This week on the Future Ear Radio podcast, I’m joined by the great Audiologist, Dawn Heiman. Dawn wears a number of hats – she’s a private practice owner, podcast host, CEO of a Mastermind group of likeminded professionals, and the President-Elect of the Academy of Doctors of Audiology (ADA).
During this conversation, we discuss Dawn’s backstory and motivation for becoming an Audiologist, which is rooted back in her childhood. From there, we talk about her journey to where she is today and some of the most pivotal moments along her journey. The second half of the conversation explores a similar theme that’s been permeating on the podcast lately, which is, “what are the big opportunities for Audiologists to be successful across this next decade?”
For me personally, this question runs through my mind constantly, as our company Oaktree Products sells clinical supplies to the hearing professional. Our success as a company largely hinges on the success of our customer base, hearing professionals. So, the podcast has essentially become a form of catharsis for me, as the most effective way to alleviate my fears is to talk through the opportunities and threats that hearing professionals face with some of the smartest hearing professionals out there.
This is why I really value people like Dawn’s perspective. She’s been challenging the status quo and pushing the boundaries of the profession for decades. So, when I have these discussions with Audiologists like Dawn, Angela Alexander, Laurel Christensen, Kat Penno, Elaine Saunders, Brad Stewart, Jon Suen, Kim Cavitt, Geoff Cooling, Steve Taddei and Abram Bailey (to name a few), and they’re all sort of saying something similar…which is that the true value of the professional is the professional, then it really boils down to how to properly monetize the professional and their time.
How exactly the professionals maximize their value/time, whether it’s by specializing in areas such as tinnitus, cognition, APD, vestibular, etc, or it’s by augmenting the brick and mortar offerings with online services through platforms like Tuned (much more to come on this), is going to be something that’s solved incrementally. Changes in the macro environment, such as an expansion in Medicare covering Audiological services and the introduction of OTC devices into the market will certainly shape the viability of the professional as well.
Ultimately, though, I believe this next decade will provide hearing professionals who are motivated to adapt to a changing landscape to make as outsized of an impact as we’ve ever seen before as industry. That’s why I am increasingly optimistic about the future success of the hearing professional – because people like Dawn are out there constantly challenging the status quo.
-Thanks for Reading-
Dave
EPISODE TRANSCRIPT
Dave Kemp:
Hi, I’m your host, Dave Kemp, and this is Future Ear Radio. Each episode, we’re breaking down one new thing, one cool new finding that’s happening in the world of hearables, the world of voice technology. How are these worlds starting to intersect? How are these worlds starting to collide? What cool things are going to come from this intersection of technology? Without further ado, let’s get on with the show. Okay. So we are joined today by Dr. Dawn Heiman. Dawn, tell us a little bit about who you are and what you do.
Dawn Heiman, AuD:
Hey, Dave, thank you for having me. I am a private practice audiologist, but I wasn’t always. I’ve worked in pretty much every setting an audiologist could practice in. And then I also have a side business where I’m trying to fill the needs of our audiology world. Basically it’s self-serving as I find something that I need, I then share it with the world.
Dave Kemp:
Well, I love that. Well, we’re going to get into a lot of that today. Before we jump into all that though, I’d love to always hear more about our guests and the backstory. And so I would love to sort of hear your journey and I should note as well that Dawn is due to be the president elect for ADA in 2022. So congrats on that. And I figured that gives us an opportunity of saying, okay, so here’s kind of where you are today as the president elect of ADA. So let’s work backwards and, and start with like, how did you even come into this profession? What was your initial motivation and some of the different monumental, kind of experiences along the way that shaped your whole perspective on this profession?
Dawn Heiman, AuD:
Well, how far back should we go? I guess when I was eight, I went to summer camp and every cabin was paired up with another cabin of campers that were the same age and that summer they paired our cabin with another cabin of eight to nine year olds as well. And it just happened to be that, that other cabin, all of the kids in it had hearing loss, they were deaf. And back in the ’80s and 1983 hearing aids weren’t really much of anything. So I don’t remember if any of the kids were actually wearing hearing aids. And when you were paired with another cabin, you received a buddy and you did everything with your buddy. And if you had to go to the bathroom, your buddy went too. If you’re on a hike, your buddy went too. You’re doing rifle range, you name it, swimming.
Dawn Heiman, AuD:
And my buddy couldn’t hear. And I remember being on this long all day hike and I go, “Oh, well, look at that.” And then realize, oh, that’s right, my buddy can’t hear me. And I’d have to like, get their attention with my hands and point to things. And it was pretty eyeopening as a kid to realize, wow, not everyone can hear. And so going forward, I tended to be a student athlete and I was pretty competitive and stuff like that. And of course, and I was also a babysitter. So I was your, I think typical American girl that thought she was going to be a pediatrician. And I get to school, I wasn’t the best student mainly because I was in honors classes, but I had no idea how to study. And whatever I get to college and I decide maybe I’ll be an occupational therapist.
Dawn Heiman, AuD:
I was doing the medical track and bio one, chem one, psychology, all of these classes were pretty big at the university of Pittsburgh, 500 to 750 kids per lecture. I was just a small little person and decided, “Okay, I’m going to do occupational therapy.” Then that first summer they sent me this packet that was about three inches thick of all of the crafts I was supposed to do that summer for occupational therapy. And I’m like, “Wait, crafts. I don’t do crafts.” That’s not the profession I thought it would be. So I was life guarding and a couple lifeguards were in communication disorders. They were going to be speech pathologists. So they said, “You should sign up for intro to communication disorders.” And I’m like, “I have no idea what that is. Fine. It’s an intro class, should be pretty easy.”
Dawn Heiman, AuD:
So my sophomore year I did that and I met [Dr.Diane Sebo 00:04:40] who was my professor. She was the director of audiology at Children’s of Pittsburgh. And she then let me start volunteering in the clinic. I got to assist with testing. I got to help check in loaner, hearing aids and all that kind of stuff. And I was like, this is it. So as a female audiologist, a lot of us, our dream, our real poll was we’re going to do pediatric cochlear implants. Okay. So back then the doctor wasn’t a thing yet, but I had a passion. This was what I was going to do with my life. And fast forward, I did end up being in pediatrics for nine years of my career. I did do work with people with cochlear implants, kiddos with it. And that was extremely fulfilling. But when I decided to go into private practice, it was more so for my family and for me. I guess I in a sense succumb to the fact that I would have to see adults and fit hearing aids in order to survive.
