More Favorable Patient Ratings When Provider Wears This

Patients perceive a more favorable rapport with providers, reporting the ability to better understand, engage, and connect with their provider when the provider chooses to wear a transparent mask over a solid face mask.1,2 Transparent masks offer adults with normal hearing and adults with varying degrees of hearing loss the benefit of improved speech understanding in noise compared to solid masks.3,4 One of the many lessons learned from COVID-19 is a heighted awareness of the role transparent face masks play in helping cultivate a positive patient experience. As the CDC continues to emphasize the need for health care providers and staff to wear masks, now is the time to stock up on these critical supplies.

For the next three days only (through July 31, 2021), save 20% on every box of ClearMasks purchased from Oaktree Products including ClearMask (item# Cm24), ClearMask Surgical (item# CM002Ez) and ClearMask KIDS (item# CM003EZ). Mention or apply coupon code CLEARMASK20 during check out. It’s Oaktree’s little way to say thank you and to keep you and your staff safe.

For more information on the benefits of transparent masks, see Benefits of Transparent Masks in the resource section of the Oaktree Products website. To place an order by phone: 800.347.1960; to place an order via email: otp@oaktreeproducts.com. For assistance with website login, call or email Oaktree Products to allow you to place orders online.

References:

  1. Little P, White P, Kelly J, Everitt H, & mercer S (2015). Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations. British Journal of General Practice. 65(635), e351-e356. Available: https://pubmed.ncbi.nlm.nih.gov/26009529/
  2. Saunders GH, Jackson IR, & Visram AS (2020). Impacts of face coverings on communication: an indirect impact of COVID-19. International Journal of Audiology.  Available: https://pubmed.ncbi.nlm.nih.gov/33246380/
  3. Schwarze ML & Kalbfell EL (2021). Benefits of clear masks in communication with patients. Journal of the American Medical Association, 156(4), 378-379.
  4. Kratzke IM, Rosenbaum, ME, Cox C, Ollila DW, & Kapadia MR (2021). Effect of clear vs standard covered masks on communication with patients during surgical clinical encounters: a randomized clinical trial. Journal of the American Medical Association Surgery. 156(4), 372-378.
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The Wait is Over: Get your E-A-RLinks from Oaktree Products NOW!

The industry-wide shortage of E-A-RLink disposable foam eartips created some pretty nasty B.O. (as in Back Orders). It has been frustrating for everybody but the wait is finally over!!! All SKUs of beige and yellow E-A-RLinks are back in stock at Oaktree Products, and can ship same day when the order is placed by 12pm CST. Never fear, remaining back orders were already picked, packed, and shipped carefully and quickly by the Oaktree Warehouse Team.

Today is the ideal time to take inventory of your ear tip supply while also stocking up on critical replacement parts including sound tubes and tube sockets. Trust me on the tube sockets….I wish I had a nickel for every time I disposed a used E-A-RLink with the tube socket still attached. Also, make sure you have a back-up plan by investing in a relatively inexpensive pair of headphones for audiometric testing (e.g. adult or pediatric RadioEar DD45 headset.).

Call Oaktree Products toll-free at 800.347.1960, email at otp@oaktreeproducts.com, or login to your account for easy ordering. For your convenience, a stock-up list for your reference:

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Benefits of Transparent Masks During Provision of Speech-Language Pathology & Audiology Services

Despite easing masks restrictions for fully vaccinated individuals, the CDC continues to emphasize the need for healthcare professionals, staff, patients, and visitors to wear masks in all health care facilities.1 Masks come in many forms including 3-ply surgical, N95 and KN95 respirator, cloth of varying fabric, and transparent with clear panels or windows. While serving an important role in minimizing the spread of the SARS-CoV-2 virus, these products make understanding speech particularly challenging when working with children or with individuals with communication disorders like hearing loss or aphasia. The challenges are exacerbated in the presence of noise and/or increased distance between the listener and the speaker.2-3

General Challenges of Masks on Speech Understanding:

