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

106 – Rachel Magann Faivre Au.D. – Entrepreneurism in Audiology

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. Rachel Magann Faivre, Owner of Ash Audiology.

In this episode, Rachel and I discuss:

  • Her backstory, motivation for pursuing Audiology, and her professional journey thus far
  • Entrepreneurship and business planning in Audiology
  • Specific tips on how to actively network in your local community and grow your professional network
  • The importance of constantly getting out of your comfort zone in order to expand your comfort zone
  • Rachel’s motivation for starting her own private practice, Ash Audiology
  • Why a mobile-first private practice was conducive to Rachel’s lifestyle
  • How Rachel’s business planning process worked with specific planning tactics
  • How she got her first patient and continues to grow her practice 

I really appreciated the level of transparency that Rachel provided throughout this conversation. She shared very specific tactics and suggestions about starting and growing a business from her own experience. It’s not often that people will be so candid at this level of granularity, and for that I am really thankful for Rachel’s willingness to “pay it forward” for the next generation of hearing professionals.

-Thanks for Reading-


Dave Kemp  00:02

All right, everybody, and welcome to another episode of the Future Ear Radio Podcast. I am thrilled to be joined today by Dr. Rachel Magann Faivre. Rachel, thank you so much for being here. Why don’t we start by having you share a little bit about who you are and what you do?

Rachel Megann Faivre Au.D.  00:19

Yeah, thanks, Dave. I’m really excited to be here as well. So, I am an audiologist and Oklahoma City. And I lived in a few different states before moving back here, mostly as a student or x term, though, in those years, and started my career in a nonprofit, building an adult hearing aid program. But I, almost three years ago now started my own practice. And it is a mobile only, or concierge audiology practice. And I travel all over the state and love it. And so that’s what I’m doing. Now. I am from Oklahoma as well, originally, I was gone for about 10 years, though, before moving back.

Dave Kemp  01:08

That’s awesome. Well, thanks for being here. I’ve been looking forward to this conversation we met, I think it was at the AAA in St. Louis. So this has been a little bit of a long time coming. But um, you know, I just saw you again at the mobile audiology conference, you know, before ADA, and I’m just super fascinated by your whole business. Because it seems like you’ve accomplished a lot and kind of built a business pretty quickly, you know, only in the matter of years that you’ve been up and running. So before we get into all that, I want to start where I always start, which is the whole backstory motivation of how you got into audiology. So do you want to share about what led you to this industry in this line of work?

Rachel Megann Faivre Au.D.  01:53

Yeah, absolutely. So I always start with my mom has hearing loss, significant hearing loss, okay. And so I always knew what an audiologist was, because I grew up, you know, going to her appointments, and you know, here and there. But when it came time, so I have a zoology background and was actually going to be a vet. That’s what I went to school for. But I had decided I probably wouldn’t be very good at that, as far as I’d probably be doing more pro bono than making money at that. So anyways, so I took a few years off between my undergrad and graduate school. And when looking to go back to school, I knew I wanted to do something in the health field. I was living in Illinois at the time and the university there. I just went looked at their PhD and higher, you know, graduate level, help health care related courses. And anyway, the audiology program there just won me over. And I think I’m lucky, I think that it combined two things that at the time, I wasn’t sure, or I didn’t know that I would like but part of it is the health care, like helping people working with community that I love. But there’s also the technical component of, you know, working with equipment and fixing things. And I really love hands on work. And so I think those two kind of components of audiology were really a driving force anyway. So I love love being an audiologist. And, yeah, that’s how I kind of fell into being one.

Dave Kemp  03:32

Where did you get your AUD?

Rachel Megann Faivre Au.D.  03:35

Northern Illinois University.

Dave Kemp  03:36

Okay. It seems like there’s like a fair amount of people, that must be a pretty popular program, because I feel like I’ve met a good amount of people there. What was, you know, so when you started that track, and you started your masters and all that, what was it that you that really grabbed your attention and in your interest? Like, clearly you have the personal experience with your mom, but when you actually started to pursue this as your own career, like, what what really stands out, in your mind is that period when you were kind of like being one over?

Rachel Megann Faivre Au.D.  04:09

Yeah. So I mean, I think I’ve probably always known I like kind of running a business or have that sort of mindset. And even if I didn’t really kind of know in detail back then, but so from the very beginning, like the looking at different programs, the audiology program made more fiscal sense and not just because of tuition, but they had more avenues for like scholarships and being graduate assistant or research assistant. And so, from a business perspective, I was like, well, this makes more sense. I’m not paying tuition and I have a scholarship right or it’s very little. But once I had started in the program, the areas I really, I really enjoyed. I mean, like a lot of programs. We did a majority of hearing aid, pediatric and adult kind of clinical experience and so I certainly liked that. But when it came to the specialties, I really loved vestibular tinnitus and animal audiology. So, that’s one of the three things that when I went to my externship, I kind of was looking for more experienced specialized experience in

Dave Kemp  05:33

Okay, interesting. So you go to Northern Illinois University, and then where was your externship?

Rachel Megann Faivre Au.D.  05:38

Mayo Clinic in Rochester, Minnesota.

Dave Kemp  05:41

Awesome. Okay. And so what was that period like?

Rachel Megann Faivre Au.D.  05:45

Oh my gosh, phenomenal. What an awesome externship and, and just in general place to work if you know, for those that are there. We loved loved our year there. And it was very hard as you might imagine. It was, you know, your typical eight to five hours however, I really, especially there my focus was vestibular and I was doing some research, but so I was really studying a lot while I was also working, because I wanted to get as much information as I could from who at the time Neil Sheppard was the director and you know, he’s written textbooks on vestibular audiology, and so I really wanted to learn as much as I could under him and the other vestibular audiologist but so, gosh, if you know, I think in another lifetime, we might have stayed and and gone that route, but it’s a totally different work environment. Right then. You know, well, obviously lots of other options you can choose, but it was a great externship site and for sure.