Dawn Heiman, AuD:
Now, in my fellowship year, I was going back. Let’s go back a few years back. Before the doctorate, you did a fellowship year after your master’s degree. And I was in New Jersey and I had the opportunity to work with some amazing people. Elizabeth Patterson was my CFY supervisor, and she knew everything about central auditory processing, testing and disorders of any person so far that I think I’ve met. She needed help with her report writing, let alone someone doing the testing. So she trained me and that year, I went back and I got some extra classes and did some long things with vestibular stuff. So I set up a vestibular clinic as well. And that foundation, I think, and we’ll talk about this in the future. I’ll put hold on that. But I feel like I had such a great foundation that I really can do anything going forward no matter what happens in our future.
Dave Kemp:
Yeah. You’ve definitely run the gamut. It sounds like, it’s like you had this, you were drawn to, you said even as a kid, you wanted to be a pediatrician, but you did find your way up in serving in a similar role as a pediatric audiologist. And then it sounds like you went the private practice route. You’ve dealt with cochlear implants. So on the most severe side of you hearing losses and then obviously specializing in vestibular, I think is a representation of this like holistic audiology approach, which is really exciting to think about what that sort of profile lends itself to here as we move forward in the future. And we can talk some of that as we go. So I’m curious though, like with the private practice piece, so you mentioned that you’re doing this, you initially started the private practice because you realized from a financial standpoint or whatever you needed to make ends meet, and so you decided to go in that direction. What year approximately was that when you launched your private practice?
Dawn Heiman, AuD:
So the first practice, I had two. The first one was in Philadelphia and it was 2005, January 2005, that I started that practice. And back then the landscape looked a lot different. Pediatricians in the area actually were pretty excited that someone was in their community that could test kids and they didn’t all have to go into the city. So I did see some kids, but back then, I guess we didn’t have as much of an imprint on the market of those who needed hearing aids. But those who did need hearing aids seemed to just go along with what our suggestions were, which is rightfully so if your doctor says, this is what you need to do, then you go ahead and do that. There wasn’t this big consumer interest in researching it to the nth degree and finding other ways to fulfill the treatment recommendation.
Dave Kemp:
Yeah, that’s a really interesting point. I would probably say that for private practitioners that have been around for 20 or more years, or even less than that 10, 15 years, there’s obvious been a big noticeable shift in the consumer education piece in the way in which they gather their information as a consumer. And then they’re armed with that information when they have that conversation with the provider. So that makes sense to me that that’s a very notable thing that’s I guess, transpired in the course of owning the private practices. So with your second private practice, where is this one located now?
Dawn Heiman, AuD:
In the suburbs of Chicago.
Dave Kemp:
Okay, awesome. So with this one, what’s the demographic or kind of the patient base that you’re seeing? Is it primarily adults? Are you seeing kids as well?
Dawn Heiman, AuD:
Again, primarily adults. One thing that I did learn growing up in the audiology world was that if you’re going to see kids, you follow the Colorado protocol method which involves a complete team approach. I don’t have a whole team and I feel like I would be deserving the families, if I said, I’m going to do everything and just try to do everything and keep them when in fact I am not on a team. So yes, I’m seeing adults again, but I have to say, I love my patients and there’s no getting around it. I love seeing little kids and I saw another little one this morning, but it’s not that often that I do, but my adults get doted on just as much as those little kids, actually the adults are easier to work with sometimes.
Dave Kemp:
So one of the things that I think that you do that’s really interesting. And I’m seeing more and more of this within the audiology space in general, but it’s like taking it upon yourself to, from a content marketing standpoint. And I’m not even sure if this is how you would classify it. But what you’re doing with your podcast is so fascinating to me because I think that, and for the listeners it’s called the Hearing Wellness Journey.
Dawn Heiman, AuD:
Yes.
Dave Kemp:
Hearing Wellness Journey podcast. And what Dawn does is she basically brings on patients and lets them tell their own story as a way I think of encouraging others to maybe take the plunge. What more of an effective way to do so than hearing it straight from those that you would basically empathize with and see yourself as? So I think it’s an incredibly effective way to really level set, I think, with the patients. So I want to just take a second here to talk a little bit about this, because again, you’re obviously very busy. You’re running a private practice, but can you talk about this whole experience with launching your own podcast and then the way in which maybe that’s impacting your business in a positive way?
Dawn Heiman, AuD:
Yeah. So the idea came about because there was a movie director who had worked within [inaudible 00:12:07] and I’m blanking on his name, Brian Scott Warren. He did a master class for my EntreAudiology group. He was teaching us of how to capture people’s stories on film and how you should have an over the shoulder camera and a camera in front. And he said, “When people call, you know a character before they’ve even arrived in your office, so make sure you have those video cameras set up, make sure that everything’s signed, because when they have that wow effect, it’s going to be perfect because you can’t stage these things.” And he had a really cool example of this hospital called SickKids, it’s a terrible name for children’s hospital, but it’s in Toronto. So SickKids had a marketing campaign that involved directors and videographers come into this hospital and videotape what happens behind the closed doors or curtains and children being prepped for surgery, parents just crying with diagnoses and it was very powerful.
Dawn Heiman, AuD:
And he said there really aren’t any words, it’s just showing these images. And at the end of this, you can Google search the SickKids campaign. It actually raised a ton of money, so much money for them that they were able to build another hospital and you can watch these videos. And some of them are the exact same video, but sometimes they have a boom, boom music going. And other times they have just a tear jerking song going, and they’re creating these images. At the very end they show, you come out of the window and then go down this ugly old gray building. And then it looks up and then it comes down onto the street and it just kind of walks away. And it’s like, it makes you realize, “Oh my gosh, I had no idea what’s happening inside those doors. For privacy reason, it’s none of my business to be in there. I shouldn’t be at the bedside staring at these parents who are going through terrible things.”
Dawn Heiman, AuD:
And he brought up a good point. No one knows what’s going on inside our offices. We use, HIPAA as our guideline. We’re not sharing people’s information. We’re not going to talk about them. So how do we tell our stories to let the world know how impactful audiologists are and how wonderful it is on the other side after you have actually admitted you have a hearing lose and do something about it. So I was like, how do we do this? Can we have a podcast? And now think about this. We have people with broken ears and I’m doing an audio podcast. How dumb is that? so we do videotape it and I make sure I close caption it, but it has been a challenge finding the time. I do need a producer because we have stuff tape, but we don’t have anyone to edit it.
