, they want to stay active, they want to stay fit for longer. And one of the papers I read it said senior consumers, which they put at 50 plus which actually made a lot of sense to me as well and I’ll come back to that in a moment. But they said that senior consumers, what they want is to break the mold of getting old and what they’re particularly interested in is kind of like anti-aging.

Dave Kemp:

Yes.

Geoff Cooling:

So within that concept of anti-aging there’s everything. There’s buying a pedal bike and cycling 45 kilometers, there’s going back to playing squash, there’s eating healthy, there’s lots of different things. But it was that that kind of really struck me and I though to myself, “Well, listen, we know as an industry that hearing loss contributes to getting old or hearing loss contributes to at least the conceptual ideation around getting old.” Somebody who has hearing loss who hasn’t treated their hearing loss, they basically become the grumpy old men that we all remember, right? Or the grumpy old women, right?

Geoff Cooling:

Social isolation leads to lots of different things and also has an effect on general health but more than that, in the last 10 or 15 years we’ve got a huge amount of evidence and we’re gathering even more in relation to untreated hearing loss and cognitive decline and the correlation between them, the link between them. I was thinking to myself these are the two big things that our modern senior consumer is basically fighting against. They don’t want to look old. They don’t want to be old. They don’t want all those problems. They understand that those are the issues as we age but they want to stave them off as much as possible. And it struck me just like that, one of those moments. You know, Jesus, hearing aids are anti-aging devices.

Dave Kemp:

Yes, I love that.

Geoff Cooling:

I thought about this, I thought to myself, I mean, let’s not talk about solutions for old people, because even though we are talking about solutions to their problems, the terms of reference that the wider population see as solutions for problems for old people, right?

Dave Kemp:

Yeah.

Geoff Cooling:

So let’s talk about keeping them young.

Dave Kemp:

Yeah.

Geoff Cooling:

Do you know? Let’s talk about keeping them young and it’s not hyperbole because we’ve a mounting wave of scientific evidence that in essence hearing aids keep you young in that context, right? We know that they facilitate active and healthy social lives. We know that active, healthy, social lives will, indeed, help with your general health moving forward. We also believe that they at least retard cognitive decline to a more normalized level, right? So, yeah, it really struck me like. So, what we’re going to do as well, what we’ve talked about, myself and Steve, the other guy who runs Hearing Aid Know, what we’ve talked about is changing how we communicate with our readers. And I suppose how we pitch hearing aids or how we pitch the idea of hearing aids, in an effort to, basically, test out this [inaudible 00:53:00]. So, we’re really going to start talking about hearing aids as devices to keep you young, right? In that, we’ll also use imagery, copy, based around that concept and that idea.

Geoff Cooling:

And basically what we want to do is test it and see what type of results we get from it, what’s the engagement from it, et cetera, et cetera. If it has an effect on people moving from a position of awareness to action in a slightly shorter manner. So, listen, I don’t for one minute think it’s the panacea to the penetration rate, the abysmal penetration rate that we have, right? But I think it could be part of it, and I think, completely reframing what hearing aids are, and that journey with hearing aids, can only be a good thing. And we’re not conning on anybody. As I said, this isn’t hyperbole, we’re not conning anybody.

Geoff Cooling:

We won’t and never would use any dubious or spurious data to support our arguments. So yeah, we only see that as a good thing. So yeah, I’m looking forward to that. We’re going to start testing that over the next three to six months, and hopefully be ready to talk about our results or how we feel about it. We did a brief post on Facebook just with this concept that hearing aids aren’t about getting old, hearing aids are all about staying young. And believe it or not, the engagement we got with that post was pretty impressive, and we hadn’t even really put much thought into it. It was shortly after I had the light bulb moment, I just said, “Listen, let’s throw this up and see what happens. See what people think.” And-

Dave Kemp:

Yeah. I love this. I think it’s so interesting. The first thing that comes to mind here is, one of the prescribed methods to ward off cognitive decline is to keep your mind really active, right? Do Sudokus, do crossword puzzles, in really the same vein, this is what I think you’re describing, is that this is something that can help to preserve your youth and your cognitive functions for as long as possible. And I do think that just that subtle difference of, “his is for old people, as opposed to this can help you to preserve your…” It’s almost like a pseudo fountain of youth, in a way. And you combine that with your first point around the whole notion that a lot of the mainstream functionality that’s going to come on the back of LE audio, and the combination of that being geared around this massive explosion in proliferation of devices like AirPods.

