How to Start a Practice and More: Interview with Louis R. Sieminski, PhD
How to Start a Practice and More: Interview with Louis R. Sieminski, PhD
Douglas L. Academy, AuD, spoke with Dr. Sieminski about his 41-plus years in practice and discussed marketing, referrals, and more.
Academy: Hi, Louis, always great to speak with you.
Sieminski: Thanks, Doug, good to hear your voice, too!
Academy: Louis, I wanted to focus our discussion on your perspectives on private practice and the changes you've seen and lived through in our profession over the last 41 years. How did you get into the profession?
Sieminski: Well, my best friend in high school had hearing loss. When I got to college and had the chance to take a class on hearing loss, I took the class. It was amazing, and the next thing I knew I had a master's and a PhD in audiology and off I went!
Academy: How long have you been in practice?
Sieminski: I earned my PhD in 1974, and I opened my private practice that same year—so it's been 41 years. I actually opened in my own office at the very beginning, then I joined forces with an ENT practice for about 31 years. For the last 10 years I've been operating as an independent audiology/hearing aid office.
Academy: What would you recommend for students finishing their doctorates? Should they go right into private practice?
Sieminski: I advise them to take it slowly. The best thing is to find a mentor who's successful in their own private practice and work with that mentor for a few years. The days of simply hanging out a shingle and waiting for patients to walk through the door are over. It simply doesn't work that way. It would also be advantageous if you can buy or buy into a hearing aid/audiology office.
You need to establish yourself and you need to be a provider for multiple insurance companies. You need referrals from a vast array of physicians including family practitioners, pediatricians, and so on. Further, it's great to develop multiple revenue streams such as industrial audiology, off-site testing and repairs, nursing home consultations, school systems, assistive listening devices, alerting devices, and more.
We also offer services in the local hospitals and geriatric centers, and we offer musicians ear plugs as well as more traditional custom-made and generic noise-reduction ear plugs, swim plugs, and more.
Academy: I agree. Multiple and diverse revenue streams are essential to financial success. And I suspect that one or two referring docs are nice, but it's not enough?
Sieminski: Right. I once had many referrals from one ENT group I shared office space with and I learned a tough lesson there. As you guessed, one day the physicians call me in and said they were hiring their own hearing aid fitter to sell hearing aids and they won't be sending me any more referrals. Lucky for me, I had my own hearing aid patients (thousands) and had referral sources other than the ENTs; it made the transition to my own independent office easier and better. So yes, the lesson is, more referral sources and multiple streams of revenue are very important!
Academy: How many referring physicians do you have?
Sieminski: Well, keep in mind it's taken 41 years, but I have approximately 125 physicians who refer to me, including pediatricians, oncologists, neurologists, and more. However, your best referral sources are the patients you've helped.
Academy: That's incredible. That's a lot of referring doctors.
Sieminski: It is…but they don't each refer every day. Some refer once or twice a year, some refer one or two times a week, but each one matters and of course, referrals from physicians are golden. Physicians want someone who is competent, who can help their patients, and help them manage hearing-impaired patients. The trend of physicians sending patients directly to audiologists will continue to grow, but only if audiologists prove their worth as the experts in hearing health care.
Academy: Louis, what are your thoughts on remote mics?
Sieminski: We fit tons of people with connectivity products including remote controls. These are so valuable and so inexpensive—and their impact is amazing. A well-designed remote mic system can add up to 20 dB signal-to-noise ratio—and that's huge—that's more than a top-shelf hearing aid can deliver.
Academy: When do you recommend T-coils versus other phone systems?
Sieminski: Telephone coils are very important and fortunately, it seems the availability of loop systems is on the rise. So if we know the patient attends a church or worship service where they have a loop, we recommend T-coils in the hearing aids. As far as recommending T-coils versus connectivity and Bluetooth, it depends on the patient, their level of sophistication, their individual needs, and the systems that may already exist in their world (such as a loop system in their church, etc.), and, of course, the style of hearing aid matters, too, as all systems are not compatible with all hearing aids. So we like T-coils, but we also like Bluetooth and I think Bluetooth offers more versatility to many people….so it just depends on the person, their needs and their listening situations.
Academy: Louis, what are the common themes you hear from your patients whom you've been working with for decades, with regard to modern hearing aid amplification?
Sieminski: The end-users are of course the most important people in the process. I'm happy to tell you that in general, as I follow people over decades, they report the newer technologies have positively changed their lives. Over the years programmable, digital, noise suppression hearing devices have improved tremendously. When I started linear was all we had to offer. Connectivity has enhanced the ability to use telephones and improved listening to television. They love it—and for most people, the thing that matters most is the demonstration of the product in their home, work and social settings.
Our office offers free no-risk trials of all hearing devices and products. However, it is vitally important that the patient connect with you as a person and as a professional. To be a success in audiology, you have to understand and respect and like people—and they have to get to know you, too. When the patient believes you're interested in them as a human being and you like them, they in turn will like you. If a patient likes you, they trust you. So like so many things in life, it's all about relationships and is a vital part of total hearing health care.
Academy: How do you make that happen with regard to marketing and attracting new patients?
Sieminski: As everyone knows marketing is a lot trickier now than it has ever been. There's a lot to learn. Some of the older protocols such as direct mailers and newspaper ads might work here and there, and if so, that's great. However, you also need a really well-designed, easy-to-navigate Web site, and you must pay attention to the search engine optimization. Doug, that's your area of expertise…what do you recommend?
Academy: Local search is key. It's not important for patients who are eight states away or across the country to find you…they're not coming in! But okay, some of the basics include the following:
- Make sure you have keywords identified and repeated in your meta-tags and content.
- Link back and forth to the best businesses in your area.
- Be visible and well-rated on YELP.
- Have a Facebook presence, too, to make it easy for people to find you.
It's best to check all your Web ratings and links once a week or more, to make sure you have a Web presence that matters and that works. And frankly, building your own Web site has never been easier or less expensive. It's very cheap and very efficient, and I suspect an excellent Web presence is second only to direct referrals, for attracting new patients.
Sieminski: That's what we find. Your Web presence is part of your identity and part of your brand. But as a caution—make sure you're branding your office and your people/staff/professionals, not a particular product. Your people/staff/professionals separate you from everyone else, there's no point in marketing a product that they can easily Google and search and find at a lower price.
The ad, the web presence, and the Facebook page should be about you and your practice, not the specific product. People searching the Web are looking for professional expertise and knowledge, and so that's where you have to be and how you need to present yourself. We recently sent every physician in town a copy of an article we wrote for Geriatric Medicine Magazine on undiagnosed and untreated hearing loss to help brand us as experts in hearing and hearing loss. This past year, we created a series of 30-second TV commercials that have been tremendous in helping to brand our audiology office as the experts in hearing health care. Let's be honest, if you are not marketing to your patients or prospecting new patients, someone else is—and they have an advantage.
Academy: Okay, Louis, thanks for your thoughts and insights. I appreciate your time, opinions, and knowledge.
Sieminski: My pleasure, Doug. Thanks for your interest.
Louis R. Sieminski, PhD, is an audiologist with and the founder and owner of The Hearing Center of NEPA in Kingston, Pennsylvania.
Douglas L. Beck, AuD, Board Certified in Audiology, is the Web content editor for the American Academy of Audiology and the director of public relations with Oticon, Inc.