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. Lindsey Jorgensen, Clinical Audiologist, Researcher and Professor at the University of South Dakota.
In this episode, Lindsey and I discuss:
– Lindsey’s backstory and motivation for pursuing Audiology and her time at The University of Pittsburgh obtaining her Au.D. and Ph.D.
– Lindsey’s many hats that she wears as clinician, researcher, and professor at the University of South Dakota
– Lindsey’s work with traumatic brain injuries and combat veterans
– The interplay between Neurology and Audiology, and Audiology’s growing significance with regard to dementia
– Lindsey’s speaking tour around the country about methods used by Hearing Professionals to verify and validate the performance of hearing aids
– How Audiologists can differentiate themselves within their market on the basis of holistic patient care
EPISODE TRANSCRIPT
Dave Kemp
All right, everybody, and welcome to another episode of the future hear Radio Podcast. I am thrilled to be joined today by Dr. Lindsey Jorgensen. Lindsey, thanks for coming on the show.
Lindsey Jorgensen, Ph.D.
It’s so exciting to be here. I always love talking to talking to you and talking to audiologists and talking to other professionals.
Dave Kemp
Awesome. Well, thanks for coming on today. I’m really looking forward to our conversation. So why don’t we start at the beginning, you know, give you an opportunity to share a little bit about who you are, go back to the start, where did the whole motivation for pursuing audiology come from?
Lindsey Jorgensen, Ph.D.
So I grew up in Boise. And both of my parents are in public school education, right as a principal, and my mom was a director of special ed. So I grew up kind of being in a in a situation where caring people, caring about others, and how giving back to others was really important to me. But I also realized really quickly, I didn’t want to be in education. And so then I went to college at the University of Washington and dabbled in different areas of medicine, I thought, for a while I was going to be a neurosurgeon, I went to my first neurosurgery and that surgery was not successful. And I really struggled with that, because I thought that that was the path I was going to go. I then ended up in a research laboratory, looking at outer hair cell regeneration. And I realized that I really enjoyed kind of pushing those limits of, of our current knowledge, but I really wanted to work with people. Right, I was doing animal research, and I realized that that did not internally fulfill me. And so I found that’s how I found the profession of Audiology. So I’m, I’m not one of the ones who thought that they were going to be a speech language pathologist and became an audiologist. But so my background was a little bit more in that kind of neurology background. And so then I got a degree from the University of Washington and the chair at the University of Washington said, I think you need to go to Pittsburgh and work with those, with the people there, given your passions. And so I applied to and got accepted to the University of Pittsburgh where I enrolled in the AUD program, and was working there. And sometime during my second year of the program, Katherine Palmer came up to me and said, you know, the questions that you ask, are not necessarily typical of a clinician, have you ever considered a PhD? And I said, Absolutely not. And then as I started thinking about it, you know, I thought that that would be something that I would be interested in. And the reason I said no, is because my experience with research been laboratory. And I didn’t realize there was a whole area of research that that actually like was with your patients. And with and not just like bringing people in, but like actual clinically based research that actually could change daily clinical function, and not just, you know, maybe understanding a neurology or understanding, you know, hair cells. And so once taught, kind of talking with Catherine Palmer through what a PhD would, would look like, and what that kind of would would do that really is something that I settled on. So I finished my third year of my AUD program and started my fourth year at the VA in Pittsburgh, which I absolutely loved, and then kind of started doing my PhD work they are I graduated with my AUD and stayed on clinically, at the VA in Pittsburgh continue to see patients I also worked in Sheila bras Research Lab, looking at some different areas of perception. And then also getting my PhD. During that time, I also met my husband and we got married, and my husband was in Afghanistan and my husband was hit with an explosive when Afghanistan. And he came back and he really struggled to hear. So me being the audiologist, I am I tested him and he had perfectly normal hearing. And so, you know, that was kind of when I had taken the information that I was really interested in from doing my PhD work. So my PhD work was on that kind of cognition and dementia, which I found very interesting, you know, how does the diagnosis of dementia help or not help someone with, you know, hearing loss in dimension where those two things dovetail together? And but not only that, but then how does the you know, maybe a TBI affects that as well. So when I tested Kyle’s hearing you’d perfectly normal hearing. And so that then left me to think well what happened and so with Sheila Pratt, she wrote it and VA grant and we started some TBI research. So I was doing both some cognitive research there and then also some TDI research, and that’s kind of where I’ve fallen into. I’m really interested in how we can ensure that our device He says that we’re bidding on people because I really love hearing aids. I really love you know, that technology piece, which is why I love audiology so much. Right? We get the technology, the rehab and the people. Yeah. And so, but I’m really interested in how can we take all of that information that we know about hearing aids and really make it individualized for our patients. And you know, whether they have dementia, whether they have TBI, whether they’re, you know, professional working in different situations. So I got my PhD and, you know, really said, I really want to make, you know, this difference in, in students in our future in our profession, and, and also still do some research. So I was really looking for a position that allowed me to teach and do research and do clinic. And so I ended up at the University of South Dakota. I’ve been at the University for 10 years. And I am now the chair of the department and the clinic director there at the University of South Dakota. So that’s how I ended up where I am.
Dave Kemp
Love it. I got a bunch of questions and little aside. So first of all, it’s really funny, you mentioned the whole SLP thing, because that has kind of almost become a reoccurring joke on the podcast is when I ask people where what’s the motivation? I would say like 80% of the time I’ve asked that question, both on the podcast and off is like I was pursuing SLP or communication disorders. And then I kind of stumbled into audiology. So you are in the minority of people that don’t fit that bill.