Dave Kemp:

So, I think what you’re ultimately getting to is that we’re entering into an era here very, very soon where the whole notion of a hearing aid is going to start to flip, because it’s going to be way, way more functional. It’s going to be capable of all kinds of new functionality, in tandem with the behavioral shift of “Well, everybody else has things that they’re wearing in their ears. And what does it matter if I prefer to listen to my podcasts in these kind of invisible devices, as opposed to the guy over there that’s wearing AirPods? So, you can’t discredit the behavioral change that’s going to happen. That’s already underway right now. Again, a hundred million pairs of AirPods have been sold, that is so large, relative to how many hearing aids are sold annually. This market is gigantic. And I think it’s going to just really shift the whole mentality of everything. And I love this idea of, as an industry rallying around this new messaging that these devices aren’t intended for you when you’re old, these are devices that you age with, and it helps to preserve all of that cognitive functionality, and really the youth that that’s associated with. I think that’s brilliant.

Geoff Cooling:

Yeah. And you’re dead right about the AirPods and stuff. What’s really happened is there’s been a normalization, or a more rapid normalization of ear level devices over the last few years, right? And, trust Apple, the usual, but Apple, with their AirPods and their AirPods Pro, have really driven that. So, it’s much more normal to have something in your ears, or to walk by somebody with something in their ears, right? And our experiences now or our experiences with something in our ears, electronic devices in our ears, is become a much more normal experience. Whereas before, one of the things I used to say to my new patients was, “This is going to feel a bit strange in your ear. You’re not used to having anything in your ear.” And that was the truth because they weren’t, they never, for any length of time really, wore anything in their ear. Older generation, the nearest they got to it, more often than not, was a set of headphones, a headset.

Geoff Cooling:

So, with everything that’s gone on, technical advancement within the last few years, Apple driving their AirPods, all of these things, it’s really begun to kind of normalize ear level devices. And again, I think that helps us move forward with this idea that these devices are all about staying young. Anything that normalizes an ear level device has to be seen as a good thing for us, has to be seen as a good thing for consumers, because it’s not strange. When they come to it or they come to have to use it, it’s not strange. And I think that’s, part of the stigma around it is that it’s strange. It makes me different, right? And it no longer does.

Dave Kemp:

Right.

Geoff Cooling:

Half the population is walking around with these funny white things hanging out of their ears.

Dave Kemp:

Exactly, that’s a huge point then.

Geoff Cooling:

Yeah, it no longer makes it different, it no longer makes you stand out for the wrong reasons, which I really don’t understand. But then again, I’m not good at that.

Dave Kemp:

I love it. Jeff, thank you so much. I think these are brilliant insights and I’m in full agreement with you. I think that this whole notion that you’ve laid out here is definitely something to keep an eye on. So, thank you for coming on the podcast this year. I look forward to having you back on in 2021.

Geoff Cooling:

No worries, Dave. Thanks again for inviting me.

Dave Kemp:

Absolutely. All right. So, we got Kim Cavitt here. Kim was on episode 47 with Karl Strom, always appreciate Kim’s perspective. That was a really good episode, having Kim’s audiology perspective as an audiologist, and then Karl, as somebody that is a media person who has the hearing review and has covered the industry for a long time. So, that was an excellent episode. Definitely encourage anybody to go back and listen to that one, but wanted to bring Kim on to get her perspective, as we head into 2021. What are the things that stand out in your mind that you’re excited about heading into next year?

Kim Cavitt:

Well, I’m excited that I hopefully will finally get to see FDA proposed rule on over-the-counter hearing aids. I’m really excited to finally see that. Excited to see what happens with the Biden administration, and what potential inroads audiologists might be able to have, in terms of the Medicare Audiology Access and Services Act. Can any provision of that move? What will happen with H.R.3, which was passed by the US house and this Congress, which would be Medicare coverage for hearing aids. Will that have any movement in a new administration? And honestly, to see what happens as more and more States start moving to these insurance mandate type provisions. And we start seeing more and more third party coverage or benefits around hearing aids and the focus that goes with that.

Dave Kemp:

Yeah, it’s interesting. I actually had Nick Reed on and he said the same thing around Medicare, and with this new administration potentially expanding it into covering hearing loss and covering the benefits associated with that. So, how do you see that working? In your mind, what does this look like, if it does play out the way that you think it might?

Kim Cavitt:

You know what? Usually, I am not one to punt a question, but given there’s so many caveats in the world of… Some of it would be, first, in some ways, reflective of what the OTC [rugs 01:03:25] look like, because Medicare then might turn around and not cover anything from mild to moderate. And then, because H.R.3, which was moderate to severe, not moderate to profound, you just don’t know what that could look like until, I think it’s like a building block, what does OTC, and then you would build a Medicare coverage in and around that. So, I don’t have a good crystal ball because this OTC has just been so punted for so long. But, I know that audiologists fear this to some degree. And I come from, maybe a little bit of a Pollyannish perspective, but not completely.

