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104 – Brandi Smiley, Au.D. – Building a Mobile Audiology Clinic from Scratch

Hello and welcome back for another episode of the Future Ear Radio podcast!

For this week’s episode, I had the pleasure of speaking with Dr. Brandi Smiley, Audiologist and Owner of Onsite Audiology.

In this episode, Brandi and I discussed:

  • Brandi’s backstory, motivation to become an Audiologist, and professional journey as an Audiologist
  • Her time working at the VA and within the Educational Audiology setting
  • The pandemic serving as the catalyst to starting her Mobile Audiology Clinic, Onsite Audiology
  • Why mobile Audiology
  • Creating a “Tiny Home” specifically designed to be a mobile clinic
  • Providing Audiological services to some of the most impoverished parts of Georgia
  • How she established her initial patient base and is expanding her business
  • The value to adding new services, such as APD therapy, to her offering
  • Giving back and being a mentor to the next generation by being an Adjunct Professor at Georgia State University’s new Audiology Assistant program

-Thanks for Reading-


Dave Kemp  00:08

All right, everyone, and welcome to another episode of the future your radio podcast. I’m very excited for this discussion with Dr. Brandi Smiley. Brandi, thanks so much for being here today. Why don’t you share a little bit about who you are and what you do.

Brandi Smiley, Au.D.  00:23

Hi, thank you so much, Dave, for having me. My name is Brandi Smiley. Some of you may know me by Carla. But I do prefer Brandi. And I am a  local mobile audiologist in the state of Georgia. My history stemmed from the VA and then I transition to educational audiology. But now I am kind of tampering with this entrepreneurship. And I’m just happy to be here. And thank you for the opportunity.

Dave Kemp  00:48

Oh, that’s awesome. Well, I want to definitely get into the various phases of your audiology career. I met you at ATA during the mobile audiology pre conference workshop. And honestly, I was just really blown away with the business that you’ve created with on site mobile audiology. So we’ll get into that as the conversation goes. But why don’t we go back to the start? I love to hear people’s backstory. So share how you even came to become an audiologist. And what was the motivation behind that?

Brandi Smiley, Au.D.  01:21

Sure. At the age of six or seven, a teacher noticed that I was having some trouble in the classroom. So she had that hard conversation with my parents and decided that I needed to have an evaluation by an educational audiologist. So my first experience was kind of experiencing the stigma of Audiology. The audiology department was housed in a special needs school. And I remember at that young age, not wanting to have a label and be defined by that label. So I remember those feelings immensely. But I also remember the feeling of walking into this bright, open space and seeing this friendly face, which I knew then as an audiologist, and she was just welcoming the bright blue cobalt blue booth and welcome meet me in was just something that stuck with me. And that’s when I kind of knew I was intrigued by it, and want it to know more. So I was really young.

Dave Kemp  02:21

That’s super interesting. Okay, so were you then fit with hearing aids at that age?

Brandi Smiley, Au.D.  02:26

So here’s the thing, I was never fit with hearing aids. And I don’t know, I’ve had this conversation with my parents. Why? My understanding is I think my hearing loss was so high frequency that at the time, there were no hearing aids that could really create any benefit for that. So I do think that was when my parents opted not to fit me. But I didn’t even have an IEP or 504. I just remember always having preferential seating and excelling in my studies. And so, you know, I didn’t have that classic. I feel like the challenges that a lot of people have with hearing loss and I was still able to excel.

Dave Kemp  03:06

Okay, all right. Yeah. Interesting. So, you, you had this foundational experience. And when did you so where did you go to undergrad? And how did you go from undergrad to deciding that you wanted to get the AED?

Brandi Smiley, Au.D.  03:20

Sure. So of course, there were no undergrad programs and audiology, there was only communication sciences and disorders. So I went to that also State University, I knew for a fact that I did not want to be a speech language pathologist. I knew that because my mom was a principal, I shadow SLP SLPs. And I respect their work greatly. But I knew that was not what I wanted to do. And so the goal was to get some education in the field of education, learn some special ed law and eventually become an educational audiologist. So that was my goal at the time of undergrad. So just kind of making that work. I got my undergraduate degree in early childhood education, a minor in music. And then after undergrad, I was going to stay and get my Master’s in Communication Sciences disorder, right. Went to a teacher recruitment. Meeting in this was in the state of Florida, and there were some individuals from Nova South Eastern University, and they had a soul audiology in big letters and automatically be lined to that setup and had that conversation about the program needed to establish Florida residency. So I moved to teach in Florida to establish that registered residency for a year and then transition into going into the residential ad program. Okay, came back full circle.

Dave Kemp  04:47

And so what was the motivation to go the educational audiology route? Do you just love working with kids and what was the what was the thought there?