Lindsey Jorgensen, Ph.D.
Absolutely no it ironically, at this point, you know, as being the chair and the chair of both an audiology and speech language pathology program. And so I understand the speech language pathology, but that was just never something that I wanted to pursue.
Dave Kemp
Okay, so the other thing I was curious about, you said that you’re at Washington State, and you’re like, you need to go to Pittsburgh. What was the connection there? What was the indication that you were giving off that like, like, lead your mentors or your professors or whoever at the time to point you toward Pittsburgh? And why
Lindsey Jorgensen, Ph.D.
yet, so that the chair of that department at the time in Washington, where there was a gentleman named Chris, and he is an SLP. But he previously had been at Pittsburgh. And so he knew that kind of my interest in this intersection. And he now says, I always knew you were going to be a researcher. Okay, now, you know, yeah, I’m like, yeah, yeah. Okay. But he sent me there, because my interests were kind of in that like, patient interaction. And he knew Katherine. And so really, he wanted me to go work with Katherine and Elaine more. And he said, you know, these two people will really shape your profession. And I mean, he was not wrong, you know, that he really said they could really help you become what, what, what I what he knew I wouldn’t do
Dave Kemp
that. Okay. So that’s interesting. Catherine Palmer, once again, makes an appearance on the podcast, when I interviewed Lori’s Atelier not long ago, that there was a lot of you no love for Katherine on that episode, too. She’s got a
Lindsey Jorgensen, Ph.D.
lot of definitely a, she is definitely an amazing human and has really had an impact on my life. And, you know, her, her children, I think of as nephews, and, you know, they’re, you know, her whole family is pretty amazing.
Dave Kemp
So you go to the University of Pittsburgh, that’s where you start your AUD work. And then what was that portion of time, like when you were at the VA.
Lindsey Jorgensen, Ph.D.
So, you know, I really enjoyed the VA, you know, I enjoy there’s, you know, a really great group of audiologists there, you know, I realized the, the, you know, the VA has some, some pretty high standards and how they fit, hearing aids and their protocols. And, you know, at the time, Richard Wilson, and now Rachel McArdle are really, you know, holding that VA saying, you know, these, these patients are really deserve the highest quality of care. And I really enjoyed seeing that part of it, I really enjoyed how the VA, you know, really implement some of that nationwide. At the same time, I also started realizing that not everyone does that, you know, and gives people gives audiologist, the equipment and the space and the time to provide that care. And so, you know, started realizing that, that those kinds of things are really important. I also continue to see patients during my PhD and I thought that that was really important for me. Because, you know, you know, when talking with students, and they have to do Grand Rounds, they try to they’re like, I want to find the most unique case. And what I try to say is every patient is unique. Every patient is interesting. Every single, you know, has some nuance to them, that you can help them in an ensuring that they reach their quality, highest quality of life. And I think that’s what the VA really taught me. You know, a lot of and there’s, you know, they also have a huge repertoire of data but you know, people think this is just you know, you have Adult white male veteran, and like, yes, but like, I think that, that looking at them as individuals, and not just the next name really helped me shape who I am shape who I am also, at the time doing that, the research and really helping Sheila move forward that the TBI grants and really feeling like I could make a difference in some of these young veterans. Specifically, my parents, you know, my husband at the time, yeah, well, he’s still my husband. But at the time, I, you know, having come back for more transitioning out of the military, and how we can help him made me feel like I was making a difference in my personal life as well.
Dave Kemp
That’s really cool. So when you say that Katherine really was like, pushing you to pursue the PhD, you know, it’s already a significant undertaking to pursue your master’s in the AUD program and all that, but to take it a step further and go the PhD route. What was what was the moment for you that I guess, like crystallized in your head that this was the right call? Were you sort of reluctant to do so initially? And like, if so, what, what pushed you over the edge?
Lindsey Jorgensen, Ph.D.
You know, I think that, that it was really that, you know, initially I was reluctant, you know, like, this is what I was going to do, I was going to be a clinician all day, and I love it. And I think one of the things that I was really super reluctant about is researchers typically don’t see patients, and I still wanted to have that personal connection. But after realizing that, like, you know, you can still see patients and the research that you could do could really have that initial impact on, on people was really important to me. You know, my previous experience with research was great, but it was in the lab, we didn’t really, you know, we had lab meetings, we had lab notebooks, like, we had these weekly meetings, but like, didn’t feel like I was pushing the boundaries. But on the other hand, I’ve always enjoyed, like, seeing, my parents will tell you, I always push the boundaries, right? Like, I went right to the edge and just kind of like, stick my toe, right, just how far over the edge can I go? You know, and that’s kind of been my whole life. So I think that’s what interested me about it. And then realizing that I didn’t have to get an NIH grant, I didn’t have to do that. Because on a personal side, I didn’t want that publish and perish and get grants and grants and grants. And, you know, being that constant stress, I didn’t want that because I was already working through with my husband PTSD, and, and his, you know, things and having that relationship was also super important to me. But once I kind of realized, like, what a researcher could fulfill what I wanted, but I also could make it look like I wanted was when I when I finally jumped in.