Kim Cavitt:

I feel that if we put consumers first, there’s always going to be space for us. We just have to think and practice differently. I mean, I think there’s so many opportunities for us, but audiologists have to practice to their fullest scope of practice, to the top of their license. And we have to focus on care. We’ve gotten so caught up in that our whole identity and our whole financial model is around a hearing aid, that I think we’ve lost sight about what makes us us. And hopefully this will give us the opportunity to kick it old school, because the reality is before we could dispense hearing aids in 1978, there were private practice audiologists, and audiologist was a very viable profession before. And I think we can be that again, we just have to change and evolve.

Dave Kemp:

So, going off of that, this idea of getting back to the roots of audiology and being very service-oriented, not as much dependent on device sales, I know in the conversation that we had on the podcast last time, you really went through a lot of this, but what are some of the obvious areas that you think that are a little bit being under emphasized, I guess, across the board, in terms of ways that you could quickly reimburse yourself or compensate for the device sales? Is it a broad scope around the evaluation side and just all kinds of different tests that you can run? Where is the gap, I guess, in terms of how you could compensate yourself in a way that maybe isn’t done to the full extent?

Kim Cavitt:

First thing is focus on the evidence and focus on the science, because science matters. And so, evidence-based delivery of tinnitus evaluation and management, of auditory processing evaluation and management, of vestibular evaluation and management, integrating the evaluation and management and monitoring and follow-up care around implantable devices, cognition, true science-based and screening of cognition. Pediatrics, there’s still not enough, there’s a lot of underserved communities for kids, families having to travel two and three hours in order to get the true care of an audiologist because they can’t find anybody in their community that will see a kid, communication functional needs assessments, and truly looking at not just hearing the communication and function, concierge care, hearing prevention. My goodness, we have failed so miserably at prevention. So, hearing loss prevention and hearing conservation programs. There’s a lot out there. We’ve just been so, that it’s all about this device that we just have… I would like to get to a point that we focus so much on prevention that we reduce the amount of people who need hearing.

Dave Kemp:

Right. Yeah. That’s a good point. Because I think that, for me, I’m always trying to understand where some of these opportunities are in terms of all of the different hard science that you can do and just different ways that you can get reimbursed, either by the government or if you are going to do more of an unbundled model, like what did these tests look like? Because I feel like the patient, in the consumer’s mind, it’s very straight forward in terms of their preconceived conception of this. It’s, “I have a hearing loss and I need to come in and maybe there’s a set of tests that I’m going to take. And then ultimately the end result is going to be, I’m going to get fit to a device.” And it just seems like there isn’t a lot of a broad understanding of the full scope of those audiology services that can be incorporated. And I do feel like part of the challenge is that you’re combating this notion of what that experience is going to look like, that has more or less developed over the course of 30, 40 years. However long that this notion of what that experience looks like, you’re going up against that.

Kim Cavitt:

Well then, we need to show them what that experience was supposed to look like. And there’s audiologists who always have, there’s practices out there that… You’re from St. Louis, do you think Dr. [Valensay 01:08:58] ever delivered anything but the gold standard, a single time in his life? No. And so, think about people like Mike, and what he brought to the patient care and delivery model, that it was about evidence-based evaluation. And the hearing aid was a tool in the toolbox. And people who do AR, there’s practices all over the country, that never let go of the AR, for thinking of John Greer, Cincinnati or Joe [Montonya 01:09:31] at Cornell, [Cindy Compton-Conley 00:17:31], people who really held onto those things. Those practices are still out there. We just have to follow what the evidence says.

Kim Cavitt:

And there wasn’t a market tracker or [Kotkin 01:09:44] study, whoever show ever, that didn’t show the value of auditory rehabilitation. And so, we lost sight. That’s what audiology was founded upon. Carhart was a rehabilitationist. There was a speech pathologist who moved into this rehabilitating of hearing loss after World War II. That’s what we need to get back to, what makes us [inaudible 00:01:10:09], really evaluate people. And that the outcome isn’t always just a hearing aid, or isn’t a hearing aid at all, because maybe they have that hidden hearing loss. Maybe they need an implant. Maybe they need an accessory, but to think around, to be more comprehensive, that’s what I did about it because it’s, I always see opportunities because the people who are doing it have had a very successful 2020, in the midst of COVID.

Dave Kemp:

Yeah, no, I think that’s really well said. I think this notion of a more comprehensive service offering is really compelling. And I think that’s ultimately the most defensible way to stand apart from all of these emerging things that are coming about, new technology, new delivery models, online hearing aids, you name it, whatever it might be. I feel like these are the kinds of things that are deeply rooted in the education, the science, and the expertise that are, more or less, really, really hard to “disrupt.”

