This week on the Future Ear Radio podcast, I’m joined by Lena Kyman, AuD, who is a Clinical Trainer at Phonak. Lena shares her journey from audiology student to working inside a private practice to her newest venture working within Phonak as a Clinical Trainer. Throughout the conversation, Lena describes what life is like as Clinical Trainer, talking in detail about some of the most common issues experienced by all the Audiologists that she’s routinely meeting with.

According to Lena, of all the issues, the most common source of both frustration and excitement is Bluetooth connectivity. As we discuss, hate it or love it, Bluetooth connectivity is increasingly a major part of today’s patient expectation. We talk through some of the ways providers can help to simplify Bluetooth and some of the new possibilities that Bluetooth now allows for.

As a Clinical Trainer who interacts with a large number of Audiologists each day, and someone who has previously worked within the same type of setting as the Audiologists she’s interacting with, Lena’s perspective is invaluable. This conversation really helped me to better understand the types of issues and opportunities that are presenting themselves within the Audiology clinics across the country.

Takeaways:

• Lena said something really interesting during this conversation, “The technology has advanced so much that when you’re doing an initial fitting for your patients, whereas, 10 years ago, the majority of that fitting was fine tuning and trying to get to targets and making it sound right. And then at the end, you’d show them how to change the battery. Whereas now you can do a first fit in seven clicks and beyond target.” — This begs the question of what’s the most effective way to utilize this excess time generated by this new automation?
• As we discuss, this time might be best spent to really educate the patient around the ins-and-outs of Bluetooth. Perhaps it would be helpful to have materials inside the clinic that goes into detail about troubleshooting (some people may already be doing this). I think though that all of this new-found time can be at the heart of what really differentiates the patient experience from say, Big Box retailers or online sellers.
• One such example would be to talk about advanced technology that can be used in conjunction with hearing aids, such as Phonak’s ROGER system. You can now pair the ROGER transmitter’s (i.e. the smart pen mic) directly with all of Sonova’s devices that include either the SWORD or PRISM chip (basically all the new Phonak & Unitron hearing aids). No more neckloops or awkward intermediary devices. This is the “upside” of Bluetooth innovation that we talk about throughout this episode.
• Lena’s story about her dad and his unique type of hearing solution combo (implant + hearing aid) is fascinating. I love when guests share these kind of stories.
• I really enjoyed this conversation because it helped me to better understand the role that Clinical Trainers play in the field of hearing health. As Lena described, she feels like she’s able to make a pretty broad impact as a trainer, being able to help influence more patient experiences by helping to educate audiologists on all the new opportunities presented by the fast-paced innovation occurring with today’s hearing health technology.
• I think I might need to lean into the whole, “let’s drink a beer while we podcast,” thing that Lena and I did here and make that an option moving forward. Firs thing I need to do is my up my beer game a bit, and drink something better than Bud Select 🤣

-Thanks for Reading-
Dave

EPISODE TRANSCRIPT

Dave:

Okay. We are joined here today by Lena Kyman. Lena, tell us a little bit about who you are and what you do.

Lena Kyman:

Thanks, Dave. It’s exciting to be here. This is my first time on a podcast. I present all the time, especially in this virtual world. I have this headset on all day, but this is exciting for me. My name is Lena Kyman. I am an audiologist and I work as a clinical trainer for Phonak.

Dave:

I love it. When I approached you about this, you were one of the first people I met in this industry, so I always had you on my radar as, I need to get Lena on the podcast at some point because I love your story and I think you’re just a really interesting person. I was like, would you like to come on? And you’re like, “I’ve never been on before” And I was like, it’s really casual. It’s just like drinking a beer. It’s just like sitting around and drinking some beers, and you were like, “Well, can we actually drink some beers?” I was like, yeah, absolutely. Here we are. What are you drinking? You have a cool beer.

Lena Kyman:

Yes. Yes. Cheers by the way. I’m drinking a Surf Wax IPA by Burial.

Dave:

That’s awesome.

Lena Kyman:

Do you want to say what you’re drinking or are you too embarrassed?

Dave:

I’m not too embarrassed. I’m drinking some lovely Budweiser Select, brewed for the loo. It’s delicious and it’s only 99 calories.

Lena Kyman:

Lovely.

Dave:

Where’s your brewery beer from?

Lena Kyman:

This one is based out of Asheville, North Carolina, which is one of the brewery capitals of the country. But they also have another location closer to where I live in Raleigh. So good access.

Dave:

Let’s start there. You’re from Raleigh. You live in Durham now, right?

Lena Kyman:

Durham. I’m not from Raleigh.

Dave:

Oh, you’re not from Raleigh?

Lena Kyman:

I’m not even from North Carolina, but I live in Durham, but I’m from Arizona.

Dave:

Okay. All right. Let’s go back to the start. How did you wind up into this industry? All the way back at the beginning.

Lena Kyman:

It’s just so many audiologists, I stumbled into it. Right? It’s funny because my dad has hearing loss, pretty significant hearing loss. He has an implant on one side, a hearing aid on the other, he’s worn hearing aids for a long time. And everyone asks me, is he the reason you got into this? I feel bad saying that the answer is no. It’s not something we ever really talked about as much. And it never, even though I knew he got hearing aids, I think when I was in high school maybe, it never occurred to me as something to study or a field of study or a profession. When I was in college, I was browsing, life choices and taking introductory courses in a lot of different fields.

