Responding to your community's needs for occupational and recreational audiology services and products can bring new patients—and profit—to your practice.

By Jennifer Esse, AuD

While it is only one of the components of my current practice, recreational audiology has played an important role in my professional success. Having spent the first part of my career employed by an ENT practice, I gained a wonderful diagnostic background and some insight into the business side of audiology. As important as these skills are, they didn't provide everything I needed in September 2005, when I entered a crash course in the school of private practice reality. I quickly discovered that I was largely unprepared for the difficulty of starting a practice with no existing patients. And I learned that while marketing and advertising have value in promoting and growing a practice, you have to sustain that practice until the marketing and advertising dollars pay off.

In my case, recreational audiology came to the rescue, not only sustaining my practice in its first year, but also allowing me to offer unique hearing healthcare services to my community.

Answer When Opportunity Knocks

Essentially, recreational audiology is the practice of hearing healthcare and consumer education that prevents hearing loss or ear disorders in both occupational and recreational environments. This facet of audiology consists of both services and products. Custom products may include hearing protection devices for industrial employees, musicians, dentists, motorcyclists, race car enthusiasts, law enforcement and military personnel, aviators, and hunters/shooters. Also included may be musicians' ear monitors, swim plugs, telecommunication earpieces, and music player earpieces (for IPods or MP3 players).

My private practice was introduced to the occupational side of recreational audiology when a local steel mill was referred to me by a colleague who had been approached by the mill to do custom hearing protection for its employees. This colleague does quite a bit of industrial audiology, but he simply didn't have time to complete the work involved in the steel mill's request for a large number of employees to be fitted with custom hearing protection devices along with complete audiological diagnostic testing following a standard threshold shift (STS). This one referral resulted in a large revenue boost when we needed it most, translating into 10 percent of our gross revenue for our first year in business. More importantly, we have continued to work with the steel mill on an ongoing basis, and in turn they have referred other facilities to us.

If you don't have the good fortune to have a colleague sending referrals your way, the best way to add occupational audiology to your practice is to contact the safety departments of your local industries and set up meetings to educate them about the benefits of custom hearing protection devices. Most companies are eager to comply with OSHA standards, so educate yourself about the industrial noise standards and how a company may be impacted if their current hearing protection does not perform adequately. Many are surprised to know that foam earplugs only attenuate approximately 13-15 dB SPL due to poor fit, whereas custom devices may attenuate up to 28-30 dB SPL. Don't be afraid to promote your diagnostic services as well, as the industry may also have a budget to pay for complete audiological testing at your office should an employee record an STS of 10 dB or greater from year to year. Some companies may even be willing to send their employees to you for their annual baselines, so be aware of these requirements as well.

Organize and Educate

If you find yourself wondering if you have the time or knowledge base to handle occupational audiology, you will be pleased to know that it is neither heavily time-consuming nor beyond your basic skill set. The logistics of handling a large number of custom hearing protection devices within a facility is not as intimidating as it may seem.

I scheduled blocks of time during which I could see up to 25 employees for earmold impressions. To organize this, I went directly to the company's safety department, which in turn organized employees to be available when I was at the mill. I generally allowed two to three hours for 25 employees, plus another hour at the office to get the orders together for shipment. The orders came back within two weeks and, upon their arrival, I checked each order personally for accuracy and then delivered the order back to the plant. I made one to two visits to the plant each month for impressions, and one to two visits for deliveries, for a total time commitment of five to ten hours per month.

It is exceedingly important to educate yourself and your patients when adding occupational and recreational audiology to your repertoire of services and products. Refresh your memory by reviewing the occupational noise exposure criteria laid out by the Centers for Disease Control and Prevention (CDC) under the National Institute for Occupational Safety and Health (NIOSH). A good place to start is the NIOSH Web site at www.cdc.gov/niosh/topics/noise, where you can download free PDF versions of the manuals "Occupational Noise ExposureÐRevised Criteria 1998 (Publication Number 98-126)" and "Preventing Occupational Hearing Loss (Publication Number 96-100)."

Build on Success

Our introduction to occupational audiology was very successful. So, the thought process began–who else could benefit from similar services and products? Other occupations that may require your services could include dentists, law enforcement and military personnel, emergency dispatchers, aviators, and musicians. Contact your local business association to find contacts in each professional area and try to establish relationships with them. Communicate regularly with associated professional groups and offer to give talks or provide in-service education about the need for hearing protection, hearing enhancement and telecommunications for each of these professions. Cultivate contacts with safety directors, human resource employees and supervisors, who are often key decision-makers in the process to obtain the products and services their employees will receive. Keep in mind that many professions do not just need hearing protection, but also require enhanced hearing over a telecommunications system while they are in a challenging listening environment. They will be quite motivated to pursue solutions that make their jobs easier.

Recreational products and services have also provided a welcome supplement to our practice. An inexpensive way to educate people about the need for recreational accessories is to contact local swim coaches, musical organizations, theaters, and hunting or gun clubs. Offer to meet with them or provide a block of time to visit their facilities to provide information and take earmold impressions. Swim plugs seem to offer particular appeal, especially once kids and parents see other children with fun colors in their ears—the word-of-mouth referrals spread from there. Keep information in your office that is visible to your patients so that discussion is encouraged.

Our world is a noisy place. At work and at play we experience a variety of sounds that our auditory system may consider to be "obnoxious," or even worse, detrimental to our hearing sensitivity. Consider making occupational and recreational audiology a regular part of your practice. You will set yourself apart in your community, and your practice will have a new avenue to explore. It makes good business sense but, more importantly, it makes for great audiology!

Jennifer Esse, AuD ventured into private practice in September 2005, founding Daniel Island Hearing Center in Charleston, SC. Contact her at dihc@comcast.net.

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