Kim Cavitt:

Correct. I totally agree with you. I mean, I just see as exciting. I think the technology, I think the self-assessment is exciting. I think some of the hearables and some of the capacities, some of the [inaudible 01:11:32] have to look at beyond just amplification, what it can bring to your life and your lifestyle is exciting. I think tele-health is super exciting and tele-audiology. That is one of the silver linings of COVID, it’s really forced us to try to think of a different delivery model. I think Concierge, and really being that patient-centric kind of delivery that’s on the patient’s terms. Imagine what you can do if you deliver someone’s hearing aid in the home that you could look at their listening environments, you could look at their TV, you could look again beyond just what the device, what the hearing aid itself does. You could look at falls risk, all while you’re there. There’re just so, again, exciting avenues. We just have to get out of our nine-to-five, booth based, manufacturer driven box.

Dave Kemp:

Yeah. It’s really interesting. I can’t remember who it was, I just had a conversation with recently, where a lot of it was around the same idea, where it’s more like giving… Obviously, you’re on a cost basis. You have to make sure that you’re breaking even, and you’re making a little bit of profit, so that you’re obviously a business, but I think this idea of having these patient relationships that are really long lasting, and it really is a rehabilitative thing where you’re more like a coach, I think.

Dave Kemp:

You’re helping to guide them through like, “Here is the way that we’re going to work together through navigating all these different things.” And that whole thing, it changes the whole relationship from being something that’s transactional. “I come and I see you that one time, you fit me with a hearing aid, and then maybe it’s a bundled offering, so I get to come and do a couple of followup things.” I think we’ve defined what you can bill for those services.

Dave Kemp:

But I feel like what isn’t fully fleshed out is the more relationship patient journey for a long time, where it might be something where you’re giving 10 times the amount of attention to that single person, but you’re being compensated along the way, because it’s a much more relationship driven type thing. And so you go from something maybe that is more relationship driven and you have your set patients in that category and you move away from the transactional one.

Dave Kemp:

And that seems like it’s just really, it just seems like it’s sustainable for the long-term because I just think you just acquire more and more people. It’s not as if it’s like, “You treat this and then it goes away.” A lot of these people are living with this for life. So, clearly they’re going to want to lean on you and defer to you for a lot of this to say like, “You’re the expert, help.” And there’s opportunities all along the way.

Kim Cavitt:

Yeah. When I saw patients, I never saw it as a transaction. It was always about the relationship and about my role in their hearing journey or their balance journey, whatever, or both, whatever that is. And again, you can be replaced in a transactional model, can’t be replaced in a relationship driven model, where maybe you refer the patient to Costco, you evaluate them and you refer them to Costco. Maybe you encourage them to get an implant and not get a hearing aid, even if you lose them, but you were part of that, of their decision, their journey. And you’re the expert then, and it’s not about selling something because the selling part can be replaced.

Dave Kemp:

Right.

Kim Cavitt:

And always, the thing is, what can we do that can’t be done, or can’t be done well, at a big box retailer or can’t be done online. And that’s where we really need to focus. And again, lots of opportunities, but we have to get out of this, again, manufacturer driven mindset.

Dave Kemp:

Device sales.

Kim Cavitt:

Device sales.

Dave Kemp:

Yeah. I agree. Well, I think that the point there, the really important point that you just made is this idea that, “Look at the things that you do that can be replaced, and then think about what’s much harder to replace.” I’m not an audiologist, I’m not a hearing professional. I’m more of just the third party, that’s looking at this and I’m trying to empathize with them and think like, “What is it like in their shoes?” And the thing that I always come back to is, the hardest thing to disrupt is going to be your expertise and your hard earned education and your knowledge about all this. And so, I feel as if the most sure-fire way to be sustainable into the future is figure out a way to monetize that. And device sales currently, a lot of avenues haven’t existed, that’s changing, there’s so many new ways that people can access these devices.

Dave Kemp:

And so, in the old age, you would be a one of a handful of options. And so, a lot of people would just sort of choose you because that was one of the only things they had. And I feel like now, in a world with tons of different options, you have a different value proposition. And it’s actually a value proposition that, I think, is going to be really exciting to a lot of people. Because I think a lot of people lament the idea that they are perceived as a salesperson, as opposed to somebody that is in the business of helping people and treating them. And like you said, guiding them, it might not even be something where you’re actually selling devices per se. You’re more or less walking them through, “Here are your options. And then let’s meet again.” And you know that that’s going to be your patient for the next 10, 15, 20 years. And along the way, you’re going to get compensated in some manner, but it’s going to be way more tied to your expertise. And it’s going to be tied to the value that you provide through that.

