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058 – Dr. Ed Farrar & Ben Thompson, AuD – Tinnitus Therapy Solutions in 2021

In honor of #TinnitusAwarenessWeek, I wanted to cover tinnitus for the first time on the podcast by bringing on two of the most knowledgeable tinnitus experts I know, Dr. Ed Farrar and audiologist, Ben Thompson. Ed spent 5+ years in the British Royal Air Force as a medic, prior to launching his tinnitus therapy company, Oto in January 2020. Ben is a clinical audiologist who specializes in tinnitus therapy and shares a lot of his knowledge around every facet of tinnitus through his YouTube channel, Treble Health.

It’s estimated that 390 million people suffer from tinnitus to some degree around the globe. Similar to hearing loss, tinnitus presents such a problem due to the fact that it’s largely invisible, which means that it tends to go completely unnoticed for those who are not suffering from it. And when I say “suffer” from it, I mean it. For some people, their tinnitus can be so severe that it prevents them from sleeping or engaging in a healthy lifestyle, which can quickly take a mental toll and lead to all sorts of additional problems.

So, for this conversation, we do our best to present the problem and then speak to the legacy solutions, as well as emerging solutions, such as Ed’s Oto app. Ed shares with us how the app was designed, the team that built it, and how the app utilizes Cognitive Behavioral Therapy (CBT) to combat the users’ tinnitus. Ben’s perspective as an audiologist and tinnitus specialist is invaluable throughout this conversation, as he shares his views on this type of app and its potential for not only the patient, but for the hearing professional as well.

My Takeaways:

  • Ben kicks off the conversation by sharing a story about a patient driving four hours to see him to treat his tinnitus. Four hours. That says a lot. Tinnitus can be so severe and debilitating that it can push you to drive four hours to seek treatment. It also begs the question, where are the local or online options?
  • Following this initial point and many of the comments that Ed made throughout the conversation, the root of the problem seems to be that it’s not clear for many people as to which medical professional they should seek out to treat this problem. According to Ed, tinnitus is not broadly studied by general physicians during medical school, so primary care doctors might be prone to refer one elsewhere.
  • I’m fully aware that a good portion of hearing professionals offer some form of tinnitus therapy, but I think the profession of audiology needs to fully assert itself as a profession to claim ownership of tinnitus treatment. It’s another service-based offering and can serve as a great bridge to local physicians and medical professionals, who might be looking for an expert to refer their tinnitus patients to.
  • The ecosystem of smartphone apps that are pertinent to hearing professionals and their patients continues to swell. As I mention in the conversation, there’s a lot of upside for professionals to get curious, download these (mainly free) apps, and familiarize themselves with them. As this ecosystem of apps continues to expand (and trust me, it will), so too will the value appreciate in matching patients to the right apps. While the app might be free, the perceived value of the professional in the patient’s mind grows in value.
  • The Oto app was designed by a team of experts, including one of my previous guests, Anna Pugh, who is a world renowned tinnitus and sound therapist. Such a small world that as I am prepping for this interview, I see that Anna has joined the company to share her life’s work with the Oto team!
  • These two guests are really good representations of what makes me optimistic and encouraged about the future of the hearing industry. We’re seeing more and more outsiders like Ed come in and build something valuable for our industry that the professionals and patients can benefit from, while Ben has taken it upon himself to leverage YouTube to educate the folks living with tinnitus on the options that exist to treat their problems, including Oto. Builders and online subject matter experts…two things we’re going to need more of.

-Thanks for Reading-
Dave

EPISODE TRANSCRIPT

Dave Kemp:

Okay, so we are joined here today by Dr. Ed Farrar and Dr. Ben Thompson. So why don’t we go one by one introduce who you are and what you do.

Ed Farrar:

Hi, Dave. My name is Dr. Ed Farrar or Ed. I want to say thank you so much for having me on today. Love the podcast and it’s a real pleasure to tell people about what we’re doing Oto. So I’m a medical doctor, I graduated medical school in 2015. So I’ve been a doctor around six years now. I spent the first six years of my medical career as a doctor in the Royal Air Force. And during that time, spent two years working in Birmingham. And then went to work… Start my surgical training in London, did two years of surgical training and it was during that time that I sort of thought maybe this wasn’t for me, I wanted to try something else. So that was when I had the idea for Oto. And around a year ago now, got together with George who’s my Co-founder, Oto. He’s a doctor in the Navy. And that’s when we decided we wanted to we want to do something different. So I left the Air Force, took a career break and here I’m as a Co-founder of Oto.

Dave Kemp:

That’s awesome. Well, thanks for joining us today, Ben.

Ben Thompson:

My name is Ben Thompson, I’m an Audiologist. I live in California. I completed my audiology residency at UCSF, San Francisco, California, about three years ago. And since that time, I’ve become tinnitus specialist. For me, it started with an appointment I had in San Francisco, where I had a patient drive for hours from Lake Tahoe for tinnitus consultation. And to me meeting that patient, realizing the need and their willingness to drive for hours to seek consultation was the sign for me to start to get involved with the digital space to leverage technology, video conferencing, telehealth to help people with tinnitus. Since then, I started puretinnitus.com. And my main marketing efforts for that has been a YouTube channel focused on tinnitus and hearing loss. Glad to be here, guys.

