Five Gaps in Practice Operations

Oct 6, 2020 | Operations

When we think about operations, it is all the things that go into getting a specific outcome. It’s not only your process and procedures, it is your human resources, technology resources, and many other resources within your clinic walls. In this particular instance, we are going to focus on the treatment of hearing aid patients as the desired outcome and the five most common gaps we see in the operations to identify and treat these types of patients.

What we know is that 9% to 15% of the U.S. population could benefit from hearing aids, but only 4% of ENT patients are treated or identified as hearing aid candidates. This is the definition of an underserved patient population and shows there are certain gaps that exist within ENT clinics that are leading to this loss in patient treatment and revenue.

Before we move on to what the five gaps are, we need to point out one major mistake practices make when trying to increase their revenue or obtain more hearing aid patients. They try to get more patients through their doors to fill the top of the funnel. The reality is, if you have a bunch of holes in your funnel, you are not going to get the outcome you want or desire. Before you start investing more time and money to increase your patient flow (increasing the top of the funnel), you need to improve your operations to maximize what already exists in your practice.

“We know operations are the cornerstone to being successful. If we just came in and said, ‘Hey, let’s do a ton of marketing to bring in more patients at the top of the funnel,’ they will end up leaking out for one of three reasons: You have a lot of variability, a lot of redundancy, and a lot of waste.” — Audigy Medical Practice Management Team

Faulty systems, processes, and operations create lost revenue and leave patients without adequate care and treatment.

The 5 Most Common Gaps


1. Suboptimal Hearing Care Provider Schedule

Some clinics might be too top-heavy in their diagnostic load, leaving limited time for hearing aid evaluations. You need to create a schedule that leads to more hearing aid sales, balancing the need for diagnostics with the desire to create better hearing aid outcomes.

Example scenario: A clinic has a large patient load, and their audiologists have their time filled with diagnostics and are not able to do hearing aid evaluations. They are shooting themselves in the foot. The clinic can complete a lot of tests and find a lot of abnormal results, but they don’t have any time scheduled to allow them to take it to the next step and sell hearing aids.”

An example of what a scheduling process could look like

2. Variable Hearing Aid Candidates

A lot of the time we see clinics and physicians are not set up with a systematic way of identifying hearing aid candidates. This leads to inconsistencies in the types of patients referred to the audiology department and the loss of potential hearing aid candidates. One physician in the clinic might have their own set of guidelines for hearing aid candidates while another has their own guidelines. To avoid these inconsistencies, we recommend creating a clinical practice guideline to identify hearing aid candidates.

Example Clinical Practice Guideline:

Purpose: Create and implement a policy for hearing aid candidates that will optimize patient care and maximize practice profitability. This policy, or clinical practice guideline, will provide the foundation, quality assurance, reproducibility, and accountability in the diagnosis and treatment of hearing aid candidates.

Clinical Practice Guideline: A hearing aid evaluation should be performed and hearing aids should be considered for all patients with hearing loss not treatable by other medical or surgical therapy.

Criteria: A hearing loss is present if any of the following are true:

  • Pure-tone threshold of 30 dB or greater at any frequency, or
  • Patient feels that hearing loss adversely affects their quality of life, or
  • Family or other close contact feels that hearing loss adversely affects patient’s quality of life


3. Poor Hearing Aid Evaluation Order Management

Is your practice able to answer the following questions?

  • How many hearing aid evaluations did the doctor order last month?
  • How many people are supposed to be coming out the other end with hearing aids? 

You need to set up ordering mechanisms and recall mechanisms. Harness the power of your EMR, retrain doctors to think about this in the same way as ordering sinus and other treatments.

You should know, if you ordered 100 hearing aid evaluations last month, how many resulted in hearing aid evaluation appointments as well as how many of those resulted in hearing aid sales.

Tip: Create a Clinician Scorecard to identify missed opportunities and areas of improvement

4. Suboptimal Hearing Aid Evaluation Communication

There can be a feeling that when an audiologist has an appointment for a hearing aid evaluation, that magic happens and the patient leaves with hearing aids. Not a lot of people know what goes into the conversation between the audiologist and the patient during their hearing aid evaluation appointment. This can lead to patients receiving different messages from schedulers, front office staff, clinicians, and the audiologist. If the patient has been receiving different messaging from each department, by the time they get to the hearing aid evaluation, it is going to make it a lot harder on the audiologist to treat them and sell them hearing aids.

You need to set the audiologist and audiology department up for success by:

  • Creating consistent communication between the front office, physician, and audiology team
  • Having a team-based management approach
  • Ensuring everyone is communicating in sync with one another and the patient


5. Poor Hearing Aid Candidate/Patient Follow-Up Care

This comes to patient management. Whether the patient has only received a hearing aid evaluation or has already received hearing aids, we see that clinics lose a lot of these patients in follow-up. Sometimes clinics have too much of a consultative mindset: “We tell you what your problem is and you can call me if you need anything.” Hearing aid patients require more of a chronic disease management approach as opposed to a consultation approach.

Once a patient has been referred to an ENT clinic for care, they should be your patient forever. Oftentimes they have already been through the primary care channel, and now they are in the ENT clinic. If the clinic does not take care of them, there are not many places they are going to go to receive care or, more importantly, the level of care your practice can provide.

You need to ensure you have the processes, tools, and infrastructure to actually take care of this patient for the duration of their life.

Tip: After you schedule a hearing aid evaluation for your patient, schedule follow-up audiogram appointments every six months. A lot of times, patients won’t seek treatment even after they have been diagnosed with hearing loss. By creating these follow-up appointments, your practice is maintaining that relationship with the patient so when they are ready, they remember you and seek your practice for treatment.

In the end, the goal is to close these gaps and create a system where patients aren’t going untreated and your practice isn’t losing revenue. 

Close the Gaps to Get to an Optimal System


Just as you do a workup and diagnosis of your patients to find the right treatment, you need to do a workup and diagnosis of your clinic operations to identify the gaps, and then find the right “treatment” to close those gaps. 

Need some inspiration for how improving your operations and closing these common gaps can significantly increase your practice’s hearing aid revenue and profits? See how one university went from being in the red to a $67K net profit in just one quarter, or how an ENT clinic increased its revenue by $490,000 with more efficient systems.

If you have any other questions about improving your practice operations and increasing hearing aid revenue, contact the Audigy Medical consulting team today