Dave Kemp
Okay, that’s, that’s really interesting. So was the PhD dissertation that you wrote, like, around the work that you were doing around traumatic brain injury and hearing loss? Or
Lindsey Jorgensen, Ph.D.
no, so actually, you know, I kind of started my PhD before my husband was hit with an explosive and you know, how our lives influenced this, my grandmother had pretty significant dementia. Okay. And so we we moved her into an assisted living facility, and it was my parents house visiting her and realizing that, like, is it possible that like, she’s not following the conversation, because she just is not following the conversation. auditorily as opposed to, you know, like, actually not remembering what was being said. And so, you know, they kind of started thinking like, gosh, like, dementia is just such a weird saying, in general, and people are scared of it, you know, like, how can we, you know, really ensure that people stay connected and cognitive. And so actually, that’s what my dissertation is on. It’s like, I was I was really interested in kind of that overlap of dementia and hearing loss. And then I realized there’s very little research on that in general. Yeah. So then I started taking a step back and be like, how do we even diagnosed people with dementia? And so I realized that like, Okay, well, let me go do some research on that. And, and we go and diagnose people with dementia with an auditory presented test. And it’ll be less clearly going to have an issue. And so if we present people with an auditory presented test, you know, how does that how is this hearing loss affect that? So that was actually my dissertation was looking at the one of the most commonly presented tests of cognition, and running it through some hearing losses. And then I gave it to a bunch of 18 year old, you know, college students with, in theory, perfectly normal cognition, and they showed up as having dementia. So you know, that so that was my my dissertation was looking at kind of how hearing loss can overlay even just the diagnosis of dementia.
Dave Kemp
Interesting. Yeah, that I want to get more into that whole area, because I know you’re very passionate about it and very knowledgeable. But it’s, it’s the hot topic. It’s one of the many hot, hot hot topics right now, that I think gives me a lot of optimism about like the role of audiology into the future. I think this whole connection between the brain and the year has been something that, you know, as professionals have known for a long time is obviously there. But as we learn more about this whole dynamic between the two, I just find it to be fascinating. And it seems like it’s going to just unlock a lot of more need for for professionals, I think for like this lately of audiologist or this role of Audiology.
Lindsey Jorgensen, Ph.D.
And I think, you know, there, there are things that we can that, you know, that we know, I think that that in some places, you know, they’re using it as a as a scare tactic. I was giving a talk in Birmingham, Alabama, and I was driving in a cab, and there was a big, huge sign and it said, get hearing aids or get dementia? And I was like, Well, I mean, you know, like, I know. But I mean, it’s it might you know, so I don’t I think that there are a lot of ways that people can take it. I don’t think necessarily that’s the best way. But you know, I think that that in general, like, you know, we can that it is a huge area, especially with our aging population. And, you know, people are scared of getting dementia.
Dave Kemp
Yeah, I remember I saw a talk where they proved the one of the things that really stood out to me was that in terms of like, I think it was some sort of survey that they pulled a bunch of people or maybe it was just older adults. And it was like the, it was a whole lot of different scary things, from cancer to dementia to you know, you name it. And I think dementia was like number one of the thing that people were most fearful of. So it’s clearly I I’m with you, though, that I don’t think the right approach is to just fear monger and say get hearing aids or get dementia, that’s probably not the right approach. But I, I do think that it’s like, it’s kind of a fine line that you have to walk because you you want there to be like some sense of urgency and take this serious. And in that regard, I think that bodes well for Audiology, that, you know, this whole notion that, like hearing losses in some isolated thing, it’s actually probably linked to a whole bunch of other things, like when we were just in Minnesota. And, you know, Victor Bray had his presentation in the morning, and he’s talking about metabolic health. And, you know, the links of the comorbidities. I mean, a lot of that was news to me, I didn’t know that, you know, like, the the kidney specialist nephrologist would be, actually, there’s some Interplay there between, if you, you know, are showing up as having sudden hearing loss, that there’s a really large link between kidney failure. And so I found that to just be very interesting as this all kind of continues to on on roll, and we and we continue to find all these links. To me, it just screams like, audiology has a seat at this, like big table of like, the inner interdisciplinary linkage between all these different things and what we can learn from all these things. And the idea that, man, maybe one of the big rolls of audiology into the future is like, you know, kind of a first responder of sorts, where you’re one of the first to detect some of these major red flags that we have salutely then, you know, just something in isolation? Absolutely. You
Lindsey Jorgensen, Ph.D.
know, I think that this all comes down to, you know, we are not just the ears, we are ear, we are hearing on a body. Right, and the people are everything is interconnected. And, you know, but but at the end, also, we want our patients to be able to hear their doctors, you know, like, yes, like ears can predict a ton of things. And I will always say that, you know, especially when we’re thinking about dementia, I see my patients a lot more often than they see their primary care doctor. So a lot of times I’m seeing cognitive decline even before their, you know, physicians do. And what we’re asking our patients to do is pretty detailed, you know, like, we’re asking them to do a thing. The physicians are always trying to do these tests, which are incredibly important. You know, standardized tests are incredibly important, but we’re asking them to do a task. And we actually can see them do this task, and if we see them decline in the ability to do that task, you know, it’s our responsibility to send them on to the appropriate referral sources, but we are fitting the whole body on the other hand, we also want to make sure that they can Here at their doctor’s appointments, so they can follow their doctor’s instructions. Yeah, so I think we kind of have both, we kind of we kind of have both sides of that.
