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Marketing in Audiology: Multi-layered strategy needed to reach every stratum of patients

Laberta, Valerie

doi: 10.1097/01.HJ.0000515649.75097.76
Cover Story




The entirety of health care is morphing at breakneck speed, and traditional marketing efforts have choked in its kicked-up cloud of dust. Some audiology professionals believe their chosen field is tied to the back of that galloping horse—being pulled along a new landscape of strategic marketing, hitting painful rocks of disruptions and adjusted realities. “We have any number of stressors in the industry,” said Brian Taylor, AuD, adjunct professor for A.T. Still University Arizona School of Health Sciences, and editor of Audiology Practices, the quarterly journal of the Academy of Doctors of Audiology.

“We are confronted with the current emphasis on access, affordability, and quality throughout health care, yet we also have to grapple with the reality of high-priced hearing aids and competition from big box retail outlets primed to sell over-the-counter hearing aids,” he explained. In December 2016, U.S. Senators Elizabeth Warren (D-MA) and Chuck Grassley (R-IA) introduced legislation, the “Over-the-Counter Hearing Aid Act of 2016,” allowing for the direct sale of some hearing aids, for mild to moderate hearing loss, to consumers. Consumers would be permitted to self-diagnose both the cause and extent of their hearing loss and to buy hearing aids without any guidance from hearing health professionals.

“I believe public health officials are reacting to research that shows linkage between untreated age-related hearing loss and other chronic medical conditions,” Taylor added. “There is recognition that people should be taken care of at an earlier age. So even outside of Washington, DC, consumer advocacy groups are getting on board and pushing for direct-to-consumer products.”

Not only is the environment in which audiologists practice shifting, so are the expectations of the patients they serve or hope to attract. “It has to do with patients having an abundance of information at their fingertips—more choices and access to improved technology,” Taylor said.



Mark Sanford, AuD, who owns multiple CSG Better Hearing Centers in the San Francisco area and spoke at Audacity 2016 about the roadblocks to audiology business success, agreed. “I can't tell you how many patients who are 77 or 78 years old whip out smartphones to look up a product, or record an appointment on their calendar,” he remarked. Additionally, while age-related hearing loss remains the primary patient driver for many practices, audiologists must not overlook a younger demographic experiencing earlier hearing loss as a result of loud recreational noise (concerts, clubs, sporting events, etc.) and the use of ear buds that pound sounds directly into the ear.

According to the American Speech-Language-Hearing Association (ASHA), fewer than 25 percent of all people needing hearing aids actually get them. A 2013 NIH fact sheet put the estimate lower at 20 percent. Clearly, the 75-80 percent of patients still underserved represents an immense opportunity for improved care and expanded business.

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A number of steps can help audiologists demystify appropriate marketing approaches. Most experts agree that the first task is to determine what your professional “brand” really is.

Bill Dickinson, AuD, vice president of audiology at Phonak, explained, “Beyond the fact that we share a professional brand as part of the audiology community, every individual audiologist—even providers within a group practice—must build and represent their own individual brand and identity.” He said an individual brand is what differentiates an audiologist from all other competitors, and noted that it simply isn't enough to present a philosophy of patient-centered care as their brand identity. “Every provider reports to be compassionate, trusting, empathic, and putting patient needs first; there is nothing unique or distinguishing in that philosophy.”

He suggested that clinicians might best develop a brand by shifting from a primary hearing health practice to one that specializes in a particular niche of care.

“Audiologists have unique professional privileges inherent to our training—specific knowledge and a skill set that is part of our professional DNA but which doesn't always show up in everyday practice,” he said. “Drill down into that skill set and decide what you want to be known for. Perhaps you will emerge as an expert in tinnitus, or a small subspecialty like single-sided or asymmetrical hearing loss. We are equipped to understand and meet the needs of the patient better than any other care option, including all current and future disruptive innovations. As a profession, we have tremendous opportunities in these areas. Or, your entire focus could be ‘this complex, noisy but wonderful world’ and your care concept could be about identifying the unique needs of the patient and maximizing their opportunities for optimal hearing.”

Taylor helped coin the phrase “interventional audiology services,” which also speaks to the differentiation of a brand. He told The Hearing Journal that the concept of “interventional services” originated in cardiology and radiology, and meant taking an alternative to the most invasive approaches to care. So, forays into diet and exercise to prevent disease were rolled out. “In audiology, one correlate is getting involved with people at a younger age, providing them with a hearing enhancement before they have a more complicated hearing disorder,” explained Taylor, suggesting that such interventional service could drive brand success.

