• Kindly give our readers an introduction to your business. Please include what your business is all about, in which city you are located and if you have offices in multiple locations/ cities.
AVA Hearing Center was started in 1998 by Karen Jacobs in Grand Rapids, Michigan. Originally the business was names Audio-Vestibular Assessments, Inc. and was established to serve the Northern Grand Rapids area with hearing and balance services. After a few years of providing Balance services, the company decided to focus on Hearing assessment, sales and service. The business name was shortened to AVA Hearing Center. At the time the business was opened, there was a real need for people to have Audiological services in Northern Kent County. Our goal was to provide professional services, quality products and stellar support for the hearing impaired in our area. We use “best practices” guidelines for assessing hearing loss and fitting hearing aids. We focus or services on meeting our patients’ needs and provide a continuance of care that includes patient education, aural rehabilitation, Complete Hearing Healthcare Services and lifelong support.
• Kindly give us a brief description about yourself (it should include your educational background and list some of your major achievements).
I started off my college career in pursuit of becoming a Speech Language Pathologist. In my Senior year at Central Michigan University, I had an opportunity to work with a number of hearing-impaired children. I was working as a speech Language Pathologist but I also had to work with their hearing aids, learn sign language and incorporate hearing habilitation into my speech and language lessons. I realized that I really enjoyed the science behind hearing and amplification. I also loved seeing the faces of my students light up when they heard sound. That experience changed by career path and I completed my Masters Degree in Audiology. Years later I would complete my Clinical Doctorate in Audiology through Salus University. My first job was working for a busy Ear, Nose & Throat Practice. This was a fantastic training ground. I was able to see pathology and hone my diagnostic skills. I was able to see a patient through identification of a problem and follow them through medical resolution or through non-medical treatment via hearing aid use. Over the years I developed the 1st PSB Accredited Physician office. I became active in my profession, first at the state level becoming a founder of our state Audiology organization, elected to serve 2 terms as President and being awarded the honor of being the 1st licensed Audiologist in the State of Michigan. I then moved on to serve at the National level. I started my National service on the Membership committee and over time served on 8 committees. I was elected to serve on the American Academy of Audiology Executive Board and appointed to serve on the AAA Ethical Practices Board, AAA Foundation Board and State of Michigan Licensing Board and the Central Michigan University Advisory Board.
• What inspired you to (start a new business venture) or (to make significant changes in an existing business)? How did the idea for your business come about?
After working as a Diagnostic Audiologist for 14 years at an ENT practice, I had reached the top of that career path. I became bored with my daily work and felt a need to find a new challenge. My husband and a colleague of mine (who is a very successful Audiology practice owner) encouraged me to start my own practice. I had no idea how to manage a business but with my husband’s help and with my colleague’s support I started AVA Hearing Center. The business not only served a goal to provide Audiology services to the underserved Northern Kent county area, but it served my goal of having more control over my work-home balance. My children were at an age where they had school activities and sports with which I wanted to participate. I won’t say that it was always easy because in a small business you work AT or ON your business constantly. But owning my own business gave me the flexibility to schedule AROUND my life.
• What three pieces of advice would you give to a new audiologist?
#1 – I would suggest that a new audiologist get involved in their profession organizations as soon as possible. Being active in the state or national level keeps you connected to changes going on in the profession. It also helps establish connections with other professionals who can provide information, support and ideas over the years. My best friends are colleagues. Audiology is a small community (around 15,000 Audiologists nationwide) and they understand the unique issues and struggles of the profession.
#2 – I would remind a new audiologist that our profession is constantly changing so stay informed. Read the journals, participate in educational sessions, talk with colleagues about how they do business and learn what changes they foresee in the future of Audiology.
#3 – My last bit of advice is to enjoy your patients. There are few jobs that allow you an opportunity to meet such a diverse and interesting population. Everyone has a story. Part of your job as a good audiologist, is to listen to those stories and identify the communication difficulties that arise because of hearing loss. Slow down and get to know the people you serve because communication builds trust and it takes trust to have a patient fully divulge the impact their hearing loss may be having on their life.
• What would you say are the top three skills needed to be a successful audiologist?
Learn Patience. Patience is the #1skill needed to be successful as an Audiologist. The patient populations most of us will work with are children, (and the parents of those children) and older adults. You will have to repeat yourself often, you will need to review information continually, you will have to explain complex ideas to people who may not have any experience with what they are about to learn. Don’t let it bog you down. Your patience will reduce your patient’s stress, allowing them a calmer mind to learn the information you are trying to share.