All masks, including transparent products with clear panels/windows, noticeably reduce speech loudness and simultaneously degrade speech quality by disproportionately attenuating higher frequency sounds needed for understanding speech. Speech reduction involves frequencies above 1KHz with most of the reduction occurring above 4 KHz.4 The degree of high frequency attenuation depends on the type of mask and reportedly ranges from 2.3 dB5 to as high as 21.2 dB.2 Corroborated by several studies, transparent exhibit greater attenuation compared to other traditional masks.2,4-6  In other words, transparent masks muffle speech more than other face masks and may lend credence to the conclusion that transparent masks may not facilitate effective communication between a health care provider and patient. On the contrary, despite greater acoustic effects on speech signals, transparent masks yield quantifiable benefits over traditional face masks for patients with hearing loss and/or other communication disorders.

Benefits of Transparent Masks:

Preservation of Visual Cues

The provision of both audio and visual cues offers a significant advantage as it helps listeners segment portions of speech better than audio only cues7 and recognize speech better in the presence of background noise.8 Traditional surgical and cloth masks obscure facial structures including the lips, tongue, and teeth. Loss of visual cues removes the ability for the listener to lipread and visualize facial expressions, both which augment the ability to understand speech. Individuals with hearing loss rely much more on visual speech cues than normal hearing counterparts, particularly when the speech signal is degraded.9-11 Elimination of visual speech cues degrades speech intelligibility by as much as 20% in the presence of a moderate sensorineural hearing loss.12 For these reasons, advocates pushed for the CDC to issue guidance on the use of masks with transparent panels for those with hearing loss13 although recent studies offer compelling evidence of the benefits of transparent masks over solid masks on speech understanding.

A preliminary study by Yi and colleagues (2021) found that normal hearing listeners correctly identified more words in noise when the speaker wore a transparent mask versus a solid mask.14 Two other studies included subject groups with hearing loss, yielding similar results. In a comparison study, Atcherson et al (2017) found improved speech understanding performance in noise for two groups of listeners with hearing loss (moderate and severe-to-profound) with a prototype transparent mask over a traditional surgical mask.8 More recently, Thibodeau and colleagues (2021) found significantly better recognition of sentences in the presence of background noise with a transparent mask than with a solid mask.15  Access to visual cues via a transparent mask provides a significant advantage to the listener with normal hearing or hearing loss, yielding significantly better speech recognition accuracy in quiet or noise as compared to solid masks.  

Minimal Negative Impact on Delivery of Services

Traditional masks negatively impact the delivery of healthcare services by limiting the ability for some clinicians to execute rehabilitative or habilitative therapies. For example, speech therapy requires speech-language pathologists to provide appropriate cues on proper speech production.16 Treatment options for individuals with other communication disorders often integrate face-to-face services, whether in-person or remotely, where visual access to the therapist’s mouth remains essential. Traditional masks obscure the lower half of a speaker’s face by blocking visualization of full facial expressions and all lip movements. Solid masks inherently preclude speech-language pathologists from executing traditional treatment options whereas transparent masks do not.   

Increased Patient-Perceived Rapport with Providers

Non-verbal communication in the form of facial expressions represents an important aspect of communication.17 When asked to rate the difficulty solid face masks impose on communication, individuals reported much greater difficulty understanding, engaging, and connecting with their provider during appointments.18 Research shows that patients are more likely to report significantly more favorable ratings in situations where the provider wears a transparent or clear mask.19 In a randomized clinical trial of 200 patients, surgeons were perceived as better communicators when wearing transparent masks compared to covered masks, and rated significantly higher by patients for providing understandable explanations, demonstrating empathy, and building trust.20

Summary of Transparent Mask Benefit:

Transparent masks are specifically designed to preserve access to visual cues, offering the following benefits over solid masks:

  • improved speech understanding in noise for adults with normal hearing;14-15
  • improved speech understanding in noise for adults with varying degrees of hearing loss;2,15
  • minimized negative impact on delivery of services,13
  • more favorable patient-perceived rapport with a healthcare provider;19
  • significantly higher patient ratings of provider’s ability to offer easy-to-understand information,19-20
  • significantly higher patient ratings of provider’s ability to display empathy,19
  • significantly higher patient ratings of provider’s ability to build trust.19-20