Lena Kyman:

And then I came to this speech and hearing sciences class and the majority of the class was speech and language and speech pathology. It was interesting, but nothing, really spoke to me. And then I think the last two weeks of the semester, they started talking about the ear and audiology and hearing sciences and I was hooked enough to sign up for another class. And then I was hooked and decided then and there I was going to go to grad school.

Dave:

Where did you go to grad school?

Lena Kyman:

That’s when I made the move to North Carolina. I went to UNC-Chapel Hill and I’ve been in North Carolina ever since.

Dave:

Wow. Okay, cool. You go to UNC. And so what was your first venture after you graduated? What was your first opportunity that you pursued in the world of audiology?

Lena Kyman:

It’s funny, at UNC I was on a pediatric training grant, so I got all this specialized pediatric training under some of the best pediatric audiologists there are. And then I did my fourth year externship at the VA hospitals, in all adults. It was the best place for me at the time. But then thankfully I got a position at a private practice. I was able to see pediatrics and adults. It was an ENT practice. I got to flex almost all of my audiology muscles. I did vestibular and ABRs and bone-anchored hearing aids. Pretty much the only thing I didn’t do was cochlear implants, but it was a good well rounded practice.

Dave:

You really have touched every facet of, yeah, I love that. You start with pediatrics, you go into the VA, you’ve done some private practice. What would you say is your favorite aspect of all of those? What was it that you loved the most of that initial tour in the audiology world?

Lena Kyman:

That’s a good one. I think it’s the positive impact we can have on people. And that on the one hand sounds so boring. I love helping people, that’s such a generic response. But whether you’re helping a kid here for the first time or an adult who’s had this untreated hearing loss for years and years, or doing an Epley maneuver and fixing someone’s BPPV and dizziness that was impacting their quality of life. There’s so many different ways that we can help people. And that’s what I love about audiology. It’s so small, it’s a very small world, it’s a very specific field of study, but you’ll never get bored. There’s so many different things you can do within this tiny field, there’s so many different facets.

Dave:

I’ve felt that way as well, that it’s small, but it’s also very wide encompassing. It touches a whole lot of different things. Just on this podcast alone in the last two or three episodes that I’ve done, we’ve had a lot of conversations around neuroscience and how that’s becoming another peripheral field that just continues to have more and more of a prominent role in this space. I do think that because it is so much of, it’s a symptom of the brain really in many ways, your sense of hearing and your sense of balance with your middle ear, it’s just so diversified in different ways. I think that allows for just a lot of really interesting ways that you can impact people in positive ways, so I think that’s really cool. How then did you wind up at Phonak?

Lena Kyman:

For me, the opportunity came up. I’d always been interested in working on the manufacturer side of things when I was a student. And when I was in clinic any time a manufacturer, whether it was the sales rep or the trainer came to the office, I would grill them with questions. What’s your jobs like? What do you do? What’s your day-to-day? They would give you some answers and then I’d be like, okay, but what are you doing tomorrow? What patients do you see and get really specific? I think I’ve always been interested in the industry side, the manufacturing side, and Phonak, great manufacturer, huge fan. I was a fan in clinic. I fit a lot of Phonak. I’ve always had great relationships and great admiration for all the research done at Phonak.

Lena Kyman:

When the opportunity came up, it just made sense. And for me, what I love about being on this side of it, is that I feel like my scope and my reach, I’m able to help more people at the same time. In clinic I would see X amount of patients a day, but now if I can see X amount of providers who see X amount of patients a day, it’s like I’m casting that net a bit further and having a bigger impact. So that was really appealing for me.

Dave:

I think that’s so cool. It really is. You’re at that next level in terms of just the sheer scope of people that you can reach, if you will. Just as you mentioned, because of the fact that each provider sees a set of patients every single day, it allows you to cast a wider net. And so I’m curious, from your perspective, because I do think that’s really unique, where I do think this industry has a number of people that are a little bit older than you and I, that have done both sides. They’ve worked for the manufacturers and then they’ve gone off and they’ve done their own. How do you see the world? What would you tell Lena, the Lena that was pre Phonak and vice versa?

Dave:

I’m just really curious of the way that you now see the world as being on the manufacturer side, what are some of the things that you think are important considerations to understand as it relates to, if you have only operated inside of one of the manufacturers or if you’ve only operated as a private practitioner, what are some things that might be valuable or interesting as it relates to operating in each of those two worlds?

Lena Kyman:

That’s such a good question. That’s a lot to think about. I think if I could go back and tell myself as a clinician, I would encourage reaching out to the manufacturers more for help, because the technology is advancing so quickly and it’s a lot. I have a full time job being an expert in one manufacturer’s technology. And so for people who are out in the field who fit multiple manufacturers, let alone keeping up with all the diagnostics and everything, it’s a lot to know. I very rarely called on a clinical trainer or called the manufacturer to help with the fitting. And yet, so much of what I do now is helping see patients and helping with specific fittings and applying this technology.