Dave Kemp:

Awesome. Well, thanks for being here as well, Ben, really looking forward to this conversation. As you can probably discern from both of their introductions, there’s going to be a lot of tinnitus talk today, that’s going to be the focus of this conversation. The way that this whole thing kind of came to be, I met Ben recently, and checked out his YouTube channel. And I thought that this was really interesting in the way that he was branding himself as a tinnitus specialist, and putting out a lot of content around that. And so we linked up, he had heard a few of my episodes before, where I alluded to some of these new like online tools that people are using.

Ben Thompson:

Because I’m a big fan of this podcast. I reached out like a fanboy and said, “Dave you got to have me on let’s talk.”

Dave Kemp:

I love it. Well, welcome. I’m glad that you did, because this is going to be an awesome conversation. So one thing led to another, we both linked up. And then I saw relatively recently, I think it was like hearing health matters, Ed’s company, Oto. It really caught my attention because it kind of falls right in the future, wheelhouse. And new app an emerging technology that’s designed to take an innovative approach on combating something that is kind of invisible, like tinnitus, but it’s also extremely pervasive. I think there’s something like 390 million people that suffer from this. So it’s debilitating for a lot of people. And to Ben’s point, you have people driving for hours, to seek treatment for this. So clearly, something’s broken.

Dave Kemp:

And we need to combat this as an industry. And so wanted to bring these two on today. Ben, being an expert and an audiologist in this space, and then Ed as the founder of a company building a tool specifically designed to combat it. So let’s just get right into it. Ed, why don’t we start with a little bit of a backstory. I mean, that’s really fascinating that you were a medic in the Royal Air Force. So I’m assuming that there was maybe some sort of connection between your time there. And then when you decided to make the leap over to Oto. Just helped me to walk through how Oto came to be. And then I saw you guys started like in 2020. So what this first year more or less has been like for you all?

Ed Farrar:

Yeah, sure. So I think this whole thing started a number of years ago, actually, when George and I first had the idea on it. The sort of the idea came about when George and I were seeing a large number of men and women as our patients in the military. We were seeing a large number of these people that had tinnitus and hearing problems as a result of their job. So as I’m sure you can imagine in the military, there’s a lot of high risk jobs when it comes to hearing. So weapons firing, explosions, loud engines, that sort of thing. And in speaking to these people, this people coming to us, obviously, their hearing was damaged, but they were getting tinnitus as well. And they were suffering a lot with tinnitus. And what I found really interesting was, I’d assumed at this point that their hearing would be a bigger problem for them not being able to hear things. But even people with bad hearing loss, their tinnitus was the bigger problem for them.

Ed Farrar:

And I looked into it and I thought, okay, well tinnitus isn’t something that we really learn about medical school, we don’t really cover much information about hearing. Which is strange because it’s such a common problem, such a common condition.” So I looked into it, and I thought, “Okay, well, there must be some help available for people with tinnitus, it really does make people’s lives miserable, what help is available.” So I looked into it, and found that, firstly, obviously, there’s no cure. And secondly, effective treatment does exist in the form of cognitive behavioral therapy or CBT. But if you want to access this, on the NHS in the UK, National Health Service, you may be waiting four, five, six months, perhaps even a year to see a therapist.

Ed Farrar:

And if you don’t live in the UK, or you want to pay see a therapist privately, you may be paying upwards of 80, 90, 100 pounds, $100 a session. And to me, I just thought, “Okay, there’s something not right here. This is a condition that makes people’s lives miserable. And they’re having to wait all this time to do something about it, and there’s no help.” So I got together with George, we got our heads together. And it taken us maybe 18 months to sort of speaking to each other and putting some ideas around. George and I have known each other a long time, we’ve always thought we wanted to start a business together and do something like that together. So we started researching and looking into it. And it transpired that tinnitus isn’t just a problem on an individual level. But it’s also a big societal problem as well. You mentioned 390 million people have tinnitus. And I think the number is actually a lot greater than that, it’s 390 million people have intrusive tinnitus, that is their quality of life is significantly impacted.

Ed Farrar:

So that’s when George and I got our heads together. And we started talking to people. I should mention at this point, George actually has tinnitus as well, I’ve got mild tinnitus, George’s I think, at one point in his life was suffering from it quite badly. So George had that understanding of what it was like, to have tinnitus and to and to not have that help available. And that coincides with what happened next, when we started speaking to people, we wanted to do some market research. And what we were finding was happening is that people would go to see their doctor, they’d be diagnosed with tinnitus, they start having these problems, their quality of life would be impacted, they’d go seeking help.

Ed Farrar:

And their doctor inevitably say, “Well, I’m sorry, there’s nothing we can do.” And that’s obviously frustrating for them because it’s incorrect, there is something we can do, there is treatment that is effective. But it’s also frustrating, because they’re going for help and that helps not being offered to them. And if the Help is being offered to them, they are going to have to wait for six months. So this was when George and I realized, “Okay, this is a big problem.” And that’s when we decided to do something about it.