Dawn Heiman, AuD:
I tried to do the Cliff Olson way where cliff just does everything because no one can do it as well as he can. But it’s becoming a time suck. For anyone who’s listening, yes, do a podcast, but find help.
Dave Kemp:
Yeah.
Dawn Heiman, AuD:
[inaudible 00:15:31] Dave he knows, right? It’s not that easy. You don’t just show up. So it has been good. It is fun to ask people to listen to the podcast. Most of the people on our podcast are not our patients. They’re people all over the country and the world that wanted to share their store. And I really want to eliminate the negative stigma associated with hearing loss. I want people to get over that fear of everyone judging them and thinking that it’s going to be something and realizing after you listen to a story after story, first of all, it’s going to be okay. People aren’t going to judge you. But also there’s we found it’s definitely a therapeutic aspect.
Dave Kemp:
Yes.
Dawn Heiman, AuD:
I don’t know Dave, if you listen to any of my podcasts or what you known about…
Dave Kemp:
I’ve listened to a few.
Dawn Heiman, AuD:
You have, okay.
Dave Kemp:
Yes.
Dawn Heiman, AuD:
My son is type one diabetes. So when he was six, he got very sick and ended up in the ICU. And type one, if you’ve never been exposed to it, I hadn’t. I had no idea how important insulin is in their survival, hour to hour. If we’re not watching what’s going on with him, he could go into a coma. It’s just a crazy roller coaster of a disease. And there’s a podcast called the Juice Box podcast and it is parents and actual people that are on there telling their stories and hearing someone’s story of when their pancreas died and they were suddenly found themselves in the ICU or who knows what happened. And they’re talking about their struggles with maintaining their glucose levels. It’s extremely therapeutic to listen and nod your head and go, “Yeah, been there. Oh my gosh. That’s so great.” Or maybe there’s a nugget like something that they came up with that was very helpful for me.
Dawn Heiman, AuD:
So we’re finding that the patients are listening to our stories and going, “Yeah. Right.” I mean, it doesn’t change the diagnosis, but it definitely helps with feeling like you’re not the only person out there. And it has become something that we’ve never heard any negative feedback about it, which is a good thing. And when Lindsay and I decided to do it, we did not want this to be something that was about us. And we weren’t doing it as a marketing thing. We just really, it was like, this is powerful. This is something that needs to happen. And I don’t know if our business has gotten better because of it. I do know that we’ve been able to meet a lot of really cool people because of it. But I know that in this world you have to give before you can receive.
Dave Kemp:
I find that I love your whole answer there. I mean, and I just think this whole idea, like I was just really nodding my head along with everything that you were saying there, because it is such a stigmatized thing, but it’s such a pervasive thing. Like we know hearing loss in this industry to be this really widespread condition, but it’s been so stigmatized that there’s this shroud of embarrassment and inaction more or less. And so this is why I wanted to bring this up at the top of the conversation was I do think that these are the kinds of things that I’m seeing more and more small examples of audiologists taking it upon themselves I think to help, to shine a light on this condition and really creative out of the box ways. And I love this idea of like, let’s just let them tell these stories.
Dave Kemp:
And so I did, I’ve a little peek behind the curtain, like of how I go and I find my guess is, I look for those people that are doing the most interesting thing in the industry. And so I found your podcast and I started listening to it and I was like, this is fantastic. And I love that you do have a variety of different people on there that I think can help to be representative of, here is a young adult, here’s an older adult, male, older adult female, like a mother. It’s like things that I think people can listen to and really relate with. And I do think that that’s part of the issue is that it just feeds into the stigma without having exposure into, like you said, the example with the SickKids, like what’s going on in those four walls.
Dave Kemp:
And having that story about our job as an audiologist is to help you to hear better, it’s to help restore in whatever capacity that we can your sense of sound and all of the things that go along with that. So I think it’s just something that I wanted to shout out, because I do think it’s a really, really interesting way to help shine more of a light on what goes on in this industry.
Dawn Heiman, AuD:
Thank you. Yeah. I’m always trying to encourage people to be as creative as possible and then also repeating what someone else has done is a good thing. I encourage more people to, if you think this is working, which I think it’s a fun project, definitely do it. It’s like just because one person has a book doesn’t mean the world doesn’t need a million more books.
Dave Kemp:
For sure.
Dawn Heiman, AuD:
You have a podcast, other people have a podcast like, but everyone’s spin is going to be a little bit different and run with it and you probably get into it and go, oh, this is good. But I think I can do it better.
Dave Kemp:
I always encourage people to just take the plunge and try these new things out, because they’ve been democratized at the point to where it’s not super cost intensive or time intensive. There is some production side things that go into it, but that’s really to your own well wishes of how much time and energy you want to put into it. So couldn’t agree more. Something that you touched on in there is EntreAudiology. So I do want to give you a chance to talk a little bit about this because again, you are a such a jack of all trades, you have so many of these different things that you’ve been doing. So can you talk about the whole concept behind EntreAudiology?
Dawn Heiman, AuD:
Sure. Well it’s the first, so it was named by Mary Chatelain, who is an audiologist in Arkansas and she created the group on Facebook and then we started brainstorming left and right and all of that. And life got a little busy for her and I just kept and she was like, “I’m really busy, honestly, Dawn, go for it.” So the trajectory continued with me, but it started out where I felt like… So I was in my second practice in 2018, I guess it was. And I was already six, seven years in and this is my second practice. And I felt like I knew no one. Now, I’m an introvert to begin with. But with being in private practice, it can be super lonely. And I kept thinking, gosh, I wish I had my people. I wish I could just brainstorm with people and not make it so public. Or about that same time. there was a lot of great things going on Facebook where it’s like, “Holy cow, what are the chances we can just ask a question and someone has the answer right there?”
Dawn Heiman, AuD:
And it also started to get ugly and someone would be vulnerable and ask a question and someone just for fun would not be nice. And then people would hesitate sharing anything because what if their competition heard it? So I had read about masterminds and I had read about how they worked. Ben Franklin had a mastermind and out of that came our public library system and all the big names of the industrial era had their own mastermind, like Wrigley and Ford and Carnegie, all of them. They would meet like once a month and they were of equal levels, but different industries. So they could vent, they could ask questions.
