Dr. Jamie Parks' Audiology Empire: Charting the Path to Success in Healthcare Entrepreneurship through Marketing, Partnerships, and Real Estate

Have you ever found yourself at a career crossroads, unsure which path to take? Dr. Jamie Parks, CEO of American Hearing and Audiology, joins us to narrate her journey from an uncertain undergrad to a business maven, operating 20 clinics across several states. Our conversation dives into the moments that shaped her audiology career, from her initial steps in clinical work to the leap into sales, and circling back to her true passion in private practice. Alongside this, Dr. Parks unveils the transformative impact marketing and a relentless pursuit of independence had on her growth, proving that a mix of vision and grit can lead to doubling revenues and successful entrepreneurship in healthcare.

When we think about business, we don't often pair it with the intricacies of forming partnerships, but Dr. Parks walks us through the complex dance of expansion. She shares her insights on building a robust team dynamic, the art of structuring partnerships, and the crucial elements of trust, communication, and aligned goals. Whether discussing how to create a solid operating agreement or leveraging each other's strengths for effective problem-solving and decision-making, this episode provides a playbook for entrepreneurs looking to scale and solidify their ventures through collaborative efforts.

Lastly, we tackle the strategies that ignite business growth and keep the engine running smoothly. Dr. Parks elaborates on the use of affiliate programs, consulting services, and the pivotal role of cultural leadership in nurturing a thriving workplace. We also cast a wider net to examine the audiology industry's trends, the role of private equity, and the strategic importance of vendor relations. For those hooked on the narrative of American Hearing and Audiology or curious about the commercial side of audiology, Dr. Parks points you towards resources and opportunities to engage further and perhaps even find the ideal location for your practice through Leaders Real Estate. Join us for an episode rich with actionable insights for both the budding entrepreneur and the seasoned business leader.

If you need help finding the perfect location or your ready to invest in commercial real estate, email us at podcast@leadersre.com.

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Transcript

Speaker 1: 0:00

Yeah, I took over and we were able to, you know, double revenue pretty, pretty quickly Once I, once I took over and we started working together.

Speaker 2: 0:10

What did you do to double the revenue?

Speaker 1: 0:12

Marketing.

Speaker 2: 0:13

Okay, she was a marketing.

Speaker 1: 0:15

Yeah, the marketing that she felt comfortable with was doing a lot of database mailing and I had felt like, okay, I've been in Kansas City for a while, people know my name, I just need to let them know where I'm at. And I, I did, I go with scrappy. I got really scrappy.

Speaker 2: 0:34

The goal of this show is to help health care organizations scale by leveraging real estate strategies and interviewing high level healthcare executives in order to pull out lessons learned along the way. If you'd like a free site selection analysis from our team, or you'd like to learn more about how we're acquiring real estate through our fund on the blockchain, visit us at wwwreuniversityorg and drop us a line. That's RE, as in real estate, universityorg. Hello, welcome back to another episode of helping health care scale. I'm Austin here. Our guest today is Dr Jamie Parks. She's the CEO of American Hearing and Audiology. It operates 20 locations in eight states and she's also a consultant where she helps other practitioners build their multi-million dollar practices. Dr Parks, thank you for coming on our show. Welcome, thank you.

Speaker 1: 1:18

Thank you so much, Austin. It's such a pleasure to be here. I'm really excited about our conversation Great.

Speaker 2: 1:23

Yeah, one of the things we like to do on this show is just get to know the guest, and I would love to start with your story. Like, who is Dr Jamie Parks? What was your childhood, like that kind of led you down to this path? Did you have entrepreneurial parents? Did you do anything in school that was like competitive or entrepreneurial, just like, yeah, what are, what were some of your earliest memories that you think helped shape you?

Speaker 1: 1:43

Oh, great question. As a child I had a normal upbringing. I'm from the Midwest and my parents really instilled in me that I was going to get an education, I was going to go to college, and when you went to college you picked a profession and you stuck with it, and so that was so much pressure for me as an 18 year old. I changed my major at least six times and my dad finally said you got to pick a major and stick with it and graduate next year, or your little escapade in college is over. And so I went home.

