As the head of business development for Consequence of Sound (consequenceofsound.net), a music blog that began in 2007, Matt Friedman attends at least one concert a week, often more as he not only writes about but also loves music. At these concerts, it is Friedman's job to critique what is played as well as interview the artists and people in the crowd, so it is very important that he be able to hear and communicate clearly.

However, he also needs to protect his hearing. Most concerts are not performed at safe levels of noise and overexposure can easily lead to hearing damage. Friedman originally, from the time he played in his own band in high school to just a few months ago, relied on foam earplugs as a protective measure. But he says, "The foam plugs really muffled the sound, reduced the quality. and made it difficult to hear people you were with." He often ended up wetting pieces of toilet paper or paper towels and pushing them into his ears, instead.

"I was getting concerned about damaging my ears," he said. "And Diana [his wife] was as well."

So when Friedman's birthday neared, Diana Olsen Friedman decided to buy her husband custom-fit musician's earplugs, a product he had heard about and expressed interest in before.

The process, she said, was extremely simple. "I Googled 'musician's earplugs,' found the most recommended brand, and then looked around on the brand's Web site for the best kind. The site also recommended a provider." From there, it was a matter of having a baseline hearing test, making a mold and waiting for the plugs to arrive.

Now that they have, Friedman loves them, commenting, "They're great; they're amazing. The music sounds great. It's like lowering the volume a little bit but the quality is still good. And I can still talk in the crowd, so I can be in the middle of the group and have a conversation. They're so easy."

And for an audiologist, custom fit earplugs are also a great way to build business, as they attract new customers and expand your practice.

Patient Benefits
From a client's perspective, custom fit plugs are appealing in that, depending on the product, they eliminate a number of concerns, primarily appearance, general worry and ease.

With musician's plugs in particular, the look of the universal product can keep a patient from purchasing them. "Universal plugs are great," says Shanda Brashears, MCD, CCC-A, pediatric audiologist at Dupont Hospital for Children in Delaware, who provides custom fit services through a separate, private business, Brashears Hearing Health Care. "But they can look really goofy, like Frankenstein. Cosmetically, a musician on stage is not going to want a big stem coming out of each ear."

On the other hand, custom fit plugs fit securely into the wearer's ear, without sticking out, and often come in a variety of colors, so even if a portion is seen it is not unattractive.

Further, the custom fit eliminates concerns about plugs falling in or out, or having to use a product that is not as secure as ones made for the wearer's ear. "Sometimes I'll sleep in the plugs and the foam ones fall out. Or I get a little worried they're going to go into my ear canal. The custom fit plugs are nice and secure. I don't have to worry about anything," Friedman says.

Getting the plugs involves only a few steps that are easily accomplished by the patient and the audiologist together which, once understood, also can attract clients.

"When people first call, the first thing we recommend is a hearing test. Most people, especially musicians, are interested in doing that," explains Julie Glick, AuD, FAAA, director of the hearing instruments division at the New York Otolaryngology Group. The test shows whether there has been any hearing damage or loss thus far and gives you, the audiologist, a better idea of what type of product is needed.

Friedman, for example, who had not experienced any abnormal hearing loss and needed plugs for attending concerts, would require different plugs than someone who had already significantly damaged his hearing or would be wearing them on stage.

After the test, a mold of the ear is made and sent to the manufacturer, who then creates the product and sends it back to the audiologist. This ensures that the client cannot start wearing the plugs without a final fitting, along with instruction about safety and use. And since an audiologist is the only professional who can administer these services, the procedure also ensures repeat or follow-up business, Brashears says.

Professional Expansion
For the audiologist, offering custom fit products is a smart way to attract new clients who may not have realized the importance of audiology otherwise.

"It brings an awareness of the field of audiology," Glick says. "It creates an awareness of what an audiologist is. And we encourage every single person to get a hearing test and, for hearing conservation, to be re-tested annually." This fosters returning clients who, if satisfied with the product, will come back for all future hearing needs.

Custom fit products will also likely expand a practice's patient base, possibly adding musicians to frequent travelers to individuals working with heavy, loud machinery. For example, Glick recently had a dentist referred to her who wanted custom plugs made so she could converse with patients and staff, yet avoid hearing damage from the sound of the dental machinery. Glick, who began offering custom fit services in Beverly Hills before moving to New York, has also worked with flight attendants, motorcyclists and members of Broadway shows and popular groups such as Spamalot and Dave Matthews Band.

For Brashears, the work is helping her expand her private practice. She said offering custom fit services has given her a foundation to start with and build upon. "It makes it a little less scary to take that leap into private practice."

And as an extra bonus, providing custom fit services can be fun and educational, Glick adds. "It [music] is an arena that audiologists don't really understand that much. I don't think you truly can understand it until you've experienced it.

"I've stood on stage with Dave Matthews Band and I've listened to what he was hearing in his [custom fit inner ear] monitors," she says. "It was really interesting and until I had that experience, I did not understand how important inner ear monitors are."

Getting Started
Of course, to establish yourself as a custom fit provider, you have to market the service, which can involve a course of action slightly different than traditional advertising.

At the moment, both Brashears and Glick primarily depend on referrals from the companies manufacturing the custom fit products. For example, Brashears lived in New Orleans prior to2005's Hurricane Katrina. There, she worked with a manufacturer at the New Orleans Musicians' Clinic. When she relocated to Delaware, the company began referring patients in that region to her, as she had already developed a good working relationship with and was trusted by the company. This has enabled her to attract clients and build a practice in a region where she was otherwise unknown.

However, to make the most of custom fit, you should do more than rely on the manufacturing organization and be creative. Those who most need custom fit plugs or inner ear monitors are often musicians or actors. Brashears, therefore, does a good deal of marketing at concerts, where she is never without her cards, and on MySpace.com, a networking Web site that many musicians use to build a fan base.

Glick, who admits she does not do as much personal advertising as she'd like, says there are many other potential venues for advertising, such as music stores. "I actually did go down to the Apple Store. and I asked if I could give a presentation to the people who work there," she said. "I got a number of referrals from them."

Music, though, isn't the only industry that could benefit from custom fit products. Other professionals require them, as well. Your advertising plan should be geared toward them, so as to attract the most clients and assure them you are not only there to protect their hearing but the ease and integrity of what they do, too.

"There are so many industries and people that could benefit," Glick says. "And it's such an important part of what audiologists could do."

Sue Coyle is on staff at ADVANCE.