He also believes interventional audiology can be successfully practiced outside of the traditional clinic. “Rather than waiting for people to come to you for an appointment, go out to the community, use some of the new technology to screen hearing in a more automated way; do this through community health workers, through primary care physicians, through geriatric nurses who may work with people who have Alzheimer's, cognitive dysfunction, dementia, and other complex needs. Become that resource person in the community who offers interventional delivery systems. Achieve what I call ‘pillar of community status.’”

In short, Taylor said a true challenge to audiologists in determining their brand is to disassociate somewhat from devices and focus more on service. “Why? Because the device has become a commodity that patients can get anywhere. So the real differentiator oftentimes is the quality of service, driven by the skill and the personality of clinicians.”

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The commoditization of devices is but one of the disruptors to audiology practices as they were known years ago. In the book, Marketing in an Audiology Practice, edited and co-written by Taylor, he explained the impact of disruptive innovations on audiology practices. Among them is an increasing availability of low-cost, high-quality digital technology leading to over-the-counter personal sound amplifications systems (PSAPs), now available at big box electronic retailers and online. Smaller practices simply cannot compete with the pricing of retail giants.

Further disruption has come at the hands of Google-searching patients seeking lowest-cost technology options. Taylor explained that a “… new market disruption … occurs when the needs of a specific group of customers go underserved for a prolonged period of time. Thus, new, and often less expensive technology can capture untapped sectors of the market.” This insight is particularly significant, again, in light of the aforementioned underserved population of potential patients.

Taylor said that audiologists can embrace disruptive innovations through better identification of their targeted patient base. He suggested that audiologists move away from traditional segmentation of consumers along age and income lines, and instead “leverage the concept of disruptive innovation [by segmenting] patients in a different way.” He said audiologists should ask themselves what “jobs” their patients really want done and allow the answers to clarify the role of disruptive innovations in practice.

He noted that unexpected answers may surface: “Provide a no-frills product without service support at a very low price point; deliver a stand-alone service (unbundled from the product); provide expert advice, outstanding service, and emotional engagement wrapped around a product. In other words, engross the patient in a memorable service experience.” Taylor noted that any of these nontraditional answers “may lead audiologists to offer products, services, and experiences to an underserved segment of their market.”

The takeaway is that the value of hearing care professionals may be better marketed around service models and patient experiences than simply the products they provide. Taylor added, “Historically, we have provided a one-size-fits-all service delivery model, predicated on multiple face-to-face office visits to fine-tune hearing aids when it is clear that consumers could benefit from a more diverse range of service and product options.”

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Once a brand is established, marketing strategy can be used to back it up, said Dickinson. “After you determine your niche of expertise within your community, all of your marketing should emphasize your specialty, first and foremost,” he advised. “And that doesn't mean your day has to be filled with only the most complicated patients. When I am talking about this topic at conferences, I hear from others who testify that when the community, especially referring physicians, identifies you as best to handle the most complex cases, patients immediately assume that they can trust you to easily handle their less complex needs. You will draw a whole variety of patients from physician referrals, and you're marketing on the weight of your ‘expert’ status in one selected area.”

But what does “marketing” look like today? A decade ago, it might have been sufficient to put a shingle out front, order an eye-catching Yellow Pages ad, place a small ad in the local newspaper, and top it all off with a direct-mail campaign. “But today? How I look at marketing now is stunningly different from 10 years ago,” said Sanford. “The days of the Yellow Pages and newspaper ads are not entirely over, but those forms of marketing have moved way down the grid of importance. If you don't have a website, how are you in business? Why are you in business?”



Alicia Ross, senior manager of marketing communications at Phonak, advised marketing to all stratum of patients because those in need of hearing health care cuts across all demographics. “The one thing I always say is you must make sure that you are marketing your services everywhere the consumer is looking,” she advised. “Some consumers prefer reading newspapers (print or online) and receiving direct mail. Some consumers are social butterflies, so speak to them on social platforms, like Facebook. If they are among those who search online for everything, make sure your information is easily found in search.”

Ross added that a website is really the new calling card. “That is the first impression prospective patients get about your practice. That is where they learn about you as a clinician, your culture, your staff, products, services, location, your hours, your phone number, etc.” She stressed that it is extremely important that your website is “optimized” so that when consumers search “audiologist in my area” you come up in the first or second spot on the search. “Some audiologists I work with want to study up on optimization—there is certainly a great deal of information available on the web or in classes—but most prefer to get outside help from an agency specializing in web development and web optimization. After all, audiologists are already busy caring for patients.