Brandi Smiley, Au.D.  04:57

I think it stemmed from my first two experience with an audiologist. And that was the educational audio, but also having a mother that was a principal. And she had six sisters that were also educators. So I just grew up in that culture, and had great respect for the education system. So that’s really what led me that direction.

Dave Kemp  05:20

I love it. Okay, cool. So that’s how you came to the decision to become an audiologist. This makes sense. And so then kind of walk me through those first portions of your audiology career. You mentioned you were an educational audiologist, you worked at the VA. So what was that period of your life like?

Brandi Smiley, Au.D.  05:39

So it started off, this is where it gets tricky. So my fourth year at NOVA, I was diagnosed with stage four cancer. I was during my fourth year residency at the Washington DC VA Medical Center. So the goal was to just go there and move back to Georgia and try to find a job as an educational audiologist. But life didn’t happen that way. So I got diagnosed with cancer during the fourth year having chemo and trying to balance that last year. And it just got to the place where I was kind of stuck for a minute, I had rounds of chemo that I had to do. I had to keep insurance. So when you have a pre existing condition, you can’t change insurance companies like that. And so I kind of got stuck in a good way. With a VA for years and loved working with veterans learned a lot. I learned a lot about hearing aids verification, very great beginning for me, but I think in the end, it was just not really what I wanted to do in my life. And so eventually, I transitioned back to Georgia,

Dave Kemp  06:48

are you in remission now?

Brandi Smiley, Au.D.  06:50

I am. So this is almost your 70 in remission. Yeah,

Dave Kemp  06:54

that’s awesome. I’m so happy for you. Thank you. Thank you. That’s, um, that’s amazing, though, that that that, you know, you were hit with such a challenging obstacle in life, you persevered, and you are where you are today, which is really cool. Okay, so you were at the VA for a portion? And then when did you decide to embark out on your own? And how did your mobile audiology clinic kind of come to be?

Brandi Smiley, Au.D.  07:19

Okay. I just feel like my my life is a whole story. But after the VA, I transitioned to education, and it started off at one school then went into multiple district. So started off at the state level one school, and then started off on the regional or went to the regional level. It was during the pandemic, when the school shut down. And I had a moment to sit with myself and say, Brandi, Are you really happy. And I love what I did. I love this, the students, I love the program. But there was a part of me that was not happy. And I think because when you start to work for agencies and people that have their vision of how audiology looks for their practice, sometimes your dreams and your aspirations are, you know, you have to shrink them back to give your all to their facility. And so I sat with that. And I said, Okay, I’m not happy. So what am I going to do about it. And so that’s when I started to just fumble with kind of passionate that I’ve had in the past was on mission trips and seeing the lack of access there, and how I could create something that was unique that was set me apart and fulfill those needs within my area.

Dave Kemp  08:37

So why so clearly, the idea of being mobile and having this I you know, you can kind of meet people where they are, that was a really important portion of it. When you say that maybe you weren’t feeling totally fulfilled in your previous role as an educational audiologist? Do you think that the the void was like entrepreneur, entrepreneurship, was that kind of what you were seeking was to be able to kind of create the world that you wanted to see.

Brandi Smiley, Au.D.  09:09

I think so I’ve always had contract position. So when the school district you get a lot of time off, so during that time I would work different contract. And I just saw that I like different aspects of audiologist audiology as well. And so I didn’t want to box myself in and so I think that was part of the discontentment is like I like I’m a little bit nomadic. And I don’t like the same thing every day. So to break up the monotony to be more creative and be authentically myself. I think that’s what was lacking. That’s cool.

Dave Kemp  09:47

Okay, so this is interesting. So then pandemic, which I think was such a giant catalyst for so many different people in so many different ways that it just kind of gave people like you said pause that they think, like, Am I happy where I’m at. And again, I guess that’s kind of a silver lining is that it, it did serve as this forcing function for a lot of people to make maybe a move that they wouldn’t previously had done, at least not as quickly as they had. So I like what you said about like this nomadic element to yourself and breaking up the monotony in your day. So kind of like walk me through the, what the process was like when you were developing on site.

Brandi Smiley, Au.D.  10:34

So the process went back to grad school, I pulled out my practice management book and my old business plan, which was horrible, horrible. But, you know, having gained some knowledge, taking some business courses during the pandemic, and learning something, and grabbing my husband’s MBA books, and just really looking at how to develop business. That’s kind of what it looked like. So a lot of studying things that, you know, we get a little bit in grad school, but not nearly enough, I feel, to feel confident to go out in business and kind of bridging that theory with passion and creating that. So a lot of research, a lot of education, but also a lot of being on Pinterest, and see design, and what’s you know, already been done and how I can set myself apart myself apart. That was really the process.