Be observant and learn to listen. I had a patient who begrudgingly came into my office. He reported that he had tried 4 different hearing aids without success. Following testing, we sat down to talk about his moderate hearing loss. With arms crossed across his chest he stated that he “could hear what he wanted to hear”. I turned to his wife and asked “how does that make you feel?” She interpreted his word to mean “nothing I say is important to you and therefore I am unimportant to you”. He uncrossed his arms and turned to look at her. Over the years this couple had stopped doing social activities together. The wife thought it was because he didn’t like her friends. In reality he admitted that he avoided groups because he felt stupid. He couldn’t engage in conversation because he couldn’t follow conversation. He was afraid that hearing aids wouldn’t help him so he had been unwilling in the past to make the effort. He did not want to be a failure. I had to say very little during this evaluation. By observing body posture, I could see that this man very much wanted to please his wife. Her opinion of him mattered. He became a very successful hearing aid wearer and a happier couple.
• How many hours do you work a day on average?
The saying goes “If you own your own business you never get a day off”. That is partially true. Part of my job is to work IN my business. I see patients about 30 hours a week. The other part of owning a business is to work ON your business. I need to do a lot of other tasks that take many more hours like: payroll, bills, employee engagement, review and reassess how we engage with our patients, read to learn new ideas and stay current, plan marketing and advertising, assess new technology, deal with insurance programs, fix equipment and PLAN, PLAN, PLAN. The benefit of owning your own business is the flexibility of working around your life.
• To what do you most attribute your success?
I owe a lot of my success to my husband who has provided encouragement, emotional support when I wasn’t sure I could start my own practice. He took on more of the home life responsibilities to give me time in the office. He brought his knowledge of management to the practice as well. He also knows computers – which has saved me hours of frustration.
• How do you go about marketing your business? What has been your most successful form of marketing?
Marketing is an ongoing, multifaceted activity. Marketing is beyond advertising. It is all about relationship building so we do that by taking time to know our patients. We market by providing excellent service and availability. Most of our business comes from our current patients. Their referrals are powerful and we make a very conscious effort to know and understand what our patients need and expect.
• Where did your organizations funding/capital come from and how did you go about getting it? How did you obtain investors for your venture?
I was fortunate to have saved a nest egg during my 14 years of working at the ENT practice. When I started my business, my colleague said to figure out what it was going to cost to open my doors and then double that amount. I thought she was crazy but it was very true. I did investigate funds available through a local Women in Business organization who offered business mentorship and grants. I also contacted the Small Business Association but, in the end, I was able to use my own funds. I will say that I learned that you do not have to have ALL of your furniture, letterhead, office supplies, etc. on day one. I started small and grew over time. Eventually I purchased the building I formerly rented in order to have more control over costs.
• What is the best way to achieve long-term success?
I guess the best way to achieve long-term success is to be brave. I never would have taken a step out on my own if I hadn’t gotten over my fear of failure. Failure can be brutal but it can also be seen as an opportunity to learn something new. I like to constantly be evaluating new ways to be better. Some of those “tries” have been awful so we take the hit and find a better way. I also want to say current. In Audiology that means staying active with my colleagues, participating in conferences, asking my patients “what can we do better”. Those answers can be scary. No one like to find out that they need to change but if you want to succeed you’ve got to be brave.
• Where you see yourself and your business in 5 – 10 years?
Well, I’m getting old. That doesn’t mean I want to retire but it does mean that I want to work IN my business less. My goal is to find another excellent support audiologist, maybe someone interested in being brave. Ideally, I would work with her for a few years and then transition out as she transitions in. That would provide great continuity for my patients and set-up a nice way to have my business survive into the future.
• Excluding yours, what company or business do you admire the most?
I love businesses that give back to their community. We have several outstanding businesses in Grand Rapids that support everything from Art to Medicine. Companies like Meijer, Amway, Gainey are all big community supporters. I am really inspired by the small business that make a difference. There is local shop that gives a portion of their business to a fund for giving basic toiletries to people living on the street. We have a local dentist office that supports dogs to be trained as Leader Dogs with Paws for a Cause. At AVA Hearing Center we try to emulate those business though on a smaller scale. We support an endowed scholarship at Central Michigan University for an Audiology student who is interested in private practice. We contribute to a local food pantry and we donate to many small, local charities that have impact on our community. I am also a member of a LIONS Club. We donate hours to help fit hearing aids to people who need assistance. People always roll their eyes when I say “I’m not in business to get rich. I’m in business to make a difference.” but it is true. I have a wonderful life and I am thankful. The least I can do is help my fellow man in some small way.
• How important have good employees been to your success?
Good Employees are key to success. I need to have people that represent my business philosophy. My employees are likely the first person a patient will encounter when they contact my office for an appointment. If they do not treat the patient well, answer questions correctly or seem unknowledgeable, then we may lose our chance to work with that person.
• How long do you stick with an idea before giving up?
That depends on the idea. When I opened my business, I provided vestibular (balance) services. I wanted to do this because there was not a balance service provider in the area. I found that it was not a cost-effective service. I continually revamped how I provided the services but after 2 years I finally dropped that portion of my business. There are other little ideas, like taking every patient’s picture when they come in, that really didn’t work and some of our patients didn’t like to have their picture taken. We dropped it after a month. Trial and error is important however. If you don’t try anything new you may miss out on something great.
• What motivates you?