Dave Kemp  06:52

That’s awesome. Okay, so then this period between starting Ashe audiology and the externship anything stand out there any foundational experience that you sort of gained in that period?

Rachel Megann Faivre Au.D.  07:06

Yeah, so after graduating? Well, as a student, I tried to attend pretty much any national association, state audiology Association and manufacture trainings, which, especially at the time, and this may still be the case, there were lots of discounts, or at least three opportunities in all those realms. And so I did take advantage of that trying to meet as many people as I could to make contacts, right. But also just learn. And after graduating, I actually did a five month stent with a practice management group. At the time, this doesn’t exist anymore, but they had a program where it was intensive learning on best business practices and from leadership qualities and business like ownership and financial pieces. But I got to shadow a few practices around the US through that. So that was a really nice hands on experience. I was paid not much but a little bit. And I also my last year during my externship here, had applied for a TAS business plan competition, the student business plan competition, which at the time, that was the first one they’ve done. And so that gave me a ton of foundational knowledge in the business sector, because you have to create a business plan, right. And so those would be the kind of learning big experiences one kind of directed and one self taught for sure. But after graduating, and after that stint with the practice, group, I, like I mentioned started with a nonprofit that was pediatric and cochlear implant focused, and I came on to create an adult hearing aid practice, it would be very much like starting a typical private practice. And I’m so grateful for that experience, not only because I had lots of wonderful colleagues, and it was just a great place to work. But I also had the opportunity to kind of build and grow practice and, and really practice all these things I’d learned the last couple years without it being my my wallet on the line, if you will. And but I also love that experience, because I guess two reasons. One, I was able to prove to myself what I could do and be successful at it and it was a really low risk way right to try something like that out, which I understand that’s a unique experience that not everyone can have right. But it also allowed me out because I was there about five and a half years. It allowed me to take a step back as well and think Is this the kind of Her work life balance, I want to be working, right I’m choosing, because the practice grew very quickly and was very successful financially. And we had lots of staff and, and so it, it was really fun and a great learning experience. But for me coming out of it, I learned, I don’t think I want to do something that big, at least not be the sole kind of leader of a group like that, like I have some ideas of what that could look like in the future. But anyway, so it was also a way for me to go big and do these big dreams that I think a lot of students have, you know, when they graduate, but also then being able to step back, when I started my private practices say is do I want to do this again, and just build it up again, or what I like to do different, so I kind of had a second go, which was also a really valuable kind of life lesson.

Dave Kemp  10:56

So, you know, I’m kinda like thinking already, like, what will the title of this episode be? And I mean, the thing that really stands out here is like just entrepreneurism. And this is an interesting thing for me, because like, I’m really passionate about this topic. And I feel like it’s, it’s like, audiology is really interesting in the sense that it is actually very entrepreneurial, historically, because of you know, it’s medical profession that’s primarily private practices, or at least it had historically been. And I think that you know, so you have like this, you have this like hybrid of kind of the prototypical audiologists that has, you know, maybe they’re real clinically oriented, or maybe they’re a little bit more business oriented. But I feel like that, you know, what I kind of tend to hear is that there’s so much focus on the clinical work, that sometimes the entrepreneurism, business elements of things kind of take a backseat. And what’s I guess, discouraging about that is, if you don’t have that ability to understand business, and how exactly to go about becoming an entrepreneur, then you can’t maybe fulfill the like the dream or the vision that you have, from a clinical standpoint. So I feel like they really actually go part and parcel like, you kind of want to have at least somewhat of a background in both. And so what I’m curious, because you had said at the beginning that you’ve always sort of had this entrepreneurial spirit, but, you know, clearly we’re doing things that were proactive, and how you could sort of foster that, whether it be like the ADA, student business plan, competition or something like that. So I’m curious of, in your experience, what are ways that young audiologist or aspiring audiologist can try to like, harness that a little bit? And what are resources almost into? Because so much of it does have to, it sort of seems like it’s, you have to kind of take it upon yourself to go and seek those kinds of things out? Can you speak to that at all?