Conclusion:

Despite attenuating high frequency speech sounds the most, transparent masks offer a significant advantage over solid masks. Transparent masks preserve access to a speaker’s lips and facial expressions, resulting in quantifiably significant improvements in speech recognition accuracy in both quiet and noise by individuals with either normal hearing or with varying degrees of hearing loss. Furthermore, transparent masks facilitate increased patient-perceived rapport. Providers using transparent masks are rated as better communicators and more trustworthy. Given the communication benefits of transparent masks over solid masks, speech-language pathologists and audiologist should consider donning transparent masks during the delivery of services.

For more information on transparent masks including ClearMask Surgical, ClearMask, ClearMask Kids, BendShape, Smile Mask Reusable (for children and adults), See Me Reusable Mask (for glasses), and other options, contact Oaktree Products at 800.347.1960 or otp@oaktreeproducts.com.

Additional Communication Tips:

References:

  1. American Hospital Association (2021). CDC: Masks still required in health care settings. Available: www.aha.org/news/headline/2021-05-17-cdc-masks-still-required-health-care-settings
  2. Atcherson SR, McDowell BR, & Howard MP (2021). Acoustic effects of non-transparent and transparent face coverings. Journal of the Acoustical Society of America, 149(4), 2249-2254.
  3. Wolfe J et al (2020). Optimizing communication in school and other settings during COVID-19. Hearing Journal, 73(9), 40-45.
  4. Corey RM, Jones U, & Singer AC (2020). Acoustic effects of medical, cloth, and transparent face masks on speech signals. Journal of the Acoustical Society of America, 148(4), 2371-2375.
  5. Bottalico P, Murgia S, Puglisi GE, Astolfi A, & Kirk KI (2020). Effects of masks on speech intelligibility in auralized classrooms.  Journal of the Acoustical Society of America, 148(5), 2878-2884.
  6. Goldin A, Weinstein , & Shiman N (2020). How Do Medical Masks Degrade Speech Reception? Available: https://www.hearingreview.com/hearing-loss/health-wellness/how-do-medical-masks-degrade-speech-reception
  7. Mitchel AD 7 Weiss DJ (2013). Visual speech segmentation: using facial cues to locate word boundaries in continuous speech. Language Cognition and Neuroscience, 29(7), 771-780.
  8. Atcherson SA et al (2017). The effect of conventional and transparent surgical masks on speech understanding in individuals with and without hearing loss.  Journal of the American Academy of Audiology, 28(1), 58-67.
  9. Walden, BE, Montgomery, AA, Prosek, RA., & Hawkins, DB (1990). Visual biasing of normal and impaired auditory speech perception. Journal of Speech and Hearing Research, 33, 163–173.
  10. Desai S, Stickney G, & Zeng FG (2008). Auditory-visual speech perception in normal-hearing and cochlear-implant listeners. The Journal of the Acoustical Society of America, 123, 428–440.
  11. Stacey P, Kitterick P, Morris S, & Sumner C (2016). The contribution of visual information to the perception of speech in noise with and without informative temporal fine structure. Hearing Research. 336, 17-28.
  12. Bannwart Dell’Aringa AH, Satico Adachi E, Dell’Aringa AR (2007).  Lip reading role in the hearing aid fitting process.  Revista Brasileira de Otorrinolaringologia (Brazilian Journal of Otolaryngology). 73(10), 101-105.
  13. ASHA (2020). ASHA to CDC: Recognize Need for Clear Face Masks, Flexible Communication Methods to Protect Those with Hearing and Other Communication Disorders. Available: https://www.asha.org/News/2020/ASHA-to-CDC–Recognize-Need-for-Clear-Face-Masks,-Flexible-Communication-Methods-to-Protect-Those-With-Hearing-and-Other-Communication-Disorders/
  14. Yi H, Pingsterhaus A, & Song W (2021). Effects of wearing face masks while using different speaking styles in noise on speech intelligibility during the COVID-19 pandemic. Frontiers in Psychology. Available: www.frontiersin.org/articles/10.3389/fpsyg.2021.682677/full
  15. Thibodeau LM, Thibodeau-Nielsen RB, & Quynh Tran CM (2021). Communicating during COVID-19: the effect of transparent masks for speech recognition in noise. Ear and Hearing, 42(4), 772-781.
  16. ASHA (2021). Using masks for in-person service delivery during COVID-19 pandemic: what to consider. Available: https://www.asha.org/practice/using-masks-for-in-person-service-delivery-during-covid-19-what-to-consider/
  17. Little P, White P, Kelly J, Everitt H, & mercer S (2015). Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations. British Journal of General Practice. 65(635), e351-e356. Available: https://pubmed.ncbi.nlm.nih.gov/26009529/
  18. Saunders GH, Jackson IR, & Visram AS (2020). Impacts of face coverings on communication: an indirect impact of COVID-19. International Journal of Audiology.  Available: https://pubmed.ncbi.nlm.nih.gov/33246380/
  19. Schwarze ML & Kalbfell EL (2021). Benefits of clear masks in communication with patients. Journal of the American Medical Association, 156(4), 378-379.
  20. Kratzke IM, Rosenbaum, ME, Cox C, Ollila DW, & Kapadia MR (2021). Effect of clear vs standard covered masks on communication with patients during surgical clinical encounters: a randomized clinical trial. Journal of the American Medical Association Surgery. 156(4), 372-378.
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How to Use Your Reception Area to Educate, Engage & Inspire Patients – Michele Ahlman