Dave Kemp
Yeah. Well, yeah, I mean, like, that’s another really, it’s another big thing that, you know, just having some sort of amplification in the, you know, physicians room could go a really long way. And I feel like those are kind of things that are, like, mildly dismissed as being, you know, what a great opportunity, again for Audiology, to build inroads with the broader medical community, like writ large is, you know, going back to the conversation I have with Laurie, we talked a lot about like, you know, what she’s doing around interventional audiology, and working with occupational therapists. And the thing that really stood out to me about that conversation was, you can, you can like, maximize your overall impact in your reach by enlisting other medical professionals to be advocates on your behalf, like at, you know, having having the nurse practitioner or the occupational therapist, being very well aware of the role of having some sort of amplification in the settings and the value of having that like, then suddenly, you have all of these other medical professionals that are in so many other settings that the audiologist could never really be in. So that that kind of stuff to me is like it just again, screams opportunity, opportunity, opportunity to listen, and in just a way for I think audiology to elevate themselves in the standing in the recognition of who they really are, and like the role they play with the broader medical community.
Lindsey Jorgensen, Ph.D.
100%, you know, so, Laurie, Laurie, you know, is one of one of my friends, and she’s amazing, and, and they’re in a hospital system, and I’m not right. So I, we have a campus clinic, and we, you know, kind of run it somewhat more like a private practice. And so one of the things that we have done is gone out into our community into our physicians and provided some pocket talkers. Or
Dave Kemp
that’s just exciting. That’s I know, exactly that.
Lindsey Jorgensen, Ph.D.
But what we did is we put a sticker on them that said, provided by the USDA Speech, Language and Hearing Clinic, you know, and I think that that’s a marketing strategy. And you know, that, and when I marketed it to, to those physicians, i Yes, it’s for the patient, but I actually talked about how it was for the physician, right, you’re not using as much effort to try and, you know, repeat the things over and over and over again, right. Like, if you market it towards them, and how it will benefit them, they’re more likely to use it, then every time they see it, they see our name on it, you know, like we put a little you know, the the things that go on the back of your cell phone, have you can put your credit card, oh, yeah, I’m popping the pot, but like, what we did is we put those on there, and we actually stuck some of our business cards in there. Like, there are all kinds of marketing things that you can do to your local physicians. Yeah, we just got like the little credit card Lucky’s and put some of our business cards. And so you know, in theory, if they go to if they feel like there was a patient that needs to use this pocket, you know, this, this pocket talker, then they hand them one of our business cards to? Yeah, you know, I think that that, you know, those are the kinds of things that, that you can do. But you know, going out to that, like we need to help the broader community, we want these patients to be able to hear in their doctor’s appointments.
Dave Kemp
Totally. So I think that you have a you’re, you’re like, in an interesting, you have an interesting Venn diagram to the way you operate. So you are a PhD, academic researcher, but you’re also a practicing clinician. And I know that when we were talking beforehand, you said that that’s part of what led you to South Dakota, was the ability to kind of operate in all these different worlds. So how did how did the move to South Dakota kind of come to be and? And was that largely the motivator? Was that you could do all wear these different hats simultaneously?
Lindsey Jorgensen, Ph.D.
100% That was the motivator, you know, looking at positions, you know, you know, do I want to, you know, I didn’t do a postdoc, so do I, you know, do I go do a postdoc Do I go to a university and you know, with the, with the intent of, okay, I’m gonna really, you know, move forward, this, you know, hard research line, and I just really say wasn’t willing to let go of that, that the patients you know, I’d seen patients all through my Ph. D. program, you know, if I was still seeing patients at the VA and, and I, I really wasn’t willing to let that go. And so although in some ways it makes my life more chaotic, you know, I’m still dealing with the patient phone calls and, you know, the those kinds of things. You know, insurance and billing and those things. I really was passionate in that I wanted to teach in an AUD program, but also like and bring current research and things to the audiologist and the future audiologist. But I also want to be able to have some, you know, authority with what I say, and some realism and say like, Hey, you know, like, yes, there are these 57 things during an appointment that like, we probably could be doing. But you can only do five of them because you have this amount of time, right. And I think that it that it justifies a lot of what I tell people, you should be doing these things in clinic, I’m actually doing them right. And I don’t have a three hour hearing aid appointment. You know, I have the same kind of appointment that you do.
Dave Kemp
It’s good, though, cuz you’re grounded in the reality of it, like, I think that’s actually really important is that sometimes it can be, you know, if you’re just working in theoretical land, to your point, you might find yourself in a situation where, in reality and practicality, can you actually perform all of these best practices? Or do you know, it’s like a ground you in reality a little bit, which I think, is probably it, like, I can see how these two work in tandem, where it informs what’s realistic within your researching, and vice versa?
Lindsey Jorgensen, Ph.D.
Yeah, and as I go to give, you know, talks, and as I go to talk to audiologists, one of the first thing I say, as who am I, you know, like, I’m running this practice, I’m, you know, teaching students, I’m doing research, but you know, what, I’m still seeing patients. Yeah, and I, you know, I still tell the stories of on Tuesday, when I saw this patient, this is what happened, or, you know, like, you know, those kinds of things, I think, just gives a lot of validity and a lot of respect from clinicians, when I’m saying these are the things you should do. I’m not just saying from a theoretical perspective
Dave Kemp
100%. So you just mentioned there, when you go to travel, you talk, you’re on the road, right now, you’re a bit of a road Dogg, and you’ve been, you’ve been touring the country, it’s like, a bunch of different talks that you’ve been giving. So you want to just share about what you’re speaking about? What are the kinds of things that you’re really passionate about right now that you’re presenting?
Lindsey Jorgensen, Ph.D.