Dave Kemp:

That’s an awesome story. And I always find founders that have the problem themselves, they’re basically innovating on something that they’ve experienced to be some of the most effective ones. So the fact that you have a bit of tinnitus, and then your Co-founder, George has it as well, I think kind of speaks to the fact that this isn’t something where you have sort of just like an outsider’s perspective. You’ve actually dealt with this and you’ve kind of recognized that this is fundamentally broken with how we treat things. So, Ben, let’s hear from you a little bit, obviously, you shared about how, the impetus to why you became interested in tinnitus. But share with us as a tinnitus specialist, what your service in that product offer or that service offering sort of looks like and what the types of experiences that people have when they actually are treating their tinnitus.

Ben Thompson:

Yeah, and there’s two factors here which I think are important to recognize is that number one, the educational systems are not teaching the comprehensive tinnitus management that introduces stress, anxiety, sound therapy, hearing aids, how to optimize all those systems to improve life with tinnitus. Medical schools aren’t doing it, audiology schools typically aren’t going as deep as they could. I went to a new program in San Francisco I was part of the first cohort, the first year. And faculty decided to have two full semesters on tinnitus. That was collectively 30 hours of lectures on tinnitus from the leading clinical audiologist at the UCSF Tinnitus Center. And I already came into it with an interest in it. So to have that deep education, I felt like the most engaged student. I loved that we’re learning. I could also relate it to my experiences with tinnitus, which is milder caused by a loud music exposure, as well as my interest in holistic living. And learning how to manage stress anxiety and how that can help someone with tinnitus a lot.

Ben Thompson:

That’s the first part that I wanted to address. The second part is that a lot of audiologists may not feel comfortable. A lot of hearing doctors, hearing specialists may not feel comfortable talking about someone psychology, stress, anxiety. Most audiologists did not sign up to be therapists, even though our role typically is to counsel someone about hearing and communication and lifestyle. It’s typically not getting into depression, stress, anxiety. But as a tinnitus specialist, as a doctor in tinnitus, we have to live in that space, because that’s often the biggest window, the biggest opportunity of what really can be done alongside sound therapy, hearing aids, et cetera. So I want to say that to anyone listening, because I feel like we need to set that frame of why this problem exists before we talk about these solutions. So what I did for a few years was research anyone in the online space who’s offering anything about tinnitus. And Ed, you might have done something similar where you research who are the potential players in this game, who is on YouTube, Facebook, who has blogs, who has forums that are helping people or seemingly helping people with tinnitus.

Ben Thompson:

And because I knew I wanted to create an online offering in the tinnitus space. I really enjoyed the work. So I started with YouTube and I learned essentially what people needed, what people wanted to learn in the online space, via trial and error, through creating YouTube videos and talking to people, having a lot of consultations. Through that process I decided that the best fit for my services in the telehealth tinnitus market which is global, because what I provide is tinnitus coaching, it’s not audiology. And in my legal counsel, that means I can provide tinnitus coaching to anyone anywhere, I don’t need to be licensed in the state of the person who’s receiving tinnitus coaching.

Dave Kemp:

Interesting.

Ben Thompson:

So I decided that the services I wanted to provide are group coaching, which we have two monthly meetings via Zoom video. Take right now about five to 15 people on each session. And tinnitus therapy, which is one-on-one individualized. Those are the services that I provide in the online tinnitus space. And they complement other existing online communities pretty well. So what do you guys think about that? How’s it going over there, Dave?

Dave Kemp:

No, that’s really good. I appreciate you walking us through that. And prefacing it that way.

Ed Farrar:

Yeah, I was just going to sort of add to your point there, Ben. Your first point, I mentioned earlier when I was in medical school, I didn’t learn anything about tinnitus. And I thought back about this numerous times. I don’t actually think I ever learned about tinnitus and that might have been my fault because it was a medical school where you go and told to learn about stuff yourself. But I don’t think there’s anything really directed towards, especially tinnitus. Looking back on this on in retrospect is actually for me quite frustrating because in the UK alone, and just the UK, there’s over a million appointments for people see the GP per year with tinnitus as the primary complaint. Now, that to me seems crazy that we’re not training doctors to understand tinnitus. For such a common problem.

Ben Thompson:

Ed, do you think that would impact the overall cost of health care in terms of, if the GPs, general practitioners are educating, counseling better, that might lead to less depression, stress, anxiety?

Ed Farrar:

That’s perfectly leading on to my next point because there’s actually been published research on this. And GPs don’t know how to manage tinnitus. So what’s happening is GPs are putting patients on benzodiazepines, for example. GPs are prescribing patients sleeping tablets. And I don’t necessarily say it’s the GP… Obviously, the GPs have a responsibility to… Sorry, GP is family doctors. Obviously GPs have responsibility to learn about this stuff, but it’s not in the curriculums. And it’s only something that started change recently. As you say, Ben, because it’s being managed incorrectly, then the cost of tinnitus, and the impact of tinnitus is going up. The NHS spends 750 million pounds per year on tinnitus, and it cost the UK economy two and a half billion pounds per year. So there’s a big individual cost, because it’s not being managed correctly, but there’s a big societal cost as well.