By the time a patient walks in your front door, you’ve already invested significant time, money and resources to get them there. To optimize this investment, you want to reinforce their decision to choose your practice and help them move forward in their decision to improve hearing health. This means using your practice environment to focus patients on their hearing health and educate and engage them so they are active participants throughout the entire appointment. You want to keep them focused on positive emotional triggers and the benefits of hearing health and use every second they are in the practice intentionally.

First Impressions Matter — A LOT!

So, how do you intentionally create an engaging reception area? First, you want to understand what your patients see. You want to maximize the investments you’ve made to get your phone to ring and capitalize on those moments in the waiting room. Even if it’s for a few minutes, that is precious, powerful time that you have to engage and interact with your patients while they wait.

Your reception area provides you the opportunity to make your patients feel appreciated, valued and respected.

To Do: Conduct a Reception Area Assessment

  • Walk outside your clinic and walk through the door through the eyes of your patient
  • Assess your clinic from all the senses — including sight, sound, feeling and smell. Start from the ceiling to the floor.
  • Look for the “little things” that patients notice and could impact how their view your practice including dust, cobwebs, clutter, temperature, organization and even outdated magazines.
  • Look for the big things, too, including seating arrangements, accessibility, design and décor.
  • Make sure there are, at a minimum, 3 resources easily available for patients to learn more about hearing health such as magazines, brochures and waiting room “info-tainment” playing on a television.
  • And finally, be excellent in the way the patient is greeted, seated and made to feel welcome by your team. Every patient contact should be intentional.
  • After you’ve completed the assessment, prioritize the changes and improvements that need to be made, assign a champion, completion date and resources, including time and money.

Create Content to Increase Understanding

Your patients do not come to you to purchase a hearing aid. They come to you because you can help them remain involved, active and connected to other people. They are looking to you to help them understand their hearing problem, understand the solutions available and understand how they can overcome any barriers to purchase, such as cost, timing and fear. This means your team must be ready and able to answer questions and provide relevant information. To do this, consider using the 10-10-4 Strategy. This strategy should be done as a team and is the ideal way to be prepared to help patients along their decision-making process by answering patient concerns and providing answers to “unasked” questions.