You know, that’s a really good question. And part of this is, when a when a state organization, or a group asks me to come and talk, I, you know, one of the first things I’m going to say is, what, what’s important to your members, what’s important to what you guys do, and I’m not giving a canned speech, these are not I never give like the same talk at the same place. And so I think that that’s something that, you know, I really am trying to tailor the things to the people for whom, you know, are in this meeting. So, you know, one of the things that I that I’m passionate about is verification. But you know, how I talk about that verification is different, depending upon who I’m talking to, you know, I may talk about the theory and why it’s important. I could talk about the billing part of it, and how, you know, you bill for those services. How do you fit those into your practice? How do you market them? You know, I think that that’s kind of what I’ve been been talking a lot about, is verification, about verification of hearing aids? How do we set ourselves apart from over the counter hearing aids? And I think that that’s one of the reasons that I’m kind of right now on a circuit is that, you know, over the counter hearing aids are here, and they’re available. And so, you know, I’m not worried about them. But one of the reasons I’m not worried about them is I am not the widget. Right? And how do we set ourselves apart from that widget is, you know, providing the care, the individualized care, not to pull something off the shelf, read the instructions, you know, you know, that that we provide that individualized care for our patients, through verification, through validation through assessing their needs. And that’s more what I’ve been talking about.
Dave Kemp
Yeah, because like, this whole theme has been, I would say, like, this is probably one of the biggest macro themes on the podcast today is the notion of you’re not a widget. And so therefore, how do you package your value, if you will, in a realistic way, in a way that is meaningful to, you know, the potential patients that you could be seen? And I just think that, like, for me, OTC really just sort of embodies the commoditization of the widget, like, the days of there being a gatekeeper of, you know, like, you can only get that kind of device, that medical grade device through professional and today, you know, even with OTC hearing aids, there’s a fine line between, you know, over the counter and clinical prescription hearing aids, but I think that the broader point remains, which is like, how do you actually justify people coming and seeing you? And for me, it’s like, you know, if you have a doctoral level degree like an AUD, then that in and of itself is a massive differentiator, but it’s really just a matter of figuring out how do you how do you like position that as being a differentiator, rather than just assuming that the patient will know, especially in today’s times when you have, you know, big box retailers that have lower cost devices? So if you’re a patient, you’re sort of in a position where you have to make a decision, do I go this route? Or do I go this route? And if over here is you, as the private practitioner whenever? How do you justify the premium that you’re going to be charging or something like that. And so for me, it’s like verification really are measurements, things that are best practices that can truly differentiate that patient experience seemed like a no brainer, even more so pronounced, I think, in the OTC era, because it’s just more obvious in the sense that that’s going to be you, you have to find ways for your services in the, in that experience of you, as the provider being differentiated. And so it just it, it’s like, How do you square that? Because it seems like, this should be something that is universal across the board. And so I’m curious, like to get your sense of why isn’t really or, for example, a universal standard within this profession.
Lindsey Jorgensen, Ph.D.
You know, I laugh about it with with Katherine about, like, you know, we just keep talking about it. And, and I hope that I’m moving the needle, some, you know, I had a patient come to me with, and he made the comment, and I think it’s a great descriptor, you know, he said, I can hurt my arm, and I can go to the pharmacy, and I can buy a sling, I can walk around with a sling, but it may not fix the actual problem, until I go to the doctor and the orthopedic. And they actually, like, you know, do whatever they can when I do some physical therapy, a cast, you know, those kinds of things. And that’s the differentiator. And he saw that right, like, um, you know, another great, I think that, that the airline industry has done a pretty good job of this as well, you have your, your airline, and you have your airlines that are less expensive, and they don’t provide you. You even have to pay for water. You know, when you’re on that when you’re on that area. Yeah, you know, those kinds of things, but you bring your own lawn chair. Yeah, exactly. Bring your own lawn chair, lock it in that I think we know that. But I, when they first came out, we didn’t, we didn’t know that these airlines were so much less expensive, because, you know, there’s no padding on those seats. You know, like, you’re not like, you’re not going to get the comfort of your airline. And so when they first came out, we didn’t know that. And now, you know, as the years have gone by those airlines are still there. But they have not disrupted the market of Delta United American League, they have not disrupted the market as much as I think that that we’re we’re worried at first,
Dave Kemp
right? It may mentally just simply grow the market.
Lindsey Jorgensen, Ph.D.
And maybe they’d grown the market. Exactly. Right. Like, you know, that, that what you’re doing is you’re giving people the opportunity to, you know, start with something, you know, start flying. And now they can Oh, yeah, no, it’s not as bad as our worry as much as much as I thought, now I’m going to go travel internationally and go to somewhere like, you know, Europe on Delta, you know, those are the kinds of things that we have to think about. And so that’s kind of where our market fits. And, you know, how do we differentiate ourselves? I really do think that really your measurements on one of those things, right? Like, we’re not just pulling it off the shelf and handing it to the patient say, so. How does it sound? Right? We’re not, you know, we’re not a direct to consumer product that’s calling the patient being like, how are things going? How are things going? Yes, that is incredibly important. But I knew that the product that I gave them was fit for them. Yeah. And sometimes I have to push my patients, the, you know, you’re paying for every single one of these sounds, so I can turn it down, but you’re paying for this sound and having them believe my expertise. You know, I think that that my, my patients are see me for a reason. And it has very, it has a small, small part to do with that I help them select the right product. But more having to do with they know that if something were to go wrong, I’m there to help. If they you know, they also know that they’re getting the most out of the product that they purchased. Yes. And that’s what I feel like you know, we’re really your measurements start is we are providing them everything that this product can do, I’ve selected the level of, you know, I’ve helped them select the level of technology that’s most important that that they are getting the most out of their 1000s of dollars.