Dave Kemp  11:33

Was there. A book A, you said Pinterest obviously was a source of inspiration for you. But what like when you were you said, you kind of like laughed at your original business plan. What were you using to home your business plan and kind of come up with how you were going to make this all work? Like was there any single source of inspiration? Or was it a multitude of things,

Brandi Smiley, Au.D.  11:58

multitude of things. So I pulled out the practice management book, which I feel is still valuable. It’s one of my favorite books from grad school. But also taking free programs during the pandemic, a lot of things were free to us to kind of occupy our time. So I used that time to educate myself on the things that I was lacking. So Bank of America and Cornell had a program for entrepreneurship with women. And so I took that and immerse myself around women who really had a goal to to grow as business owners. We had a program called Operation Hope here in Atlanta that gave free business classes, and help people get certified as minority as women and veteran. So just really taking just, you know, grasping those free things that were available during the pandemic. That was really the biggest thing that I was lacking in that I wanted to invest in.

Dave Kemp  12:54

Totally. Okay, cool. So, you, you kind of created this thing, but when did you start to bring it to life? When was on site audiology born?

Brandi Smiley, Au.D.  13:04

Okay. So, onsite audiology itself was born in July of 2020. Okay, and so that’s when I’m like, Okay, I have this

Dave Kemp  13:13

idea pandemic,

Brandi Smiley, Au.D.  13:14

right in the heart of the pandemic, because I had time Yeah, time. And I remember not having money, though. I didn’t have the money to build, I knew that I wanted to go mobile. At that time, it was not a tiny house here and clinic on wheels. I just knew I wanted to mobilize services. And I knew the agencies that I wanted to work with, but I didn’t have the money. And so I reached out to a few friends and family and say, Hey, this is my mission. This I feel like is partly ministry, would you like to partner with me? Would you like to support and within a matter of months, we raised about $85,000, that was enough to get started on this and not start a business in debt, which was very important to me. Because I didn’t want a high overhead, I really wanted to be able to provide services. And if it took a minute to get a lot of revenue, still be able to provide it and not have to worry about being in debt, one providing services.

Dave Kemp  14:14

I love that. So you started in July. When did you start? You raise the money? When did you start to get revenue? When did this thing start to kind of come to life?

Brandi Smiley, Au.D.  14:26

So I launched in June and almost Yeah, well, I launched in June 2022. So this was a process. So June of 2022. I haven’t been in business long, but I immediately was able to generate revenue. And I think the reason why is because it was a plan. It wasn’t something quick okay, I’m gonna do something this is going to be quick and easy. You know, it was almost two years, you know, of researching and getting the right builders and contractors and engineers Is it really talking to other professionals in different industries? Because it wasn’t done in audiology, to see how they do it and what advice, you know what caveats they were, and, you know, go that route. So but I revenue came immediately because there needs

Dave Kemp  15:19

that needs. Super cool. That’s super cool. We’ll get into that a little bit. But I want to actually go back a little bit. So how did you land on you wanted to be mobile, but why the tiny house, which I should mention, for those that are watching this as a video, your virtual background is your tiny house,

Brandi Smiley, Au.D.  15:35

right? That’s my tiny. That’s so cool. Thank you so much. So I thought about several things. What I was most commonly familiar with was the mobile van. But I knew to set myself apart myself apart. I could not do the van I needed to think outside of the box. So I thought in different ways I thought about the hauler, and I’m glad I did and because Brady Murphy and I came out at the same time. And I just think it’s great to have two different aspects of mobile audiology. But I remember a couple years ago, I was watching tiny house big nation, and there was this rapper that created this. It was a tiny house on foundation, he created a studio with a sound booth. And I remember telling my husband, wouldn’t that be cool to do a tiny mo will tiny house on wheels. And that was years ago. And that thought came back? And so,

Dave Kemp  16:30

so cool. We’re gonna do this.

Brandi Smiley, Au.D.  16:33

They didn’t know if it was gonna work, but it does.

Dave Kemp  16:35

Well, okay, so this is super interesting. So you literally have a clinic on wheels. And so you know, this thing comes to be when you were first getting started, like, you know, what were the groups that you were targeting? I know that you do a lot of work with underserved populations around the country, just kind of walk me through, like, as this thing was starting to take off, what were kind of like the what was the day in the life?