Rachel Megann Faivre Au.D.  13:09

Yeah, so I would absolutely agree with what you’ve just said, my university training. You know, I think we had like a half of a semester with, you know, business principles. So if there was no educational aspect, as far as like entrepreneurialism, or business planning, anything like that, I will say, my university professors, though, were very open minded to any student who just had an interest in any area, even if that area wasn’t really supported academically by the program. And so I think first off just talking with your university professors and and hopefully they have open minds and want to help you foster relationships in those areas that you might have interests in, or at least allow you to go off and pursue those interests. So like I said, I in starting, I didn’t really know what I was most interested in. I think most students don’t know that kind of what specialties you might like. So my approach, again, was just to attend everything I could and meet everyone I could. That’s really hard, not the going places, at least for me, that was fun. But the meeting people and putting yourself out there that’s it is hard. And so very early on as a student, when I went to like triple A or at a conferences, I had my own little student business card, right? This is a little more before when you maybe swap mobile information, right. But when I went to a lecture that I really liked, I made it like a pact with myself that every time I went up, stood in line to talk to the speaker. And often I would just say, hey, I really liked what you presented on. I just want to let you know like I didn’t even Have anything grand to say or questions to ask? And I just say, you know, here’s my business card, if you ever, you know, maybe need help in this research area or you know, whatever the topic was on, and so that at least you have to venture outside your comfort zone, right, I guess the first thing. But for me in my personality that so the student business plan, competition was the first real concrete I guess. process I went through, and that was very self taught, I should say, my research project. So I did research on telecoils. And hearing loops in grad school and in my externship, and so, and I did do more than the required amount for that. Because, again, I wanted to get as much experience in the research field as I could to see if that was something I wanted to pursue further, like, my might like to get a PhD. But the business plan, because it was a project with a deadline, and you had to research to you know, create all the pieces of it. That was a great opportunity. And in that the ADA, student business plan competitions still exist. So that’s something students can still do. And so that created kind of a structure, right? Upon graduating, and after working, I think I was probably like three years into my career. I was itching for more learning, right? Like, I’ve read a lot of the books that conference, like keynote speakers would recommend that often or like motivational or leadership qualities or best business practices, those sorts of things. And they were okay. I mean, they’re good. But I’m not a great one to just read something, digest and take it like I need something a little more practical, personally. So I started really looking locally of Was there something I could do in my community that would help foster some of some of the ideas I had. Because at that point, I felt very confident clinically, right, I had a few years under experience under my belt. And so I started looking at things like the Rotary Club, I have a really good relationship with my vet for my pets. And so I asked him, Hey, do you know any organizations that might be good locally to be a part of just generally from like a business perspective, I had a few physicians that I knew, personally. And so I kind of reached out to them to basically anyone that was kind of in the general health care arena. And, but kind of by chance that the thing that kind of, I guess, stuck the most for me locally, we have. So through the University of Oklahoma, there was an entrepreneurial kind of leadership building course. Fellowship, if you will, it was a nine month program. And it was free to the fellows. However, the companies you worked for, had to sponsor you. So it was kind of part of the deal, your company had to say, yes, we want our employee to participate in this program, which I think is just really cool, because they’re getting buy in from the whatever company, and that’s local, not just the individual, right. And so, what appealed to me in this program, other than it was all about learning what kind of what I mentioned, leadership qualities, best business practices, but it was all geared around helping the community. And so what the program did was identify a need in the city. And then your group was and it was a five person group for my group. There were two of them in Oklahoma City. So there’s 10 of us total on the program in our city, and you go and research how to fix this problem. And so it’s very applicable. It’s non audiology. Ours was helping disenfranchised, primarily black area of town, be able to build individual wealth in training in some fashion. And so the project was fascinating. The four other fellows that were on my team, were all from different professions. I’m still friends with all of them. I’m friends with a lot of people that were in the program. But that was a way for me to get involved in the community to feel like I was doing something good to make contacts outside of audiology and see another perspective on all those that training and information out again, something that was outside of ideology. A lot of it was McKinsey, the consultants that was kind of their training philosophy. So the leader of this this group, it’s called the mind, Am I any good I had been a minor mine fellow, I had been a McKinsey fellow when he started his career. But anyway, and so that ended up leading me after I completed that fellowship. The next cohort round went, the next year, I became a team leader for it. Because each, each team has a leader that’s already been through the program. And then the third year, so I enjoyed doing that the third year comes around, and I propose an idea to help underserved populations in Oklahoma for hearing care. And it ended up being one of the projects they chose. And so then there was a whole fellowship year of five fellows working on that project for me. And that’s, you know, it was, you know, no charge sort of thing. It was, you know, obviously, time involved. But it was it just helped everything come full circle to kind of participate in different ways. I certainly, throughout those three years, met lots of people in lots of different professions, and just communities, right, like different socio economic statuses and live in different parts of the overall like, larger metro. And anyway, so locally, I think you’ve got to find something that is helpful. And so sometimes that can be really simple, like a rotary club. But I think the biggest thing you can do is, first, just ask people, you know, that are generally in health care, or maybe just successful business people, because we’ll also know these types of resources. And you’re probably going to get some duds out of those things that don’t like really pan out or aren’t as is helpful as you might have hoped they would have been. And but you learned from that, right? And I certainly did. And then there’s also looking at like you’re in generally, I would say, these are larger metro areas downtown areas are going to have but your universities, your venture capital firms, these are all groups, it might host these kind of entrepreneurial programs. And so you know, just doing a little more research locally, to find what what could be helpful.

Dave Kemp  22:14

Yeah, there’s this. There’s this like meetup in St. Louis, that’s called Venture cafe. And the whole idea is that it’s in sort of like the, you know, emerging tech, entrepreneurial part of St. Louis. And it’s open to everybody. And you can just come and I’ve gone a few times, and it’s just like, to your point, a really great way to get out of your, you know, the current siloed view of the world that you’re in and just kind of like, meet other people. And so again, just like that’s just to kind of piggyback on that, and say, I think these things actually do kind of exist all over the place. But he said a couple things there that really stood out. So first of all, getting out of your comfort zone, like I would say that is probably the best piece of advice for any young person, really anybody is the best way to grow is to get uncomfortable, and then your comfort zone expands. And I love what you said about how like, take it upon yourself to go and tell the lecturer or the person that you saw present, that they that you really enjoyed that because look, at the end of the day, 99% of people don’t do that. And so it’s another way to just kind of stand yourself apart. So I really like all of these is just like concrete, little things that you can do, because it’s all part of a theme, which is like, you have to be proactive. And you have to understand that the vast majority of people don’t do this stuff. So things that might even seem trivial, like having a business card and handing it to a presenter and telling them you really enjoyed their presentation, actually are the kinds of things that set yourself apart in ways that you probably don’t even realize, because that presenter might be like, That’s really interesting. Who is this person? They look into a little bit and chances are, they’re connected. And they’re like, Hey, I have this audiologist, this young audiologist that took it upon herself to introduce her to me, didn’t you say that you needed somebody in this in the same Metro that you guys exist. So it’s a lot of stuff like that, where you can never predict the type of serendipity that will probably unfold. So the best thing to do is just give yourself a lot of at bats to use, like a baseball analogy. Yes.