Dave Kemp
Yeah, totally. And I think making them aware of what you’re doing, you know, that, like, I’m performing this real ear measurement, which is just a great way for weather, you know, like the speech mapping and showing them like, you know, I’m basically tuning your hearing aid in a way, I don’t know, it just seems like those are the kinds of things where people will walk away from feeling like they that the premium that they paid was justified. It’s as simple as that. Not obviously, there’s like a continuum of care, you know, like, the idea would be that this is the first of many subsequent appointments, and that, you know, these are your patients for life kind of thing. But I kind of think that it’s about how do you, like, ensure that you get people in the door initially, and that, you know, for the people that haven’t even contacted you before, there’s at least a surface level understanding of why you’re different. And I do think that like really are, is a really good example of something that you could do that is just a way to differentiate yourself on the basis of best practices or however you want. It’s not like a silver bullet. But it’s, it’s an obvious thing that I think resonates with people that they will understand that. I mean, again, it’s like using OTC as a way to, you know, juxtapose it basically and say, you can get something that’s truly out of the box, one size fits all, where you can come to the professional. And along with me being your medical professional, I’m going to tailor this thing to you. So anyway, it just, it seems like a great way to differentiate yourself.
Lindsey Jorgensen, Ph.D.
Absolutely. And I think, you know, we also are the medical professional, just as you said, which is, you know, if someone has a sudden hearing loss, like or, you know, I had a patient a couple weeks ago, that told me that she had really bad tinnitus, and when she pushed on her jugular, her tinnitus went away. And so that was quite concerning. So I pushed her to the ear, nose, and throat physician, you know, like that I am still part of your overall health. Right? Like, I’m not just selling you a product, I am ensuring that that you’re still your overall health is still in the front forefront of my mind. I had a patient on this week who I saw who, you know, I did my case, she’s brand new to us. I did my case history. She’s worn hearing aids for a really long time. And then I am always, in my case history with Is there anything you want to tell me that you don’t think that I’ve asked? So I always end by in my case history section. And she asked me if there was any kind of vibration on her wrist, that could be an alarm clock. And I kind of paused for a minute and then actually kind of took a step back. And we started talking about how does she wake up in the morning? And, and those things that, you know, and I think that having, you know, those kinds of conversations, she said, I’ve been seeing audiologist my whole life and no one’s really talked to me about these kinds of things. You know, and actually she hadn’t been seeing audiologist she’d been seeing, not audiologist. Yeah. But you know, I think that part of our healthcare is we are the whole person. Yeah. But coming back to relayer is I know that that that product that I’m selling, is providing them everything that they’re purchasing.
Dave Kemp
Totally. So to change gears a little bit, going back to your husband and the whole work around the TBI and all that, like, what did you learn? That’s really interesting that you said that the initial audio Graham came back in that apparently, he has perfectly fine hearing. But again, this is this is another sort of portion of audiology that fascinates me is like, the pure tone. audiogram is like just one clue. And sometimes it’s one piece of the bigger puzzle. And I’m learning a lot about all the different kinds of jigsaw pieces that you can sort of, you know, extract from your patient. So this, but this one’s really interesting. So, to kind of, like walk you through what you guys learned.
Lindsey Jorgensen, Ph.D.
Yeah. So, you know, when when we’re in school, and we’re learning how to do tests, who do we always do them on our friends and family? And so, you know, I was learning about auditory processing disorder and, and I have no, he was my boyfriend at the time. And I put him through an entire auditory processing battery. And he was like, Yeah, okay, this is fine. Well, then, you know, he went to Afghanistan, and some things happened. And he came back and he has these problems, and I put them in the booth and he is perfectly normal hearing. And then I put him through that CIPD battery again, and he had completely different results. And so, like, that was really, you know, eye opening to me, is that what is the effects of blast exposure? And so, you know, one of the things Just looking at, you know that Shange and I think we talk a lot about sudden hearing loss and the emotional effect of that change. And we’ve been talking about auditory processing disorder for a long time and children. Yeah, but what about that change? And so that’s the other thing that I keep kind of coming back to is going to start it in this blast, and what do we do and, you know, my husband got out of the military and decided to go to school, well, he was struggling in the classroom. So I actually fit in with with hearing aids. And, you know, I fit in with some high frequency gain hearing aids and an FM system. And he was very successful in school, after getting that input, right, that talking about signal to noise ratio, and, and that’s part of what I keep saying, like, we got to think about the whole patient. Now, we’ve been talking about this from like, the veteran blast expose, which I really do think, you know, is a big focus of the VA, obviously, you know, we went, we’re, you know, the data say, Now, like, you know, it basically, if someone can make it off the, if they get injured, and they can make it off the the outer theater, they’re going to survive. And so we’re now dealing with some of these bigger complications when they come back. And so, you know, some of them, we can see, you know, my brother lost his leg, those kinds of things. But, you know, once we, you know, done with the other things we can’t see, and we’re getting better at PTSD and, and this TBI, and so we are seeing it in the veterans, and we’re focusing in on the veterans, but there’s a lot of other populations, you know, we talked about football players, okay. But also car accidents. And then one other group that I’ve really been thinking a lot about are domestic violence survivors. And how we’re, you know, it’s not something I’m going to necessarily bring up in our in an appointment. But when we see someone who, you know, maybe struggling a little bit more than we would have anticipated, or, you know, is, you know, one of those things about providing appropriate amplification is improving signal to noise ratio. And improving signal to noise ratio is so critical. But it’s possible this that these people are domestic violence survivors, which is a traumatic brain injury. And just not something I had really thought about when I’m thinking about oh, yeah, this TBI people in my husband, and we, you know, hear about it, and we see it in veterans, there are other populations for whom this is incredibly important, as well.