Brandi Smiley, Au.D.  17:04

Okay, so I’ll tell you this, the mobile clinic, even though that was launched, that did not take off immediately. So contracts did not come, I had to pivot. And I guess we’ll get into that a little bit later. But I had to pivot services in order to get that revenue. But when it came down to the services for the mobile unit, the goal was to find the agencies that had the patient, I didn’t want to do a whole bunch of marketing for a one of the patients to be there and be able to take the clinic to them. And so my population that I was most familiar with was education. So I was targeting school districts that were under resource and had no audiologist within close proximity. But of course, sometimes with those districts, they don’t want to spend money on things that they don’t know if it’s gonna work. And so I had to think of other options. So I started to approach the Headstart agency, where there are, they’re under resource underserved, these kids have to have their hearing screened within 45 days. But then also, if you find the hearing loss, who are who seeing these kids are no audiologist and even EMTs in those areas. So just trying to become that bridge and familiarize myself with the practitioners in the area, create relationships so that there can be that continuity of care.

Dave Kemp  18:31

I love that. And I think it’s the Jumpstart thing makes a ton of sense to because I think that there’s clearly been a push, it seems like lately around early intervention, whether it be Edie and like the newborn screening, but also I think these programs like jumpstart to intervene. We know these are really impactful things to do. But to your point, like I think that there are so many gaps that audiology could be filling. And I think that it takes out a box thinking, you know, to come up with like, Okay, well, how are we going to like meet these people where they are, we have to put a clinic on wheels or something like that. So when when this part of your business was forming, was it a lot of you know, like hearing screenings, or were you doing a lot of the work with the kids that maybe had failed the initial screening, and you were doing the follow up? Or were you doing both?

Brandi Smiley, Au.D.  19:34

So it’s both so I have a contract with babies can’t wait program here, which is the therapy part of early intervention. So after their newborn hearing screenings, if they fail, then they’ll get connected with babies can’t wait and get into early intervention programs, and still have to have that audiological follow up. So I see, you know, infants up to three years old in that regard. Doing it Oh, acoustic emissions join paediatric tympanometry. So that level. And then when you get to the Headstart program, these were the kids that were missed because it would go from Edie and then go to maybe babies can’t wait, then to public school, but everybody was missing the Headstart program. So these are the three, four, and sometimes five year olds, that did not have audiological care. And so it would almost not be caught until they entered pre K, in the public school system and have to have those testing to make sure they didn’t have to be placed. So I didn’t know that at first until getting into the that that was a gap. And they had immense need for audiological services.

Dave Kemp  20:45

Do you feel like your life’s come full circle where you have kids coming into your, you know, tiny house, and you’re kind of presenting them with that same experience that you had, where it’s dry, you know, you have like this, you know, really happy? audiologist like standing there waiting for them does that does that sort of fulfill you that you’ve kind of come full circle with your life?

Brandi Smiley, Au.D.  21:10

It does, it shows me that representation matters, especially in these areas where the kids look like me, and they’re not used to seeing practitioners that look like them. But just giving them hope, you know, that you to, even though this may be your situation, can be whatever you want to be can build whatever you want to build, but just to see those smiles, and you know, just hear their conversations where they’re sitting in there. They say, Oh, this is so cute. You know, that just warms my heart and it does come full circle.

Dave Kemp  21:40

That’s awesome. Okay, so you, you’ve outfit this whole thing. You’re now a full blown mobile audiologists like are you ever gonna look back? Or is this this is like, what is like, what is it about? I’m sure, touching on the nomadic element, and then breaking up the monotony and all that, but like, what are the aspects of being a mobile audiologist, that that you love the most?

Brandi Smiley, Au.D.  22:06

I think is I feel like, at this point in my life, we may have an edit at this point in my life, that I am free. And I’m authentically me. And there’s so many things that I had to I feel conformed to to appease the vision of other people in their mobile or not their mobile, but their audiology clinic. But for me, I’m just authentically me, you know, you’re going to get best practices, you’re going to get the skill set, but you’re also going to get compassion, and empathy and understanding, you’re not going to get a rest appointment, I’m going to spend time taking time to meet you where you are, and get to know you. And I feel like it develops a different type of relationship that I never had with patients in the clinic before. Very different very fulfilling,

Dave Kemp  22:56

I like that. Okay. And so, you know, one of the things that I thought, and I’ve mentioned this on some of these other episodes that I’ve released, is like, the thing I really enjoyed about this year’s ADA, was the sense of collaboration. You mentioned earlier, the other Brandi, you know, Brandi Murphy, West Texas mobile audiology clinic, doing something similar. But, you know, with that mobile audiology, pre conference shop or workshop, I just was really struck by the transparency that everybody had sharing their experiences, how they’re finding ways to generate revenue, like it was just really neat. To have them kind of be this fly on the wall in a sense of seeing how the industry is collaborating in the professionals within it. We’re, so I’m curious of like in that spirit. Now, if you were to kind of like go back to yourself, when you were first getting started, or others that are going to follow in your footsteps? What have you learned so far with embarking on your own? And doing the mobile Adi audiology clinic? Like what kinds of experiences and lessons have you learned that you wish you would have known when you were getting started? The