Speaker 1: 2:18

I knew that I wanted to be in a helping profession. I had explored social work, I had explored psychology, really a lot of physical therapy, and my roommate at the time was a speech pathologist and I thought sounds interesting, if she can do it, I can do it. I think like a lot of 18 year olds or maybe I was 20 at the time I just had had some insecurities about making a commitment that was going to be lifelong, and so, anyway, I jumped into speech pathology. I took my first audiology course and I loved it. I thought the science and the anatomy and the physiology of the way the ear and the brain work together was right up my alley. So that's exactly how I fell into audiology. It wasn't planned, but it was a good fit.

Speaker 2: 3:01

Yeah, that's cool. So, even then, though, there's still such a big gap between okay, I want to be an audiologist and I now own an operate 20 locations.

Speaker 1: 3:10

Yes, 100%.

Speaker 2: 3:13

Yeah, so yeah, I'd love. I just love to hear that story, yeah.

Speaker 1: 3:16

Yeah, once I graduated with my masters, I took my first job working as an audiologist, and I was in a practice with five ENT doctors and I realized quickly this is not what I want to do with my life. I do not want to work for somebody, spin a dial and really not have relationships, relationships, what I was always looking for in my profession. And I felt very unfulfilled and I remember thinking, oh my gosh, I've made a horrible mistake. I have my masters, I've did two years of extra school, what am I going to do? And I went straight into sales and I worked for a hearing aid manufacturer and I got to travel all over the country and I got to see how other clinicians were running businesses and I opened my eyes to the fact that I didn't need to be a single clinician in a big practice where other people were telling me what to do. And so I got my. I got sales experience, and then I got married and I realized I did not want to sleep at a hotel 250 nights a year, like it wasn't fun to travel alone anymore. And so I came back to audiology in Kansas City and I worked for a group of private practices that was local and I had the autonomy that I'd always wanted in a job where it was like look, you are the professional, you're the doctor, do what you do best and build relationships with patients and help people. And I loved that. It was a perfect fit for me.

Speaker 1: 4:52

And then that private practice sold to a big corporation and it was no longer a private practice. It was one of hundreds of retail clinics across the country and I knew immediately no, I want back what I had and I don't see it anywhere Sorry, I don't see it anywhere in Kansas City. So I'm going to have to do it myself. And that was really where the entrepreneurial aspect of my life my stepped up to it, because I didn't have another option. I did not want to go back to where I was. I didn't want to necessarily leave audiology. I knew I was good at it and I had learned enough in my previous position to start a private practice and to go for it. So that's really where it started. It was out of desperation.

Speaker 2: 5:38

So at that stage, that's when you said I'm going to go just open up my own practice from scratch.

Speaker 1: 5:43

So I actually had a mentor that I had worked with in my very first job. She had a private practice and she was getting ready to exit and the stars aligned and she was ready to sell and she stayed on for a couple of years to help me through that and so she had a very small practice. It was just her. I remember when I bought the practice, I'm like, okay, let's look at your calendar and it was a paper calendar Like what are we doing here? Very small practice. And yeah, I took over and we were able to double revenue pretty quickly once I took over and we started working together.

Speaker 2: 6:18

What did you do to double the revenue? Marketing Okay, she was a marketing Marketing.

Speaker 1: 6:22

Yeah, the market that she felt comfortable with was doing a lot of database mailing and I had felt like, okay, I've been in Kansas City for a while, people know my name, I just need to let them know where I'm at. And I did. I go scrappy. I got really scrappy. I was stood outside of a jazz concert and I passed out earplugs with my phone number on it and mostly got taunted because people going to concerts don't want to wear earplugs. But I did crazy things like that. I joined groups, I went anybody who would let me talk about my business. I got in front of them.

Speaker 2: 6:56

Okay, that's cool. So, yeah, it's make a big difference where you go from zero to anything, right, if she's just getting slowly on word of mouth. I'm guessing.

Speaker 1: 7:04

Yeah, 100%.

