If your audiology practice was subjected to an annual marketing physical, how would the health of your practice look? A number of offices might be a bit dismayed at their diagnoses. Having dispensed for a few decades, I saw in my own practice how I might have been able to be more effective in marketing. And I say, sheepishly, my business "diagnosis" probably didn't look as positive early on as it did by the time I sold my practice.

Having written and presented on marketing for some years, I've had the opportunity to discuss this topic with many audiologists. What I've found has been interesting: Given the "annual physical" analogy, I've seen that some practices across the country seem to suffer from maladies mimicking attention deficit hyperactivity disorder (ADHD), anemia, gait instability, personality disorder, and failure-to-thrive syndrome. A handful might even be terminal-with only a short time left before they close their doors. While these diagnostic analogies are certainly tongue-in-cheek, they are based on some solid observations.

There are really a number of ways to grow our practices, but many audiologists just don't do them for a variety of reasons:

1. "I'm too busy" (ADHD analogy)-Are any of us really too busy to increase revenue? To provide quality services to patients? To fulfill a community need for what we do best? I think most of us would relish opportunities to expand services, yet some audiologists report they're just too busy. I know as a single practitioner I was running my practice at near-max. More business would have required another audiologist, which I resisted but ultimately ended up doing, discovering that it more than paid for itself. For other practices, someone who's too busy may discover they have a time management issue. Perhaps you're bogged down with paperwork that would be better delegated to front desk employees, or perhaps one additional clerical employee would more than pay for the expense that keeps you from doing what you do best-direct hands-on work.

2. "I don't want to be identified with a manufacturer" (anemia analogy)-The desire to distance ourselves from manufacturers can result in lost revenue. For example, manufacturers spend millions of dollars advertising and can offer access to co-op marketing materials that utilize the talent and market research ideas of their extensive marketing departments. Dispensing audiologists can't spend that kind of money, but they can benefit from manufacturer insights and wisdom to better tap their markets. Some people in our industry have a moral opposition to this kind of assistance, but I don't see it that way, especially for periodic advertising. Choosing to co-op with a few manufacturers does not preclude you from dispensing one hearing aid over another in order to offer the most patient benefit.

3. "I don't want to spend too much money" (gait instability analogy)-Some practitioners get very nervous if they have to spend even a reasonable amount of money to market their services, especially when the marketing till is fairly depleted. But I have found, even in practices with well-defined advertising budgets, that money often is spent on ineffective campaigns. As if this weren't bad enough, money is then poured each year into the same black hole with no meaningful financial rewards. It's easy to track marketing results by including a question on the case history form that asks every patient how they found you. Based on those answers, you should invest your primary marketing dollars only in the activities that brought in the majority of patients.

As you query your patients, you'll find that the best advertising distinguishes you as unique from your competitors. Maybe it's your tinnitus or balance clinic, or maybe your office carries a particular brand of hearing instruments that others don't carry. If you don't have a unique edge, find one, and then make it the focus of your marketing activities.

4. "I'm not comfortable selling myself" (personality­ ­­dis-order analogy)-Our personality types (intro­vert vs. extravert) often influence our core marketing decisions. I ran a Myers-Briggs study among audiologists,¹as did Traynor and Holmes.²The studies showed quite parallel results. They found that 74 percent and 77 percent, respectively, of surveyed audiologists fell into the introversion Sensing-Judging or Intuitive-Feeling types. In the general population, it has been documented that there are about 25 percent introverts, but my study indicated a temperament toward introversion in

about 50 percent of the 217 dispensing audiologists surveyed-twice that of the general population.

The implication here is that if this substantial sampling is indicative of audiologists in general, and it could be, then perhaps half of audiologists are likely to be reluctant to go after certain markets that would require them to step beyond their personality temperament. I know such lack of motivation personally because my temperament tends toward introversion, and I've willingly given up market shares when I've been required to reach outside my comfort zone.

At a meeting of several hundred audiologists, I made a presentation on the results of this personality study.³For fun, I took an audience poll, asking only those who judged themselves to be extraverts to raise their hands. I knew that if I had asked introverts to raise their hands, many would not. About half the audience of 300 raised their hands, quite consistent with the study. At the end of the presentation a woman, after being sure I was alone, stopped me just before I walked out. "I just want to point something out to you," she said with humiliation on her face. "I am an introvert, but I was so caught off-guard by your request for extraverts to raise their hands that I too raised my hand because I didn't want to be identified as an introvert if anyone looked at me."

So how can such introversive audiologists effectively market themselves?

First and fundamentally, nobody needs to apologize for their personality type or temperament. We are who we are. There is nothing wrong with being an introvert or an extravert. That said, in my practice, I always wished I was more extraverted. I was a bit disappointed in myself that I wouldn't market more in social ways, so I fully understood this gal's humiliation, though my situation was never as extreme. Even so, I would have loved to bang on physician doors, introduce myself with a big smile, deliver my business card, slap them on the back, and ask, "So, when are you going to start referring?"

Even extraverted audiologists won't be this obnoxious, but you get my point: the social approach goes against the nature of mostintroverts. It's just not who we are, so being honest about it and then either surmounting it or addressing alternative choices is important in building a practice.

5. "I'm not comfortable marketing myself to physicians (failure-to-thrive analogy) Seeking physician referrals is perhaps the single most neglected marketing opportunity in audiology practices. Whether you are comfortable reaching out to it or not, the medical practitioner market holds the highest, most consistent rewards with the least money and effort invested.

Physicians want to know who we are. They want to refer. Their medical staffs, including nurses and PAs, also should be included in the loop. But if we tend to be too busy or too shy to get in the doors of potential referring physicians, we are setting the stage for lost revenue. Worse, we're not reaching out to get our services to the people who need them and could benefit greatly.

With this in mind, and based of my own tendency toward introversion, I developed a direct-mail book marketing program to physicians that proved very effective for a practitioner who preferred not to leave the walls of his office.⁴In my first 30 days using this approach, my gross revenue significantly increased and three new physicians were established in my referral base.

Other viable physician marketing strategies include:

• Sending short but powerful introductory letters to physician offices;

• Making introductory phone calls;

• Listing physicians in your referral base for community medical needs;

• Visiting medical offices, perhaps bringing lunch for the staff and sitting down for a casual chit-chat (extraverts, start your engines);

• Offering a lunch-and-learn seminar;

• Participating in local healthcare screening programs often sponsored by a local hospital; and

• Using established physician marketing programs such as those available from the Better Hearing Institute⁵or the American Academy of Audiology. ⁶As for my analogy of a terminal diagnosis, if your practice continues to lose market shares, the handwriting could be on the wall. The time to catch the failing health of a practice is when you're aware you can do more but aren't doing it. An emergency physical-taking the pulse of the business-should reveal what is going wrong and what you need to do to set it right before it's too late.

References 

1. Carmen, R. (2003). "Personality types among audiologists as measured by the Myers-Briggs type indicator." Audiology Today, 15(4).

2. Traynor, R, Holmes, A. (2002). "Personal style and hearing aid fitting." Trends in Amplif 6(1):1-31.

3. Carmen, R. "The Human Link: A Framework for Success." Oticon Winter Conference, 2005.

4. Carmen, R. (2002). "A Direct-Mail Book Marketing Program to Physicians is Tested." Hearing Journal 59 (4).

5. Kochkin, S. (2004). "BHI physician program found to increase use of hearing healthcare." Hear J, 57(8):27-29.

6. Physician Hearing Health Kit. (2000). American Academy of Audiology, Reston, VA.

Richard E. Carmen, AuD, is publisher, Auricle Ink Publishers. Contact him at rcarmen27@yahoo.com.