Value is our service
Ontario’s healthcare system is ever changing and expanding. Privatization of health care has been all the talk lately, but in Audiology, private services are not new. Paying for services and products out of pocket is also not new for our patients. What is new, however, are conversations (and perhaps the acceptance) around the value of the services and the skills that we provide to our patients.
After an undergraduate and a Master’s degree, as well as an AUD. and/or a Ph.D. for some, endless hours of continuing education, as audiologists, our breadth of knowledge, skill and insight in regards to our patients’ auditory care is plentiful.
We live in the Amazon™ age of convenience, where consumers, ourselves included, expect efficiency, efficacy, expediency, and value in almost everything that we do. We like a one stop shop and we like a quick fix. Unfortunately, in Audiology, there is no such thing as a quick fix, but we can certainly offer convenience and thoroughness to our patients with the services that we offer them when they’re with us, and the services and work with do for them on the back end, when they’re not physically with us. The key is to communicate this value to our patients.
What is a boutique?
We opened our practice in 2017. The vision for AudioSense, was for it to be a boutique audiology clinic in Toronto. But, what does boutique mean? For us, it means that we’re a small clinic, but we focus on service within our full scope of practice, as audiologists. We communicate our value to our patients by offering what we call white glove, above and beyond care. Our services are individualized and customized. We cater to patients of all ages, from pediatrics to the elderly. Our audiology services range from cerumen management and custom earplugs, to hearing assessments, to hearing aid dispensing and fittings, to cochlear implant mappings, to management of complex auditory concerns such as tinnitus, hyperacusis, misophonia, and auditory processing difficulties.
Our clinic is design-friendly with bold warm colours and designer furniture. We have water, tea and coffee easily available and on demand, for our patients. We have a great work culture within our team; we believe that if we’re happy being here and together, then our space will have this beautiful, vibrant and positive energy that our patients will surely feel when they come in the doors. We make sure to leave same-week appointments open, so that we can see patients right away when they call to book, and we allow for a lot of time for each appointment, to make sure that we can address any questions that they might have. Our time is very flexible. While we do have our set hours of business posted on our door and our website, we try our best to accommodate our patient’s schedules, which means that if someone wants to come in at 6:30pm on Friday, then, we will typically be able to accommodate them. We have no wait times. We offer a lot of follow ups and check-ins with our patients, either in person or virtually. We also very much believe in a team approach to patient care. This means that we have frequent team meetings and make sure we all discuss and agree on recommendations made for our patients. We all know that two brains are better than one, and being able to confer on cases has allowed us to make better and more appropriate recommendations to patients or ‘see’ things we otherwise may have missed. We also share patients sometimes and when appropriate, to allow our patients to receive a different perspective and feel like they’re being followed by more than just one person. Really, they have a team to encourage their success. To that end, we also take a very collaborative approach to our patients’ cases. We always involve their primary care practitioner, by making them aware of their patient’s appointments and results with a detailed report. Depending on the nature of the concern, we will also typically collaborate with other health care professionals and/or educators, that are part of our patients’ circle of care.
To that end, we are always thinking outside the box and looking to other disciplines, holistic solutions and informal day to day non-audiology tricks and tips that could help our patients with their concerns and complaints, when appropriate. For example, could buccal massages help our patients who grind or clench their teeth so much that it’s affecting their hearing? Could we invite our patient’s auditory-verbal therapist to their audiology appointment to offer insight on hearing aid programming? Could music therapy, laughter therapy or simply listening to an audiobook help with auditory strengthening and processing? These are all things that we consider and discuss with our patient, as we help them and aim to set them up for success in their hearing journey.
Fees, fees, fees
An important point of discomfort in Audiology, is the fact that as regulated health care professionals, our services are not covered by OHIP, at least in Ontario, even for the more vulnerable and at risk-demographics (i.e., children under 18 years of age and seniors). This means that we spend a lot of time discussing fees for service. When we first opened AudioSense, we spent a lot of time cozying up with the OSLA schedule of fees. Today, we still follow this fee guideline, and charge for all of our services. When patients book an appointment, we simply let them know that there is a fee for the appointment, and share the cost with them. We have never had any push-back; patients understand and value that just like dentistry, physiotherapy, massage therapy, optometry, etc…, audiology is a professional service and there is a fee for the appointment. They can simply submit our receipt to their extended health coverage for reimbursement.
Innovation is Key
As a boutique clinic, we try to stand apart. It’s hard to compete with larger retail clinics, hospital clinics and long-time established clinics. So, we differentiate ourselves through our full-service services. Of course, we perform hearing tests and dispense hearing aids, but that is only a portion of what we do. The split between hearing aid services and our other services is pretty equal. We put a large emphasis on our varied assessments and a certain specific focus on counseling. As a team, we host regular meetings to evaluate, update and innovate our protocols. This is how our post-concussion auditory assessments and management services were born, and has now become an integral service that we offer. We look to the literature for innovation, and we try to implement those as part of our clinic offerings. For example, recent research in Tinnitus management have suggested that bimodal stimulation may offer promising results in reducing Tinnitus complaints. We scoured the literature and we will now try to incorporate this management therapy to help our patients habituation to their Tinnitus. In the same way, we constantly keep our eyes and ears open for evidence-based innovations for any auditory issue that we can incorporate as part of our clinic offerings to help our patients with their hearing care.
Thinking Outside the Clinic
We think of our patients as family. We build a rapport with them, and we imagine that they are our mom, brother, sister, dad, uncle, daughter, son, cousin. What type of care would we want our family to have? What type of care would we want ourselves to get from an audiologist? With every person, we ask ourselves the question and that’s the care we give them. For this reason, it is not uncommon for us to respond to patient emails over the weekend or at 10 o’clock in the evening, or to offer a quick at-home drop off when they need supplies. We celebrate their achievements and their joys, and we cry in their despair. It works, because we truly do care. While it’s true that the way our clinic looks and feels, and they above and beyond care that we offer our patients is what makes it boutique. To us, it’s rather we are small but with a big heart. We feel that the saying “We stand on the shoulder of giants (Isaac Newton, 1675)” applies to us, whereby, “We” is AudioSense, and the “Giants”, refers to our patients.
About the Author
Salima Jiwani is the Founder/Director and Lead Audiologist at AudioSense Hearing, Balance & Concussion, an audiology clinic in Yorkville, Toronto. Salima has a keen clinical and research interest in disorders of the external, middle and inner ear, including hearing loss, auditory processing difficulties, tinnitus, sound sensitivities and post-concussion auditory deficits. Salima is passionate about understanding how the brain responds to sound after injury and in post-surgical management of cochlear implants. Salima works with children and adults of all ages at AudioSense, and provides her patients with industry-leading audiological care by leveraging her clinical, research and industry experience. She firmly believes in a holistic cross-collaborative team approach to audiological care and is always looking for outside-the-box evidence-based innovative ways to offer care to her patients. Outside of work, Salima continues to be engaged in advocacy initiatives to elevate the profession of audiology, give audiologists a voice and promote optimal audiological care for her patients.