Lena Kyman:

I always liken it, if you’re a clinician trying to fit another manufacturer’s hearing aid that you’re not as familiar with, it’s like driving somebody else’s car, you know what you’re looking for, but you don’t know exactly where to find it. How many types of options there are. Do the windshield wipers, are there three different speeds or four, or is it a twist or a click. The technology is changing so fast. I think I would encourage myself as a past clinician and all clinicians now to rely on your clinical trainers. That’s why we’re there. It’s different types of conversations, of course your sales representatives have more business conversations which are important of course.

Lena Kyman:

There’s a difference too, between calling on your trainer, who’s in your geographical area, who’s probably met you before versus calling headquarters, maybe getting put on hold and not having a face to the name of what you’re talking to, especially in this virtual world, we can connect on video and share screens. It can really be so meaningful. I would encourage, again, my old self that it’s not shameful to have to ask for help or to not know the answer. It’s not like you’re uneducated or not keeping up with the times. There’s just so much and so many nuances and the software, we can do so much more now than we could however many years ago, that it’s worth calling to ask for the expert in that technology. Because maybe there’s something that you don’t even know exists, that could be the exact answer for that patient.

Dave:

That was such a good answer. It’s like I’ve never been on a podcast before. All right, let me hit you with a very difficult question to kick things off. I love the analogy too, to the rental car, because that’s a great way to think about it, or it’s not your own car. You’re not fully used to it. You have an idea of what to expect. Let me ask you though, what are a lot of the common questions? It sounds like obviously technology is at the heart of what a lot of what you’re doing, is guiding people to some of the new solutions, some of the different capabilities that the technology that today has. I would definitely to get into that as the conversation goes. In your day-to-day when you’re meeting with all these different providers throughout the day, what’s the common denominator, if you will, what are some of the frequently asked questions?

Lena Kyman:

Bluetooth, is the answer. Everything’s Bluetooth. It’s so funny because Bluetooth hearing aids, we talked about how you and I are on the younger end of this profession, but I’m going to date myself that even though I’m one of the younger audiologists, Bluetooth hearing aids were not invented when I was in grad school, they were not a thing yet. We had accessories that could Bluetooth, but there was not Bluetooth and hearing aids. And yet now Bluetooth is such a huge part of what we do. The technology has advanced so much that when you’re doing an initial fitting for your patients, whereas, 10 years ago, the majority of that fitting was fine tuning and trying to get to targets and making it sound right. And then at the end, you’d show them how to change the battery. Whereas now you can do a first fit in seven clicks and beyond target.

Lena Kyman:

And then you have the rest of that appointment to pair it to their phone, download the app. Most of the time you have to reset somebody’s iCloud password for them. It’s such a huge part of what we do. I know more about Bluetooth now than I ever thought I would know about when I was in grad school to be an audiologist. Not a day goes by where I don’t ask, did you turn it off and back on again? Which I think was an SNL sketch with Jimmy Fallon, back in the day, the IT support. But it’s true, and sometimes it’s such a simple solution, but we all just got to turn it off and turn it back on again. But the biggest common denominator is Bluetooth, and it’s amazing, it’s a wonderful technology. We can do so many cool things wirelessly, but there’s no doubt about it. It’s a glitchy technology.

Lena Kyman:

There are times when I get into my car, which granted is not very often anymore, but I go to pair my phone to my car because my partner and I, we share a car, so his phone was last connected, so I have to connect mine, and it’ll take me three tries. I know what I’m doing. I know how to do it, but it doesn’t work the first try and it doesn’t work the second try. And then I have to change the order of turning things off and on and then it works. Same thing with if you have a smartwatch, there are times where it takes me three or four tries to get my watch to reconnect to my phone after it had died. And that’s just the way it is with Bluetooth, it’s everywhere.

Lena Kyman:

Bluetooth is wonderful, but it’s a glitchy technology. I had a customer recently, an audiologist, she was just getting so frustrated with all this Bluetooth. She told me, I wish I had a shirt that said, I’m an audiologist, not a cell phone technician. And that actually spurred creating this whole hour long CEU presentation on Bluetooth alone, that we’ve been giving a lot and getting really good feedback from, because it’s like, here’s all the things no one ever taught us, but now we need to know about fixed bandwidth versus adaptive bandwidth and 2.5 gigahertz, Bluetooth classic, Bluetooth low energy, LE Audio. There’s so many different things now that just weren’t around when we were getting educated on hearing aids.

Dave:

You hit on such an important topic right there, for real though, this is I think such an important thing to talk about. I love that you mentioned at the beginning there where it’s like, I have this excess portion of my day, because some of the automation that goes on. I totally understand the frustration that is felt by audiologists like the one that you mentioned where it’s like, I want to just have a shirt that says, this isn’t what I signed up for. But the fact of the matter is, is that, this is such an important part of the technology today. Hate it or love it. It’s just part of it. I love that Phonak is going above and beyond to do everything they possibly can. But to your point, as a tech savvy person, I struggle with it too, and it’s like, who knows?

Dave:

You get a software update overnight that you’re unaware of, and then bam, your technology isn’t pairing properly anymore. It’s something that I think we’re all frustrated by, but at the same time, the upside is all this great connectivity that comes with it. But it is something that I love. I just love that whole thing, because it’s like, this is something that isn’t, I don’t think being talked about enough, which is that it’s something that everybody’s experiencing. It’s something that every patient wants, but also is offloading the heavy lifting to their provider. It’s part of their patient expectation of like, well, why is this thing not working? My audiologist must’ve done something wrong. Right? I really, really sympathize with this whole thing, because I do see it as being both, it’s a double edge sword, there’s a lot of positives, but there’s a lot of negatives that are tied to that.

