The telephone rings and your front-office person answers. “How much are your hearing aids?” asks the caller.

And thus begins, in many cases, an opportunity lost for the frightened and suffering patient—and the hearing care professional who has been trained to help and has spent thousands of dollars in Yellow Page and newspaper ads to generate this phone call.

Like you, I have watched the number of hearing aids sold annually in the United States over the last 8 years hold steady between 1.8-2.1 million per year.1 And, like you, I have watched the Veterans Administration increase by 7-fold and Internet sales increase by 3-fold since 1984,2 taking a deeper cut of our business each year. One cannot help but wonder where this will end up for the hearing industry and for those who make their living dispensing hearing aids.

Although technology has exploded over the last 10 years, I do not think the growth in 2004 of 150,000 hearing aids dispensed in the United States has much, if anything, to do with the technological advance of the devices. In my opinion, it appears more likely that an improved economy is the cause.

The hearing aid industry today is dedicated to helping hearing-impaired patients communicate better, yet from 1998-2003 there was little, if any, appreciable growth in our industry. In terms of year-to-year growth, the last dozen years have witnessed only four years in which net unit hearing aid sales increased by more than 5%—and it should be noted that there were also four years in which net sales decreased from the previous year (twice by more than 5%).

When you subtract VA and Internet sales from the total sales figures mentioned above, the picture becomes even more dismal.

Are We Looking at the Correct Place to Increase Market Growth?
You say you want more growth in your practice, company, and industry. But how might that growth take place? Beyond wishing and hoping, have you given serious thought as to how to accomplished growth in an affordable fashion?

As I observe hearing care offices, I often notice that a large advertising budget is driving appointments, and thus sales. If a staff at a dispensing office or clinic is able to help 50% of the people they test—after determining that some are not candidates for amplification, and counting those patients who decline to purchase hearing aids, as well as those who return their aids for credit—that might be viewed by some as “good.” The thinking goes in this field that, if you double your budget for advertising, you cannot expect the closing rate to change, but you can expect to get the same slice of a larger pie. An example: If $7000 in monthly advertising is generating 35 hearing aid sales, then one could expect to create 70 hearing aid sales with $14,000 in monthly advertising.

Like fishermen, we cast our advertising dollars upon the waters of newspapers, fliers, telemarketing, and various other media. Our nets are poised for return on investment (ROI). It is my personal observation that, when advertising goes well, decision-makers are pleased with their creative attempts; however, when advertising does not go as planned, the message is blamed. We find ourselves saying, “That ad did not pull.” Likewise, in telemarketing, we can historically expect 1-3 “hits” to be generated from 100 phone calls, and these carry a low rate of conversion in terms of generating an actual appointment, let alone those that result in the purchase of a hearing instrument.

Although advertising is a necessary component in any successful practice, this sort of blind thinking needs to change if the hearing industry is to grow. We need to look at the problem of growth in our individual offices and clinics in a different way, and we need to create better and more efficient results with fewer advertising dollars. In short, the industry and its individual players need to re-think how they do business from a “point of entry” approach.

Are There Holes in Your Net?
When patients call our offices and, in affect, raise their hands saying, “I am interested in what you have to offer me,” we as an industry pay little attention to how effectively these phone calls are handled. Do we not realize that inquiring phone calls are the lifeblood of our existence as a business? Do we not realize that we have spent thousands and thousands of dollars to make the phone ring? Do we not realize that there is a science to answering phone inquiries in a manner that will create appointments?

Yet, we rarely examine the “net” with which we hope to maximize our advertising dollars, and we do not notice the gaping holes in the net in which a high percentage of callers slip through without making an appointment. The Patient Care Coordinator (PCC) is the “net” at your office and he/she easily has one of the most important jobs (including the “high-skill audiological jobs” in the back) in your office or practice.

Without a clear and rehearsed road map for inquiring phone calls, you will have to settle for the law of averages when making appointments from incoming calls. In fact, if you ask the most successful practitioners in the industry what is one of the keys to their success, many will not hesitate to tell you that a large part is due to a particular front-office staff member. And this shouldn’t surprise anyone. As the front-line “office representatives” (or salespeople), they drive the appointment-making process. They are the very first person who speaks to the patient, and they set the tone for all subsequent office visits.

Training Your PCC
If at this point in the article, you are taking exception to my assertions, I want you to notice one very important principle of life: If you always do things as you have always done things, you will always get what you have always gotten. If you take exception to my statements, you are in effect arguing for the status quo in your business, and I promise you will have it. Growth in your business depends directly upon your willingness to move beyond what you presently know.

It is your receptionist —the patient care coordinator, and not the owner or clinician—who has their hands tightly wrapped around the throat of the business, and few people are comfortable talking about this fact.

What have you instructed your PCCs to do when they answer an inquiring phone call? What does your PCC answer when asked:

1. How much are your hearing aids?
2. What do you charge for a hearing test?
3. Does insurance pay for hearing aids?

In essence, most office/practice owners have told their PCCs to inform the caller that they need to make an appointment to have their hearing tested. There is the implied recognition that no appointments means no sales, which means no staying in business and no further paychecks. That much understanding of the caller and the receptionist is in place. But, for many offices, beyond this amount of “understanding,” it is a crap-shoot at best. Simply stated, owners do not know what to teach their PCCs regarding answering the phone effectively.