Dawn Heiman, AuD:
So a mastermind technically is you have two minds and if you put them together, you create a third mind, the master mind. Now, imagine if you have eight to 10 people that are in this and you really get to know each other well, and there’s no competition and you know everyone’s backstory and usually by about… So by the way, so I run masterminds. So usually by four weeks, eight weeks into it is when it really hits its stride because everyone has already told their backstory. You know where someone’s coming from. When a question is, or there’s a topic that’s out there, you get some strong advice back or together, you can work on something that’s challenging. And what better time in this world than right now to work together on challenges. We could have a topic and we’re like, “Oh, [inaudible 00:24:43] what we’re going to work on next time.”
Dawn Heiman, AuD:
And everything’s tabled because holy cow, did you see what just happened yesterday? And so we get to behind closed doors brainstorm or just support each other. Sometimes someone’s just having a really bad month. When COVID hit, it was amazing to be able to be with people that you knew, liked and trust. EntreAudiology is also just kind of [inaudible 00:25:12] there’s been a couple things that I have had challenges with. I’ve been frustrated by the fact that some of my patients might have low cognitive skills, maybe dementia, Alzheimer’s, low vision, their hands aren’t great. They came in in a Walker. Maybe they got a cab that came over. And I’m fitting them with hearing aids and I know they’re hearing great, but I worry about what happens tomorrow. Can they figure out how to put these on? What’s happening? When they go back to their senior community, I’m like, “Oh, I’m sure someone could help you.” [inaudible 00:25:50] thinking, “Did I just lie to that person?” Or when they go home.
Dawn Heiman, AuD:
So I created a program to train caregivers and nurses on how to assist with hearing aids. And then the Hearing Wellness Journey is an aural rehab program that I created for me for my practice, because I felt I wasn’t giving the same level of consistent care to every person. I was reactive. And I know a lot of people do this. Someone comes in, they’re like, “I have a problem on the phone.” You’re like, “You do, oh, here, let me tell you how you can use your phone with your hearing aid.” Or they’re like, “Oh, well, I have this issue or I didn’t hear well at someone’s wedding yesterday.” So I started to script out everything that I would teach someone and then I started videotaping it. And then before I know it, I built an entire program that all of my patients use and I don’t have to keep repeating the same thing over and over again. I can set them through a six week process and audiologists all over the country are using my program also just to help make their lives a little easier.
Dave Kemp:
Yeah. I mean, again, it’s like this idea that, one of the cool things with this podcast is I’ve gotten to meet so many people. And in a way it’s almost like my own version of the mastermind is that I made able to really gather some of the best ideas that are floating around out there. And I’m always just so blown away when I get a chance to talk in depth with people, to hear about all of these things that they’ve come up with over the course of their career of like, “Look, I keep running into this issue, I’m spread too thin. How am I going to basically try to accommodate for all these different?” And then boom, you come up with a program that’s then replicable across what other providers are using out there. So that’s what I think probably is at the root of my optimism is that the longer I’ve been in this industry, and the more people that I talk to, the more I realize there’s a lot of really smart people in this space.
Dave Kemp:
It’s just a matter of like, I feel like it’s taking already what you’re doing and elevating it as much as we can to where I’m of the mind that like knowledge sharing is a good thing. We should be pooling the best ideas out there, because at the end of the day, we are dramatically underestimating how big this market really can be. There’s things that you can control and there are things that you can’t control. Right now, a lot of the things that you can’t really control are actually trending in the direction of an expanding market, lower cost device, the potential expansion of Medicare, including hearing benefits. Like we’re actually seeing systematically a lot of things that bode well for the idea that there’s maybe going to be a lot more people interested in this.
Dave Kemp:
So this idea that there’s going to be some cutthroat competition for this small pool of people is just preposterous to me. And I just, that continues to kind of be reaffirmed in my mind the more that I talk to people. Because every person that I talk to that’s very progressive and on the forefront of this industry seems to be saying the same thing, which is I actually don’t have enough time in the day. I wish I had more opportunity to do more with my patients because there’s so much more that you can do.
Dawn Heiman, AuD:
100%.
Dave Kemp:
That’s what’s exciting to me
Dawn Heiman, AuD:
We have so much to be excited about, honestly, as things change so fast and the technology is there. Going back to when I was in just graduate school, my CFY year and even just starting out, I learned so much and then I stopped doing it for so long. And I think there’s so many of us that are like, I haven’t done a vestibular screening in forever or APD. We have been doing it and then we kind of stopped and now we are back full force. There are so many opportunities and there are so many opportunities to just provide services to correct something that wasn’t done. If someone buys something online, we know there are many things that were probably missed, and you could just save the day for someone. So I think you’re right, Dave, where there will be so many more people where it was such a small population that we were working with, now it is going to grow exponentially and we need to be ready. It’s really exciting.
Dave Kemp:
Okay. So now let’s get into opportunities and threats. So in your mind, as again, somebody that you’re working with, a lot of people within the industry, through EntreAudiology. You are the soon to be president of ADA. So I feel like you’re a great person to be sitting on a perch and kind of looking at the horizon right now and determining. You had alluded to maybe some of the opportunities there, but I’m just curious to kind of get your thoughts on what’s top of mind for you of the things that get you really excited? And then maybe what are some things that we can pair that with that I think we, as an industry need to be weary of, or we need to at least be anticipating as to combating some potential threats in the market?
Dawn Heiman, AuD:
Okay. So if we start with the opportunities, rule number one is if you don’t know what you’re doing or you’re scared, start with the basics. Get all the way back to your fundamentals, pull out the old textbooks. Try to look at, okay, what could we do better? And then we need to create up systems around that and finding out, okay, if I could do this better, if I can go into aural rehab better, do it more consistently, write out what I want to do with people, slow down. That’s the one thing that I recently learned Cliff Olson is slow down in what you’re teaching your patients. Don’t assume anything. Don’t breeze over stuff that’s even the basics because that patient actually really appreciates the fact that you took the time. With third parties coming in and even like over the counter, over the counter right there, it took out any time that anyone is spending with this person. So then if you have a third party, that’s dictating how much time you could possibly afford to spend with those people.
