From Cairo to Audiology: Seizing the Future!

If you have ever wondered whether or not significant change can be driven by an organized and focused effort, certainly the recent events in Cairo suggest that it can. After decades of tolerating the social and individual disadvantages dictated by the few upon the many, an organized and focused series of actions by the Egyptian people non-violently secured what most would have never thought possible.

Few can doubt that if Egyptians so dissatisfied with their circumstances merely continued to complain amongst themselves about their plight, change would not have occurred. Few can doubt that if only a few hundred Egyptians had taken to the streets, change would not have occurred. And, few can doubt that if the protests had only lasted a few days, or weren't as organized as they turned out to be, change would not have occurred. When the need for change becomes more important than the status quo, change can and does happen. It is not easy. It is not the responsibility of a few. And, once started, it takes commitment and organization to see it through to the desired conclusion.

Audiology's Past (and Future) Revolutionaries

Regarding change, two historic audiology milestones come to mind. First, the "revolution" of the 70's that brought hearing aid dispensing into audiology's scope of practice. At first, audiologists complained about the fact that the American Speech, Language and Hearing Association (ASHA) would not allow audiologists to maintain their membership in ASHA and dispense hearing aids. Then, a few rogue audiologists challenged the system and dispensed anyway, suffering the chastisement and sanction of their professional association. Eventually, dispensing became a popular cause, driving ASHA to change its view and add dispensing to an audiology member's scope of practice.

Next, was the "revolution" to make audiology a doctoring profession. At first, this concept was the brainchild of a small group of professional leaders. They met a great deal of resistance from the audiology community who were comfortable with the status quo. After debate and discussions across the country, more people came over to the Doctor of Audiology (Au.D.) way of thinking, and not only did this change happen, but many of the audiologists who initially challenged the notion went on to earn the Au.D. degree.

The need for change to "win" audiology's future is not over. Today's challenges to the audiology profession are widely evident. Audiologists express concern about direct-to-consumer Internet hearing aid sales, optometrists including hearing aid dispensing in their scope of practice, manufacturers competing at the retail level, and the dominance of chain marketing in their practice markets, just to name a few. Each of these activities do put stress on the status quo of the hearing care delivery system - stress that concerns some audiologists, if not angers them.

What makes these challenges different from the challenges that produced the dispensing revolution or the Au.D. revolution, is that today's "change-agents" are external rather than internal. They aren't audiologists trying to change the audiology profession from within. They are external forces advancing business plans that are intended to secure business objectives - objectives that do indeed impact the status quo of the hearing care delivery system, and consequently the status quo of audiology practice and audiology's future. However, because these outside influences are less familiar to audiologists, how to address them may be more difficult for the audiology community to embrace.

The natural initial human reaction to change is to defend the status quo. We should boycott Internet hearing aid sales. Manufacturers shouldn't "bite the hand that feeds them" by competing with their customers. Optometrists should not be allowed to sell hearing aids. But, at some point, we have to recognize that defending the status quo is a recipe for failure. Recording moguls reeled at the notion of online music distribution. Their "status quo" was doomed to failure in the face of online music delivery competition. Netflix killed Blockbuster. Border's Books chose not to enter the e-reader market at their own peril. And, Facebook facilitated a revolution that removed a regime.

Leveraging Unity of Purpose Commercially

Things are moving too fast in the world for the status quo to be a defensible argument. "Change or Die" is today's reality for any enterprise -- business, social, cultural or professional. The reason why there are Internet hearing aid sales companies -- the reason why corporations enter the hearing care distribution market -- the reason why optometrists are adding hearing aid dispensing to their practices, is because these enterprises are not illegal and they are profitable. The wounded sensibilities of the audiology profession cannot and will not change this reality.

In order for the audiology profession to win its future, audiology must compete in the rapidly changing marketplace of hearing care delivery. The status quo of individual audiology practices buying their hearing aids from manufacturers with mutual deference to each other's distribution "niches" is a model that is doomed to failure. And, the corporations and/or manufacturers who are challenging this status quo are not bad people - in fact, some would argue that they are smart business people.

