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Help is on the way!

Kasewurm, Gyl A.

doi: 10.1097/01.HJ.0000314722.72816.e5
Gyl's Guide to Managing for Success

Gyl Kasewurm, AuD, is Founder, President, and Owner of Professional Hearing Services in St. Joseph, MI, which has more than 16,000 patient visits a year. Readers may contact Dr. Kasewurm at



As 2007 came to a close, I found myself absorbed in the painful but necessary process of analyzing year-end data in order to assess the health of the business. While the numbers were better than the previous year's, they weren't what I would have liked them to be. Searching for some hidden profits, I wondered, “How can I increase the profitability of my business?”

Business experts contend that there are only four ways to increase the profitability of a business: increase the number of customers, reduce expenses, increase the average sale per customer, and increase the frequency of sales per customer. But when it comes to a hearing healthcare practice, I think there is something else to consider.

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While completing my AuD degree, I conducted a time study on the types of activities audiologists in various practice settings perform on a daily basis. Data revealed that the audiologists spent more than one third, and probably closer to half, of their working day performing minor, time-consuming tasks that could have been performed by individuals with lesser qualifications. It would seem that delegating these tasks to support personnel would allow professionals to see more patients, which would lead to greater revenues and increased profitability.

Most other medical and allied health professions have long assigned certain tasks to support personnel, and audiologists can do that too. Just imagine how many additional patients you could see if you didn't have to spend time cleaning hearing aids, completing order and repair forms, setting up testing procedures, troubleshooting equipment, and teaching patients how to clean, insert, and remove their hearing aids.

What's more, delegating such tasks to an assistant would free up more time for you to demonstrate new technology, teach clients the uses of remote controls and t-coils, and explain the benefits of LACE programs, loop systems, and other assistive technology.

You could also devote more time to such important activities as family counseling, speech-in-noise testing, assessing central processing function, and developing relationships with patients.

Think about walking into a hearing aid fitting where the patient has already been oriented to the use and care of the hearing aids and the instruments are hooked up to Noah and ready for programming. Employing support personnel can make this dream a reality.

Although audiologists have been advocating the use of support personnel for 30 years, the practice remains controversial in some quarters. But with the advent of the AuD degree, I think that audiologists should consider the fact that most other medical and allied health professions, including physicians, nurses, optometrists, physical therapists, occupational therapists, dentists, and veterinarians, have well-developed technician positions.

With the burgeoning need for hearing healthcare services and a potential shortage of qualified professionals, the best way to increase productivity and profitability of a business may be to hire support personnel. I have heard rumblings from colleagues that their state license will not allow them to use support personnel. In fact, I've found just the opposite to be true. More than half of all states specifically mention support personnel and regulate how they should be used in hearing healthcare.

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When I first hired support personnel for my practice many years ago, I had no choice. The steady growth of my business and the absence of audiologists in the small community where I work forced me to hire support personnel to perform tasks that didn't require the education and expertise of an audiologist. However, as the practice continued to grow, it became evident that the addition of support personnel actually improved productivity, service accessibility, quality of patient care, and patient satisfaction.

While employing support personnel is not yet routine, a review of practices today shows they are being used successfully in a variety of settings, including the military, the VA, educational institutions, hospitals, industrial settings, and private practices. In any setting, the hearing healthcare professional must maintain full clinical authority and assume legal responsibility for the support personnel and must ensure that a good quality of patient care is maintained. Adequate and continual training of support staff is also essential.

Examples of the types of services an assistant can perform (after appropriate training and demonstration of competency) include: equipment maintenance, hearing aid cleaning and repair, hearing aid orientation, neonatal screening, preparation of patients for electrophysiological and balance testing, hearing conservation, and assisting the audiologist in testing children. Record-keeping, assisting in clinical research, clerical duties, and administrative support can also be delegated to a well-trained assistant.

The era of using support personnel in audiology practices has arrived, and it's long overdue. Focusing on activities that best utilize our education and expertise and delegating less demanding tasks to non-professional staff can be a big step toward increasing the profitability of a hearing healthcare business. Once we've taken that step, our most difficult decision may be what to do with all the free time on our hands!

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