Dave:

The thing about it is, it doesn’t feel as if it’s going to go away. I feel in fact, it’s actually going to probably increasingly become more complex. I know that there are things that the manufacturers can do that can help to simplify things and try to make this just a little bit more seamless. But, man, it’s so true of everything that you said there, where it’s, I feel this is something that is probably the most frustrating thing amongst a lot of audiologists today, is this notion of, I didn’t go to school for this and I get that. But I feel at the same time, there’s really no avoiding it.

Lena Kyman:

It’s not. It’s not going away. If you don’t want to deal with Bluetooth, you got to find something else to do. And I don’t know what that is. It’s not going anywhere. I just feel there’s this disconnect, the rate at which technology is progressing and the rate at which we can educate people, it’s like, one is going faster than the other. I had an appointment recently, where, Phonak has this great technology called Tap Control, which can enable you to do all these cool things. You can double tap your ear and access your voice assistant and do anything. You could ask, what’s the temperature outside? And you’ll hear it in both ears. Or you could double tap and say, text mom, I’ll call her tomorrow. And then I’ll hands free send a text to my mother.

Lena Kyman:

And then I can double tap and say, set a reminder, call my mom tomorrow. Anyways, you can do so many things. It’s great technology, but the patient has to be taught how to do it. The provider really, there’s a lot of nuances to set you up for success. It’s not just as simple as turning it on or off. I met with someone recently who I hadn’t had a chance to connect with in a while. They said that they’ve been fitting all these devices, but they turned that off, because they didn’t really know what it was and didn’t understand it. And they just automatically turned it off for everybody to avoid the complication. That hurts my heart to hear that, because if I could have gotten there sooner to teach you this and set you up for success, how many people could have been using it.

Lena Kyman:

And granted it’s not for everybody, not everybody needs it or wants it, but the potential is there. And so I think there’s this disconnect, the technology is advancing so rapidly, which is wonderful, but we need to get all of the people interacting with that technology caught up, and that’s a challenge.

Dave:

It’s a big challenge and it’s not going away, like you said. I think that’s, again though, this is where I think that it’s all about how you frame it both in your mind and also the that you position it in your clinic, because here’s the fact of the matter, big box retailers and online sellers are not going to be doing this. And so this is where, again, even if this frustrates you, you have to recognize it as being an opportunity to really differentiate yourself, on the basis of going the extra mile for people. And to your point, the fact that now maybe that fitting process went from being a 60 minute window to now really 45 minutes, but you still have that additional 15 minutes. The name of the game is like, how do you maximize the time in that space? Some of it might be getting them set up, right?

Dave:

This is something I’ve been talking about. I’m going to be doing an audiology online presentation soon where, this idea of, you might have patients in there that were voracious readers and they’ve never been introduced to an audio book and you have that opportunity. That’s not really in your scope of service, but at the same time, we all know this to be a very word of mouth driven business. If you can have that person walk away, A, feeling awesome about their own experience, the secondary effect of that is, they might go out and tell everybody, I love these hearing aids that I have, because I can hear better. But also because now I’ve been introduced to this audio book. I know that’s a really roundabout way in which the provider can harness some value and derive value from that experience.

Dave:

But again, put yourself in the shoes of your patient. They don’t know a lot of this stuff that exist. You can be the one that shepherds them along into these different aspects that are really, really cool and will really resonate with some of them. But again, it all fits into this bucket of like, if you’re always going to operate under the assumption of, that’s not really audiology, that’s not in the scope of my service, then you have to ask yourself, well then how do you really differentiate from some of these other places? And that’s not to say that it’s the end all be all, but these are just opportunities I think, to really stand apart.

Lena Kyman:

Absolutely. Especially as you think about all the research coming out, looking at how hearing health is related to overall physical health, audiology is changing. And again, it’s wonderful, but it’s on us to open our patient’s eyes, because they don’t know what they don’t know. For a lot of people, just the term Bluetooth is intimidating. There are people out there with flip phones, a flip phone is a choice at this point and they might think, I don’t want Bluetooth. That’s complicated. But if you set it up for them and teach them that instead of holding their flip phone on speaker phone up and trying to hear it on one side, they can leave it in their pocket, have a hands free phone call and hear it in both ears, that might make the difference of whether or not they talk to their grandkids every week versus once a month, or it’s connecting to their family.

Lena Kyman:

And even little things like enabling caller ID announcements. Most people don’t know that that’s an option, but that’s something that people love. I love it. I wear my hearing aids all the time. I don’t have hearing loss, but I have two phones. I have a work phone and a personal phone and they’re always on me. I typically go on a walk every day and I’ll put one in each back pocket or one in each coat pocket if it’s cold, but I have my caller ID announcements enabled, so that if my mom calls me on my personal phone or my boss calls me on my work phone, or somebody’s calling me about the extended warranty of my vehicle, that I don’t even own, I’m going to answer the phone with a slightly different tone of voice for each of those.