Dave Kemp:

Yeah, that’s well said there. I guess, as we start to get into… Obviously, we’ve now framed part of the problem, I think you both have really illustrated that, well. Talking about solutions, Ben, you’ve highlighted the fact that you have these group therapy sessions and the one-on-one sessions. But I’m curious, Ed from your standpoint something that is maybe a little bit more accessible and scalable, like an app really intrigues me. I think this is a great application of mobile technology. And so help me to understand exactly the way this app works? How you guys designed it? And the benefits that people are getting from it when they start to really use it in a way that it was intended for.

Ed Farrar:

So I just preface that by, when we started this we wanted a way for people to instantly access, effective treatment whenever they needed it for tinnitus. And it didn’t matter where you are in the world, doesn’t matter what time of day it is, it doesn’t matter what type of treatment it is. And we came to the realization that the only real way to do that for something that is scalable, is a digital product. And what better use of an app. Something that’s constantly in your pocket whenever you need it and you can just access this stuff at the touch of a button. That’s why the decision made was to go for an app. So how does that work? Well, it’s free to download. Anyone can can download and try it for free.

Ed Farrar:

And the therapy is split into a series of progressive modules that incorporate all the evidence-based treatment. So focused around CBT, cognitive behavioral therapy. There’s also elements of cynical ACT, action centered therapy. And targeted mindfulness specific to tinnitus, relaxation therapy, and some physical therapy as well. And all these things are blended into a spiral curriculum, whereby you’ll start with just the basic elements of this. And as you work your way through the modules, you’ll go into more complex ideas. So each day, we’re intending for the user to sit down, find somewhere comfortable, put a pair of headphones on, or maybe without headphones, press play and that’s it, you’re in the therapy session. And it’s a five to 10 minute session of recorded voice taking you through either a cognitive exercise or meditation.

Ed Farrar:

So once you’ve gone through those initial four modules, the core therapy that blends all those things together. That’s when we can start to introduce users to some more complex concepts, such as a mindfulness module, or sleep module. Or we can take them back to the exercises that they enjoyed the most or they found the most helpful and they can access these exercises whenever they need. So an answer to a question about the benefit that it provides to people. I think there’s a few things there. Firstly, and I keep going back to this, it allows people to instantly access tinnitus therapy whenever they need it. And if they’re waking up in the middle of the night, and their tinnitus is bad, they can’t get to sleep. All they need to do is pick up Oto and open up and they can go into a sleep session. And that’s something that we feel is really important, it’s instantly accessible thing. I’m sorry-

Ben Thompson:

Hey, Ed, so when you say tinnitus therapy, can you define what that means? Sound therapy, talk therapy, other forms of therapy.

Ed Farrar:

So tinnitus therapy sort of encompasses a number of things. I think the key element of tinnitus therapy that we use is CBT, cognitive behavioral therapy. And I’ll just quickly explain how that works for tinnitus. So cognitive behavioral therapy is a type of system psychological therapy that was initially used to help treat things like anxiety and depression. But it’s since been demonstrated to be effective in tinnitus. And the way CBT works is it helps to sort of refocus the way the brain reacts to the tinnitus. So, of course, when you first get tinnitus, it’s a very loud, unpleasant sound and your brain reacts negatively to that. And that stress response causes the tinnitus to become even worse, because we know stress makes tinnitus worse. And it sort of you get like a horrible spiral of you’re more stressed because your tinnitus is terrible, you can’t sleep that makes you even more stressed, your tinnitus gets louder.

Ed Farrar:

And CBT aims to interrupt that negative cycle. And the eventual aim with CBT is to get to what we call habituation, where the tinnitus is perhaps even the same volume, but you just don’t notice it anymore. And I’ll use a metaphor to describe that, if you imagine going in a long car journey, five, six hours. And especially if you’re in an older car, the sound of the wind rushing past the car, and the sound of the tires on the road is quite loud. But even after 20 minutes, you stop noticing that sound. Even though it’s not a very pleasant sound, you stop noticing it, your brain just doesn’t recognize it anymore. And the same thing happens with tinnitus. And that’s what CBT and these other therapies aims to train your brain to do.

Dave Kemp:

I love that. Thank you for that. Ben, as a specialist working in this space, share with me your perspective on this app, what it represents. And from a professional standpoint, the way that we as an industry and all the different professionals that might be listening to this right now should be thinking about what Ed and his team are building with Oto.

Ben Thompson:

Definitely, I have so many thoughts when I hear this because, as we said, there’s many people with tinnitus, most people just need basic information. Most people need to learn what no one has shared with them so far, which is this relationship with anxiety, stress, their psychology. How to use sound effectively, which is called sound therapy, sometimes via hearing aids, but oftentimes not. And learning potentially that we need to get out of the mind and relax into the body. Most of what helps people with tinnitus involves some of that. There’s more obscure offerings people have online, but what I just shared are essentially the three pillars psychology, audiology and relaxation. So it’s important for someone listening who works with tinnitus patients to realize that there’s not one solution for everyone.