Dave Kemp
So just kind of as somebody that is not nearly as well versed in this space as you are, what is, how can I be thinking about this in terms of what’s going on, there were a blast makes sense for me, in the concussion piece is making more and more sense to me as I learn more about it, and audiology is role super interesting in that, given the type of specialty equipment that is in this space, and how you might be able to diagnose, but for something like, you know, domestic abuse, I’m just, I’m trying to understand what the leak is there with. I mean, you know, it seems like, to your point, it’s around something bad is going on with your brain. And that in the Bible, one of the byproducts of that could be, you know, something about the way in which the sound is processed, or something like that. So I mean, just like trauma in general, is it just the way that the brain is like wounded, and then how it’s healing itself, and then, you know, the ways in which your body’s responding to that, and how something like the ways in which you process auditory or audio, you know, that that could be impaired? I’m just trying to kind of better understand this.
Lindsey Jorgensen, Ph.D.
So, I don’t know if, if you remember, when I said that my undergraduate was focused on neurology, I see. That’s one of the reasons that I find this so interesting, because it comes back to that like, neurology, neurology side of me, you know, as with injury or anything like that, we do know that some of that, that neural mechanisms really formed back, they don’t warm back the same way. So simple tasks, like raising your hand when you hear the beat are just fine. But, you know, being able to perform in difficult listening situations, being able to suppress one signal wallet in danger to another signal is really where we start to see things, you know, differentiate and, and that is one of the things where providing appropriate amplification, especially in those high frequencies are really helpful. Right, high frequencies are typically Yes, where people have hearing loss, but in English is also where a lot of contextual cues are knowledge of, is this a question or is it a statement because it goes up in the end or down flat? All of those things? A lot of those things occur in those high frequencies. And so ensuring that people are hearing all of those sounds and making sure that it’s audible is really important for them, because they can’t do the things necessarily, like suppress the low frequency sounds of noise. Additionally, technologies of being able to perform, you know, directional microphones and how those technologies actually help people is the other way that we can differentiate from some of those OTCs, making people aware of how those technologies work. But also when we think about things like TBI, when we’re related to last exposure, or domestic violence, is those overlap with PTSD. And part of this is that it’s really hard to separate those two, because, you know, the, the awareness of their environment is part of that PTSD. And so being able to say, I promise you that these hearing aids are providing you the audibility that you need to be able to hear everything around you, you know, at least really hear that so that then your brain can figure out what to do with that information has been really saddling, because I know that I am providing that, and I have documentation that my hearing aid is doing that. Additionally, I can document that this hearing aid is not going to hurt your hearing, right, I’ve run my maximum power output. So I know that this hearing aid is also not going to hurt you. And so being able to have that documented is one way to not only just help our patients, but also protect ourselves. In some of these situations that can be a little bit more tenuous.
Dave Kemp
Yeah, no, that makes a lot of sense. Okay. Well, thank you for walking me through that. So, you know, as we kind of come to the close here, what’s going on in whether it’s in your world at South Dakota, or on the road with your speaking tours? You know, we’ve talked about some of the different things that you’re passionate about right now. But what is the remainder of 2023 look like for you? What are the things that are the big picture things that you’re really passionate about? Both on like a individual personal level, but also macro for the industry as a whole? Like, what are the things that you feel strongly about that either we need to, you know, get on the same page with or something that you really optimistic about? Just in general? Like, where’s your head right now, kind of with where either you personally or audiology as a whole stands and moving into the future?
Lindsey Jorgensen, Ph.D.
No, I think that that’s really interesting. No, I think many states are opening our state laws because of OTCs. Right, like, how are we going to, you know, look at look at a rewrite it, you know, kind of solidifying our rule and what we’re allowed to do in our licensure laws. And so I think that it’s something that we should consider about adding verification into our licensure, licensure laws as we move forward. Right, that, that we’re providing appropriate or ensuring appropriate amplification with the devices that we see. I think that that’s something that, you know, I would I would hope as we move forward with our, with our licensure, you know, as many states are opening their licensure laws. I think that that one of the things that I personally am moving toward is not just verifying that the hearing aids are functioning, but some of the features within the hearing aids, directional microphones, and when we receive a hearing aid from a manufacturer, or are we checking it in to make sure that it’s doing the things and hearing aids that are coming back for repair, are the hearing aid that we sent in, so we need to recheck those, that’s something else that that I, you know, I’m saying like, where else can we make a difference? And not just when we fit a hearing aid, we’re providing the we’re providing documentation of the audibility. But what other things do we need to be checking and, and in the future, I see us being able to really push manufacturers to say, how do I verify the difference between the economy level and the high end levels? How do I know that the hearing aid is doing the thing that you tell me that it’s doing? And so I think that that’s one of the things that I’m really working on is verifying some of those advanced features within hearing aid, that will help us better select the level of technology that’s most appropriate for our patients and their lifestyle?