Dawn Heiman, AuD:
They don’t feel seen, let alone heard if the clinicians trying to click, click, click, click, click at the computer, and then getting back over, “Put this on. Please, we have no time to talk right now.” If we can create programs and fee schedules that it’s around where we’re going to take the time with you, people will come. I mean, let’s think really creative. Let’s go to the hair industry. There’s a multimillion dollar market for just someone to blow dry your hair. They don’t cut hair, they don’t wash it. Well, maybe they wash it. They don’t color it. They have blowout stations. There was a need that they found that people just want to, and they say, look, we keep your haircut looking good. All they do is blow dry it.
Dawn Heiman, AuD:
So if we said, look, we keep your hearing aids sounding better, it doesn’t matter where they get them. I really believe that we need to have marketing campaigns about the experts are coaching you along. Just like you go to the physical therapist, the surgeon gave you a new knee, and then they send you to the physical therapist, which technically physical therapy shouldn’t be a profession. You’re given all the exercises, you know what you’re supposed to do, but people don’t do it. So they need someone to sit there and count for them as they do their leg lifts and do all of the stuff that was in that worksheet from the surgeon. We’re the same way. If we say, look, we’re going to test you, then we’re going to make things better, then we’re going to work with you. And then we’re going to test you again and show you how we improved your life.
Dave Kemp:
I couldn’t agree more. I just want to pull up here for a second and just interject because I think that is such a good analogy. I always I’m looking at these sort of like look outside of the box. Don’t just look in our industry, look around. I’ve used the dental industry before. I love the hair stylist. That’s a really interesting one. But the physical therapist, there’s such a psychological aspect to that. It’s honestly the same thing with going and you work out in a class where yeah, I could go work out on my own, but there’s something about having that routine. It’s like the environment that you’re in, it’s conducive to the workout. Same thing with the physical therapist. You go, you know I have an hour that’s dedicated to this. I can ask them questions along the way. I can just put myself at ease with that.
Dave Kemp:
And so this is where my head’s been at too which is, look at the end of the day, I don’t think it’s a matter of like these aren’t going to be patients that are available to you. It’s that these aren’t patients that fit a square peg and a round hole. These just, you have to be creative with the way in which you’re conducive as a business to these people. And I feel like that’s where we’re at is we have to really kind of like wrap our heads around what’s the right way to make people feel like this is approachable. Because I think it’s really, really from a long term view, I think it’s really shortsighted to just turn your back on these people and say, “You’re not ready to see me yet.” I just think that’s like really, really shortsighted.
Dawn Heiman, AuD:
Absolutely. And if you look into the Ida Institute, they even talk about group aural rehab. And there is a little course, a presentation that was done a few years back where they break it down, how would you do group aural rehab? And just going to your local library and offering aural rehab to people who have over the counter hearing aids, it’s a marketing opportunity. All these people are like, “Well, I still can’t hear.” And we’re like, “George, why don’t you schedule an appointment? Come on in, let’s see how things go.” There are so many opportunities to help people on a grander scale and you could charge for those rehab group session, or you can do it for free. But there are going to be so many people who have no idea what to do with those four different size domes they were given, let alone, no one’s looking in their ears.
Dave Kemp:
It’s more often than not progressive hearing loss. It’s a condition that’s only going to get worse. I agree with you where it’s, this is something where you have the opportunity to be their lifetime expert. And it might be as, “Trivial” as helping them with their domes. But more broadly speaking, they’re going to have conversations that are more sophisticated than that. They go way beyond the way in which they can hear. It’s going to be about a lot of the things that I feel like are linked to hearing loss. They’re aging and so there’s a lot that can be done here that just goes and transcends the audiogram. And it gets way more into the link between your ears and your brain. Again, I think it’s just a matter of like how, for those that, that are willing to really sort of carpe diem and like just grab the bull by the horns.
Dave Kemp:
I feel like their future is as bright as can be, but it’s not going to just be the status quo anymore. The status quo is going to change. I’m not sure how much that will cannibalize the current market of hearing aid sales. I think there’s arguments that you can make that maybe it will a little bit on some that this might just be an entirely different market. But regardless, I just think that if you are willing to just, like you said, do these things that are like, have a community meet up where you encourage people to come and see you. We know this to be a huge word of mouth referral generated business.
Dawn Heiman, AuD:
Absolutely.
Dave Kemp:
[crosstalk 00:38:08] just start to get the ball rolling with people being introduced to this. And then before you know it, I just think that you’re going to be able to layer on more and more services because it’s your time that you’re ultimately talking about here. And it’s how, how do you maximize that?
Dawn Heiman, AuD:
Exactly. And you asked what are our opportunities and then what are our threats? I feel like our own personal psyche is our biggest threat. If we personally think, oh, I can’t change. Or who am I to do this? I’ve never done this before. The more we give ourselves positive pep talks and say, you know what? You’re you are so capable. You’re more than capable. I think you can change even a little bit, what’s [inaudible 00:38:53] the compound effects say. The book says, you change one little thing every day, look at what you’re going to look like in a year, completely different. If you can just change one little thing and say, “Okay, I’m going to try to add five more minutes onto aural rehab, or I’m going to consider doing one aural rehab session a quarter,” where you are just offering an opportunity for people to learn from you.
Dawn Heiman, AuD:
You know a lot but if you put it in a structured manner and I’m telling you go to Ida Institute, they have it all planned out in multiple sessions that you could do. It’s going to be a great thing because again, if you give, you will receive. That’s one little incremental step that you could add to your practice where you’re saying, “Look, I’m going to get out there. And I’m going to offer an opportunity to help people who are struggling.” And then when they do come into your office, who knows what they need. Do they need just a wax removal and just those domes changed? Do they actually need real hearing aids? Do they need that positive reinforcement of listen, if you wear these every day, I did real measurement on them, they’re doing great. But I noticed that maybe you said something about how you don’t wear these every day.
Dawn Heiman, AuD:
If we encourage people to wear things more, their brains will acclimate and they will just do better. So we could do listening therapy and coaching and things like that. But I can’t wait to tell you who it is that I’m watching through in this industry, because there are so many people that are doing fantastic things.
Dave Kemp:
Let’s just go there.
Dawn Heiman, AuD:
Let’s jump there.
Dave Kemp:
This is where your head’s at. Yeah.