Brandi Smiley, Au.D.  24:13

biggest thing is when you have a crazy vision, to not suffocate that vision, you know, it may not be the status quo, you may not have people that right now can relate to you. But don’t quench that vision and your spirit. Because it could be the thing that breaks barriers in this world. And I really wish I could have told myself that because this was like I said, I have my business plan during my fourth year, and just have that boldness and confidence to step out on faith. And also to, I think, find that support that’s needed. And you have to put yourself out there you have to be vulnerable and I think during my early career, because I was hurt by people that I trusted, that I became more reclusive, I stayed in my little silos I worked. I didn’t put myself out there. But I feel now that I’ve become more vulnerable, I found different tribes, tribes with mobile audiology tribes with APD. And people who really want to see you succeed, and that you learn from and so, just yeah, just step out on faith in and walk in that vision because it can break barriers and change lives for sure.

Dave Kemp  25:31

I like that. That’s really cool. So you’re obviously one of your sweet spots is with educational audiology and seeing you know, kids in the like, you know, the various stages of their, their school, you know, ages are you expanding into other fields like occupational health, other areas, and other types of patients, I’m trying to kind of just understand the full potential of being a mobile audiologist and kind of like where maybe some of the opportunity lies.

Brandi Smiley, Au.D.  26:07

Okay, I would say that the opportunity is vast. So I built a mobile unit to do one thing. But onsite audiology has become an umbrella of services. So I have a virtual office where I do more consultative evaluation. So I might do hearing consultations, they’re doing some APD, evaluations and therapy in that office, that might be a Monday, Tuesdays and Fridays. In the morning, I’m at an e and t clinic where I contract so I’m seeing a highly medical cases. And you know, anyone that needs hearing aids, they become hearing aid patient. On Wednesdays and Thursdays, those are pretty much my open days for contracts is so contract work is more PR in. And so you want to have consistent revenue coming in if in case your contract doesn’t need you for a stint of time. And so mobile is to me just being mobile is not this one dimensional type of process for Audiology, I just feel like you can be creative in it. And as long as you use best practices and have compassion, you know, it can be what you want it to be.

Dave Kemp  27:19

I like that. So one question I have going, you know, kind of like to start or even when you were in school of your career, what’s changed in terms of the call it like the equipment, or just kind of like, how have you been enabled by the current landscape in 2022? In ways that you previously might have been limited? Like, are you able to do a lot of what you’re doing because of advances in any aspects of technology, or anything like that, like, where you look back? And you say, I would have been limited? Because this piece of equipment wasn’t portable in the way that it is? Is there any element of that? Or is it relatively what it was when you were in school?

Brandi Smiley, Au.D.  28:10

I think most of it is what it was. So for real air, I still use one of the suitcase very fit. Because it’s most portable for me, I would love to have a very fit too, but it’s just not feasible. And I’m you know, an audio scan very fit person. So I haven’t transitioned to the metaphoric so that I still use in terms of the audiometer in the mobile unit I use in last era, PC base. So I think that has changed since 2000 to 2006 I don’t think we had a lot of PC based equipment back then it was more so GSI like 61, I believe. So just, you know, transitioning to that video otoscopes may have, you know, I don’t know when they came about, but yeah, having access to that. I’m trying to think of what else I use away II s are more portable. Now. You know, you have the arrow scan. So those things are more portable, but I really think it some of the things we use back then could have, you know, things is in mobile.

Dave Kemp  29:15

Okay, cool. I was just curious about that aspect of it. What about the social side of it? So obviously, you’re interacting with people all the time. But do you get lonely at all working by yourself in a mobile audiology clinic? Or do you feel like you’re doing so many different things and engaging with so many different types of people that that part of your job is, you know, satisfied?

Brandi Smiley, Au.D.  29:40

Yeah, I’m not lonely by any means. So I’ve spent most of my career with multiple audiologists working in the VA. There were 14 audiologist, you know, I kind of was at the point in my life where I kind of gelled on my own. But there’s so many people around I rely on school staff to help out a lot in different areas. And then again, I have these audiology support groups where it’s not a lonely world.