Speaker 2: 7:05

Wow, that's cool. So you take over this one, double the revenue via marketing. And then how long was it before you got the itch to do multiple?

Speaker 1: 7:14

When I bought that first clinic, I had a vision of maybe three or four clinics and really my vision was to recreate private practices that gave professionals like myself the autonomy to come in and do what they do best. But I loved my job in private practice. I loved that I was treated with respect, that my opinions mattered, and I really wanted to recreate that for any audiologist that followed, and so I had a vision. Pretty clearly it was just waiting till I got to that revenue to open and also looking at the footprint in Kansas City as to where I wanted that clinic to be. It's a pretty competitive market and I knew that I wasn't going to start anything without the talent. You can open the doors, but if you don't have somebody in there, that can do the job and that you trust.

Speaker 1: 8:06

It's just it's not worth it.

Speaker 2: 8:08

So this okay. So did you start like identifying the location first, or did you start identifying the team first?

Speaker 1: 8:16

Team, team. First I found an audiologist who was eager to get into an autonomous private practice where she could do things the way she wanted to do, and we made an agreement and I went out and rented a spot and we got everything we needed and we just started. And again same thing.

Speaker 2: 8:34

She got out in the community we marketed, I think another big and you, was it a 50-50 partnership, or what exactly?

Speaker 1: 8:41

No, it was not. She was an employee. I was, so she was an employee.

Speaker 2: 8:44

Okay, all right, let's talk about site selection because that's our bread and butter, right? Like we love site selection, we love purchasing real estate, talking real estate. What was your process for that site selection? And, to be frank, we do a lot of retail healthcare. We do a lot of healthcare. We have not done very much audiology at all, so I don't know if it's. What we see is, if it's a referral-based business, you kind of want to go. You don't need good street visibility, right, you can kind of go where you want to be. Like good proximities, people aren't driving far. But for a lot of like general practice type businesses and dentists, like you want to be on the corner of main and main, to the extent that you're able, right. Like you want to be in those grocery anchor stores so that as many people as possible are seeing you. But I'm just curious, what was the criteria for you guys?

Speaker 1: 9:24

I had an insight in my previous job to look at 11 different clinics in the Kansas City market and see how profitable they were.

Speaker 2: 9:31

So you can actually look at the back room data.

Speaker 1: 9:34

Yeah, I had it. I had worked in that organization, so I knew where my, I knew where my competition was at the time and I knew that if I had a provider better than the one they had, that I could recruit business. And all of that being said, I also did a ton of research into zip codes. What, what type of demographics are in this zip code and where can I pull from? And where do these people in this city? Do they not like crossing the highway? Do they like crossing the highway? And then, of course, I had to take my population into consideration. I need something easy to get to and wheelchair accessible. Beautiful big doctors offices are great, but they're not always the best to get a wheelchair in. It is that retail front. I have both. Now we have with 20 locations where we've got a mixture, but that was where I first started was can you get to me easily, can you see me, and can you get in the front door?

Speaker 2: 10:26

That's cool. So at this stage, this was your second one, and how did business go? Was there a long ramp up period or was it pretty quick?

Speaker 1: 10:32

That clinic was not. It did not come out of the gates hot and successful, but we were able to make it profitable within our first year.

Speaker 2: 10:40

And a lot of times within 15 months, right the profitability.

Speaker 1: 10:44

Yes, and I can say 10 years later, it is, to this day, one of our most profitable clinics.

Speaker 2: 10:51

Oh wow, I was going to ask that Is this on the? Same location, same location Nice, big bro.

Speaker 1: 10:56

Yes, location works well. I have different staff and I think that always changes things up, but I just have an amazing team there that's committed and they're in the community all the time, so they do a great job. I love those girls.

Speaker 2: 11:10

So yeah, and then how long was it for your second location? So that was number two, yeah.

Speaker 1: 11:14

Number two, and I think it was probably just a year after that we went to number three and number three. We had a dynamite location, we had a dynamite provider and that was able to really fuel us to go faster and go harder. It was around that time where I also joined partnerships with my partners now, and so we were able to move at such a quicker, such a quicker pace than I was able to move alone, and I had the comfort of knowing I'm not in this completely alone. I've got some business partners and, yeah, we really hit the gas hard.