Rachel Megann Faivre Au.D.  24:21

And I know everyone says audiology world is a small community. And that’s kind of a cliched line. But I mean, I agree with it. And there are so many relationships that I you know, met early on that maybe even five years later became something a contact that I actually needed for some sort of, you know, use and just to even know, like, that those people existed and to be able to reach out to them was has just been like super helpful. And so all those people I met early on, you know, there was no goal to start something immediately with them or learn something immediately from them. But a lot of them ended up being very helpful for me down the road.

Dave Kemp  25:06

Yeah, that’s awesome. So going back to your story, thank you for entertaining my tangent there about entrepreneurialism, because I just find it fascinating. But it’s obviously a huge part of your journey and all that. So you come to the point to where you make the decision that you like you said, you’re part of this nonprofit, you’ve kind of grown this like division within it for five years. Sounds like you were really successful. But you learned through that process of maybe some things you would do differently if you had a second go around. So let’s talk about the second go around ash audiology. Just give me a sense of how this thing came to be what was the motivation behind it? And you know, what, what you learned this first time around that maybe you wanted to do differently this with with ash with your own thing?

Rachel Megann Faivre Au.D.  25:54

Yeah. So I think I always knew about myself that I probably wasn’t meant to work in a like Corporation setting. Because as a company gets large enough, there become rules. And rightly so to help the business run smoothly. But those rules don’t always make sense for like, individual decisions, right. And so the so, as our company, the nonprofit grew, I think it was a slow progression of just seeing more rules and regulations put in place that made working less fun, right. And, and so I started thinking about doing my own thing. I mean, not really concretely or in any sort of planning capacity, but to the, to the point where I was like, I know, I’m not where we’re going where I am, and where I’m going is not where I want to be, right. And so, anyway, so I, I probably took about a full year of more concrete planning, if you will, and not planning as in like, creating documents and a financial plan and that sort of thing. Because, personally, I liked where I worked, I wanted to do everything I could to leave them in a good spot, right with my leaving. And I just didn’t feel like kind of ethically or morally right, planning another business when I was working for one. And so my goal was to take three to six months off, after working there and then plan the next steps. I had general ideas of what that would look like, but And so but the pandemic happened right at the beginning of that, and so that kind of slowed things down. So I probably wouldn’t have taken a full year if that hadn’t happened. But in the in the end, the things that I found I didn’t like about how I was working was one, I mean, all those years I was there, I worked 6070 hour weeks, I loved it, it was it was my choice, it was not the the clinic, you know, dictating that. But that wasn’t what I wanted to do long term or not that many hours, especially for a company that wasn’t mine, right. And I also just learned how to manage people or how I like to manage people. And the types of kind of flexibility that didn’t exist as a company gets larger, there’s a lot more flexibility, typically with small businesses and then larger ones. And so I knew that autonomy and flexibility were two really important aspects to how I enjoy working. And I think that goes back to kind of entrepreneurial spirit and just, I love to build, I love to create, and then I get a little bored. And so I love teaching others how to do that whatever they’re interested in or are helping open up doors for them. And so I really enjoy teaching students and just like new hires, and not just audiologists front office, audiology assistants, all of the all of them hiring. And so when I left, I guess I knew I didn’t want to work, the hours I was working. I knew that the number of people I managed was something that in a kind of general term was building a large business right just on its own like to start team and I’m more interested in helping others pursue their dreams, right and so, so with my staff, we’d have personal professional and financial goal setting and we’d meet quarterly, individually quarterly, to discuss those and so I thought if I’m the owner of a business, how I would see this going I mean some I mean everyone’s goals are very are different, right. But I never wanted to be a leader of 1520 30 people, I would much rather find the other people who like to lead, and then help them kind of, you know, create their own like wing basically and lead it. So I do like smaller groups, I found that, and yeah, I just I, I just wanted, I guess more control as well in a certain way, but control for how I got to live my life. And so when I started, or when I left, the goal was to plan a pretty typical brick and mortar practice, I looked around at local practices, and seeing if any, were in the market to be sold. That was my kind of first option or my preferred option. The second option was just starting from scratch. And then the the third, which came about and with what ended up happening, is the mobile audiology piece. And really, that kind of fell into my lap as a temporary option, initially, because I had found out I was pregnant two weeks after I left my job. And so I thought, well, this isn’t a good time to open a traditional clinic. So I thought, I’ll do mobile for like, the next year until I’m ready to go back to work after the baby. And then I’ll do brick and mortar, and the more traditional route, but in that process of doing mobile for those months, I just loved it and never looked back. And so I Gosh, with mobile, there’s so many things that are very similar to your, you know, traditional practicing, but so different to right. And so, for me, like the flexibility and autonomy, you just can’t beat it. Like there’s no more flexible jobs and a mobile job. I don’t think I love being in people’s spaces. So whether it’s their home or their office, you really get to see their real world listening environment, right. My the second patient I ever had was a physician. And his number one hearing goal was to hear his patients one on one in their exam rooms. Well, guess what I was in his exam room doing his whole evaluation, so I knew exactly what, you know, environment we were looking at, or one of my patients who lives home alone. And this was down the road, it wasn’t an initial visit. She had called upset her hearing aids weren’t working. So I go out and visit her. And she can’t hear her doorbell. And so neighbors and family members are just walking in the door. This has happened for the last few days. And so I’m like, Okay, well, we get her hearing aids up org, and she has terrible hearing one of those patients that you know, is there’s only so much you can do. And so I make sure your hearing aids are working fine. Then I start to leave as equate, let’s make sure you can hear your doorbell cycle on ring it. Well, lo and behold, of course I didn’t, she didn’t tell me this, her daughter had just installed a ring doorbell. And it didn’t actually ring inside the house, that it wasn’t set up properly or whatnot. So you know, had she come into a clinic, got her hearing aids fixed, she still would have gone home and said, Gosh, I still can’t hear my doorbell. And I’m still really frustrated. Where then I could just email her daughter and say, Hey, this new doorbell you’ve installed isn’t working, and you need to come back. And so problem fix. So anyway, so there’s some real advantages, to see people in their environment. But to me, it’s also fun, because it’s always changing and different. And, you know, you’re always working in like a different space, whether it’s an office table, whether it’s on a picnic table in an RV park, whether it’s the lobby of the dialysis unit, I mean, I’ve been in all sorts of places doing appointments. And so I really liked that aspect as well.