Dawn Heiman, AuD:
Absolutely. Okay. Oh gosh, where do we begin? If we start with Angela Alexander, let’s say. Now, Angela has been talking about APD and APD therapy and all of that for a long time. And as I said, I grew up in an APD world in a sense, but no one was doing therapy. And I thought, well, that’s just for APD folks and there’s speech pass out there for these little kids and all that, until more and more, we start getting phone calls from people who are adults and who have been struggling their entire life. But it’s such a small world, not too many people know what auditory processing disorders are. Not too many people are trained properly to do the evaluations. So there are a lot of people that live their entire life and they’re in their mid 40s, let’s say. And they always had a hard time hearing in the restaurant. They couldn’t understand what was being said. And they have normal hearing. They’ve gone to specialists, they were told you’re fine, go home.
Dawn Heiman, AuD:
So there’s that. And I considered, I’m like, “Maybe I could do listening therapy, until I saw what she’s been doing with [Matt Hay. 00:41:43]” And he has a brain stem implant. And the ability for him to improve his understanding abilities because she’s doing phonemic awareness training. Everyone could benefit from that. That’s so exciting. And then we go to the Ohio State University with Gail Whitelaw and [Christina Rupe 00:42:05]. And they’re doing fantastic stuff with working with adults with hidden hearing loss or APD, and they’re using low gain hearing aids. And that is so exciting to me because Gail is the number one person to say, there are people that need us and we should not be turning them away. I just love people that are excited about new opportunities, because I’m like, “Yes, bring it.”
Dave Kemp:
Oh my gosh. So I’m going to let you continue, but I just want to say really quick that like this has been where my head’s at too is the more that I’ve… Because I’ve been wrestling with this question for this whole year on the podcast, which is like, what does the future of audiology look like? And it’s not meant to just be like this facetious question. And I’m really trying to understand like if the role had sort of been pigeonholed progressively more and more into hearing aid device sales and programming hearing aids, that from every account that I’ve had is a pigeonhole. It’s like that’s only one facet of this. And as I’ve really learned more about the various specialties in the way in which this whole scope of practice can be expanded, that to me is like the most exciting thing that is going on right now, is there’s been like this almost existential, I don’t want to call it crisis.
Dave Kemp:
But like this like forcing function that’s kind of really made everybody really sober, clear-eyed, ask this question of like, where is our value? And it’s been fascinating to watch all of these people step up and I want to hear you continue on because this is really interesting to me, but it’s this new pattern that’s really emerging. That’s so exciting, which is maybe we can really lead in this area and we can specialize here in all of the new connections that makes in the broader healthcare environment. When we are the liaisons for this particular facet. That’s what’s really exciting to me is it’s elevating the scope of practice considerably, like in a bold way. That’s really, really exciting.
Dawn Heiman, AuD:
It really is exciting. And you know so you know my background, I went over it where I did a lot it with paeds. And when you identify a baby or a newborn, a toddler, even a preschooler with hearing loss, it’s really important as a team that you make certain that this child has the best opportunities to hear speech and language. And you fill their world with speech and language and you have a hearing itinerant, you would have the speech pathologist. You might have an occupational therapist. You have the audiologist. You have the school even calling saying, “Hey, I don’t know. They stopped saying their letter S. I did my Ling sounds this morning.” And everybody is so concerned with how this child is hearing. And this child is right away, if they’re a little guy under the age of three, they get early intervention in the home, teaching the parents and teaching the child the meanings of sound and they break it down in [inaudible 00:45:12] model.
Dawn Heiman, AuD:
And they break it down where, okay, identifying the sound there’s someone goes to the front door, rings the doorbell dingdong and then you pick up the baby and you run them to the door and you’re like, “Who’s here?” And you teach them sound has meaning. And then we get into discriminating between sounds and then identifying the exact word and then learning language. When an adult’s ear changes, we don’t do any of this with them. It’s very rare. Now, when I worked with cochlear implants, it was for a little brief stint. I worked with adults and we would say, okay, you’re going to get an audio book at the library. And then you get at the same library, make sure you ask for the written book. So you can read along while you hear and you put these sounds and letters and words together. So it starts to synergize and you’re like, “Oh, that’s a letter S and that’s an F and that’s an L and that’s an R.” And it’s just by listening to the language. So I have a patient whose whole family is deaf.
Dawn Heiman, AuD:
She lost her hearing as a teenager and she signs and she’s a very big advocate. She’s at a national level. She came in for a tubing change one day, her husband is deaf. I referred him for a cochlear implant. He had never had a cochlear implant. He had been deaf his entire life. He got a cochlear implant for the one inside. And she said, “I know you know how to create a program. And I know what you know.” Because she was around when I was even working with the kids and she was with Hands & Voices and all that. And she goes, “I know that you know how to teach people how to hear and listen. You’re going to create a program for Joe.” And I’m like, “What are you talking about?” And I’m like, “Didn’t he get any like follow up lessons or therapy or anything?”
Dawn Heiman, AuD:
She goes, “No, the clinic didn’t have any time for him. They just implanted him, did his mapping, sent him home. No one did any listening therapy with Joe.” I was like, “You’re kidding.” And she goes, “I’m telling you right now, you’re going to do this.” So that, that’s how the Hearing Wellness Journey really started-
Dave Kemp:
Interesting. [crosstalk 00:47:17].
Dawn Heiman, AuD:
… with her telling me to do that. It’s just rehab, but I put in the listening, I broke down, I put in lip reading, all of that. And these are things that we need to think about when we’re working with adults.
Dave Kemp:
For sure.
Dawn Heiman, AuD:
Can we teach this stuff? It’s billable guys. It might not be billable through their insurance, but you are a valuable person that could change their life. Look at what Angela Alexander is doing for Matt Hay. She’s helping link the sound with something meaningful and it’s starting to work. He has a brain stem implant. That’s amazing in and of itself. But he went for 15 years without being able to understand what people were saying, two garbage trucks. And now he’s understanding the letter N and M and A, and it just blow my mind. Yeah, and this is just the beginning of all of the people that we could be working with and expanding our knowledge. Okay. Let’s look at Dr. Richard Gans who has been doing vestibular forever.
Dave Kemp:
Richard Gans.