Dave Kemp  30:09

Yeah, yeah. That’s cool. So when you were getting started, who were some of your mentors? Who were people that you know shaped your career, whether it’s your mom, your you know your aunts? Or were there any? Was there anyone in the audiology world that shaped shaped U

Brandi Smiley, Au.D.  30:31

shaped mom? Well, of course it started at home. I talked about that earlier. I will say I think I short it myself as a beginning audiologist with mentorship, I was hurt by one person that I really looked up to and asked to be my mentor. And I shut myself off from that earlier on in my career. I’m seeing the value now transitioning and opening myself up more to that. So connecting to Gosh, Alexander, Angela Alexander for APD in that group, so I just finished her master course and going into the treatment master course. Don Haim and just connecting with her and trying to get to know more people in this area, Randy Murphy and other people in mobile audiology, Brad Stewart. So these are new relationships that I’m trying to just build in home. Because that’s not something I opened myself up to. I mean, that was extremely hard went through some hard time. And but you can’t allow your career to be defined by that you have to grow. And you have to, you know, understand you can’t do things alone. So

Dave Kemp  31:43

totally, totally agree. Okay, so you mentioned Angela Alexander hurt. Yeah, deprogram. So this is, this is kind of a cool element of this, too, that I’m really excited about, broadly speaking about this chess industry in this profession, is that there there is this prevailing narrative that their sky is falling, you know, that, that, you know, in this OTC era, where will the audiologists find work? And I couldn’t disagree more with that I think that we are entering into in a way, I think the audiologist is reinventing themselves, like writ large. And I think Angela is a great example of somebody that’s like really helping to pioneer something that’s existed for a long time, but taking it and making it putting it more in the front of the conversation, though, how did how did you decide that you wanted to make APD a bigger element of your services, your practice? What was the the impetus for that portion of your services to, to kind of take hold.

Brandi Smiley, Au.D.  32:50

So the passion stemmed from grad school, and I remember having a preceptor, Erica Fruitland, that really spent time with me, helping me hone that passion and connecting me with preceptors that can help me grow that. But when I went into the VA, of course, that fell to the wayside. When I met Angela, I’m like, okay, I can get back into this. And it was overwhelming, because I had been away from it for so long. But she was so she’s so relatable and comfortable to her audiology group, in wanting to just really develop audiologists and not be afraid, and to step up, because it’s such a greater need. And so that’s just kind of what has been with her. It’s just really taking her courses and learning as much but and not being afraid, because I’m one I’ll take the education and maybe sit on it, and they’re like, No, you go ahead and start seeing patients, and you have the support. So just really, again, stepping out afraid and and getting that done.

Dave Kemp  33:48

So what’s that been like making that part of your repertoire? Having another tool in your belt that you can use I mean, is that that’s got to be a really cool feeling of just feeling like you’re even more capable to help more people. Can you just give me a sense of what this feels like it’s unlocked for you,

Brandi Smiley, Au.D.  34:12

I think is unlocked the opportunity for patients to have more access to services that they have been they’ve led they’ve just been under resourced or not a lot of specialists in our area in the world. So just really providing another outlet, like you said, another notch to your bill to provide a service that where there’s been a lack of access, and not just stop at evaluation, but continue on with the treatment in different areas. So you have pediatric, you have our rehabilitation or with the elderly population with cognition, doing some auditory therapy. So there are different aspects where you can bargain this APD into light and I think it’s great to do it in a way that’s mobile and offer telehealth services with it as well.

Dave Kemp  34:58

So are you okay, so Let’s continue with APDS. Like this example. So you make that you start to get comfortable with it, you see there’s a ton of value, how do you then mark it that service? Or how do you make it known to the contractors that you’re working with, or the folks that you’re working with, in general, that this is something that you’re providing. That’s I’m trying to just kind of understand how you materialize this as a commercial offering.

Brandi Smiley, Au.D.  35:27

It depends on what aspect you want to market. So my aspect is a school district, having those relationships from before makes that easier for me to go to the school psychologists and say, This is a service that I’m offering, you know, if you have a student that shows some sides, talking with the educational audiologist, some of the DHH teachers that you know, they don’t provide services and the students that’s been diagnosed with APD, but they’re aware of that. So just really letting them know that you have that service available. Your en t clinics, you see a lot I’ve seen a lot of females, especially since COVID. display some symptoms of auditory processing, such as marketing, that way, I will say to you, I’m not a heavy marketer, I like to go where the patients are, marketing is not my forte, and I know it is a must do in business. But for me, it’s just easier to go where the patient, the clientele is, and market to those professionals. And then, you know, that’s how I get my referrals, really from word of mouth.

Dave Kemp  36:33

Totally. But for something like APD, like the kind of in the question, I’m trying to ferret out of my own mind. Yeah, sure, is, like, you know, you, you almost have to make some of these educators or, you know, whatever profession it is that, like, make them aware that this exists, because I kind of almost wonder, you know, again, it’s like, the audiology bubble, if you will, where we as an industry or, you know, and then like the professionals as a whole, they know that this, this tertiary area could very well be the culprit behind this specific patient. But like, I feel like there’s this disconnect between what and non, you know, somebody outside of this bubble understands the potential, you know, solutions to be, so they look at it, and they’re like, Okay, like, I have, I don’t even know where to begin this, this child clearly has some sort of need. So like, how do you? How do you start to kind of work your way in and say, there’s more, there’s more than meets the eye here. It could be anywhere on things. I mean, do you basically just say like, let me be the one that does the analysis in the evaluation to determine what that is? And what are those conversations like with these, with these folks, where they’re becoming exposed to the fact that an audiologist isn’t just a hearing aid? Hearing?