Lena Kyman:

So being able to be holding my dog on a leash and holding a water bottle and not have to worry about who’s calling me, I can just double tap my ear and answer the call and know who I’m picking up for, it’s such a big deal. It’s a wonderful thing to have. And it’s so simple. It’s just a setting in your phone, but most people don’t know about that. And no it’s not an audiological setting, but it may be an audiologist who tells somebody about that feature.

Dave:

I’m curious, since your dealing with so many of these providers that would be in those scenarios, what’s the feedback that you’ve gotten? Obviously you mentioned the woman who had the shirt. And again, I understand that, but is this something that you think is recognized as like, yes, it’s not necessarily in the scope of service, but it could be part of that process. It could be part of your suite of services, if you will. If you view this more of, you’re a communications expert to an extent. Do you feel as if this is something where it is actually resonating with the providers in the industry that as frustrating as it might be, it does present that opportunity?

Lena Kyman:

I think we’re getting there. Any given day, I’ll see a whole range. There’s lots of different types of providers out there, but I think the ones… Change is hard. Change is scary. There’s no doubt about it. Even I get frustrated when something new comes out, because I’m like, well, I have to teach everyone else. Change no matter what, even if you’re excited about it, change is hard and change is scary. But I think the most successful hearing care providers are the ones who embrace change. Maybe they never thought they would do telehealth when I was in clinic, they first came out with remote support and telehealth and they came to me, to the office to talk about it. I immediately said, no, thanks. Very close minded. I was not even interested in learning about it.

Lena Kyman:

And now, look at 2020, telehealth is what saved so many practices and kept them open. People embracing change and embracing that, maybe I have a whole appointment where all I do is help somebody with their phone, you charge for that, you bill for your services. I think we’re getting there and I think people are embracing change, but it’s a slow process and it’s not a uniform process, so many different types of providers out there.

Dave:

Well, I love the comparison to telehealth because I think you’re right, where it’s like, it starts off as a novelty and then it becomes a nice to have and then it becomes a need to have. Right? Bluetooth is a very similar in the sense that I was actually just looking at some old surveys that were issued by, I can’t remember one of the publications in the industry. It’s really interesting. I would love to plot this to show where you can see based on the survey respondents who are hearing aid wearers, basically the demand for Bluetooth functionality. It starts off and it’s in the single digits and then it’s in the tens. It’s in tandem with smartphone adoption growth, that you go into the mid 2010s and then you get up to about today and it’s almost like, it’s a standard, it’s something that you just come to expect.

Dave:

I think telehealth might ultimately get there too. I think it will take a little bit longer, but I think you’ll have to have some element of telehealth, where you’ll have to have that need, because of the patient expectation. Again, I think this is the really big thing to understand is, it doesn’t necessarily matter what you think about it. It’s, what’s the overall consensus of your patients? And so I think that that’s a really important thing to think about, is that, especially around Bluetooth today is becoming standardized. I think there’s just more elements of this that are new, that are novelties right now that ultimately might become in that standard, fit that same bill.

Lena Kyman:

Absolutely.

Dave:

Changing gears a little bit. I want to talk about, so you mentioned your dad, this is pretty interesting. I always find it cool when people have this personal connection to what they do. Your dad has, you said he has an implant or he has implants?

Lena Kyman:

He has one implant. He has a hybrid implant. It’s part implant, part hearing aid on one side, and then he has a hearing aid on the other.

Dave:

I find this interesting though, because obviously you’re a provider and now you’re a trainer. But you also have this very direct experience with a hearing aid wearer, or a technology wearer. I’m just curious, what has his journey been like in your opinion? As somebody that has sort of, it sounds like early on he’s been diagnosed with this. You’ve probably seen somebody that has partaken in this evolution of technology in the progression of it getting more advanced. What would you say is his experience in terms of that whole span of the different iterations that he’s experienced and maybe some of the really big benefits of that? Maybe some of the detractions, I’m just curious to hear about his experience.

Lena Kyman:

He’s a difficult patient. I emailed and called his current audiologists personally to warn her ahead of time that he’s a difficult, capital D, difficult patient. He’s wonderful. I love him, there’s no doubt about it, he’s a difficult patient. His journey has been interesting. It’d be so different if he didn’t have an audiologist for a daughter. For example, again, he started seeing an audiologist and recognized that he had hearing loss and got hearing aids before I knew how to spell audiology. But since then, I’ve gradually become more involved in his care and in his journey. And when he had a dramatic decrease in one side, it was when I was in grad school and I was immediately, I’d learned about it that day. I was like, daddy, you have a tumor.

Lena Kyman:

You have an acoustic neuroma. He didn’t. I was like, you had a sudden loss on one side, that’s it, you have a tumor. He does not. But he was wearing hearing aids and just really struggling. I live thousands of miles away from him. It’s not like I can test this hearing whenever I want. It’s not like I can change his wax trap form or resync as Bluetooth when he’s having trouble, which I wish I could. A lot of walking over on the phone. I presented the idea to him, there’s this new technology where it’s designed for people with hearing loss like yours, where you still have good, low frequency hearing, but worse than the highs. I had never worked with a hybrid implant. They had just gotten approved from the FDA when I was still in school.