Ben Thompson:

So we’re talking right now about self-guided app, which is similar to an online course. And that’s distinctly different than referring to a psychologist. And referring to a psychologist is similar to referring to someone like myself, who is a tinnitus specialists consultant. And that’s also sort of similar to a group program, which is commonly referred to… I know that the British Tinnitus Association and the American Tinnitus Association have support groups. So as we can see here, that’s most of what’s covered. Now, there’s also sound therapy resources, different audio files, different apps that are designed specifically for managing tinnitus with sound as a therapeutic tool. So Ed’s app Oto, I downloaded it from the App Store, I was looking at it before this session. And yes, like he had mentioned in focuses on the cognitive behavioral therapy techniques, and the relaxation and sound as a therapeutic tool, sound therapy.

Ben Thompson:

And I’ve learned that those are solid foundations for most people with tinnitus, those are building blocks, I would say. A lot of people will find that enough and then they will get on with their lives. The tinnitus will probably still bother them here and there. But it’s they got what they needed, it’s not this mystery that they have to solve on their own. They have some guidance. So my perspectives here for a professional who’s listening is to ask a few extra questions to the patient they’re seeing to realize what do they really need. And if you as a professional aren’t sure what they really need, then try to give them resources for sound therapy, for group support, for relaxation, to let them pick and choose what works with them. That’s my major reflection on Oto the app for tinnitus therapy and CBT. And its place in the market as a resource for doctors who are working with tinnitus patients. Ed, you want to expand on that?

Ed Farrar:

Yeah, thanks, Ben. I think you’ve described it almost perfectly there. One of the problems that we found was that, you’re completely right, it is possible to access these things perhaps to a lesser extent CBT. But it is possible, certainly sound therapy, relaxation therapy. But we felt that from what the feedback from the people we spoke to in our market research that it’s actually quite overwhelming when you first get a diagnosis for tinnitus to try and look for help. There is nowhere where you can get this stuff all in one place. And if you’ve just got a new diagnosis of tinnitus, or you’ve got a flare up after a few years, it’s getting worse.

Ed Farrar:

And you go to the doctor, and the doctor says, “Sorry, there’s nothing we can do.” You go to the audiologist and say “Sorry, I’m not really sure.” You’re left looking online. And then you get recommended putting onions in your ears and stuff. People do recommend, by the way, if it’s tinnitus. And it’s very overwhelming. What we want to do with Otto is we want to be, as Ben said, be that first point of call, where they can access those three things, those three elements the CBT, psychological, the relaxation, and the sound therapy. And have that all in one place.

Ben Thompson:

I completely agree. And I wanted to make this point, I was thinking about this, as I was preparing for this podcast session that if I’m a professional, and I see someone who tells me their tinnitus is bad, and it’s affecting them. If I don’t give them a specific trusted resource, then they will be guaranteed to search themselves. And you can imagine what someone would find, because the first thing that appears on a search are three advertisements from companies who are trying to profit off of someone’s desperation.

Ben Thompson:

So I know it’s sad and I know it takes the audiologist or the doctor an extra few minutes to explain these things. But from my experience working with people one-on-one, it could save them three months, six months, one year of going down the wrong path. I was just working with a patient who, for the last 12 months has basically been trying things that are more obscure, instead of focusing on the fundamentals, and they share with me. They found me because they feel like they have to start from scratch and their life is completely turned upside down. So that’s what we’re working with here, Ed.

Ed Farrar:

Yeah, I think that’s a really important point, really relevant and it’s so important to signpost. As long as it’s a trusted resource, whether it’s the American Tinnitus Association, British Tinnitus Association, it’s so important to signpost, these patients to the right resources. And what happens as a result, when patients aren’t signposted, they either end up spending a lot of money on something or a lot of time as Ben said on something that isn’t going to help them. And that’s going to make their tinnitus worse, that’s going to make their psychological state worse. Or they become very bitter, and untrustworthy of… All you need to do is to go on to an online tinnitus community and they’re very distrusting because of so many companies have tried to take advantage of these people.

Ed Farrar:

And I feel for them because left, right and center, they’re trying to be sold something that doesn’t have any scientific basis for it and doesn’t necessarily work. And they’re being sold as a miracle cure. And it’s really upsetting. And I can imagine how frustrating and upsetting it must be for these people particularly if they’re going to spend some money on one of these things. And then when it transpires it doesn’t work, it actually might make something worse. Because tinnitus is something that’s so common and tinnitus is something that is incurable you have these crazy things popping up. And some of them are dangerous they could potentially do damage to your hearing or make your tinnitus worse.

Ben Thompson:

Dave, I want to bring in a point, which I think is core to your message here with Future Ear, all about hearables voice technology. I’m wearing an AirPod right now. I recently did a video about how to program AirPods Pro for milder to moderate hearing loss and for tinnitus relief. And I think that this is a conversation we can have because Ed has a mobile app which has sound therapy. And I’m essentially creating a tutorial on how someone can use a $200 pair of AirPods to help manage their tinnitus. And both of those are not the end all solution. Goodbye, audiology, sorry, but it’s a tool, it’s a stepping stone. And I wanted to bring this into your space Dave with the hearables world?