In order for audiology to compete in this new and ever changing world of hearing care delivery, audiology must learn how to collectively compete in the modern hearing care delivery marketplace as a professional "corporation". Corporations exist to offer a unique product or service to a target market, and to meet the needs of "customers" better and more appealingly than their competition. Through marketing, these corporations get their unique product or service into the consciousness of their target market. If the corporation's product is superior, and their marketing is at least competitive, the corporation stands a real chance of beating its competition.

Now, as bizarre as this may initially sound in describing a future audiology profession, it really isn't. Audiology offers a unique product (a university trained hearing and balance testing/treatment professional) to a target market (people with hearing and balance problems) to meet the needs of that market (effective diagnosis and treatment of their hearing and balance issue) better and more appealingly than their competition (a professional hearing health care path to problem resolution rather than a product-(commodity)-focused path to a presumptive problem resolution).

Sounds good so far, right? But, where the audiology profession drops the ball in terms of succeeding as a professional corporation is that the audiology profession doesn't market itself competitively. Our product is superior, but we are not marketing our product competitively, and so our target market doesn't know we exist, and doesn't know to ask for our product rather than the product that is being marketed to that same market better than ours.

In 2009, 2.6 million+ hearing aids were sold in the U.S. market, generating an estimated $2.1 billion dollars in wholesale hearing aid revenue (Hearing Journal, 2009). If we assume that at least one out of every ten dollars of this revenue was re-invested in growing consumer demand for hearing aid products, then $210 million dollars was spent last year marketing hearing aid products directly to U.S. consumers. Because these marketing dollars are primarily being used to market the value and importance of hearing aid products or brands, our product (the education, training, skills and value of audiology care) is not part of the message.

If $210 million dollars is being spent annually to get the hearing aid solution into the consciousness of people with hearing problems, it is going to take more than individual practice marketing efforts or professional association philanthropy to make the audiology message competitive. It is going to take unified economic resources (a "corporate" resource, if you will) to market audiology competitively to the same target market. In today's changing hearing care delivery market, effective, competitive marketing of audiology care should be the audiology profession's primary goal. The profession must recognize that marketing audiology care is not something that can or will be done by manufacturers or corporations. They have their own businesses to run, and their own goals to achieve.

Using a GPO to Market Audiology Nationally

From this perspective, unified group purchasing can become a powerful economic tool to subsidize massive corporate marketing of audiology care to the target market needing these services. Most providers look at group purchasing organizations (GPO's, or "buying groups") as a mechanism for securing better cost-of-goods pricing on the products they eventually sell to their patients. Certainly, leveraging collective buying power can and does accomplish this. But, GPO's also generate revenue. Thus, if a GPO commits to using its generated revenue for the purpose of subsidizing nationwide marketing of audiology care, then that GPO becomes a corporate marketer of audiology care. If audiologists choose to buy their products and services through that GPO, they are not only securing better cost-of-goods pricing, they are also building a revenue stream that subsidizes the competitive national marketing of their profession. Since at least half of the 2.6 million+ hearing aids purchased in the United States are initially purchased from a manufacturer by an audiologist, unifying that kind of buying power would indeed create a revenue base that could be used to market audiology care competitively in comparison to any other marketing investments reaching audiology's target market. With enough audiology participation in this GPO concept, the consciousness of the American hearing care consumer could indeed be shifted from "I have a hearing loss, I need to get a hearing aid" to "I have a hearing loss, I need to see an audiologist!" The audiology message would now effectively "compete" for consumer mind share.

In addition, with existing audiology purchasing leveraged in this unified way, the audiology community could become the primary influencer on how hearing care is delivered in this country. External change-agents would have to consider the impact their strategies would have on the audiology profession if the audiology profession was their single biggest customer, or their single biggest competitor. Operating audiology practices as thousands of individual business entities will not make this happen. Unifying audiology's collective buying power will. And, this approach not only costs the individual practice nothing, it lowers individual practice costs for both products and marketing resources.