Lena Kyman:

But I reached out and got him in touch with a surgeon and an audiologist who works with implants and that ended up being his journey. He talks all the time like, he hears so much better now, but he never would have even looked into that if I hadn’t suggested it. That’s one of the flaws in this industry, where there is this disconnect, where you’re either an audiologist or you’re not, but there’s so much middle ground where we could be making referrals and getting patients access to more technology. Same thing with Roger, Roger can change people’s lives. It has my dad’s. He refers to Roger, like he’s his best friend. It took me years to convince my dad to use Roger because he was intimidated by the technology. He thought it’d be complicated. He wasn’t sure.

Lena Kyman:

And then finally I just made him do it, because I have the ability to do that, and now he loves it, but it took time. And so his journey, again, he’s a difficult patient and it’s complicated because he has a mismatch of manufacturers, where he has the cochlear implant on one side and a Phonak hearing aid, spoiler alert, on the other. But it’s really Roger that bridges the gap for him, that makes it so that he could stream his TV to both ears or his phone or his computer and his podcasts. There’s no doubt about it. It’s complicated technology. Just as recently as last week, he needed help resyncing his Roger to his implant. There’s no doubt about it, there’s job security for hearing care providers to provide that service for patients and for clinical trainers who work for manufacturers to provide that same level.

Dave:

You said a few things that I really want to unpack there. The first thing I’ll comment on is I fully agree with you. I’ve said it before that as the complexity rises in this industry, which I think it will do because of the amount of technology, that will lead to more demand for expertise. And so that’s why, again, I think that there is such an impetus on the industry too, as frustrating and challenging as this can be to own it. This is our domain, right? We have to own this, so that nobody else comes in and takes it from us, more or less. I do think that’s a huge boon for the providers out there, is that, you will have really good job security so long as you’re willing to change with the times.

Dave:

One thing you said though, that was really interesting there, you said that, there seems to be a gap around implants. I know that you said at the beginning that, cochlear implants was the one aspect of audiology that you never really did. For my own curiosity sake, and for some of the listeners out there, how can the industry be better about implants as a whole? What do you think is the right role that the industry by and large can be playing here? It seems to be another one of those areas that’s just almost underdeveloped, within the industry and I’m trying to understand what should we be striving for that might collectively make sense.

Lena Kyman:

That’s a big one. I don’t have the full answer to solve all the problems, right here, right now. I think especially in rural areas, having more hearing care providers be more familiar with and more willing to serve implant patients. For example, my parents live in a small town and I won’t say where just for the sake of not calling anyone out, but the point being, where he got implanted, the closest implant center, I think is a six and a half hour drive for him. He had to drive six and a half hours up there. Of course stay the night when he had a surgery and all of this, come home. And then however many weeks later it is, go back for the activation and then go back home. He couldn’t find an audiologist in his town who worked with cochlear implants.

Lena Kyman:

Anytime he had a problem, and again, he’s a difficult patient. So there were problems, there were air mold issues and all kinds of stuff. If his receiver died or whatnot, anytime he had a problem, he had a drive six and a half hours. In the beginning, that was his impression that he had to do that, even to just get somebody to look at his ear mold. And so I think, and granted now, he has found a new provider who’s much closer to home and she is wonderful. Again, I called her to preemptively apologize for how difficult he is. But I think having, especially in rural areas where there’s not necessarily a huge cochlear implant center with world renowned ENT surgeons, where maybe somebody travels for that surgery, but having more providers in rural areas be willing to see implant patients. And even if you’ve never done it before, learn how, contact those manufacturers, get training.

Lena Kyman:

But I also think, that’s going to change as telehealth becomes more and more prevalent and available, we’re able to do so much more. But I think there’s opportunities for hearing care providers to branch out into more things, just for being ready to help anybody who walks in their door. Whether they bought a hearable online that they want to know if it’s meeting their needs or not, or whether it’s their hearing aids or an implant or whatever it is. I think just being more open to conquer any challenges that come through your door is going to be important.

Dave:

Great answer. I love that. The next thing I wanted to ask about that you mentioned initially was. Roger. I’ve actually not really talked about Roger before, and this might be a really good opportunity as somebody that is a clinical trainer on the technology, especially as it relates to the new chip that you all have, which as I understand it, you can integrate directly into it. It connects and pairs directly. Will you just share the premise of Roger?

Lena Kyman:

Absolutely. Roger’s the best. It’s the most exciting technology to talk about. It’s the most fun technology to demonstrate, because people’s jaws hit the floor when you’re demonstrating Roger. Granted it’s been over a year since I’ve done an in-person demonstration, but demoing Roger is so much fun. Roger is a wireless protocol, it’s on 2.4 gigahertz and it’s a system. It’s a transmitter and receiver. If you think of the phrase, Roger that, Roger stands for Received Order Given, Expect Results. And that’s what we want. We want you to understand the message. That’s what Roger does. There are different types of Roger transmitters and different types of Roger receivers, and Rogers for everybody. When I was in clinic, I totally shied away from Roger.

Lena Kyman:

I found the technology intimidating and complicated, and I didn’t know how to talk about it. In my mind, it was only for severe to profound hearing losses who needed cochlear implants or kids in schools. And granted, I dabbled in those populations, the majority of the people I saw were not necessarily in those buckets. However, and it’s funny, in six years of private practice, I think I fit one Roger. And now it’s my favorite technology to talk about. I presented on it, at Phonak’s national sales meeting. I tweet about Roger all the time. My dad uses Roger, it’s my favorite.