Brandi Smiley, Au.D.  38:06

It just, you know, yeah, I think it comes down to taking that objective measurement and helping it make sense to the complaints, because the patients are coming in with these complaints. And most times being pushed away by people because they have normal hearing. So really doing those measures to see, okay, these are your deficits. And these are the treatment plans that we can do to help alleviate some of the problems that you’re having. I have, I don’t have a lot of patience, but the ones that I have, that’s really what it’s been about, is having that hard conversation. And then being a support system for the IEP team say, Okay, this is what was found on the APD evaluation. The student clearly has issues processing speech and noise, though they may seem like they’re getting by this is a detriment. And so really giving the teachers the support that they need, and just helping that student also advocate for themselves, and especially if they’re older. In those situations, a lot of it is education. Yeah. And that’s the biggest piece, we’re gonna have to get out there. And educate. I was just reading an article by frightened music earlier today. I think it just came out by htm. But there was a councilman Fetterman that has been kind of putting FTD on the map. And so I think with it becoming more prevalent, especially with COVID, because there’s some burning fall that’s similar to a lot of people who have chemo with brain fog, just really putting it out on the front forefront and not ignoring it and having the conversation and audiologist not being afraid of it and getting the education to provide that information to these individuals.

Dave Kemp  39:49

You know, it’s interesting because you’re like, I’m not really a marketer, but you’re kind of marketing in a different way. Yeah, sure. Education, right. Yeah. So You know, I’m thinking about like, what’s cool about your business? And again, I think like this is so representative of the bigger opportunity for Audiology is that there’s so much education that needs to be done. I mean, I think that the industry and the profession needs a total rebranding of say, like, we’re so much more, the hearing professional is so much more than what the the initial perception is, or the existing perception of it is. And there’s. So I think, like, I think about your business, you’re just getting started. And I would imagine, like, you’re probably you said, I don’t have a lot of patients yet. But how many of the patients that you do have came from referrals?

Brandi Smiley, Au.D.  40:46

So I have a lot of patients, I don’t have a lot of APD patient? Gotcha. Okay. And so I do have a lot of patients. I think, at this point I’ve seen maybe since June, I don’t know if it’s a lot because I’m not, but it’s a lot to me by myself. 150. That a lot. Okay. Okay, so. And so I missed your question, because I was.

Dave Kemp  41:09

Well, the question was, like, you know, if, if the, you know, opportunity basically stems from the fact that there is this giant, like, need to educate people that there’s more than that, like that the audiologist is the de facto person for a whole series of things beyond just hearing loss, and shisha. And so my question is ultimately, like, of the people that you’re already seen, how many of them are coming through your doors because of word of mouth referrals? Or

Brandi Smiley, Au.D.  41:47

most? Most of them? I honestly have not done a lot of marketing and

Dave Kemp  41:54

marketing. Yeah, no,

Brandi Smiley, Au.D.  41:55

I know. But I’m saying just personally join direct mailing and things like that. That’s what I mean. Yeah, I get what you’re saying. But yeah, most of it has come from word of mouth working with, you know, contracting with an EMT, local audiologist, that may not, you know, provide services in this area, you know, sending patients this way. Insurance companies, you know, being excited hearing aid manufacturers being excited. So most of them have come from, and I see what you’re saying.

Dave Kemp  42:25

You know, yeah, yeah, no, totally. I just think it’s like, again, the reason I’m like, kind of like sticking to this whole thing is that I look at your business, and I think, Okay, first question I have, like, ultimately, that we’ve been talking about is like, where do you start? Where do you how do you get the ball rolling on establishing a patient base? And I think you’ve outlined some really smart ways to do that. But like, it’s like, how does that growth happen? And in what I’m hearing is, it compounds on itself? Because what happens is, you you through the course of seeing all these different patients and having these different one on one experiences, people realize, oh, like, we the whole root of the problem was something I never would have anticipated it was actually related to APD where then gets back to, you know, the preceptor, whoever it is, that’s in charge of that educational audiology community, whatever in and it starts to become part of the mentality that there’s just way more here and again, I think that’s the really optimistic argument for Audiology, broadly speaking is like, as more time goes on, and as more people lean into these other aspects of what the full scope of audiology is, I think it’s gonna like ultimately lead so many more people through the doors of the geologist, because they’re going to realize that it’s so much that this professional does more than just hearing aids. Yeah, only what I’m getting. Yeah, and I get

Brandi Smiley, Au.D.  43:58

that and I feel like too, is educating providers that we would not typically work with optometrists, psychologists just kind of thinking out the box of those individuals that will see your clientele and can be that direct referral.