Audiology-Focused GPO Dollars In Action

In today's world, getting a message quickly and effectively to the marketplace is rapidly becoming an Internet media game. So, national audiology marketing must be meaningfully in that game. The audiology-focused website NOWiHEAR.com is an excellent example of a consumer-pointed website designed specifically to generate demand for audiology care and to link consumers directly to audiology providers in their area. Through GPO funding, this website has been underwritten for over six years already in an effort to build its search engine optimization (SEO), a key ingredient for websites to earn organic top-of-first-page listings on search engine results' screens for the key words target-market customers are likely to type into search engine browsers. In addition to investments in SEO, GPO funding is also being used to secure sponsored listings on the top of the first results page. These sponsored listings can be expensive, especially for certain commonly-used key words that our target market may type into browsers. However, through sufficient GPO funding, the dollars needed to competitively keep the audiology message on top of the first results page even when the searcher types in the words "hearing aids" is not only possible, it is inevitable. Building these tools effectively requires millions of dollars in investment. Through the GPO mechanism such funding is possible with no negative impact on the financial condition of the participating audiology practice.

In addition to growing audiology's national consumer visibility through consumer-pointed website management, audiology-focused GPO funding is also being used to secure ongoing visibility in the media. Stories that appear in hundreds of online newspapers, blogs and social-media environments are being regularly pushed out by audiology-focused, GPO-funded marketers. These stories build consumer interest and demand for audiology care by showcasing the impact audiology care has on the quality and effectiveness of patient care. An Android app has been developed through audiology-focused GPO funding that screens for hearing problems and directly connects people with their local audiology provider, further leveraging electronic media to build the audiology care story and to bring consumers in touch with local audiology practices.

Yet, even as much as GPO resources can be used to build a national consumer-pointed presence for audiology care, this unified economic effort can also build greater visibility for audiology practices locally. By being listed on the national website's practice locator, and by tying local practice websites to the ever-changing audiology-focused content of the national website, local practice websites secure greater local visibility and search-engine appeal. Utilizing practice news releases and local advertising messages that carry elements of the national message articulating the value and importance of audiology care starts to build a form of "brand recognition" for audiology. Practices visibly associated with that brand secure better visibility for their practice. People start to see the brand and its messaging as the identifiers of "True Audiology Care."

Summary

Yes, the hearing care distribution system in the United States is in flux. The ambitions of forces outside of audiology are changing it, and these changes will impact audiology's future as a profession. External change-agents are not going to alter their strategies simply because the audiology community is pointing them out and talking about them. And, if the audiology community believes that the best way to meet these challenges is by arguing to preserve status quo, it will do so at its own peril.

As recently as March 2011, an online USA Today Article written by Anita Manning entitled Hearing Loss "Incredibly Common" As Boomers Grow Older (Manning, 2011) made a valiant attempt to educate people about noise exposure and hearing loss. Noted audiologists and researchers were quoted. Yet, even this article ultimately landed on the same marketing-driven focal-point that hundreds of millions of marketing dollars have worked so hard to secure - that what is ultimately to be sought to treat hearing loss is hearing aids. And, the article went further to suggest that today's hearing aids are too expensive, with cheaper solutions (through such distribution channels as "Wal-Mart") being investigated as alternatives. In other words, it focused on the "commodity" when deciding what one should do about a hearing loss.

Even though audiologists were quoted in the article, nowhere was it mentioned that the first and foremost step someone with a hearing loss needs to take is to see an audiologist - to have a proper diagnosis of their hearing condition by a qualified professional as an essential first step in determining how best to treat their hearing loss. Nowhere in the article was the value and importance of qualified audiology care positioned as the focal-point of decision making.

Audiology care will continue to be a behind-the-scenes anecdote to hearing aids until audiology care is marketed competitively up against hearing aids. The audiology community needs to make the decision here. Either the profession embraces the corporate marketing initiatives essential to securing broad-based consumer recognition and demand for audiology care, or the audiology community relinquishes the authority to shape consumer thinking to those external change-agents more than willing to invest in the marketing that secures consumer mind-share for their products, distribution systems or business plans.

As you are deciding, remember this: Positive change is possible when enough people get behind the right goal and stay committed to their objective. Just ask the Egyptians.

References:

Hearing Journal (2010). Q4 sees double-digit growth in HA sales. Hearing Journal, 63(2), p. 7. Retrieved March 24, 2011 from: https://journals.lww.com/thehearingjournal/Fulltext/2010/02000/Hj_Report.2.aspx

Manning, A. (2011, March 21). Hearing loss 'incredibly common' as Boomers grow older. USA Today. Retrieved March 24, 2011 from: https://yourlife.usatoday.com/health/story/2011/03/Hearing-loss-is-incredibly-common-/45099370/1