Kim Cavitt:

And compassion. That whole compassionate care, the big box and online retailers, that’s not part of their equation. That needs to be part of our equation. And people ask me all the time, “What do you think the future of audiology is?” I’m like, “The practice of audiology.” That’s really my answer, is to practice audiology. And if we do that, we have, again, a very, very bright future. But if we let ourselves continue to go down this path of all about the sale of a bundled device, those types of practices are going to struggle. You’re really going to have to kind of differentiate yourself in the marketplace and really show what am I bringing to this person’s journey. Again, integrating new technologies and being open to, “Hey, you know what, patient A? After doing a communication function needs assessment, you would be really well suited with OTC.”

Dave Kemp:

Right.

Kim Cavitt:

“That’s the best option for you.” I’ve been doing a Costco journey with my next door neighbor. Again, people are going to judge. I presented to her every numerable option. She had been in the Bose study, so she had worn Bose products before. I looked at Costco, she wanted something unbundled. I gave her a local unbundled audiology option.

Kim Cavitt:

She could have been in another study that’s happening here about comparing provider driven delivery versus direct to consumer delivery. She chose the Costco delivery and it’s funny, we just went to her fourth visit and they told her that they’re very close to turning the hearing aid into an earplug because she’s turned it down so low. The moral of the story is this is a person who was always the perfect OTC candidate. She loves her Bose earphones, they’re just clunky to wear all the time.

Kim Cavitt:

But she’s still a perfect OTC candidate, that’s what she was meant to be. I think I’ve almost convinced her to return the Costco hearing aids because I’m like, “I don’t understand why we still have these.” I think she needs an OTC, because that’s what she needs. She’s the perfect example of she doesn’t have a $3,000 problem, she has a $300 one. That’s what we need to be open to, that everybody doesn’t have a $3,000 problem, and everybody doesn’t need a top of line hearing aid, and everybody doesn’t need… What does the person in front of you need?

Dave Kemp:

Right.

Kim Cavitt:

It might be AR, and it might be TV, it might be an implant, it might be an OTC, but what is that? We need to monetize our expertise to get them there and not just monetize the sale of the device.

Dave Kemp:

Love it, well said. I completely agree with you and I think you’re right that this next year, and really moving forward, I mean, you have to imagine the FDA is going to eventually finalize the OTC guidelines. Assuming that it is going to be next year, it definitely will make an impact. I think that it’s to be really interesting to watch this all unfold, because I think if nothing else, the market’s going to continue to become saturated with more and more options, creating more complexity, generating more demand for expertise. In kind of a roundabout way, I think it actually drives the demand for audiology up and-

Kim Cavitt:

I think so too. Also all of the press and awareness around the value of hearing is just going to drive it up. It’s how we respond is how we’ll be perceived.

Dave Kemp:

Totally.

Kim Cavitt:

So if we respond that, “Hey, look, we welcome this. We want more access,” then we have great opportunities. But if we become responding like we have so far in a lot of instances with sour grapes or against it, how is this going to play out? If you’ve ever read any books from Clayton Christiansen, who got hurt the most from fighting Uber, it was taxis.

Dave Kemp:

Right.

Kim Cavitt:

Rather than embracing how could they have-

Dave Kemp:

They could have created Uber.

Kim Cavitt:

How could they have integrated in to that model, no, they fought it, and there were the big loser.

Dave Kemp:

Yes, completely agree. Well, Kim, this has been awesome. Always appreciate your perspective.

Kim Cavitt:

It’s nice to talk to you too. I love myself some [crosstalk 01:22:16].

Dave Kemp:

Very, very interesting. Well, awesome. Well, thank you so much. I look forward to having you on the podcast again next year.

Kim Cavitt:

Great, happy 2021 everyone.

Dave Kemp:

Happy 2021. Okay, last but not least, we’ve got Dr. Cliff Olson, Cliff AUD. Thanks for coming on the podcast this year. I had you on episode 43 with Andy Bellavia and we did an awesome discussion around, it was titled The Seminal Moment in Hearing Aid Technology. I just really look back on that conversation as it being a really good reference point of just how dramatic the technology continues to advance.

Dave Kemp:

You obviously highlight a lot of this type of stuff on your YouTube channel, so I feel like you’re as well versed as anyone, but aside from the pandemic, it definitely seems like 2020 and 2019 were really setting the stage for I think some explosive growth in all the different facets of the market in terms of the severity. Mild market all the way up to the severe market, there’s just a lot to be excited about. As we head into 2021, I wanted to get your take. What are the things on your mind right now heading into the new year that get you excited as it relates to this industry?