TO DO:  Implement the 10-10-4 Strategy

  • Write down the top 10 questions patients ask on a regular basis and the “best answers” to those questions.
  • Write down the top 10 questions your patients should be asking you but aren’t, along with the “best answers.”
  • Create 4 additional key content pieces that would be meaningful to your patients.
    • Call to action: what do you want patients to do next in every decision-making point along their journey?
    • Portal for more: make sure your patients know your web address and place specific key information that answers the 10 most frequently asked and 10 “should be asked” questions.
    • Appreciate in advance: let your patients know — in advance — that you appreciate them taking their hearing health journey with you. Our CDM TV OnDemand service brings your patient education system to your patients in the home. With a simple URL link, you can deliver all of the awesome educational content and custom video content to your patients in an email or embed it on your website.
    • Added value: make sure patients know all the great services and added value you deliver, such as a battery program, auditory therapy or financing.

Don’t Just Educate. Inspire!

Reception area “info-tainent” is one of the most effective ways to educate patients about hearing health and your practice. If you have a television but are currently using it solely to entertain by playing the Travel Channel or Food Network you are missing a great opportunity. Our company contracted Accent House Research to conduct a waiting room impact study. They found 93% of the doctors that participated indicated that their patients asked much more thoughtful questions after viewing digital signage or digital video in the waiting room. Because video/television engages several senses (hearing and vision), it is a great way to not only educate but also inspire patients. When you create your own video, you control the content and can tell your story. You can introduce your team and their passions in life. You can share patient testimonials as social proof that other lives have been improved because of care and the hearing health solutions you and your team provide. Finally, you can ensure patients are exposed to content that will validate their decision to choose you for their hearing health and help them make great hearing health choices. Remember, repetitive messaging will enhance retention and understanding. So make sure the content you created from your 10-10-4 Strategy are included as content on your video “infotainment,” website and displays throughout your practice.

Michele Ahlman is CEO of Clear Digital Media, an Austin, TX-based privately held company that prides itself in providing high-quality, educational content to healthcare providers’ waiting rooms. Michele is responsible for leading the development and execution of both long and short-term strategies and strategic partnerships. With vision, passion, and commitment this privately held, family run, women-owned company creatively, stylishly and economically transforms healthcare waiting rooms into a powerful patient engagement tool. As CEO and company cheerleader, Michele’s goal is to provide a great waiting room experience that gives patients an opportunity to learn about their health, their clinic, and the latest healthcare trends. She believes that being informed is an essential part of an enjoyable life and is dedicated to delivering it in the most ingenious ways.

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Cool New Specula offers Clear Advantage

The Welch Allyn LumiView Clear Specula is new and totally worth checking out. Why? The disposable specula are transparent, providing a much brighter field of view than the opaque specula we are all used to using. Since the otoscope light shines through the specula, the light output is 4X – 8X greater in the ear canal than traditional adult and pediatric specula respectively. Compatible with the Welch Allyn MacroView, Digital MacroView, 3.5V Diagnostic, and Pocket otoscopes, the LumiView Clear Specula are available by the bag (850 specula) or sleeve (34 specula) at the same price as traditional disposable Welch Allyn diagnostic specula.

Order adult and/or pediatric size Welch Allyn LumiView Clear Specula from Oaktree Products by calling toll free 800.347.1960, sending an email to otp@oaktreeproducts.com, or logging into your account on the Oaktree Products website. These new specula are cool, cost the same as what you are already using, and make it easier to see what you need to see!

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Treating Excessive Ear Wax in a COVID-19 Environment – guest post by David J. Smriga, MA

Much to the disappointment of many in the world, humanity is still dealing with the impact COVID-19 is having on the way we live our lives.  As we continue to social distance and restrict our out-of-home activities to as little as simply acquiring groceries, we exacerbate a myriad of psychological and physical side-effects that extend beyond the risk of contracting the virus.  It is true that many hearing health care practices in the United States have crafted both innovative and extraordinary ways to continue to treat people with hearing issues as we try to carry on within the boundaries of this contagious new reality.  But, as we have done so, we have also identified new issues that our patients are confronting as a result of their virus mitigation efforts.