Lena Kyman:

So when you actually look at the market research and fitting data, the majority of people who use Roger, have a moderate degree of hearing loss or less.

Dave:

Wow, okay.

Lena Kyman:

When I was out the door, my misconceived notion is that, the audiogram determined who could benefit. Ultimately anybody who needs to hear better in significant amounts of background noise or distance can benefit from Roger. It can help in group situations, in your yoga class, in your church, in your school, in your book club, any number of situations and even more so than that. It’s so much more accessible than it was before. There’s no doubt about it. It used to be complicated, but it’s financially more accessible. It’s logistically more accessible for the provider. It’s functionally more accessible for the patient, with the developments we’ve had with Roger direct like you said.

Lena Kyman:

Instead of adding external parts and pieces and wearing things around the neck and making it all super complicated with pins and stickers, it’s this digital installation of a receiver, and then you can connect to these transmitters. There’s so much research on Roger and the hearing performance with Roger, there’s no arguing with it. They did a study and it hasn’t been published yet. I don’t have 100% of the details, but ultimately they had patients and all different types of technologies, different types of hearing aids, and they were given the opportunity to use Roger. And then I think at the end of the study asked, would you want this? Would you use this? Did you prefer this?

Lena Kyman:

100% of the people said, yes, they want Roger. They prefer Roger. There’s no wiggle room there. There’s no arguing with 100%. They’ve done studies comparing listening for people with hearing loss with Roger, compared to normal hearing listeners and people, even with hearing loss, when they have access to Roger, they hear better than normal hearing listeners. It’s this amazing technology, but again, we need to talk about it more. There needs to be more awareness about it and it’s accessible to everybody. While the seamless integration, the best case scenario is that it works with Phonak hearing aids. It’s accessible to people with non Phonak hearing aids. It’s assessable to people with cochlear implants.

Lena Kyman:

It’s accessible with sound field systems. It’s accessible to everybody and it can make such a big difference. It’s accessible to people with auditory processing disorder or ADHD who just needed a boost in school. There’s so many applications for Roger. And again, it’s the most fun one to demonstrate, because when you turn it on, especially if you’re in a noisy place and granted, I haven’t left the house in a year, I haven’t been in a noisy place and I don’t know how long, but when we moved back into that, it’s the most fun demonstration, because when you turn it on again, people’s jaws hit the floor, their eyes light up. You can just see this reaction, and you’re so blown away by the clear sound quality.

Dave:

Let’s just hypothetically say I come into your clinic back when you were a clinician and you’re all on board with Roger, what are going to be maybe the two to three most common, red flag just went up, that’s a Roger candidate right there? What are some of the most common examples? Because I understand it, but I’m trying to really communicate to the audience now to say, these are the times where it really makes sense. You’d listed a few there, but just in your mind, are there a few where you’re like, man, this is, gosh, Roger is a killer application for this particular instance?

Lena Kyman:

That’s an easy one to answer, because it’s so versatile. It’s not just one thing for one situation. So say you came in and you were like, I have trouble hearing my partner on date night. We go out to different places. I have trouble hearing them and I have trouble hearing my TV. I have trouble hearing everybody wearing masks. When I’m in line at the grocery store and the cashiers has the mask and the plexiglass, I just can’t hear. And I have trouble with my friends at our book clubs. That’s four different things. As a clinician, you might be thinking, well, I could do the hearing aids for this. I could do a remote microphone for the one-on-one conversations, a TV device for the TV, maybe just increase gain, or noise reduction. You can piece together these different things.

Lena Kyman:

Whereas, one Roger can handle all of that. It can handle one-on-one conversations. It can handle TV streaming. It can handle masks with just a pointing mode. It can handle group conversations. The best example of a red flag indicator, this person needs Roger was, I was helping somebody, an audiologist called me saying they had this patient who’s a horseback riding instructor. Immediately I was like, they need Roger. But they went the whole story about what their problems are, there’s distance, there’s noise, there’s wind. I of course let them finish, I didn’t want to interrupt, but that was the most red flag. Of course they need Roger. That person ended up getting Roger and it made such a difference for her. It’s really, it’s a night and day difference with Roger.

Dave:

I love the comparison of like, yes, you can piecemeal this together. You can come up with all these different things, but as I understand it, that’s what’s so great about it. Is it’s this all in one solution and it used to be before the Roger direct capabilities, you had to wear a neck loop, where it would then stream to the neck loop and then the neck loop would stream it to your ears. So now that it’s all integrated in the hearing aid, it really is, it seems to be a killer accessory. That again, this all comes back to this notion of, how do you stand apart in a market that’s constantly becoming infused with new offerings and new channels that people might be able to go and get this from.

Dave:

And so if your whole notion is, well, I’m a premium offering, I’m an expert, I’m medical, whatever that might be. I just feel these are the kinds of things that, yes, they’re different. I think that’s so interesting that you were in a position, in a private practice for six years, you knew about this, but you never really took that next step. And so the question is, how do we get people on board with this notion of, technology if you embrace it and you take the time to understand the ways that you can position it. I just think that historically there hasn’t been as much of a need to do that, because there weren’t as many competitive channels that were competing for your patients, good or bad. And now everywhere you look online, there are these shoddy devices that people are trying to market to your patients.