Cliff Olson:

Yeah, yeah. Thanks for having me again. 2020 was a weird year. I mean, I have been in this profession for a really long time, but from what I’m used to, 2020, I think for anybody in any profession, would have been weird with how everything kind of shook out. I would say though, and this is probably echoing a lot of other individuals that you’ve talked to is that currently, here at the end of 2020, things have recovered to a large degree, almost to the point where, except for us sanitizing to a really obnoxious degree inside of the clinic, wearing face masks and face coverings inside of the clinic, you wouldn’t be able to tell that we are inside of a pandemic right now versus any other time that we’re practicing.

Cliff Olson:

It’s just kind of crazy to see people adapt. It’s not just audiology. I mean, every profession, every individual, they adapt to the circumstances that they’re presented with and you either sink or swim. You either figure it out or you don’t. If you don’t figure it out, then in relation to our profession, you go away. That’s just how it works out. It’s unfortunate to look at it that way, but it is a sink or swim world that we live in.

Cliff Olson:

I think by and large, a lot of individuals I’ve talked to, a lot of them have been able to swim throughout this time period, which is exciting. When it comes to 2021, I mean, I think that we’re going to be kind of back on track with what we thought we were going to see in 2020. I know that when I did my new year’s video… Each year, I try to do a new year’s video and say what are the things that I think are going to come down the pipeline the next year. One of the things that I was talking about for 2020 was over the counter hearing aids.

Cliff Olson:

Really thought that was going to come in 2020. To be honest with you, I’m not sure that the pandemic specifically is what prevented that from happening. I mean, it almost seems whether the pandemic was going on or not, that that was just kind of getting delayed. The weirdest thing is, is that we have not really even been seeing any updates from that to any degree, so we really don’t know where they’re at with it. My expectations for 2021 are kind of tampered down a little bit on the OTC route.

Cliff Olson:

I don’t know for sure if we’re going to see OTC come out and be available to consumers, because once they announced the guidelines, then there’s a six month comment period, and then after they make those adjustments if they’re going to make any adjustments, then it will become a category. Then, you have to have manufacturers respond to that. To be quite honest, I’m not sure even if it happened early in 2021, which I don’t think it will, I don’t think we’d see OTC coming out, but it is going to come out.

Cliff Olson:

It has to come out at some point, just [inaudible 01:26:42], right? That’s one thing. Then another thing for me, and this is something that’s just involving me, is that I have a new clinic that we are going to be opening up January 11th. I’m really excited about that. Right now, I have more stress in my life associated with getting this clinic up and running than I did with COVID going on. I wouldn’t wish this on my worst enemy, this whole process of opening up a new location.

Cliff Olson:

I think that it would be significantly easier doing it another time now that I have an understanding of what actually goes into it, but we’re just trying to finish up the finishing touches on the space. Then we have to get all of the patient base moved over, and getting used to coming to a new location, and all of that. That’ll be exciting for early on here in 2021. Maybe when we have this talk in a year from now, I can let you know [inaudible 01:27:38] or not, because right now, that is up in the air.

Cliff Olson:

As it relates to technology going forward, I think we’re not probably going to see any kind of hiccups in 2021. I mean, I still have manufacturers reaching out to me to review their products before they come to market. The technological advances are present, they’re still there, but the stuff that I review right now is stuff that was created and developed by engineers from several years ago. The question really will be when we get into 2022, 2023, what potential slow down would we have there because of what COVID did to potential research and developments and all of that?

Dave Kemp:

Yeah, that’s a good point.

Cliff Olson:

I know that manufacturers, there was a… If you look at the sales, at least in the United States, the sales of hearing aids took a massive dive for several months right when COVID was kind of getting going, and no one really knew what COVID was, and were afraid to go out and get treatment. It’s recovered a lot right now, but that little window likely led to a lot of layoffs in a lot of these companies that are developing tech. I’m not just talking these companies developing tech in the major hearing aid market.

Cliff Olson:

I’m talking about all of these potential companies that were kind of gearing up to create these OTC technologies. Did some of those kind of get pushed to the wayside? Did some of them go out of business? Because they were expecting to be able to come to market with something in 2020 and that just didn’t happen. It’ll be interesting to see, not just in 2021, but really going forward, what’s going to happen from a tech standpoint.

Cliff Olson:

As with anything, especially in the tech industry… I think tech, when you look at a lot of the different technology companies, they fared pretty well through this time period with being able to do things remotely. I mean, right now, you are in Missouri, I’m in Arizona. We’re still able to do things like this and this is through a tech platform that we’re able to do this. So it is incredibly resilient.