Prior to the onset of COVID-19, it had been estimated that approximately 850 million people worldwide experienced complete occlusion of their ear-canal approximately every three months due to excessive cerumen. Now that stay-at-home patients are regaining some access to professional hearing care, patients seeking treatment for excessive cerumen is exploding.  One hearing care professional describes current trends as a “tsunami of cerumen”.  Google searches using ear wax-related terms are up 5000% compared to pre-pandemic trends.  All of this is likely the direct result of the interruption to regular hearing health care access the pandemic has fostered.

Excessive cerumen not only can contribute to a loss of hearing, its presence can complicate or even confound efforts to treat other more permanent aspects of hearing loss.  As a result, when a hearing care professional encounters a patient with excessive cerumen, the first order of the day must be to remove it.  For some hearing health professionals, this may entail referring the patient to another provider.  And, data suggests that this referral process alone can significantly reduce the likelihood that the patient will return to the original hearing health professional for continued care.  For other providers, the wax removal process becomes the next step in their treatment of that patient – a step that may take time and introduce the potential for re-scheduling the patient for the treatment they originally expected to receive.  In addition, all re-usable equipment employed for cerumen extraction must be sterilized and decontaminated prior to its safe use with the next cerumen-challenged patient.  This is especially important since recent evidence suggests that cerumen may be a source of COVID-19 spreads.1 With COVID-19 significantly expanding the need for such treatment, these time and procedural issues represent a new challenge for the hearing care practitioner.

In a recent online survey conducted by AUDNET Hearing Group, collected data indicated that only 17% of the respondents (all in private practice) who provide cerumen removal services do so using disposable devices.  This means that for 83% of the procedures, inter-patient sterilization and decontamination protocols are required.  In addition, the survey found that only 1% of the respondents indicated that they use a disposable technology purposely designed to significantly reduce the time involved in effective cerumen removal.

Since 2014, EarWays Medical (a company located within the thriving Israeli life sciences community) has been researching, producing and ultimately distributing an innovative cerumen removal technology called “EarWay Pro”.  This, single-use cerumen extraction device consists of a flexible helix (corkscrew) styled and open profiled tip that, when rotated inward into the ear canal, can effectively encapsulate and collect cerumen for extraction as a single cluster.  It enables expedient extraction of cerumen impaction quickly, effectively, and hygienically with no need for a subsequent sterilization/decontamination effort. See procedural video HERE.

Prior to the pandemic reaching the United Sates, AUDNET Hearing Group organized a clinical field trial of the EarWay Pro device with several private practice clinics across the country participating.  Of the twenty-one ears that were treated using the device, it took on average less than one minute per ear to remove excessive earwax and gain sufficient visualization of the tympanic membrane to proceed with the next phase of testing/treatment.  Participating clinicians judged the procedure as both very effective and very safe.  

In a recent webinar, Alicia Spoor, Au.D., owner of Designer Audiology and past-president of the Academy of Doctors of Audiology (ADA), acknowledges a learning curve with the product. Once sufficient proficiency and comfort using the product is achieved, she reports great satisfaction and success in being able to remove cerumen quickly and effectively, and finds this technology useful in delivering cerumen removal services, especially in a COVID environment. 

Since FDA approval of the EarWay Pro in December of 2019, the product has been steadily gaining traction as an effective and useful clinical tool in the U.S.  Considering the effectiveness of this procedure in significantly reducing the amount of time needed to remove excessive ear wax, eliminating the need for inter-patient sterilization procedures, and recognizing the potential “tsunami” of cerumen extraction need fostered by months of social distancing, it seems reasonable to encourage all hearing health care professionals in the Unites States to explore the use of this technology in their clinical practice.  To assist, AUDNET Hearing Group will be conducting its second webinar detailing the EarWay Pro product and procedures March 24, 2021 at 12:00 pm EST.  For more information about this webinar, visit the AUDNET Hearing Group Blog.