Dave Kemp:

Well, I think that like what’s going through my mind right now, as I hear you two speak is that, this allows for, obviously, we need to as a society address tinnitus at scale. And so somebody needs to take ownership here. And this is a tremendous opportunity for the hearing professionals to do so. And it just strikes me that so much of where this trajectory fall, with all of this new emerging technology that’s coming about, I can’t stop thinking about this notion that much of what the hearing professional of tomorrow, their role is largely going to be to guide you to the solutions. And to match you to these solutions. I had a conversation with a fellow British company, with ChatableApps not long ago, Giles Tongue over there.

Dave Kemp:

And it’s kind of the same thing where its like, it’s not to say that this is in any way, like a replacement to the types of services, maybe your products that you’re selling. But it’s just another tool that you can add to your repertoire. And in a day and age where these professionals are constantly being bombarded with these sort of this speak around disruption and all of these perceived threats of new avenues of how you’re going to be displaced, whether it be people are going to buy their hearing aids online, or they’re going to buy them from a big box retailer. And so, in my mind, everything kind of boils down to what are you going to do to stand apart? What’s going to be the way that you really differentiate yourself? And I’ve said it on this podcast 100 different times that, for me, it all comes down to leveraging your knowledge and your expertise. And I think this is a huge byproduct of that is to familiarize yourself with these kinds of applications.

Dave Kemp:

And understand that you might have a subset of your patients that would benefit from this dramatically. I mean, as what you two are saying, where a lot of this is just pointing them in the right direction, and helping them to understand what is available to them. It might be an app, or might graduate into something where you do need a tinnitus specialist. And if that’s not something that you provide, so be it, but at least familiarize yourself with the tinnitus specialists that you can refer them to like Ben, so that still become something that you’re providing value around. At the end of the day, the people are coming to you, because like you said, they’re desperate, they’re looking for whether it be my quality of life has depreciated so much because I can’t hear the world around me, and therefore I need some sort of improvement, our hearing aids usually. Or it’s something like this, where I’m suffering from this debilitating tinnitus, and I can’t seem to find an answer. So please help me.

Dave Kemp:

And again, like in my mind, this all represents a really big opportunity for professionals to take ownership of this and say, “Here are all kinds of out of the box solutions that are new, they’re emerging.” And the onus is going to be on the professional to really educate themselves. Like if I were in your shoes, I would be like downloading the app playing around with it, making sure that I at least understand it, so that I can speak intelligently for any situation that arises that this is pertinent to.

Ben Thompson:

Yeah, I wanted to comment, and I wanted to ask Ed. So my comment is that what I’ve learned doing review videos of hearing aids and hearables, like AirPods on my YouTube channel is that they’re getting closer and closer to hearing aids. And the audiologist might not think that’s the case. But when I wear them, sometimes I think they actually sound better than some hearing aids I’ve listened to. So just to put that into perspective for some situations. I want to ask Ed, so hearables, AirPods, Bluetooth things in our ears. Oftentimes, people with tinnitus who need constant sound therapy are depending on something like this. How does that mesh with your app? And what are your thoughts on the app with Bluetooth stuff in the ears? Because I think that’s really where us three, have this merging conversation.

Ed Farrar:

It’s certainly something we’ve put our thought into. And I don’t think we have the resource or the capacity to be able to do something with it now, because it’s a very sort of technically intensive area, but it’s certainly something that we need to look into in the future, I completely agree it’s really important. And one of the things we’re looking into is single notch therapy where you cut out the sound at the frequency of that person’s tinnitus. And I think that would be a good stepping stone for us from our masks at the moment. And one thing, I think that’s relevant there is the application machine learning and artificial intelligence. So we want to better understand the nature of people’s tinnitus so we can make suggestions about the mask that might be benefiting them. Again, it’s not something we’re doing at the moment, it’s certainly something we want to be looking into. Of course, people using the therapy, a lot of them will be using headphones as well. So it’s certainly something that we need to be thinking about and certainly something that’s important.

Ben Thompson:

Yeah, and for an audiologist listening, for a professional listening. At the end of the day whether we like it or not our business model as a whole is based on hearing aid sales. So whether we admit it or not, the audiologist wants to know that if their patient who has tinnitus who might benefit from a hearing aid. That professional wants to know if they’re sent to an app or if they are sent to my group coaching program. Will I reinforce that hearing aids help tinnitus? Or will I say “No, don’t worry about that, you don’t have to do that.” Because the professional will want to refer them to a resource that agrees with their overall mission.

Ed Farrar:

It absolutely fits in to audiologist best interests as well. And I’ll tell you the reason why we think that’s the case. So obviously, a large number of patients with hearing loss also have tinnitus, the two conditions are very closely interlinked. Now our hypothesis is that, and I’m sure many of the listeners out there will agree with me. Tinnitus is a huge pain point for audiologists that focus on selling hearing aids. And I’ll illustrate that with an example, let’s say you have a hearing aid and you go to get a hearing aid fitted Boots or Specsavers, which are the two big hearing aid vendors in the UK. And you go back to get a checkup. And you say to the audiologist, well, this hearing aids amazing but what can you do about my tinnitus? My tinnitus has been quite bad recently. Is there any way you can help with that?