Dave:

Everybody knows, that’s not what they want. So then it just becomes, well then how do you solicit their attention? How do you make it so that they come and see you? It feels like it’s a combination of all these different things, which is just knowing so much about what exists and that’s challenging. And that’s why we need clinical trainers like you. Because it does feel at the crux of everything is going to be that expertise of not only audiology, but the technology too.

Lena Kyman:

I think there’s a lot in how we present it too. We need to get out of the habit of making assumptions about what people want or don’t want, or making decisions for them. Like, well, they’re not going to want an extra thing, or this is too expensive for them, I can’t talk to them about it. We need to lay all our cards out on the table. I found that when I’m training people on Roger, it makes such a difference. A lot of people and I’m guilty of this. I say this, not to shame anyone who thinks this, but we just need to reframe the conversation. In my mind, Roger was a last resort. If you were still struggling, if somebody came back and you fit them with hearing aids and they had problems, you’d make adjustments.

Lena Kyman:

And then if they came back again, you’d add a manual program. And then if they went out in the real world and came back, and then you said, well, I have this other thing, we can try it. This is what it is. It’s like, at that point, it’s a last resort. Why didn’t you tell me in the beginning? I don’t know. I’m frustrated. I don’t think I want that. Whereas if on day one, you lay it out, again, as a provider, you don’t just fit hearing aids, you provide comprehensive hearing solutions. This is the best case scenario, backed on research to get you hearing better in the situations that you had described from the beginning and doing that demo, which is just mind blowing for some people.

Lena Kyman:

Even if maybe they decide to get it after that demo on day one, at that point, they know it’s an option. They can go out into the real world and realize, wow, this is great, but it could be better and then come back. I think, I have my work cut out for me to get the word out about Roger and train everybody on it. But again, just making it more accessible for people, it’s not as complicated, it’s not a last resort to pick up for when hearing aids fail. It’s part of the big picture, best case solution for a lot of people.

Dave:

I love that. The comprehensive suite of solutions, that’s how I see it too. I think that’s such a great way to frame it. As we come to the close here, pandemic, any new hobbies? What’s life been for you? I know you’ve been working from home, but what’s 2020, and now into 2021 been like for you?

Lena Kyman:

I can’t say that I have any tremendous new hobbies, which I feel like, man, I should have better used the pandemic to build a hobby. But I will say, I’m a rock climber. And I stopped going to the rock climbing gym obviously, but we built a rock climbing wall in my shed.

Dave:

Holy cow.

Lena Kyman:

Yeah. It’s awesome. So now just on my lunch break, actually right before this, I was rock climbing. My hands are a little tired.

Dave:

Nice.

Lena Kyman:

I can just walk out, three steps out the door and do some climbing. That’s been the biggest upgrade.

Dave:

You don’t do free solo, do you?

Lena Kyman:

No, no, no, no. It’s eight feet tall. I mostly go left to right. Pretty low consequence climbing.

Dave:

When you do go out and about into, when you go climbing outside of the shed, what’s the coolest rock you’ve ever climbed?

Lena Kyman:

Coolest rock I’ve ever climbed is Grand Teton and Wyoming. I climbed with my dad. Funny story, he did not wear his hearing aids. I think he cared about losing them. It’s like, if anybody could afford to be a little bit reckless with their hearing aid technology. I could help him out, but he could not hear anything. And it’s-

Dave:

Sounds peaceful.

Lena Kyman:

Now I actually use pictures of us climbing, being like, imagine if he had Roger, imagine how much better I would have felt if he could have heard me, because he’s holding the rope that I’m attached to.

Dave:

That’s so funny.

Lena Kyman:

That’s the biggest and most beautiful rock I’ve ever climbed.

Dave:

I love it. Cool. Well, this has been such a great conversation. For your first podcast, I think you really killed it.

Lena Kyman:

Thanks.

Dave:

Thanks for coming on though. This has been an awesome conversation and I love your perspective. I really do. I think it’s so cool that you had this passion, you pursued it, you got into these different facets. You were in private practice. Now you’re a clinical trainer. I love what you said at the beginning where it’s like, initially when you were in your practice, you got to impact just your own patients, but now second hand, you get to impact all of the providers that you train their patients. I just think it’s so cool. I think that as a fellow young professional in this industry, it’s just really cool to see what you’re doing.

Dave:

I’m really cheering for you as you continue to progress up the ladder, because I saw, as you said, you did that national sales meeting and you presented there and it sounds like you really kicked butt at it. Congrats on that. Again, thank you for coming on here today. This has been great.

Lena Kyman:

Thank you. Same to you. I think you are such an awesome presence in this industry and you have such a wide reach and so much of the information I get is just from your Twitter. Here’s what [inaudible 00:54:16] or voice assistants. You’re such a great resource for people.

Dave:

I appreciate that.

Lena Kyman:

I feel honored to be here. Thanks for having me.

Dave:

My beer is just about gone.

Lena Kyman:

Same. That’s our cue.

Dave:

Cheers to you. Yes, that is our cue. Cheers to you. Cheers to everybody who tuned in here to the end and we will chat with you next time. Cheers.

Lena Kyman:

Thanks Dave.