Dawn Heiman, AuD:
So think about this, he has clinics and he can help you up a vestibular clinic. Going back to me and myself as a young person, I could add on vestibular as well. And then we go back to Gail Whitelaw and her working with concussion patients or Lizlee who worked in the VA and the posttraumatic concussion syndrome folks that came out of war. There was an explosion and they have tinnitus. We didn’t even talk about tinnitus yet, Dave. Tinnitus and the vestibular and the auditory processing and the clouding of the brain and everything. We could be setting up concussion clinics. We could be getting referrals from neurologists and neuropsychs. I haven’t started marketing the extra services I’ve been adding and just, well today’s Monday, just this week alone today, we got three new referrals from doctors I’ve never spoken to before. Audiologists have a lot to offer this world and it’s beyond the hearing aids, but the hearing aid, yeah, it’s important, but it’s one little piece.
Dawn Heiman, AuD:
And then we need to help people that they don’t know what to do. We take driving lessons when we buy a car. It’s actually required for kids. I don’t know if adults have to in order to be licensed, but you would think you could try to figure out how to drive a car, but you’re going to learn it faster, better if someone else shows you how to drive the car. If we could show people better, faster and how to use their hearing aids, how to listen, guide them along, make them do their homework. Now, Dave, you talked about going to the gym and being in a class. Part of that is the accountability that people are going to ask, “Hey Dave, where were you?” Or you paid for something. So you’re more like to up. And then you’re the most likely to actually succeed and be happy with the fact you took that class because you have positive outcomes.
Dave Kemp:
I mean, yeah. You’re like, this is exactly everything that’s been going on in my head, which is like on one hand, if you’re really fixed on hearing aid device sales and don’t get me wrong, I know that that’s where the bulk of the revenue generation within this industry exists. However, I look at all the people that you just sited and there’s a laundry list of others that are doing very interesting things along the same vein. What you really see. I think back on the conversation I had with Kim [inaudible 00:50:56], which was about a year ago, and she was saying, go back to audiology, really go back to the roots of audiology. And what’s fascinating is that’s what’s really transpiring right now. And now the matter that I think is coming to head is like, all right, so what are the new business models that are tied to this?
Dave Kemp:
Because you’re right where there is, I feel like we shortchange the… I’m not an audiologist, so I’m speaking a little bit on their behalf, but I do feel like that there’s a little bit of this like short changing, where you’re not fully like valuing yourself in the market the way that you should, because you do bring such a valuable piece to this puzzle. And I think that this whole, like everything that’s going on between the link, between the brain and your ears, it does like it elevates the standing of the audiologist so much more dramatically in the eyes of all of your counterparts across the broad spectrum of healthcare. And so I’m not surprised to hear that a lot of people that are leaning into whether it’s the stuff with cognitive view or it’s the stuff with Richard and dizzy.com and the specialty centers that he’s been basically franchising.
Dave Kemp:
And then what Angela’s doing with APD, tinnitis, all of these different things. One of the big things that I’m hearing are we’re seeing a lot more referrals because now we’ve become cemented in our community as an expert for all of these things, rather than just the person that deals with hearing aids. And I think that in a nutshell is what is so exciting is again, it goes back to this idea though, that it’s like, if you’re just going to kind of sit on the sidelines and just wait for this to happen, then that’s not the takeaway. The takeaway is be very cognizant of what’s going on around you and figure out which of these things can you start to kind of implement into your practice? Because it seems very plausible to me that the revenue side of things will work itself out.
Dave Kemp:
But it’s a matter of like you said, at the beginning here, which is like open up a textbook again. Go back to the roots of getting comfortable with being uncomfortable in expanding your comfort zone of what you do in the clinic. And I think that’s what’s really cool is like I keep hearing all kinds of anecdotal things about people that are like, I’m now getting into APD in a way that I hadn’t really ever done before. And it’s reinvigorating me in a way that like I haven’t been reinvigorated. I’m passionate again about what I’m doing. So those are the kinds of things that there really does feel like a ground swell that’s happening right now that is really, really encouraging in my opinion.
Dawn Heiman, AuD:
Absolutely. It’s so fun. And when you take the extra time with someone or say, “You know what? I want to do one more little test, or I want to, whatever.” Maybe you didn’t change the outcome of anything when they left the appointment, but when they pull you aside and they go, “You get it, thank you.” It’s all my gosh. It’s amazing.
Dave Kemp:
And what are they going to do?
Dawn Heiman, AuD:
Feels so good.
Dave Kemp:
What are they going to do when they leave that appointment? They’re going to go and tell everybody.
Dawn Heiman, AuD:
They’re going to tell someone else. They go, “Do you mind if I take five cards?” And I’m like, “I don’t know. I mean, five, that’s a bit much.” Yeah. So the word of mouth marketing is incredible. When they go talk to their doctor and then the doctor calls afterwards going, “What exactly did you do?”
Dave Kemp:
What did you do?
Dawn Heiman, AuD:
She was so thrilled. It’s a good thing. It’s an exciting time. And you see these memes and you see these little posters or if you go to little shops and they have little sayings and stuff. And it’s like that one thing that causes you the most stress and angst is probably the one thing you should be doing. If you feel like you’re getting all butterflies and you’re like, and it keeps coming back to that, “I don’t know. I don’t think I can do this.” Like yes, you can. Call me, I will tell you. Yes, you can.
Dave Kemp:
Totally.
Dawn Heiman, AuD:
If you feel like that, this is something that, yes, it’s going to… nothing good came too easily or you don’t appreciate it as much if you didn’t work for it. I know a lot of people I guess their two biggest hangups is how will they report on this? They have to write out, like what will the report structure look like and all that to send out to, let’s say the primary doctor. But more importantly, how are they going to get paid? What will the fee structure look like? How do they train their front office staff to say, “Yeah. And this is the way we do it. And this is how much you will pay.” And a lot of this stuff that I’m talking about is not reimbursable by insurance. Sometimes it is, but creating a way so that it is feasible in your office.
Dave Kemp:
For sure. I mean, I just was going to say, I think that you look at all of this stuff with OTC and if you follow the trajectory out across the next five years, is it really heretical to say that maybe the margins that you’re seeing in the OTC world might eventually be the margins that you see in the premium offering as well?
Dawn Heiman, AuD:
Sure.