Ed Farrar:

And the answer then is almost certainly going to be “I’m sorry, but there’s some resource available online, we need to go and see GP.” And that’s a real pain point for the patient, because that’s what the customer should say “Sorry.” And that’s what they should say… And that’s something they’ve been told time and time again, by their doctor by their EMT, “There’s nothing we can do.” So that’s a pain point for them. And it’s frustrating for the audiologist as well, because there’s that feeling of helplessness.

Ed Farrar:

And I think there’s real value Oto can add to the practice of audiologists that sell a lot of hearing aids. Because it’s a way for them to say, “Here’s something I can recommend that will help you and will go together with you… Because hearing aid is technically sound therapy, it will go together with the sound therapy that the hearing aids providing. And you can learn all these other techniques that will go well with the sound therapy.” As Ben has been you said earlier, three pillars of this. You’ve got the sound therapy with a hearing aid, but there’s other techniques that you can learn with this app. And that’s why I think that this can have such a big impact on audiologists as well.

Ben Thompson:

I totally agree with you, because I’ve been having this thought of, I know my services with pure tinnitus are helping people, but how do I motivate an audiologist to care about it to send their people to potentially get value from it? And I had to bring into the topic of will this help their bottom line? And that’s probably a strong argument to consider or something of value for them that helps not only their goodwill, but also potentially their business?

Ed Farrar:

Is it providing a better service for their, we can call them patients [crosstalk 00:39:14]. As you say a lot of them will be their customers and of it’s providing a better service. And if they’re recommending to their clients, something that is helping them and something that is benefiting them alongside the hearing aid. I think that client is much more likely to come back to see them in the future to just say “Thank you, doctor for recommending me this app. It’s been it’s been really helpful and it’s worked really well with the hearing aid.”

Ben Thompson:

Yeah, I think about when I went to an EMT, I was having problems snoring. And they said, “Oh, well, there’s a sleep apnea specialist.” So they sent me to a sleep apnea specialist. And the EMT knows nothing about it. They don’t know how happy I’ve been working with this sleep apnea specialist. They just sent the referral and I’m much more likely to go back to that ENT, because I trust them.

Dave Kemp:

So let me just say something really quick. If you look at a lot of these market track studies, these market research reports that come out, there is always a question in there for the professional, it says cite your two largest sources of referrals or sources of how you acquired your customer. And it’s the top two, unanimously, every single year is word of mouth referrals and physician referrals. So like fellow doctors and again, if we’re talking about an issue, that there’s seemingly not a whole lot of ownership being taken here, I think it presents an opportunity for that ownership. And therefore, from a physician marketing standpoint, in your local area with all the physicians that are around you, they recognize that just like you mentioned, there, Ben, with the EMT, referring you to the sleep apnea specialist. It could be the same thing where your general physician is referring you to the audiologist, because that’s in their wheelhouse.

Dave Kemp:

Vice versa with the word of mouth marketing piece that can never go discredited with how important that is to the sale of hearing aids. Because at the end of the day, like you said, Ed it creates a better experience. So chances are, if you go that extra mile and you provide them with more value, what they’re going to do is they’re going to walk away from that, they’re going to say, if you’re also a candidate to have hearing aids or seek these kinds of therapies and solutions, “You need to go to this particular person because they know what they’re talking about. And they’re the expert, as it relates to all these different things.” It’s like a perception thing, it creates a perception with the patients. And all of their networks. It’s just another opportunity to brand yourself as an expert in all of these different things and take more ownership in different sources of how you can acquire new patients and new customers.

Ben Thompson:

Want to add that, I believe any audiologist can learn more about tinnitus and probably be a decent tinnitus specialist. So for someone who’s listening, that’s also an option, you don’t have to refer out. You can study, you can create that service, and you can do it as well. But of course, that won’t be the case for every single patient. So having some trusted resources are still important.

Dave Kemp:

Yeah, I couldn’t agree more. So we’re kind of getting to the end here. I’m curious Ed, one really interesting facet of your company is that a lot of this was designed by audiologists too, right? I mean, I think that you’ve had significant amount of input from the audiological space, but just helped me to understand like your team, and the brains behind it. And the different sorts of walks of life that you have that are gelling together to kind of create this thing.

Ed Farrar:

Sure. For me, that’s one of the coolest things about this. I get to surround myself with people that have a lot more knowledgeable than I am, a lot better at things. So I’m going to start with my Co-founder, George. So George has built the app and as you can see, it certainly doesn’t look like the work of one person team on the development. So he’s done a marvelous job of building something that functions very well and it does a great job. And he’s come there very fast as well. So the app, that’s George’s hard work. And then we have the therapy team. So the therapy team consists of Anna Pugh, who I think we mentioned earlier-

Dave Kemp:

Yeah, Anna has been on the podcast before such a small world but [crosstalk 00:43:56].

Ed Farrar:

Yeah, I’m sure many people listening will know Anna. So Anna is a very experienced hearing and tinnitus therapist. And I’m sure she’ll be listening now. Hi, Anna. So Anna has got decades of experience in looking after patients with tinnitus and hearing loss. And she’s use that experience to provide us with the therapy content ranging from this to CBT, the ACT, but also the mindfulness as well. So Anna’s depth of experience is something that’s really made this possible.