I am motivated by many things. Not all of them are altruistic. I am motivated by having a financially solvent company that supports myself and my employees. I am motivated by the patients that share their happy stories about doing well with the technology and services that I have provide. I am highly motivated by positive reviews.
• How do you generate new ideas?
I read a lot. I have 4-5 professional journals that I read religiously to look for new information. This often sparks an idea about a new product to carry, better ways to provide service, new treatment management options or even better ways to work with my patients. I also have a great network of colleagues who are very generous with sharing their thoughts and ideas.
• How do you define success?
To me success is happiness and happiness comes from having control over my time. Yes, I want to be financially compensated to a level that allows me to do the things in life I enjoy like travel or purchase a new car. But success is about having time for family life but also having the gratification of being good at my job. The happiest people I know aren’t those who work day and night to make large salaries. The happiest, most successful people are those who have control over their work/home balance.
• How do you build a successful customer base?
You give people respect, honesty and appreciation. Basically, you treat people like you would want to be treated. By building a relationship based on these principles we build trust. When everyone in the business holds to these principles, patients feel good about their interaction with us. They tell their friends and their friends trust us to do the same for them. Our patients are our best referral source.
• What is your favorite aspect of being an audiologist?
I love the science. I may be biased but the ear is the most incredible system in the body. It converts sound from the air into a mechanical energy in the middle ear and then to an electrical signal to the brain. That electrical signal gets attached to meaning and we “hear”. The ear also tells us where we are in space. It’s our internal gyroscope that keeps us on our feet. Now you add in the science of hearing aids or cochlear implants – amazing! We actually learn new things about how the ear works or how our hearing benefits us in ways other than detecting sound all the time. Don’t get me started because there are endless fascinating facts about the ear that I could talk about.
• In one word, characterize your life as an audiologist. Fulfilling
• If you had the chance to start your career over again, what would you do differently?
I would have gone into private practice sooner.
• How has being an audiologist affected your family life?
• What is your greatest fear, and how do you manage fear?
My biggest fears are the changes being made around Audiology. Insurance companies are cutting audiologists out of the Hearing Health Care picture by dictating which services can be provided and which products an audiologist may select for a patient. These dictated options don’t typically include BEST PRACTICES or the latest technology. It is cheaper for insurances to manage but it is a nightmare for the people who need help.
Audiologists have a Doctorate degree with experience in identifying and treating hearing and balance issues. They are a licensed profession in all 50 states because damage can be done if hearing aids, balance or tinnitus treatments are not performed correctly. Unfortunately, with the introduction of over-the-counter (OTC)hearing aids, so to come on the market, patients will be able to fit their own hearing aids. They don’t even need to get a hearing test or speak to their physician. This sounds great but in reality, this is not a good treatment model. Patients with hearing loss are often not a good judge of the shape, degree or nature of their loss. Hearing loss typically happens slowly over time. People “forget” what “normal” hearing really sounds like. Even if they were able to correctly gauge their degree of hearing loss, buying an over-the-counter product allows them to set the hearing aid to “what sounds good” as opposed to what is correct. They will likely select an item that may be comfortable to wear at first but it is likely not what the brain needs.
OTC instruments also remove patient support. The majority of my day involves counseling patients on how to the use their hearing aids and how to acclimate to normal hearing sensitivity. As the brain learns to hear again, hearing aids need to be adjusted often and the fittings need to be validated using sophisticated technology and equipment. Patients also need support for the questions they will have about how to use their instruments. Not every hearing-impaired person is technology savvy. How are they going to know how to sync their phone to their OTC product, how to clean the product or even know how to get it in their ear correctly.
The OTC model does not require that a patient even have a hearing test. This will keep people from knowing if their hearing loss is medically treatable or if their hearing loss is the sign of an underlying pathology like ototoxic medication, tumor, heart disease or diabetes. There is no inspection of the ear to look for abnormalities, infection or even earwax that could cause pain and damage over time. OTC guidelines take away need for shared knowledge, guidance and support for a minimal amount of money. Amplification should not be an Over-the-counter product without overview from a health professional.
• How did you decide on the location for your business?
There was a service void in the area. There were a couple of hearing aid dealer practices when I opened my business but none of those businesses could provide a diagnostic level assessment. They didn’t have the equipment or sound booth to get accurate results.
• What are some of the biggest mistakes you’ve made?
One of my biggest mistakes was not letting a bad employee go soon enough. I always argued with myself saying “she’ll get better” or “I have a lot of time invested in her training” but the reality is that an employee with a bad attitude changes the entire personality of the office. She will make other employees unhappy which trickles down to patients. It is best to take corrective action sooner than later.
• What are your hobbies? What do you do in your non-work time?
People always seem surprised when I tell them that I am actually very antisocial on my time off. I think because our profession requires us to deal with tough-to-manage problems like hearing aid use, balance or tinnitus disorders, we end up talking with people all day long. When I get home, I need solitude. I usually enjoy quiet hobbies like gardening, fishing, golfing and reading (I always have 3-4 books going at a time).