Dave Kemp  33:47

I just think it’s so interesting that, you know, kind of like, just also happened to kind of break a certain way where you’re, you’re like, first, you know, commercial endeavor that you’re doing on your own, you know, at times in such a way where you’re pregnant. And so like sort of forced your hand a little bit and considering this third option, but then you come to really embrace it. Like, for me, the thing that goes through my mind with all of these mobile audiology themed discussions that I’ve been having, is like, you all seem like you’ve kind of discovered something that other people are just sort of waking up to, which is like, you can, you can do so much of what you’ve already been doing, but do it on your own terms. And, you know, we look at this industry and it’s predominantly a female oriented industry, I’m sure you’re not the only one that’s, you know, like the pandemic was a catalyst for a lot of people to consider their whole like, work life balance situation. And so I just feel like this is something that will probably resonate with more females in the audience and in males too, but just, you know, the idea of like, you can still be an audiologist, but do it in a way that’s more conducive to like becoming a mom and, and whatever other things might be interesting to you that you don’t want to commit to the brick and mortar, like, you know, kind of like pre existing notion of what a private practice looks like. And it’s like I say all that. And I feel like we’re at a point where it sure seems like I don’t have any hard data to support this. But it seems like private practice participation, if you will, or, you know, like the young professionals in this industry that are entering in and deciding what they want to do, it seems like it’s at the lowest level it’s ever been. And part of my thinking is that ideologically, it’s not aligned anymore with the wants and needs of the younger generations. And maybe that’s just generational. Maybe it’s because our generation sees all of these other kinds of, you know, kind of like Remote Jobs and ways that you can have more balanced, but I just look at this, and I think, is this maybe the solution to what sure feels like the really low rock bottom, private practice pursuit that is underway in this industry? Like, do we need to reinvent what private the whole notion of what it means to be a private practitioner in this industry even means anymore?

Rachel Megann Faivre Au.D.  36:23

Yeah, and I think, Dave, an important thing you mentioned there was, you know, at the beginning, you mentioned, Mobile allows you to do a lot of things you’ve already been doing and know how to do but on your own terms. So I’ll first comment on that, that, that my hours are nights weekends, all through the day. I mean, if you looked at my office hours on website, I It’s like 80 hours, or I don’t know how I do not work all of those hours. But they’re available. And for me, in our lifestyle, evenings and weekends were great. I mean, that that worked for our family, right. And so that was kind of working on my terms, right? I think the other thing that’s super important is, when you do start asking around for maybe advice or information, you’re gonna get people who tell you, that’s not a good idea. And so you want to listen to those people, as well as the ones that say, yeah, that is a good idea. But I would just say, follow your gut, and whatever you’re really interested in, because you’re going to be successful. If you’re really interested in something right. Now, you do need to plan and have like a good business model to support what you want to do. So I mentioned animal audiology is an area that I love, right? And when it came time for me to decide, what services am I going to provide, you know, am I going to do hearing aids, cochlear implants, vestibular animals, tinnitus? APD? What’s that going to look like? I mean, you do actually have to run the numbers. And you know, what’s the demand in your area? What’s your reimbursement, you know, what’s your desired salary and profit levels. So you do need data to back up your interest. But especially for like, what I ended up doing this mobile audiology, I will say, the manufacturers in particular, they can be super helpful for you. As for asking just information and help in different areas, but every single one of them told me it was a bad idea to go mobile, and that anyone that did it, within a year or two is out of it. And so, you know, there’s a lot of negativity, and I’m sure there were a lot of reasons and, you know, they were while well meaning, but it probably did delay me a little bit and starting whatever I wanted to start because it was so kind of frowned upon. But I think another area is reimbursement for things that aren’t your traditional bundled hearing aid model, right. And so, all the other specialties are unbundling, it’s harder to find, you know, support in those areas. But, again, if that’s where your interest lies, and you can do some planning that supports it financially, then the sky’s the limit, right? Like you can get in or out of whatever specialty you like, whatever work environment you like, whenever you’re your own boss or your own owner. Obviously, there are a lot of lot more responsibilities that you take on and some pieces that you may not like, but the benefits far outweigh those extra responsibilities and a lot of those responsibilities if you don’t like them, you can outsource them right so it just, I just can’t say enough of when you follow your dreams. And what you’re interested in, you’re going to be successful.

Dave Kemp  40:04

I just like one of the things I’ve really appreciated from you, when we’ve talked is that you’re really transparent about your process. And I think this is where the rubber really does meet the road between being aspirational. And looking at this and thinking, This sounds so exciting. I would love to do that. But where do I even start? Do you want to talk about like, how you like what this process has been like, especially getting off the ground? Because I feel like that once you get the ball rolling, then you can kind of start to figure out on your own. But for me, it seems like where the biggest gap is, is how do you even get started? So you know, like, what was your planning process? Like? What went into the calculus of like, what services you were going to provide? And ultimately, kind of like, what led you to your business model? If you will?