Speaker 2: 11:53

That's interesting because I think there's a lot of limiting beliefs around partnerships, like one of the things that I heard was there are two types of ships partnerships and sinking ships, meaning like a lot of partnerships end up not working. Are you guys still operating together successfully? We are.

Speaker 1: 12:07

Yeah, which is awesome.

Speaker 2: 12:08

Congrats on that, thank you. My question to you would be how did you structure it? Because I think what my personal experience or opinion is just that the partnerships are hard. Right, look at marriages they're hard, and they do fail a lot, both, unfortunately. But when it comes to partnerships, I think that there's just a learning curve, right, and so you can. Your takeaway after a failed partnership can be oh, they don't work, but they obviously do, because the most successful people in the entire world all use partnerships. And so, I think, really comes the question of how do you do it? And I think there's just a lot. There's some things you don't know that you don't know right, and you have to learn them the hard way. But it sounds like you guys laid a lot of the groundwork correctly. So I'd love to hear what you were looking for in your partnership. How did you define roles and responsibilities? How did you structure it? Yeah, anything related to that.

Speaker 1: 12:52

I have a lot of structure around it. The beautiful thing was that we'd worked together before, so we knew each other, we knew our personalities, we knew our dedication and we were hungry there. Our first meeting was over some cocktails, we were making up notes on a napkin and we knew the direction we wanted to go, and failure was not an option. So we set forth, knowing that partnerships don't last forever and what is it going to look like when it ends, and so we had a very clear operating agreement, down to the detail of my spouse signed it. My spouse is part of my business. Any other spouses that were not involved in the business signed it.

Speaker 1: 13:36

It was very clear what this looks like and what decisions could be made. Can I walk in tomorrow and say I'm out and what does that look like? Or we really got detailed on our operating agreement and just the mutual respect. We did have certain partnerships where we had a majority owner and some of us had equal ownership and even though we weren't all equal at the table, we treated each other with equality and we did assign. This is your role.

Speaker 2: 14:07

There's four of you. Yeah, so just like from a high level, what was the responsibilities of each person Like? How did you spread those up, yep. Cfo, marketing director, ceo and VP, and what was the high level responsibilities from each child? Who was in charge of growth and site selection? And did you have to raise capital? You don't mean all those mergers and acquisitions, all those types of things. Yeah.

Speaker 1: 14:27

So that we had one partner who had done a ton of acquisitions. We had another partner who's really good at negotiating leases. I'm really good at building culture and engaging teams and doing that, grabbing onto new staff and understanding who's going to stick around, who's not, and who do we want to stick around and who do we not, and how do we make that work. And so we all took different pieces together. It was always a team approach.

Speaker 2: 14:53

Yeah, I feel like this is the type of stuff that just gets glossed over so often. It's like you hear somebody's story and it's oh great, you just opened up a couple of locations, brought in a couple of partners and then we did these strategies, blah, blah, blah. But, like, to me, the partnership structure is so interesting because I feel like it doesn't get enough attention and interviews and stuff like that for the weight that it brings and the significance to the outcome that it can have.

Speaker 2: 15:17

So, because the other thing too is you may be frustrated with somebody else's output. You think that you're clear about your expectation and then you feel like you always feel like other people aren't dragging their weight Right. So did you guys have a process for that?

Speaker 1: 15:29

One of the things that we do really is we communicate well and we can say what's on our mind and we can go back and we can think about it, and then I think every single one of my business partners is very introspective and has the ability to look at it from a big picture. I have one business partner specifically who there's nothing that we do business-wise that isn't a win for everybody always, and so when we go to it's a level of trust.

Speaker 1: 15:59

It's a level of trust that I know they have my back, I have their back. We all want the same thing right. We all want the same thing and by working together we're going to get it. So when we look at a new acquisition, it is an entire partner conversation. One person may be really pro into it and the other one not, and so we're going to have that debate, we're going to talk about pros and cons and we're going to lay it all out on the table, but anytime we go into negotiations, we meet with vendors, it's all of us together. We come as a team.