Cliff Olson:

Hopefully, we won’t see any slow down and maybe these manufacturers will play a little bit of catch up as we go here into 2021, if they did miss out on R&D time. I think that from a technological standpoint, that way, that we’ll probably recover and end up being okay and maybe see a little blip on the schedule for some of these companies with technology coming out, but not a massive one. The other thing that I would really, really, really like to see, and this kind of goes hand in hand with the OTC guidelines, is I think we need to have some kind of legal intervention with a lot of these amplifier companies that are out there that are making false claims about their products and the capabilities of their products.

Cliff Olson:

The attorney general in Arizona had issued a press release talking about the dangers and the risks from these companies who are selling these products online to consumers. The individuals who are buying them are thinking that they’re buying legitimate hearing aids and they’re not. They’re buying these products that are cheap knockoff products that are being touted as being as good or better than hearing aids sold by some of the major manufacturers out there.

Cliff Olson:

They are nowhere even near being able to have a conversation of being in the same conversation as some of these hearing aid manufacturer products. The thing that I don’t want to have happen is I don’t want consumers to be tricked by these companies and buying this technology that is technology from so many years ago, I probably wasn’t even alive of when this stuff was developed. I think that something needs to happen on a bigger scale to get rid of a lot of these companies that are out there because they are popping up everywhere.

Dave Kemp:

Right.

Cliff Olson:

If you’re trying to seek out legitimate information and legitimate technology online, you can’t even find it without stumbling across a million of these other companies that are just peddling their garbage and that’s a disservice to consumers. Now, I will say this. There are a lot of individuals who will listen to my statement that I just made and say, “Well Cliff, of course you don’t want us to purchase those types of products because you sell the good stuff in your clinic.”

Cliff Olson:

I have sponsors in the industry that are from the major manufacturers, so from a financial perspective, they look at me and say, “Well, no kidding you’re recommending that we stay away from those products because that’s bad for Dr. Cliff financially.” I can see their justification on that, but at the end of the day, all you have to do is order one of those products online. I suggest you don’t, but if you want to, you’d tell right away that the technology that’s going into a lot of these online hearing aid companies is nowhere even near as good as some of the major technologies out there.

Cliff Olson:

So until something happens from a legal standpoint, a lot of these companies that are selling these cheap amplifiers online are going to trick consumers, and then consumers are going to think that hearing treatment doesn’t work for them, and it is ultimately going to increase the pandemic that we have on our hand, but it’s not the COVID pandemic, it’s the pandemic that we have with hearing loss that’s been going on treated for years.

Dave Kemp:

Yeah, no, I think that was all really well said. You said a couple things there that really stood out in my mind. I think that this whole notion of sink or swim, this idea that this is a real defining moment, I think, for providers in general to differentiate themselves on the basis of value. One of the biggest themes right now that’s happening is that there are new access points. The unfortunate by-product of that is that a lot of people are now being exposed to shoddy devices. These things that appear to be something that they’re not. We’re going to have to really grapple with that as an industry.

Dave Kemp:

I do think that there’s an element of regulation and that there needs to be an intervention to some extent, but I think that there’s a huge onus on this whole idea of the professionals. I think this is part of the opportunity is reclaiming all of this into the idea that we are the experts as it relates to this whole type of offering. That’s, I think, where a lot of the value lies, is that it’s unfortunate that I think some people are going to get burned by thinking that they’re buying something that is marketed in a way that it isn’t, that it actually doesn’t perform that way.

Dave Kemp:

But I do think that it sort of ties into this overarching message, which is that you can’t be passive anymore. You can’t just think that people are going to come to you because they’re being bombarded with things online every day, Instagram, Facebook, all these highly targeted marketing channels that they have these very highly sophisticated methods of targeting you. I think that the most effective way to combat it is to do things like what you’re doing. I think you do a really good job of educating the patient on here is what’s going on. I actually spoke with D’Anne Rudden, who’s part of this episode.

Dave Kemp:

She said one of the things that she’s most excited about is that there are just like more and more professionals that are sort of getting into your territory of educating the patient. Starting YouTube channels, starting all of these different ways in which you can communicate this. I think this idea of being able to really position yourself as, “Look, this market’s only going to get more complex, there’s only going to be more options available to you. My job is to help to guide you through that.”

Dave Kemp:

I think that’s actually a really exciting proposition because that in itself sort of changes the notion between being somebody that’s more a business model that’s very tied to the device itself to something that’s more oriented around the service and the idea of, “We’re going to, maybe to start with, you are in the midst of the early onsets of this, and you don’t warrant a full hearing aid, and maybe I don’t even get compensated on the device, but you’re hiring me more or less to help to navigate you through this, to say let’s start you off with this entry level OTC type device or a hearable.”