Sanford said he uses a call tracking/lead management/business analytic service to determine from which specific marketing outlets most of his new patient calls are derived. Because every marketing vehicle (newspaper, magazine, direct marketing, website, electronic newsletter, Facebook page, etc.) is assigned a unique phone number for his business, he can easily track which number (and associated advertising) is drawing the most prospective clients. This has helped him to place marketing dollars where they are most powerful, “And I'd say it has saved me $50,000 a year in marketing costs,” said Sanford.

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All of the experts agreed that good marketing leads to patients calling or visiting an office. But if those call or visits do not convert to appointments, the efforts are all for naught. “We used to get a decent number of calls, but our conversion rate was only about 45 percent,” said Sanford. “We really needed to be in the low 70s. If conversion rate is 20-50 percent instead of 60-80 percent, that can be the difference between making $10,000 and $100,000.”

Realizing that the front desk person is the first human contact consumers have with his practice, Sanford decided performance could not be average—it had to be stellar. Using his call tracking analytics solution, Sanford said he was able to listen in to the manner in which calls were answered. He realized the front office person was the bottleneck.

“The phone must be answered with, ‘Hello, this is the XYZ Hearing Center and my name is Jane Doe. How can we be of service to you?’ That last sentence is magic. If an existing customer is calling with a problem, you have already offered to solve it, and the entire conversation shifts to a positive tone. If a new patient is calling with a question about a hearing need, you are ready to address it specifically and assure that patient the help they need is available.”

Sanford said he has had to fire an employee who was resistant to training and unwilling to change her “script.” But today he employs a well-trained staff to ensure a good first experience for patients and proudly reveals his conversion numbers now stand at 85 percent. “Too many audiologists assume their staff is fulfilling the goals of their culture, but never really check to be sure. My advice is to be absolutely certain, because if you lose someone on initial contact, they will never come back.”

Ross, too, said in-office perceptions must be consistent with marketing messages. “The people in your practice must fulfill the promise you imply in your marketing. What is online must represent reality; it can't be hype.” She emphasized the urgency to provide a great patient experience from start to finish. That may even begin with something as simple as the comfort of the chairs and information available in a waiting room. “And maybe it's time to refresh the artwork and displays in the waiting room,” Ross said. “Besides selling hearing aids, audiologists are selling themselves, medical expertise, and technology. The office setting cannot afford to look behind the times. It all matters in a tough, competitive world.”

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Perhaps the most potent prescription for any marketing effort is found in the people within the community. Setting up a local physician referral program makes great sense, said Sanford, because patients trust providers recommended by their family doctors. He recommends making time to visit physicians’ offices, with an offering—such as a flower arrangement for the front desk—in hand. Deliver a letter about your audiology practice and the services you provide, and “request a lunch-and-learn discussion.” Sanford advocated offering a gift at the time of the lunch—perhaps an otoscope/screener suitable for a physician to use in-office. “One referral can pay for the screener, lunch, your time and energy,” explained Sanford.

Dickinson advised putting efforts into patient referrals. “We all know the strongest marketing tool is a highly satisfied customer. Get others to tell your story,” he suggested. “Look to your previously satisfied patients. Our patients are a fabulous cohort, and that is only growing as our consumers change. Many want to help or desire to contribute and they want others to experience the significant life change they have gained from your care. Set up a formal ambassador program within your practice and recruit people who would be comfortable talking about their experiences and outcomes with you.”

Often patients want to participate simply to help others with hearing loss, Dickinson said. “When it happens organically, it is truly a beautiful thing” But he said if you feel compensation should be offered, you might provide an ambassador with upgraded equipment as it becomes available, to make sure they are talking about the latest technology, or agree to provide access to a special level of opportunity within your practice to show your appreciation for their contributions.

Dickinson said that patient-driven marketing works “amazingly well in our little corner of health care,” because it removes the stigma of a “hidden agenda” that prospective patients may perceive when a pitch is coming from a practice owner, audiologist, or manufacturer. “Their guard is down when it is peer-to-peer messaging,” said Dickinson.

Ross reminded that audiologists should make the most out of patient relationships by securing a signed permission form during intake to meet HIPAA guidelines. “When a better device becomes available, you really want to be able to let your patients know,” she said. It serves patients well because they have the advantage of the best care and devices, and it serves audiologists well by keeping patients engaged and satisfied.

And that satisfaction, said Ross, opens the doors to testimonials. While a positive written review has value, she stressed, “Consumers really like to see the person giving the testimonial, so plan on recording in office and put videos online whenever possible. People really relate to other patients’ experiences, and when they see others who had a hearing loss and found meaningful help, it is so powerful. It is marketing at its best.”

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