Speaker 2: 16:30

Yeah, did you okay. So how much is it cost to open up a location, a new location, like what's the build out?

Speaker 1: 16:35

Yeah, usually about $150,000 for a clinic. Oh wow, that's not bad at all. No, it's not.

Speaker 2: 16:40

You can pretty much just bootstrap everything, either Azure or Bankday, like you don't really have to bring on partners, finance and investor partners right.

Speaker 1: 16:46

Yeah, and we're really lucky in our industry too, as a lot of our vendors will do almost like seller financing. Maybe, they'll have some clinics that they ended up owning because the owners went bankrupt or they weren't profitable, and so they have this clinic and they know that we're really good at running clinics and making them profitable. So they'll say, hey, we have this clinic and if you meet some milestones, key performances, we can make a deal on this, and so that's really unique, I think, to our industry and audiology. Yeah, we were able to.

Speaker 2: 17:19

There's not more competition then it's so cheap to start one up. Is there a lot of competition?

Speaker 1: 17:23

Absolutely, Absolutely there is. There's a lot of competition and I think our industry is changing so much that what sets you apart and what the insurance companies will allow you to do with patients is it's becoming a more narrow road, but we've got a big footprint. We've been here a while.

Speaker 2: 17:41

After you guys had the partners, you said, that's when it really started to take off. What happened after that? Cocktail agreement?

Speaker 1: 17:46

Absolutely. We had again one clinic, funded the next, funded the next, and within two years we were up to nine clinics. And then, at that point, a vendor did come to us and had some clinics that they no longer wanted to manage. They were selling them and we were able to acquire them, buy them from the vendor and overnight we doubled in size, like overnight. We bought 11 clinics.

Speaker 2: 18:14

Wow, yeah. And so, in terms of like deal structure and deal financing, like when you're buying these clinics, is the industry like sophisticated? Are they all private practice? Do they want? Is it a percentage of collections or is it a multiple of EBITDA?

Speaker 1: 18:25

It's a multiple of EBITDA the industry in itself has. You will have audiology clinics working out of ENT practices. You will have audiologists working out of iClinics. You will have just a private practice with audiology retail hearing devices only. You'll have private practices that also do balance and tinnitus and therapy, and then you'll have vendor owned and big box chains. You can certainly walk into a Walgreens right now and buy an over the counter hearing aid Right. So it's a plethora of everything. And insurance companies, as of right now, are really putting limitations on what products a patient can buy, how much care, who can see them, that sort of thing. So it is narrowing the path.

Speaker 2: 19:15

So what is the average square footage for each location?

Speaker 1: 19:18

Typically, if you're gonna have one hearing healthcare provider and a receptionist, you're looking at 1500 square feet. Now we have several clinics that have five hearing healthcare providers and one of those, like one of our clinics, is in an old blockbuster, so you know how big those are, but we can fit five providers in that clinic, so we have a staff of 10 there. Our traditional model, though, is that 1500 square feet. One hearing healthcare provider, one front office staff and possibly a part-time technician.

Speaker 2: 19:52

Okay, so would you say it's like low overhead. I don't know high overhead.

Speaker 1: 19:55

Yeah, it depends on what part of the city you're in and the landlord right. The landlord is a big. We've had leases where they'll do the entire build out for us and we sign a 10 year lease. And then we've also had where they won't pay for a thing and it cost us a couple hundred thousand dollars. So it really depends on the area and it's all different.

Speaker 2: 20:17

Yeah. So let's see, at this point you guys are like 11 locations, what was it? Pretty quick to go from 11 to 20? At that stage you probably have a model and are you still scaling up, or did you get to a point where you're happy, or what's going on now?