Dave Kemp:
So again, it kind of begs the question of like, “Well, if that’s how you feel, if your gut tells you that that might happen, then you’re going to need to find a different alternative revenue generation source as is.” And the most exciting thing for audiologists in particular is that you have the most defensible thing, which is your experience. Like you have your education and you have you. So it’s a matter of like, I think that the big question that’s going to be, have to look square in the face at these next five years is like, how do you make money off of your time in a way that you feel like that’s the way it should be valued in the market. And it probably will have to be some really challenging, uncomfortable situations where you do have to kind of decouple from that and say, “Look, you can buy the product with an insurance benefit or whatever for a couple $100. But what I’m bringing is going to be…”
Dave Kemp:
And you list off all of these things where it’s way more comprehensive and understanding who you are as a patient, your overall journey. And I’m going to work with you and we’re going to rehabilitate you so that you’re going to, and we’re going to really understand all of these secondary things that are attached that are linked to your hearing loss. It just seems to me that there is a very viable business model in that, but it’s like, everybody is kind of like, we’re a little paralyzed right now as an industry. And so I’m not like singling anybody out. I’m saying broadly speaking, it’s like, this is kind of the status quo and it feels like the status quo it’s going to be disrupted here in the not too distant future. It’s already the early shots are being fired. And so I feel like there is a little bit of this urgency around this.
Dawn Heiman, AuD:
Yeah. But well, if you follow Cliff Olson, if you joined his network, which I did and is my number one referral source. Cliff is very confident in letting people know, look, if is doing a good job, you are going to have good outcomes. And empowering people who don’t know anything about, hey, if you’re frustrated with the way you’re hearing with whatever it is, wherever yo bought it, find a provider who does best practices. So then they come into our office ready to spend money.
Dave Kemp:
For sure.
Dawn Heiman, AuD:
At least to start with the reprogramming and the assessment and just do the whole workup. Not too long ago, I made the big, hairy, audacious, crazy announcement that we might not ever sell another hearing aid again. And I’m okay with that. If you’ve ever been to Chicago, if you know how crazy our market is, and we are so saturated. 15 minutes in each direction from me, there’s a Costco. And we have every store chain there is in every, like within 10 to 15 miles, they just keep replicating themselves. There’s plenty of places to buy stuff, but not enough clinicians that are taking the time to make certain that they get good outcomes. And that is billable folks. You get paid to do a good job.
Dave Kemp:
Exactly. I mean, again, if it ultimately comes down to the device, and what I was alluding to is almost like a race to the bottom. You’re competing on price and I’m saying you as the audiologist are so differentiated, you’re increasingly more differentiated in this market that is moving in a direction where you can get these things in big brick and mortar, Big Box retailers. You can buy them online, all these different things. So it’s like, so what sets you apart? What sets you apart is you? And it’s like so how do you properly quantify that in the market?
Dawn Heiman, AuD:
Absolutely.
Dave Kemp:
And to your point, it might ultimately come down to, “Look, we don’t even sell hearing aids. We’re here to do nothing more than the…” Just like your analogy earlier. You saw the surgeon and then you come to the physical therapist and that’s what I’m… and it’s expectation setting. I think that to your point, like with Cliff and everything, it’s like setting the right expectations of like, look, you’re not going and seeing just your run of the mill provider, you’re getting the creme de la creme. And so that’s what’s exciting is it’s like, there seems to be with that pivot, that trajectory where it is all about rooted in the value of the provider and in the expert piece, there’s a lot of really exciting things that are going on there.
Dave Kemp:
And I think that for me, I look at this and I’m most bullish on that side of things, because I think that it’s actually underdeveloped still. There’s still more and more things that the provider can be layering into their practice and specializing in. And then all of the secondary benefits that come along with that. So that’s kind of where my head’s at and it sounds like it’s where yours is at too.
Dawn Heiman, AuD:
We’re on the same page for sure. Yeah. And you said, we’re just, we’re trying to compete with the bottom. Second cheapest doesn’t win. We will never be cheapest as a private practitioner or even in a medical group. We can’t compete with Big Box and all of that. So why not go the opposite and be the best?
Dave Kemp:
Exactly.
Dawn Heiman, AuD:
Yeah. And then my thing is, let’s create a whole nother category, disrupt the entire industry and just be the therapist for all of it. And then we’re not a commodity, they can’t pre shop because nobody else has these prices. Do you want a solution because I have a solution? If not, go ahead and go do whatever you’ve been doing. I don’t really care.
Dave Kemp:
Exactly. So very much on the same page there, Dawn, this has been such entertaining conversation. I’ve learned a ton from you.
Dawn Heiman, AuD:
I’ve learned a lot from you. We’re definitely on the same page, Dave.
Dave Kemp:
For those that are listening, this is I think largely listened to by a lot of fellow hearing professionals. So if they want to connect with you, what’s the best way for them to do so?
Dawn Heiman, AuD:
They could probably direct message me on Messenger on Facebook.
Dave Kemp:
On Facebook. Okay.
Dawn Heiman, AuD:
If you email me, I might not see it for days as Dave found out. If you have my private phone number, text me, that’s the best way. Otherwise, you could probably find me. I’m out there somewhere.
Dave Kemp:
You’re out there. EntreAudiology.
Dawn Heiman, AuD:
EntreAudiology [inaudible 01:02:59 whatever. But just, all I can say is I appreciate you doing this and giving us a platform, Dave. This is incredible. And we are a little scared, but I know that we are going to be just fine.
Dave Kemp:
I feel the same way. Again, like I said, this will be episode, I think 84. The bulk of these have now kind of become hearing professionals as a means of, I think so many people are in the same boat, which is kind of like, where do we go? And what’s been really awesome is having people be willing to… I think it back to what you said earlier, where it’s like, I think we’re better off when we share our knowledge. I think that you have hard earned wisdom by being in this industry and going through some of the different experiences that you have. And we all appreciate you being willing to share that wisdom with us, because it’s something that you can just pick up willy nilly, you have to kind of go through it. So we appreciate that. Thank you.
Dawn Heiman, AuD:
Thank you. All right.
Dave Kemp:
Awesome. Well, thanks for everybody who tuned in here to the end and we will chat with you next time. Cheers. Thanks for tuning in today. I hope you enjoyed this episode of Future Ear Radio. For more content like this, just head over to futureear.co where you can read all the articles that I’ve been writing these past few years on the worlds of voice technology and hearables and how the two are beginning to intersect. Thanks for tuning in and I’ll chat with you next time.