Dave Kemp
Yeah, and that’s fantastic. And I know that this year is AAA, you’ll once again be doing the verification lab. Is that correct?
Lindsey Jorgensen, Ph.D.
That is correct. So that the Wednesday morning, before AAA starts, I’ll be doing a learning lab. And it’s about verifying advanced features. So we’ll be talking about, you know, maybe how do you verify an over the counter hearing aid or we’re going to be talking about that, but then also how do you verify some polar plot things? How do you verify frequency lowering things, the features within the hearing news? How do we verify that they’re actually functioning and we’re not just checking the box turning them on? And trusting the manufacturer? I always say trust them, but verify that that what we’re getting in our hand is what they turned it So the fda
Dave Kemp
100%. Just to go off a quick tangent, so with the OTC side of things with that, where you can verify that, do you think there’s much opportunity there? Were like, do you envision a scenario where you could see consumers coming in with something that they bought insane? This thing doesn’t seem to be working the way that it was advertised or something like that. Well, so
Lindsey Jorgensen, Ph.D.
going off of University of Pittsburgh in the lane where we’re have a phenomenal thing that they have, that is a relationship between pharmacists, and, and here and audiologists and kind of taking that model, we actually met with our good neighborhood pharmacy. And we, we met with with them, and they’re phenomenal, and the local pharmacists, and we said, we will vet a hearing for you, we will tell you which OTC to carry. And but when patients come to you and say, Help me fit this device, here is my card, I want you to give them my card. And so that is kind of the relationship that we have with our with our pharmacist, because pharmacy is the only medical professional that you can see without an appointment. Yeah. And so, you know, they, they come, you know, you patients are just going to them? Well, pharmacists are feeling like they don’t I mean, they don’t really want much to do with this, right, they deal with medications. And so giving the pharmacist that avenue, so I do see this as an opportunity for us, we are not personally carrying it over the counter hearing doesn’t mean that the clinic that private practices can’t, we are not personally doing that. But you know, if if somebody comes to us with an over the counter hearing aid, we do have a protocol on how we are verifying that that device works. And it’s really just very simply the similar to what I hear ringing, you know, we put a probe in their ear, and we we have their hearing tests, and we know what that device is doing. And then we’re giving that patient advice as to how to utilize that OTC. And when that device is no longer meeting their needs, that they can come back to us for advice on what to do next.
Dave Kemp
I love that I, I really liked the proactive approach to to go and seek out, you know, the pharmacy, I mean, that, to me seems like a really positive opportunity is, you know, if you don’t want to be the one that’s actually going to dispenser facilitate, you know, the OTC fitting or whatever, like, at least you can still point them in a right in as in a certain direction. And maybe you can build, you know, some sort of mutual relationship where they’re kicking up the people that do actually really warrant that moderate to severe, profound hearing loss level of care. So I mean, this whole OTC space is like, it still feels very much like the Wild West, I don’t know, totally how the professional channels going to be involved with it. Like I don’t know, if it will always just sort of beyond the sort of on this, like, Next Level Up plane, where if there will actually be a real role for them in that space. It just, for me, it’s kind of yet to be seen. But I think the moral of the story, what I gathered from you is that, you know, it’s like, you can, you can still be involved in this all by positioning yourself as the expert.
Lindsey Jorgensen, Ph.D.
Absolutely. And, you know, we have market track. And, you know, if you want to read about about market, track 2022, the seminars and hearing from 2022 is open available for anybody to read. It’s open source. And so that that’s the US data, but there’s also the Japan track. There’s also Euro tracks, by the way, but Japan track, one of the things that I was reading about in the Japan track is they’ve had an over the counter hearing aid for about a decade. And so you can actually kind of think that that could be a predictor to demonstrate where the OTC market will be here in the United States. And it’s had very little disruption on, you know, on the actual market, kind of back to what we were saying about once people realize what they got out of the basic hearing, airline, whatever, then people are, are choosing where to go based upon their personal need.
Dave Kemp
100% Yeah, I mean, it could for all we know, for me, the big question is, is this a new market? Are these people that aren’t even in the funnel at all, you know, or is this part of just bridging that seven to tenure gap? Is there going to be cannibalization? Like will there actually be people that work prescription grade hearing aid candidates that went the OTC route? I’m sure there will be some of that. But sure, I’m not convinced in any way that this is going to really impact the market that has historically been served by the medical channel. To your point, maybe that airline analogy is actually really spot on where it’s just kind of like a budget tear that might be the place that people begin they get their first experience with and then they graduate into something that they realize what they paid for, like you said, and then they move into the actual professional channel down the line. Who knows, but it’s, I think, you know, again, the the number one thing I think that you can take away from it is like, regardless of what happens in that space, you just differentiate by finding ways to communicate to the market of the kind of experience they’re going to receive from you. And if you’re an audiologist, I think that means it’s going to be something that adheres to the kinds of best practices that you are capable of providing, like verification.
Lindsey Jorgensen, Ph.D.
Absolutely. And I think that that really differentiating our market is, is what will continue to be what sells us as a profession and keeps our profession in that in the top of the mind of the physicians of the patients of the pharmacist, the community when they really actually want the holistic care and not just the widget.
Dave Kemp
100% Well, Lindsey, this has been a awesome conversation. I really appreciate you coming on the show today. This has been a lot of fun.
Lindsey Jorgensen, Ph.D.
Thank you so much for having me. Have a great day. Absolutely.
Dave Kemp
Take care everybody. Bye bye