References:

  1. Hanege et al (2020). SARS-CoV-2 presence in saliva, tears, and cerumen of COVID-19 patients. Laryngoscope, October 23, 2020. www. onlinelibrary.wiley.com/doi/10.1002/lary.29218

David J. Smriga is an audiologist and Vice-President of Corporate Communications for AUDNET Hearing Group, a national organization that provides business, marketing and buying support services for independent hearing care practices.  As well as positions in both clinical and research audiology, Mr. Smriga has held senior management positions in sales, marketing product management and public relations for some of the industries top manufacturing firms.  Since 2002, Mr. Smriga has also been Senior Audiology Consultant for Audioscan, a premier manufacturer of real-ear measurement and hearing aid verification test equipment. 

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My COVID Year – Kristi Mendoza, AuD

Do you remember the start of 2020? It was going to be the year of focus, the year of foundation, the year to burn the candle far into the night. Many of you probably purchased daytime planners or already has an influx of iCalendar events extending well into the future. Travel plans were mapped out with pre-purchased tickets because it was going to be that kind of a new year. Success and ease of life was at the fingertips.

Well, if that sounds familiar, it should be no surprise to hear that this was my story as well. I was safely and conveniently located within an ENT clinic. Five years of a Tax ID that sat by the wayside as I let the ENT do my billing and liaison contracts. Then COVID-19 hit and I initially wasn’t sure if those of us in the Audiology arena could sustain our businesses. I, along with many of my colleagues, temporarily shut-down our practices and stayed home for a span of time (6 weeks for me) while the world turned right, left, and every other direction except forward. There was stagnation, zoom meetings galore, extra drinking, a few extra pounds, and an unforeseeable future.

When businesses were offered the opportunity to re-open, I realized that I was about to go back to work in an environment of an ENT practice that was seeing patients with the symptoms to which my aging population was advised to stay away.  I started realizing that my choices for addressing the needs of my patient’ were severely curtailed. I had no control of the front desk, the protocols outside of my one room office door, nor the staff. I was a ship taking a downward dip into a large unattended wave.

And that’s when Facebook Groups, Colleague virtual hugs, and ALL of us experiencing the same “sideways life” started to turn towards one another for support. This had the effect of making us stronger. In the kaleidoscope of online activity, I was learning how other audiology practice owners were staying a float including pursuance of PPP and SBA loans. With much apprehension, I applied for both loans and was shocked that my PPP application was accepted and in awe that my SBA loan was approved. I had money in hand, so what was I going to do? I could either play it safe and hope to stay afloat until things retuned to normal, or I could take a leap and use the money in a way that would best work in my favor. It was time to take everything I learned and heard from others to build my very own dream practice.

As I was getting ready to move forward with my plan, something more awful than the earlier business shut-downs happened. In July 2020, I was diagnosed with COVID-19. While out from work for another three weeks, my recovery was not easy; at one point in time I was concerned that I would become a statistic, leaving this world without having achieved by dream practice. I did fully recover but it turns out, this scare made me push harder, dream bigger and believe in myself more.

I literally started to dream my bank account into action. I would lean into and believe that I could open a new business. I would walk away from the ENT and known financial safety net and seek out a location that would have all my ideals: location, cleanliness, staffing, protocols, equipment, more clients, more staff, more help for the hearing impaired, more help to the community. I dared to board the ship to a new adventure! And that’s when my real year of 2020 began. Right there, in my mind, with my small school-lined paper notebook, in August 2020. If COVID-19 taught me anything in 2020, it taught me that the quiet of the night, amidst all my insecurities, was when my hand did the most pen to paper engagement. Before I knew it, I had secured a Commercial Real Estate Broker, a 2nd Floor Corner Office with a view, an architect that drew to my dream and dimensions, and a building contractor – all who answered to me, the owner, and business decision maker, the purse strings. And I did all this WHILE continuing to work at the ENT.

I secured my current staff well before my doors opened. I purchased office equipment, with a now known end date in mind. I had the audacity to hold tight to my dream and not release it into existence until it was ready. I dreamed my new life and office space and before I knew it, the dream became a reality. Me, a woman who was once a young girl growing up in Colorado, who was afraid of her shadow and who struggled through many of her last adult years with her identity and self-worth.