Rachel Megann Faivre Au.D.  40:58

Yeah, absolutely. So I am a planner in that way. And I do probably move a little slower than some folks and not as much of a risk taker in a lot of ways. I am a data driven kind of gal and just all aspects of my life. But so the things that I did kind of in the planning process. So first was my general business plan, right. And luckily, I had a template because I done the ADA, business plan competition, so I had a template to work with. But I will tell you, the Small Business Association is a phenomenal resource. It’s really, if there’s one resource I can point people to it’s that one because it gives you step by step instructions of, you know, how to create a business write successful business. So and I’m happy to share this information with your listeners as well. Or your followers. So outside of a general like written business plan, and that, you know, was looking at financial planning, that was looking at what services to provide. That was looking at market demographics, staffing requirements, I’m sure I’m forgetting a few other, you know, general topics, I started with a just a big Excel sheet. On the financial end, I wanted to look at a three year projection. And in that have it. So this document has a lot of editable fields in it. And so you can say, Okay, I project, I’m going to, you know, sell this many hearing aids a month, or I’m going to have this many this percentage of patients that are Medicare, and this is the you know, deduction of a reduced reimbursement rate I’m gonna get from those, those particular patients versus my private pay, versus my private insurance. These are, this is a percentage of high end hearing aid versus low end that I think, you know, I’m going to project I’ll sale I’ll sell, or this is the projected amount of tinnitus evaluations, I think I’ll have any year. So all of these, like calculations of this is what I think I’ll do. And especially if you do have a little work experience, you can have some pretty realistic numbers to put in there, in theory, some realistic numbers. But even without the real world experience, like I said, I did the business plan as a student, right. And so it can’t be done as a student as well. And so I think, really, not only does that give you good financial numbers, but it makes you think about, okay, I need liability insurance. How much does phone and internet cost? What are general like supplies, startup costs, like, you know, things from Impression materials and

Dave Kemp  43:46

all the oak tree stuff?

Rachel Megann Faivre Au.D.  43:48

Exactly. You know, it, it makes you think through all those steps, right? And so, financially, you’ve got to kind of predict that, and what are you going to set your pricing models as? And I think that’s a hard one, because that’s, I think everyone that at least I’ve talked to, or has reached out to me kind of asking, how what would their first steps be? They want to know, can they make the money they need to make in this way, right? And so you’ve got to start at that financial peace, right? And so, in setting your prices, you’ve got to first just figure out what do you need to make to live? Or what do you want to make to live? Those are different amounts usually. And then you break that down to an hourly or even minute, right. And so I had started out with kind of those big numbers kind of like I mentioned, I think I’m gonna have this many patients, this many sales, this many conversions of whatever type of appointment right and there’s those numbers, but then you have all the service and like reimbursement, so nine to 557. What’s my audio reimbursement what is to have sinned reflexes what is CI programming? What is you know, earwax removal, all those things. And so you can get fee schedules from insurances health insurances. So I did that in my local area. Blue Cross is one of the better reimburses for those services. And so I got fee schedules and made sure I didn’t set any of my service prices lower than what I’d get reimbursed from them. So that was part, you know, part one of kind of figuring out service costs. Certainly you can look at if you are practicing in the area that you might have your own practice later, you can kind of look at what are you getting reimbursed? Or what are you charging there, that can be a helpful, just general data point. But starting off with looking at your breakeven point plus profit. And so I would encourage people to obviously look up what that means. How do you calculate that it’s very easy. But generally, you just look at what’s the salary you want to make, plus your expenses for running the business and divide that by how many hours, you’re going to be working better billable, in a year. So you don’t want to just look at 40 hours a week, right? Because you’re not typically billing for 40 hours a week. That gives you a general idea of your breakeven plus profit value. And then you can add in, you know, different levels. So I had, here’s what I need to live here, here’s what I’d like to make here is if I’m really successful, you know, what’s my hourly rate? So with all those services that I mentioned, and audio, tips and reflexes, I said, Okay, how long does this generally take this service? 20 minutes, two minutes, you know? And I said, Okay, well, my hourly rate is, let’s say $200 an hour, okay, per minute, that equals x. And if this procedure is five minutes long, I need to make at least, you know, whatever, five minutes times my minute rate is, and also not have it lower than what my insurance would reimburse me. Right. So that gave me my first general step of setting prices and seeing, is this even feasible? The other thing, and this is a more kind of high level thinking piece, so that what I’ve mentioned, so far, all the financial is very detailed, right, you’re going through a lot of numbers. And sometimes that is a little overwhelming at first, because it is a large project, right? But I made a decision tree. And that’s just simply saying, what are the areas I’m interested in? What are the pros and cons of each of those? And what what I need to do to make those happen? And so so I had created a document and it had again, like animal audiology it had hearing aids and tinnitus. It had vestibular I think it had one or two other items. And, you know, pros and cons are almost like a SWOT analysis to like a strengths, weaknesses, opportunities and threats, right. Okay, this this particular specialty is there’s no one doing it in my market, or there’s a lot of people doing it. Or I really love this one, this is my favorite. This is my least favorite. And anyway, and so that really helped me at least figure out a place to start, and what services I would start with. And then and what kind of practice I wanted to have, right? Because like, in my instance, I mentioned, I’d love to love the singular, that’s not so easy to do mobile. And so that kind of got rolled out when I went mobile, right? So you may find things that just don’t end up fitting your model, even if you really liked that area. Right. And so that kind of concrete piece, I guess, there was helpful. And the market analysis piece, that’s another high level, it’s helpful information, but I wouldn’t let it dictate your decisions too much like looking at your demographics of okay, this zip code has this average income, or this zip code has this age group, right? Because I mean, those are helpful data points and knowing maybe where you might want to practice or where competitors are located. Or where maybe specialties are located, but not an audiologist is certainly helpful. But you know, I wouldn’t spend a ton of time on those general like city demographics. I think I spent probably more time on that than really was useful in the end. So that that might be a piece I would, I guess, recommend. And then yeah, I think gathering costs, because you do have some fixed costs to start with, right? You’ve got to buy equipment. Even if you’re not mobile, you’ve got to take into consideration rent, utilities, insurance, I mean, all that stuff. And so um, Are you looking at all that it just becomes a more realistic vision. And that’s all things you can kind of do on the side and your free time if you want. I mean, like I said, I did mind kind of after I left, because I plan to take a little time off to really devote to planning what I wanted to do next. But you could do those things while you’re working too. I know, not everyone has that luxury to take some time off. And so I guess those would be the the things I’m thinking of immediately that I worked on. I guess one other resource I’ll mention, since I mentioned, the SBA, that I really liked, was the lemonade accounting standard book. It’s a very, like Charlie Brown level accounting, with pictures, but it makes it very, and I like numbers, don’t get me wrong. I’m not like a verse numbers. But I didn’t know anything about accounting, right. So that was one of the foundational books for me early on, like as a student that helped me like figure out how to calculate, you know, just different things that you need in that in that area. So that I might recommend that for folks to