Dave Kemp  44:13

Totally. So what does 2023 look like for you and for on site, audiology?

Brandi Smiley, Au.D.  44:21

I’d like to develop a more, I think feasible plan for APD. I see that being a big thing and 2023 and maybe doing less hearing aids, because I didn’t want to do a lot of dispensing. So I see that being more of my practice, and more contracts with the schools. That’s just my heart and what I want to devote that time to, and also developing other audiologists that may be interested in taking this route into mobile audiology, just embracing their vision and helping them build what they feel their ideal business will

Dave Kemp  44:56

be. So you want to be more of a mentor.

Brandi Smiley, Au.D.  44:59

I do Want to be a mentor something that I felt like I didn’t necessarily have when I was starting this yet?

Dave Kemp  45:05

I’ve mentioned this on the podcast before I personally over the course of doing, you know, 104 of these conversations. I think that’s actually one of the biggest gaps that needs to be filled, is I think that we like I think the industry needs to do a better job of fostering the mentor mentee relationships, whether it’s a program that’s dedicated to connect people, but again, I just, I think that one of the most positive things that’s happening right now, within this industry, is this sense of collaboration. Absolutely. And it’s like, how do we continue to build on that, because you’ve learned so much, and the sky is the limit. So there’s not I really don’t think that there’s any need for or, you know, like this scarcity mentality, where people would be like, you know, hey, you’re infringing upon my opportunities, and my clientele or whatever, there’s plenty of opportunity again. So it’s like, how, how then do? How do we make it so that someone like you that has this wealth of experience and knowledge, you can transfer that to the next generation or whoever it is in? So like, I just think about that a lot about that. That’s such a big need, I think, for this industry is to create a mechanism, I think of connecting mentors that have so much field experience with the people that are just starting out. So that, you know, I just think of it as like, you have so much to give and so much to share. And I would love for that to shape more of a reality.

Brandi Smiley, Au.D.  46:43

Yeah. And I see I’m optimistic about it, because like I said, Before, I was not involved on the private side. So a lot of these private sector, audiologists I didn’t know, but just putting yourself out there and not shrinking back your vision and, and trusting that someone won’t take it and run with it. That’s the big piece just being vulnerable to that connection. But I do see some I see it gone into a positive direction I have I felt like I’ve been very blessed with new mentors in my life.

Dave Kemp  47:15

Do you see yourself like working with a university? Or, you know, kind of like, some source of where you could obtain the mentees?

Brandi Smiley, Au.D.  47:28

Yes. So I’m currently working with Georgia State University. They just started. They just started an audiology assistant program. And so providing opportunities where they can come and get some training and hopefully I can hire one of them to be my assistant. But hopefully, we’ll get a program in Georgia and AED program. I don’t know how long that will be, but absolutely will provide some opportunities and mentorship.

Dave Kemp  47:54

That’s fantastic. Sure, so cool. Okay, so as we kind of come to the close here. You know, we just talked about what your goals are for 2023. But, you know, like, where are you sit today? What do you what do you hope that onsite audiology ultimately becomes and what are your major aspirations with it?

Brandi Smiley, Au.D.  48:17

My major aspiration is just to bring access to those areas that lack it, and to break barriers in those regions. And so I can’t do it alone. It’s by community partnerships by growing and not being, you know, repelling the idea that I don’t know everything and to accept that grow and evolve and pivot when needed to make it feasible practice because I think mobile audiology practice can be feasible and can be lucrative if you play your cards right. I love

Dave Kemp  48:47

it. So cool. Where can people connect with you if they want to reach out?

Brandi Smiley, Au.D.  48:52

So Instagram is dark Smiley 404. I’m also under LinkedIn. So that will be under Dr. Carla’s smiley email address is info at on site And website is www dot onsite audiology. dotnet.

Dave Kemp  49:09

I love it. Brandi, thank you so much for coming on today. I I love your story. It’s super cool. You really did just Carpe Diem, you know, you seize life. And it’s just really inspiring to see, you know, the what you’ve built and really a short span of time. And I think it is exciting for me to see, you know, as like this podcast continues just all the different walks of life inside of Audiology. And, you know, it really is kind of the only barrier is your own imagination. You can kind of turn it into whatever you want. And I think you’re extremely emblematic of that.

Brandi Smiley, Au.D.  49:52

Thank you so much. Thank you for your time.

Dave Kemp  49:54 Thank you for everybody who tuned in here to the end

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