My blessing was that I had many who supported me in my dream. They pushed me when I was saying forget it, they reminded me of my why when I was feeling defeated, they encouraged me with flowers, videos, friendships, and inclusion. I credit these individuals, including my three kids, Brayden, Taylor, and Sydney for helping me to defy the odds. A female business titan – 100% owner that has tripled my revenue in 3 years to over $600,000. All of this from a small ENT location with a footprint of about 200 square feet. If I can do it, trust me, you can do it too.  

My many thanks to so many but especially to my parents, family, Entheos Cooperative, Dr. Gyl’s Women of Wonder Network and hosts, Entre Audiology, Sofia Figueroa, Sandi Mierish, Glenn Lundy, Danielle Delgado, Karen Michaelle, Chris Crumley, and Angela Loucks Alexander. You helped me to believe in myself and for this I am eternally grateful. But above ALL else, my greatest cheerleader and hope giver is God who is my true and constant North.

Kristi Mendoza, AuD is owner of Optimum Audiology in Apple Valley, California. Since 1991, Dr. Mendoza has been helping people improve their hearing by identifying custom solutions and offering products from a variety of leading hearing aid manufacturers. Prior to establishing her own private practice in 2015, she worked as an audiologist in private practice and as an outside sales representative for a large hearing aid manufacturer. Dr Mendoza earned her clinical doctorate from A.T. Still University in 2009. She has volunteered for numerous hearing mission trips, bringing the gift of hearing to children and adults in New York and the people of Kenya, Africa.

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Disinfectants: How to Make the Best Choices for Your Clinical Practice

Disinfectants are chemicals designed to kill microorganisms residing on non-living surfaces. These products must be registered with the Environmental Protection Agency (EPA) and are required to display the designated EPA-Registration Number on the product label. The main ingredient found in EPA-registered, hospital grade disinfectants used throughout the hearing industry range from a form of alcohol, quaternary ammonium compound (“quat”), hydrogen peroxide, citric acid, or a combination formula of alcohol/hydrogen peroxide or quat/alcohol mix. With so many products available, here are things to know when choosing disinfectants for your clinical practice:

USE EPA-REGISTERED, HOSPITAL GRADE PRODUCTS

While household products kill germs, EPA-registered, hospital grade disinfectants kill a broad spectrum of microorganisms commonly found in hospitals and other facilities providing patient care and/or provision of allied health services. The Centers for Disease Control and Prevention (CDC) recently qualified EPA-registered, hospital grade disinfectants as effective against SARS-CoV-2 (the virus causing COVID-19) in healthcare settings.1 A list of EPA-registered, hospital grade products offered by Oaktree Products is found HERE.

USE ALCOHOL-FREE DISINFECTANTS WHEN RECOMMENDED

Alcohol chemically denatures acrylic, rubber, plastic and silicone. Since most audiology components are composed of these materials, many manufacturers recommend using alcohol-free chemicals to disinfect smaller components and items like hearing instruments, earmolds, remote microphone systems, and headphone cushions. A table of alcohol-free disinfectants (click to see product details) offered by Oaktree Products is available HERE.

DWELL TIME

The EPA registers the specific microorganisms a disinfectant kills and the corresponding amount of time it takes to kill those specific microorganisms. The product must stay wet on a surface for the required amount of time in order to be effective. Referred to as dwell time (or kill time), most EPA-registered, hospital grade disinfectants require 30-seconds to 3 minutes to effectively kill microorganisms although some products require 10 minutes to effectively kill certain microorganisms. It is important to read and follow product instructions.

Final Thoughts:

  • For larger touch and splash surfaces (e.g. countertops, table surfaces, door handles, etc), use any available EPA-registered, hospital grade disinfectant in any form (e.g. spray, wipes)
  • For equipment and related components comprised of acrylic, rubber, plastic or silicone parts, use an alcohol-free, EPA-registered, hospital grade disinfectant in any form.

References

  1. CDC. Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Updated April 13, 2020. Available: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
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