Dave Kemp:

Then you establish that relationship and you guide them over time into whatever types of solutions meet their needs as time goes on. I fully agree with you and I really don’t know if… The whole way that OTC has been handled has shown me anything it’s that this isn’t a very high priority within the government and that I’m not sure if we should just be waiting that we need some sort of government intervention. I think the industry has to take it upon itself to combat this, using every tool that we have available to us.

Dave Kemp:

One of the most obvious tools, in my opinion, is through the educational piece and making sure that the industry, as a whole, everybody is going to bat around this idea of this is our territory, these are the things that we know the most about. That I just, again, I think that that allows for a really differentiated position in the market, because there’s going to be more and more types of devices that are sold online, more ways that you can get access to these things.

Dave Kemp:

But the real differentiating value for somebody to come see you as opposed to just trying to do it yourself online is that they get your expert opinion and they get all of that knowledge and hard earned expertise that you’ve acquired because you’re an audiologist. That’s what actually gets me excited about this, but again, going full circle, that’s the whole thing around the sink or swim notion, is that it’s not as if that people are just going to know this about you. I mean, the vast majority of people don’t even know what an audiologist is.

Dave Kemp:

You’re kind of fighting this uphill battle. I think that if you can really put yourself out there and put forth that effort, you’re going to really stand apart from every other type of offering in the market, because everything else is very transactional, it’s a race to a bottom. It’s just like, “Here’s the cheapest price available for you for this thing.” That’s where you get into this territory where it starts to become a snake oil type thing where you have to avoid, am I buying something that is perceived to be something that is just truly not?

Cliff Olson:

My biggest challenge when I first started my channel was trying to be able to communicate what value do I actually provide to the end user? I mean, I wasn’t developing the technology, I wasn’t manufacturing the technology. I was dispensing it in a way to optimize the performance of that technology for that individual and what their specific wants and needs are. That is what led me to identify, okay, what are the tangible things that I actually bring to the table?

Cliff Olson:

What I identified was is that, yeah, I feel like I’m a personable guy, but no one is going to pay me money just to be nice to them. So what else do I do? Well, I follow best practices. Best practices are the things that are proven by research to improve the value for the end user when you’re using technology to treat them. I started hammering home these tangible aspects, which are best practices.

Cliff Olson:

It’s come a long way since I started the channel. The exciting thing about that is that now I’m starting to see, like you said, other providers are getting out there and starting to share this message of why audiologic care is important. Not just the devices, but the care that you receive with that is important. But now I’m starting to see people talk about and blog about best practices. You never, three, four, or five years ago, and before that, you never would’ve heard of anybody talking about best practices or even measurement. Now, consumers, that’s what they’re talking about.

Cliff Olson:

Providers are starting to be like, “You know what, maybe this is a thing. Maybe best practices are actually the thing that make us important.” And I truly believe that. In 2021, if another thousand providers started to adopt and to strictly adhere to best practices, that in and of itself is going to create more value in what they do and a tangible value, because no longer are you just saying on your website, “We join you, you become part of the family with us.” And all of that. It’s not tangible for a consumer.

Cliff Olson:

You go to every single website and they say, “Oh, well, we work with the best technology and we treat you like family.” It’s like, okay, but what do you really do to provide me with additional value? If providers can start following best practices, and I think that they will, because the more that we talk about them, the more that consumers are going to be like, “You know what? I want to go to a place that follows best practices.”

Cliff Olson:

We’ve seen it happen to some degree in 2020, even in 2019, where consumers on these online forums were saying, “Hey, my provider doesn’t do [inaudible 01:41:44] measurements, so I actually decided to go somewhere else that does.” That word is getting out there and this… Five years from now, and I know we’re talking about what am I excited about in 2021, but I think in five years from now, if you do not follow best practices, you are going to be one of those providers who sinks.

Dave Kemp:

Yeah. Yeah, no, I couldn’t agree more with you, Cliff. And I think you’re right. I think it’s become more apparent than ever that in a world where there’s multiple access points to all this technology, you have to differentiate on the basis of service and therefore you have to abide by best practices. You have to differentiate as much as you possibly can through a lot of these different things that people like you are doing.

Dave Kemp:

I really appreciate that and I think you’re right. So thank you for joining me on the podcast this year. Thanks for joining me here for the end of the year. I definitely want to speak with you again in 2021 and into the future to just continue to get a feel for what you’re thinking about, how everything’s kind of evolving in this industry.

Cliff Olson:

It sounds good, Dave. I appreciate you.

Published by Dave Kemp

Part of the Oaktree Products Team. Big fan of tech and empowering people through it. #Audpeeps #hearables #VoiceFirst

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