Speaker 1: 20:28

Yeah, great question. It was a challenge. We were merging two cultures right, there was 11 of them and nine of us and there was some culture there and for the most part it seemed like a really smooth transaction and we felt like we got amazing staff. We consolidated some of our offices because we were literally across the street from each other things like that. We consolidated, but it was a fairly smooth transition and financially it worked out better than we expected. We thought that it would take some time to ramp up and that worked out well, so we were able to open up a couple of clinics from scratch and get those going. I think that what really today we're not growing, we're not buying clinics, the partners, we don't wanna travel. We've all done that and we're not wanting to travel and so if we're gonna do any growth, it's gonna be within driving distance or we're gonna do it through our affiliate program and we've covered every place we can drive to.

Speaker 1: 21:29

There's no place that we would wanna go, and so we're really only interested in growing, growing, in a sense, with affiliates, and we also have an online telehealth company that we launched a couple of years ago where we're growing that because nobody's traveling, it's all online and you can reach clients in remote areas and all across the country.

Speaker 2: 21:53

Okay. So yeah, lynn, let's talk about the affiliate program, because I think that's closely connected to the consulting right.

Speaker 1: 21:58

Yeah, absolutely. With our affiliates, we've had mostly people come to us and say, look, I wanna grow the business. There's no template that we use. It's based on the business that's coming to us, the CEO that's coming to us and saying, look, these are my needs, this is what I want, this is where my vision is, and I believe you are marketing, you're billing, you're talent acquisition, your operations can help us get there. And from there it's a partner conversation of how much do we wanna invest, what can we help, where do we think we can take them? And take it on a one-to-one basis. It's not a franchise package, it's not cookie cutter. It's very tailored to what that particular business needs.

Speaker 2: 22:42

Somebody might reach out and they just heard about you guys from some form or another, and then that process is you start consulting with them and then what's the path to affiliation?

Speaker 1: 22:52

Do you mean the path to purchase or?

Speaker 2: 22:54

Yeah, if you're gonna purchase them or whatever, yeah.

Speaker 1: 22:56

Absolutely Typically, we start a new LLC and my company will buy into that LLC. They'll still remain owners, still have ownership and will map out another concrete locked-type operations agreement showing exactly how this relationship is going to work and how this relationship is going to end.

Speaker 2: 23:17

What metrics make a good partnership? Like if you're sort of reaches out, you're do you have a checklist of? Okay, you know what. This is just going to remain consulting, like we'd love to help you but it's not going to be a good fit, versus oh wow, like this would be a perfect practice to apply and partner with. What do you guys look for?

Speaker 1: 23:32

We jokingly say we buy ugly businesses, like we're not buying the Taj Mahal, we're not buying the practice that you know once top dollar. We're looking for a place where we can come in and make a big, quick impact, and that's usually through pricing, operations, marketing, you know, streamlining those things. And so if we see a practice or a business where we're really, we see a vision for we could just make these few tweaks, that's where we're going. One of my business partners is a CPA and everything's in a spreadsheet, right, so we plug in some numbers and we go, wow, at the end of the day, we could make some money on this one, and that's how we work.

Speaker 2: 24:10

Okay, so then let's go, let's talk about consulting. There's obviously we only got a couple of minutes here, so I'm sure you can talk about this for a day. But, like, where do you start? What are some of the most common questions that people have? Or even like the most common issues? I'd love to just as much value as you can provide in the time that we have left.

Speaker 1: 24:26

Yeah, absolutely. This is a fun part. A lot of people have a vision for going big and they have this desire to go big, but they're not exactly sure of the steps to take or where to even start. And so hiring a business coach, a business consultant like myself. First we start with a business audit.

Speaker 1: 24:43

Let's take a look at the business. Where do we see what's like in your own family? You sit there and you go. That relationship could be dysfunctional, but I don't really know how to change it. But then somebody else looking out maybe the neighbor across the street can judge you and tell you exactly how to fix your family right. So a business coach can do a business audit. Look at what's going right. Where are some holes, where are some gaps? How do we close them to get you to where you want to be? What's standing in the way? So that's number one, and helping people to walk through that goal setting process again to give them tangible what do you want the business to look like in five years? And I think a lot of times people are afraid to say their goals because they think if they don't get there, it says something about them personally. That's not the case it's. Let's stop running towards the horizon and actually make a goal. Let's make it a big goal. So if you're halfway there, you're happy, but just having some accountability as well.