Let’s examine this idea a step further. The telephone rings and your PCC answers:

PCC: Good morning, ABC Hearing, may I help you?

Patient: Yes, how much do you charge for your hearing aids?

PCC: That depends upon the type of hearing loss that you have. Do you know what your hearing loss is?

PCC: (…or) Our hearing aids range in price from $495 to $3000.

PCC: (…or) We don’t give out prices over the phone. You will have to come in and have your hearing checked.

Patient: What do you charge for a hearing test?

PCC: Our hearing tests are free.

PCC: (…or) We don’t charge for hearing tests.

PCC: (…or) Our hearing tests are complimentary.

Do any of these sound familiar? Notice that, when you give a price or price range over the phone, the caller “never” says, “I will be right down.” The caller is not really calling to find out the price of your hearing aids or what you charge for your hearing evaluations; they are asking the only questions they intellectually know how to ask. The real questions are psychological and emotional, and these types of questions are difficult, at best, to articulate in our culture. The caller wants to know if YOU can help them, and if YOU can be trusted. Often he/she does not realize that, in the vast majority of cases, the person to whom they are talking will not be the person who will be doing the evaluation or consultation.

Recently, my 22-year-old daughter called an office that preformed Lasik eye surgery that could correct her poor vision. The first receptionist was business-like, direct, and she insisted that my daughter make an appointment to evaluate whether she was a candidate for the surgery. Upon my daughter’s second call to another office, she was treated with warmth and friendliness. It was at that point—while on the phone with the receptionist—that my daughter made the decision to come into the office and be evaluated. This choice by my daughter resulted in a decision on her part to spend $2500 and have the surgery. Score one for the “receptionist.”

Valid Tests Are Tests that Include a Third Party!
It is the Patient Care Coordinator that makes the first impression that the caller has of your office. If you spend $1000 a week in advertising and you get one phone call, then that one phone call is a $1000 phone call. It is a matter of survival that the inquiring phone call is answered effectively and an appointment is set that includes a third party (eg, significant other) who is also willing to attend.

When advertising blankets your region, involving several offices within a multi-office dispensing chain, it is commonly noticed that the appointment rates vary greatly. Why? The profitability of each office has a direct correlation to that office’s ability to convert inquiring phone calls into tests that include the third parties.

Clearly, there is much at stake regarding the professional skills of the PCC. An opportunity for the patient to meet with the hearing care professional should not be left to chance. If market penetration rates are really 23%,2 that means 77% of people who have a significant hearing loss walk away from your message every day. Would you accept these kinds of odds in Las Vegas? Further, if you knew how to stack the odds in your favor by a substantial percentage (with little effort and no risk), wouldn’t you do it?

Let’s take a look at what is minimally possible if the PCC answers the phone in a compelling manner. If your PCC sets up only three more appointments per week from inquiry phone calls, then:

3 X 52 = 156 additional appointments.

Conservatively speaking, let’s say there is a conversion rate of 40% of these new valid tests relative to the purchase of a hearing instrument, then:

40% X 156 = 62 additional patients

Let’s say 31 sales are monaural at a $1500 average sales price, and 31 sales are binaural at $3000, then:

31 X $1,500 = $46,500; and
31 X $3,000 = $93,000

This is a total increase in gross revenues of $139,500 per office without one additional penny of expense—except in the appropriate training of the PCC or receptionist!

We need to teach our PCCs/receptionists how to engage potential clients, gently take control of inquiring phone calls, and how to help both the patient and hearing care professional achieve what they want. It is naive to think that warmth and friendliness are by themselves going to make a difference. That is not what I’m suggesting. However, a PCC who has a clear sense of direction while fielding an inquiring phone call, and knows how to detour the conversation into “caring territory”—if that is necessary to help the patient move toward making the third-party appointment—is vital to the growth of a business or practice.

If you are willing to change, then you are willing to grow your company regardless of its size. What to do? For starters, you may wish to consider changing your receptionist’s title to one that more adequately describes the gravity and importance of his/her task (eg, Patient Care Coordinator). Second, invest some time and effort into honing the skills of your PCC. It may be the wisest investment—with the greatest return—that you ever make.

Von Hansen is a business and communications consultant for the hearing health care field. His office is located in Lebanon, Ore. Hansen lectures extensively throughout the US on topics pertaining to hearing health care, and in 2005, he conducted more than 50 training seminars for receptionists and patient care coordinators.

Correspondence can be addressed to HR or Von Hansen, 1773 Post St, Lebanon, OR 97355; email: [email protected]; telephone: (541) 259-1550.

1. Strom KE. HR 2004 dispenser survey. The Hearing Review. 2005;12(6):18-36,72.
2. Kochkin S. MarkeTrak VII: Hearing loss population tops 31 million people. The Hearing Review. 2005;12(7):16-29.