Dave Kemp  51:05

these have all just been fantastic suggestions and real, concrete, tangible suggestions that people look into, I mean, I love the decision tree and the whole spreadsheet. I mean, I think that’s, that’s got to be the very first place you start, if you are going to go and pursue your own businesses, you have to make sure that you’re setting realistic expectations. And so I think that the planning piece, like you’ve clearly you’re an expert in I mean, if if you haven’t already, you probably are already in the process of building a consulting company here. Because I’m sure there’s a lot of people that would love to spend hours with you really, you know, working through this stuff. But I guess then the other question, you know, kind of like the, the yin to the Yang here is okay, so you planned all that. But then like, when you start to go to execute, and you’re actually going to market? I’m just like, so fixated on this, like, how do you get your first customer? Where do you start? Like, what’s day one, like, Okay, you put your, you know, metaphorical For Sale sign on, and it’s like, okay, doors are open, I’m open for business. Where do you start?

Rachel Megann Faivre Au.D.  52:12

Yeah, so for me, I started with a website and Facebook, like a calendar of posts, before I put really put my name out there, just so that it looks legitimate when people you know, did by me and whatever avenue that, you know, they could see me online as well. So those were my, I guess, first two steps and having a really nice presence, at least, I hope it’s a nice presence online, the net and having like a professional logo and branding, you know, you’ve got to, you’ve got to look really good and professional, don’t start, like you’re just selling hearing aids out of that. Right,

Dave Kemp  52:52

which I think is like, easier than ever, like, you can use something like Canva. And you can make a really nice looking logo. And you know, and again, like a lot of I don’t know, there’s just a lot of easy to use tools that were things that were like historically perceived as barriers of entry, like, how do I even make a logo, or a lot easier to do today. So there are a lot of like tools out there that are really easy to use.

Rachel Megann Faivre Au.D.  53:17

Yeah, and again, this is me kind of going back to like being a slow starter, I guess, two things that were important to me is when I did need help, I wanted to use local sources as much as possible, because I like to support my community in small businesses. And so that was difficult to find things like who would my accountant be? Or who is the lawyer that’s going to look over like my HIPAA policies, and you know, just different paperwork in that realm. And those were very tough areas to kind of focus on. But I think when you’re so certain, like I said, so I’m pretty slow at that. And I think a lot of people would, like, you know, not create everything on their own, right, like, outsource some of the things creating a logo or your first letter to a physician. But once I had kind of my online presence set up, I mean, first I just on my personal social media platform just said, Hey, I’ve opened a business, right? So at least all my local contacts knew this is what I was doing. A big one. My first goal was to market to physician so in a traditional marketing sense, I was not going direct to consumer by any means. I still don’t. I still think positions are the best way to build your community. And for me, literally, that was one letter that was done by a local printer helped, you know, design it and make it pretty, I mean, I created the content in it. And it was all you know, medical information and just kind of a general overview of services we provided insurances we took and that sort of thing. So that’s where I got my foot in the door. And specifically with position, so I looked at primary care physicians first, and I picked a certain radius. So I picked within an hour’s drive of where I was, which in Oklahoma, that’s a pretty big radius. But that was kind of where I wanted to start, if you will. And I also focused heavily on the physician practices, those family medicine practices that were had a similar model as mine. So I found out in just research, I mean, I literally, this was googling primary care physician, and, you know, checking out every single website, how many physicians are in this practice? Well, you know, I found out there was a mobile Primary Care Physician Group. And so I was like, Oh, well, this is perfect, I need to reach out to them. There’s also a group, this is more nationally, that might be helpful for people everywhere, MD VIPs, that’s a certification or a title, if you will. And they primarily serve self pay patients, some take insurance, but most of them don’t. And most of them, it’s, you know, you pay a fee for a year of services. And you know, xy, and z is included in that. So it’s kind of a bundle model. So they’re looking at a patient demographic that was similar to what I would like to start with, right. Plus, most of them are private practice physicians as well. So they want to also help other private practice health care providers, because that’s, you know, they’re in the same same field, I guess. So those two pieces. And then I also, again, in my primary care looking, I found there were a few physician groups that were that were not MD VIP, but they were still that self pay model. And that attracted a lot of folks who didn’t have insurance, or whose premiums were so high, it was just cheaper to pay out of pocket. And so that’s like a very middle class, at least in my area, as in my experience of who’s coming to me from those practices, a very middle class kind of market. And so that is where I started to get people and honestly, between physicians, and then just word of mouth, your, again, your community, right, and not just your family or whoever you live near. That’s why it’s so important to get involved in things like rotary club, or like I did this mind program, because I had contacts in lots of different areas. So my reach was further, you know. So that’s, that’s really where it started, how I got my first patients in