Speaker 2: 25:38

Yeah, figuring out what do they really want, because there's the answer they think you want to hear, or they think other people want to hear versus what they really want. So that's step number one, I think, mapping out a process to get there.

Speaker 1: 25:47

Yeah, mapping out the process to get there, seeing again, closing those gaps and then recognizing you're not going to do it alone. You need a team, you need a culture. I can wholeheartedly say I would not be where I am today, the business would not be where it is today, without the partners or without our team. Our team is what holds us together and finding the right people and building that vision and sharing that vision and being able to lead it. I think that's that is a struggle for a lot of people. So then we build the culture and then from there you you recognize okay, what do I want the next five years to look like? Eventually, you plan an exit strategy.

Speaker 2: 26:22

So when you say closing the gaps, is there any commonalities that you notice that in terms of like gaps people have when you felt for them for the first time?

Speaker 1: 26:30

I do think it's leadership, it's culture, it's building that, but it's also doing things the way they've always been done because it's easy, and not necessarily making sure that it's relevant or that it is the most efficient for the culture of the business or the timeline of the business today.

Speaker 2: 26:49

Yes, culture is hard right. It's what like culture exists, but, like, the definition of good culture versus bad culture changes depending on who you ask. So you have like culture metrics. Or how do you go about addressing when there's a culture problem?

Speaker 1: 27:03

That's a great question. I think it's being a leader and being able to show people how the culture goes right. When I walk into a clinic or when I'm training anyone, or anyone comes into the organization, they see how I interact in the front office and recognize what's expected of them, and there's going to be people that join your organization who are not a good fit. So to me it's courting someone, making sure your interview process is solid and then cutting ties when it's not a good fit, because I may love the organization and my employees may love it, but I hire someone new and it's just not what they want to do and it's not a reflection necessarily of our culture. It's just not a good fit and so it's cutting those ties. And I think sometimes small business owners will put up with somebody who's not pulling their weight because they're afraid to break those ties.

Speaker 2: 27:56

Yeah, that's good. So yeah, in terms of I guess if somebody comes in and you're working with them, they want to go from doing a maximizer growth right, Blow it out of the water. Is that going to affect the way that you guys consult them? What would you start to do to help them, just if their goal is to grow as fast as possible?

Speaker 1: 28:13

We're going to do a lot of territory analysis and just look at those demographics. Where's the competition? Where can you go? What talent do you have? In our industry, and probably in a lot of healthcare industries, finding a professional who can do a really good job is the tough part, and audiologists are thin. We're getting smaller and smaller.

Speaker 2: 28:38

Yeah, everybody, labor shortage is huge and then provider shortage across the board dermatology, dentist, hygienist yeah the shortage is crazy. Everywhere you go, yeah.

Speaker 1: 28:49

So I get excited, I get really excited when I meet young people who are starting their first private practice and maybe they're in a remote location or they're in a big city, but they have a following already. So it's really just understanding your demographics and it's understanding your competition and where you fit in and what you can do. Competition is good. It makes everybody step up. How can you challenge that competition?

Speaker 2: 29:14

Yeah, that's great. So, yeah, if somebody you're, working with somebody you're, and it seems like it's going to be a good fit, what are some of the benefits that they could get if you guys were to partner together? Money, take your chips off the table, yeah.

Speaker 1: 29:26

Yeah, absolutely, become more profitable. I think having a good partnership also relieves you of that solo entrepreneur, alone-ness or isolation. You have a team working together and you've got people to bounce ideas off of it, and that's what I love about my partnership and the different personalities within my partnership.

Speaker 2: 29:46

Right, yeah, no, that's cool. So yeah, let's talk macro for a second, because I just don't know a whole lot about the audiology industry, like about how many locations are there nationwide? Do you have any idea? Stuff like that.

Speaker 1: 29:58

Oh my gosh, that's a great question.

Speaker 2: 30:01

Something that private equity is coming after. Have you seen?