Ed Farrar:

We then have the Chief Scientific Officer, Jameel Muzaffar. So Jameel is an academic EMT surgeon working in Birmingham. He’s been working on ontological research completing his PhD over the last five years at University of Cambridge. So Jameel is responsible for the academic output of the company. And Jameel also has clinical oversight for what goes into the app so the therapies review by Jameel. And also Jameel is working on some research, they we’ll be working on over the next year to demonstrate the effectiveness of Oto. And finally, well not Finally, actually there’s a few more people. So we’ve got Lili. So Lili Thomas is a trained actor, and she uses her creative experience to bring the therapy to life.

Ed Farrar:

And I’m sure if you’ve heard any of the therapy sessions, that’s Lili’s voice you’re hearing. So I think Lili is the voice of Oto. And Lili’s sort of taken Anna’s life work and turn that into a journey and she’s done a wonderful job of that. I think her voice itself is brilliant. And we’ve had excellent feedback from the voice. But of course the journey that she’s created. And Anna and Lili has done a brilliant job of making something that people can work their way through. And finally, last, but not least we’ve got Jake Marshall. So Jake is our sound engineer. So he’s got experience in industry previously in music. And one of the reasons why Lili’s voice sounds as relaxing as it does and as clear as it does, is because of Jake’s hard work, producing the therapy content.

Dave Kemp:

I think we all would benefit from Jake making our voices extra beautiful.

Ed Farrar:

Honestly, Lili’s voice is very relaxing and very calming in person. But Jake, sort of taking it that extra level, he’s done a great job. Jake’s also put the masks together as well. So Jake’s responsible for the sound therapy and the masks. We’ve just put on a marketing person, Denise. So Denise, she’s sort of just joined us join us a couple of weeks ago. And Denise is working on the marketing and getting new users from all over the world. And then we’ve got a very hard working team of interns. We’ve got three interns who are working on some of the academic stuff, and also writing blogs and getting content created. We’ve got a great team.

Dave Kemp:

You got a great team, yeah. That’s really cool. All right. Well, as we kind of wrap up here, guys. Closing thoughts what are we thinking as we kind of come out of this episode.

Ben Thompson:

My closing thoughts are that the online space is where people go to search for solutions to their problems. Tinnitus is a problem in a lot of people’s lives. And it’s a big problem in still many people’s lives. That was my inspiration for creating online videos and blog posts to educate properly. And then to offer services that I feel are beneficial and not currently present, at least in the United States. That is the group coaching program, and individual consultations focusing on the three pillars audiology, which includes sound therapy, psychology and relaxation.

Ben Thompson:

That’s the summary of what Pure Tinnitus is offering to this online space. And I really enjoyed listening to Ed and talk about the team that goes into it. And certainly a trusted, credible source when we have the medical doctors, audiologists and psychology coming together. So I’m happy to be introduced to Ed, happy to be on this podcast Dave, it’s been great to meet you guys. Ed you want to go next to wrap us up.

Ed Farrar:

Yeah, thanks. Ben. Yeah, so firstly, Dave, thank you very much for having me on. It’s been really enjoyed talking to both of you about this. And, Ben, I think you’ve made a lot of the points, a lot more eloquently than I could have done. So it’s been really useful to hear your insights. So thank you very much. And I’m sure Pure Tinnitus is definitely that really important step for a lot of patients. So I encourage anyone struggling with tinnitus or struggling with patients with tinnitus to get in touch with Ben. He knows what he’s talking about.

Ed Farrar:

In terms of sort of final thoughts for me. I really want to create something that… There’s 400 million people with tinnitus worldwide. And I really want to create something that can help these people. And I suppose this is an ask for the listeners. If anyone wants to help, if anyone wants to get involved, please get in touch. You can go to the websites, just joinoto.com. You can find me on LinkedIn and we’d love to have you on board and we’d love to help. And if anyone’s got any questions or wants to talk to me about Oto please do to get in touch. It’s been great talking to you guys. So thank you very much both of you.

Dave Kemp:

Yeah, absolutely. And before we wrap up, Ben, share with us where we can find you on

Ben Thompson:

YouTube Ben Thompson AuD, website puretinnitus.com. Pretty active on LinkedIn as well.

Dave Kemp:

Awesome. Well, guys, this has been such a great conversation. I fully agree with both of what you said. It’s just cool, like when I first started this blog, and then the podcast, I anticipated that there were going to be lots of new cool emerging technologies. But to really now be living in this period where it’s all coming to life, and getting to see these really awesome different groups and teams that are formalizing around these big problems. And using a lot of the tools that are available to us and using them as building blocks to create brand new things. And then hearing people like Ben who are really taking it upon themselves to make this a big part of their value proposition.

Dave Kemp:

And redefine maybe what the audiologist and the hearing professional in 2021 looks like, just at least another facet to think about. So, this has been tremendous conversation. Really enjoyed it. Definitely, we’ll be keeping an eye on what Oto does hear across the next few months. Like Ed said, if you’re at all interested, just be sure to reach out, get in touch, because I do think this is something that a lot of providers can take advantage of. And then obviously a lot of patients can benefit from this as well. So this has been a great chat. Thanks, everybody for tuning in here and we will chat with you next time. Cheers.

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