Dave Kemp  57:38

the door. And there’s probably a rotary club in like, every single city, I think, right? So that’s a pretty applicable one. But I mean, again, I just love that you’re being so open about all this because it this scratches the itch I have. And I hope that there are people listening that like, this is really enlightening to hear. Okay, so that’s how you go about doing it. And it makes sense to I mean, okay, if you I’ve referenced this a bunch of times before, but like the, I think it was hearing help that matters. Put out a survey that surveyed audiologists asking about their patient acquisition and like, number one, word of mouth referrals, number two, patient or I’m sorry, physician referrals. So it seems like, you know, there’s just, you can do yourself a tremendous benefit by building inroads with the medical community around you, because they’re gonna send people your way. But I love what you said too, about these different services in these groups that can help to, like, get you in with different sets of patients and all that, because it might be daunting, if you are trying to go direct to consumer, like, there’s definitely an element of that. And some of the word of mouth stuff would I guess apply to that. But it seems like there’s some more tactical ways that you can kind of get something off the ground. And then obviously, as you get the ball rolling, it starts to compound on itself, like even more word of mouth marketing.

Rachel Megann Faivre Au.D.  58:59

Yes, exactly. And you can start adding in extra, you know, outreach, I guess, if you will. So I think the thing that I started, it was probably a year into the practice, I started reaching out to senior living communities, just a handful because I wanted to start really small to work out the kinks basically. And, and that’s been really just really fun. For me a different type of seeing patients I have almost a different model, not from a service perspective, but from like financial model. Because those folks don’t carry wallets on them. Most of them don’t even or a lot of them don’t have full control over their finances. So you’re talking with, you know, children or, you know, their family members regarding that. So it’s a totally different model than just going to someone’s house but but it you know, it opens other areas because once you get comfortable I would just say choose one specific thing that’s probably the most comfortable to Do you and that you’re confident in and that the numbers support your data and your research supports. Don’t feel like you have to do all like, I want to do these five things, I need to, you know, I have to get physicians, I need to, you know, contact potential patients, I need to contact senior living communities. You don’t need to do all that, like, do one thing. And then Step by Step Add on when you can, and when you have time, because, one, it’s just a lot less stressful, right? less overwhelming. But I think it’s also just feasible and works, you know, works better that way as well.

Dave Kemp  1:00:38

Totally. So as we come to the close here, you know, I could go for another hour here, just asking you questions, but I don’t want to take too much of your time. So what I am curious about is What does you know, we’re only in February. So what does the remainder of 2023 look like for you? What are the goals for Ashe audiology kind of moving forward? Now that you’ve got your feet underneath you? It sounds like and like you said, you know, you’re kind of like incrementally adding different elements of your business. So what’s sort of the current phase? And then where do you want to go from here?

Rachel Megann Faivre Au.D.  1:01:13

Yeah, so gotcha, I, pretty much every step from starting to now I’ve been in a really comfortable position. I’ve not felt like I was totally overwhelmed by the amount of work I had. But I also didn’t feel like oh, my gosh, I’m not making enough or I’m not seeing enough people. And that’s a just really liberating feeling in general to have that kind of mindset, if you will, in flexibility, right. And so, for 2023, correct. So I’ve got a pretty good just, you know, general, home in office, visit kind of clientele, right, your individual patient, and then a few living communities that are enough for me right now. I’m not really looking for growth, I’m actually expecting baby number two in a few months. And so that’s going to take obviously, a big chunk of my time and energy, you know, adjusting to that, and that change and life. So, I honestly don’t have big goals professionally, because of what I have going on personally. Last year, I had lots of professional goals, right? Because I didn’t have big changes personally. But again, that’s the beauty of I think, right? Practice, the way you want is you can be so flexible about your life, and I guarantee you come 2024 I’ll be back in that realm of Okay, what’s next? What can we do? And so, yeah, so I mean, a big goal for me, I will say a little bit more longer term is getting into a PDE. And it’s another specialty I’m interested in that I think will work really well with my model. But also, I’ve always wanted to help underserved communities and, and I’ve been doing that. But getting getting into that community has been very tough, and there’s not a lot of resources. How do you do this? Well, and so that’s another area I’d still like to continue to grow in, and what we’re doing,

Dave Kemp  1:03:14

that’s awesome. And I love that too. Like you can kind of oscillate between your focus on professional development or personal life. And again, I think that’s kind of like this whole conversation in a nutshell, is that you’ve given yourself the ability to be in a position like that, which I think will probably resonate with a lot of people. I think that’s kind of one of the best parts about this whole thing is like that work life balance. So Rachel, this has been an absolutely awesome episode. Really cool conversation. I’ve really enjoyed getting to know you and learn about your business. And I can’t wait to see what you do from here. So I’m really appreciative of you coming on the show today. Oh, he’s so

Rachel Megann Faivre Au.D.  1:03:56

sweet. David’s really been my pleasure. There’s a lot of fun on my end, too. So thanks for having me.

Dave Kemp  1:04:01

Absolutely. Well, thanks, everybody who tuned in here to the end and we will chat with you next time. Cheers.

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