Speaker 1: 30:04

Yeah, yeah. I have seen that we have big buying groups where hearing instrument specialists will join buying groups to get better pricing from the vendors, and buying group will promise a vendor so many units and so those buying groups are worth a lot of money. And we have seen some private equity moving in that space. And of course I get phone calls all the time.

Speaker 2: 30:29

We'll have bigger, some of the biggest groups, like we get 90, 100, 150 location groups.

Speaker 1: 30:33

Yeah, I think you're probably going to start looking at vendor owned. We're one of the largest privately owned practice groups with 20 plus clinics, but you will see some that have 55, 100. There's not many people in that bucket. If you're going to see somebody who has 200 locations, it's going to be a franchise location or vendor owned.

Speaker 2: 30:58

Okay, yeah, I was at the biggest vet conference annually. Like a week ago I was there back in 22. And then I was there again last week and back in 22,. There was all this roll up happening. We're often, you know, riding that wave of zero interest rate money and a lot of consolidation was happening and everything was really frothy and people were just buying up everything. Right, there's no de novo's, no startups at all, and because we want to buy the real estate for them and develop and provide them a good location, and there was very much, not a lot of opportunity for de novo's and site selection. And then a week ago it was a totally different atmosphere and it completely changed. And so now every single person that I talked to has a de novo arm, or at least the aspirations to have a de novo arm. And so I think what happened is just like the multiples went up so fast and even with the higher costs of capital, like multiples did not come down at the same rate.

Speaker 2: 31:48

So what do you do? It's so much more expensive to do an acquisition now than it was years ago, just because of the cost of capital. There's been no adjustment for that and everybody's getting priced out, and so it's interesting. You're now seeing a lot more startups in the industry, and even in the dental space too. It's like the same thing. There's a lot of groups, like a lot of people who wanted to get acquired, got acquired. So then what do you do? If you're growing, if you have a private equity directive to grow 30%, whatever, 50% this year and you can't reach that with your acquisition, you got to switch to de novo. So we're seeing that happen in different industries. I'm curious do you have any experience one way or the other in an audiology?

Speaker 1: 32:23

Yeah, I think for us there it comes in waves and, just like you said, right, the season changes, we will have our vendors. There's six main vendors in the world that may curate right? Only six. So think of you only had six companies that made cars, right? So those six vendors, they want to protect their market share and they'll get aggressive and one of them will come in and buy up 30 clinics from on the West Coast and then their competition will come in and try to buy another 20. And then those vendors will realize, hey, we're not as profitable, so now we're going to sell them to people that do more business with us to make them profitable.

Speaker 1: 33:01

We go through waves like that. I also see a shift in the industry where a lot of people are retiring or getting out of that private practice because it's perfect timing with the insurance changes, and so they're getting out, and so we're going to have to wait for the younger generation to jump back in and say this is wait, we've got this as an opportunity for us, and so it comes in waves.

Speaker 2: 33:27

Yeah, that's cool. Yeah, it makes sense. Look, as we're getting closer to our time here, is there anything that we didn't get a chance to talk about that you'd like to talk about?

Speaker 1: 33:33

No, this has been fascinating. I love talking about the business and the strategies, but also the nitty gritty, and thought you asked some great questions, so thank you. Yeah, my pleasure All right, listen.

Speaker 2: 33:45

Thanks very much for coming on the show and obviously we're in our connector groups together, so hopefully we'll be seeing you in person here soon. But your time and then, if anybody wants to reach out, get more information. What's a good resource for them to find out more about what you guys are doing?

Speaker 1: 33:58

Yeah, so you can go to americanhearingus, you can go to enjoyhearingcom, which is i-n-j-o-y hearingcom. And then my Instagram is Dr Parks, Dr Jamie Parks. It's d-r period j-a-i-m-e-p-a-r-k-s.

Speaker 2: 34:18

Great, I'll write that in the show notes and thanks very much.

Speaker 1: 34:21

Awesome. Thanks, austin, I appreciate it.

Speaker 3: 34:24

If you need help finding the perfect location for your practice or you're ready to invest in commercial real estate, email us podcast at leadersreecom reasinrealestatecom, or go to leadersreecom and fill out our form. See you next time.