Running A 31-Location Hearing Clinic Without Losing The Human Touch

A hearing clinic can buy the same equipment as everyone else, but it cannot copy trust. That is the thread running through our conversation with Dr. Zack Miller, a private practice owner who now leads Midwest Hearing Aids across 31 locations in Kansas, many of them in small towns where your reputation travels faster than your advertising. 

We talk about the real work behind practice ownership: building a team you can count on, staying “coachable,” and keeping a culture where you still learn from patients and staff. Zack shares what he believes cannot be commoditized in audiology and hearing healthcare, even with over-the-counter hearing aids and price pressure in the market: patient service, time, and relationships. We also get practical about what happens when someone tests and walks out, how follow-up works without a high-pressure sales feel, and why inviting a spouse or family member into the appointment often changes everything. 

On the technology side, we dig into modern hearing aids and fitting strategy, including Omega AI, Edge Mode+, DNN 360, and why many patients succeed with a simpler approach that starts with hearing better before getting lost in app features. We also address AI fatigue and privacy concerns, then explain how data logging helps clinicians personalize care by checking wear time and real-world listening environments. 

If you care about better hearing outcomes, better counseling, and building a practice that lasts, you will get a lot from this one. Subscribe, share this episode with a colleague, and leave a review so more people can find better hearing care.

Transcript

Welcome And Better Hearing Month

Dr. Dave Fabry 0:04

Welcome to Starky Soundbites. I'm your host, Dave Fabry. Now, before we dive in, please hit like on this episode and subscribe if you've listened to past episodes. That can help us spread our message of better hearing and helping people and professionals connect better and raise awareness for the importance of hearing as a health condition. So May is better hearing month, and uh we wanted to take the opportunity to shine a light on the hearing care professional and uh people who are helping those with hearing loss each and every day. And so joining me today is somebody that I've known for a long time, actually, but it's been a minute since you've been on the Starkey campus, uh Dr. Zach Miller. Uh welcome to the podcast today. Um Zach is a private practice owner who um purchased Midwest Hearing uh a bit ago.

Dr. Zack Miller 0:56

Um yeah, it was uh beginning of 25. 25.

Dr. Dave Fabry 0:59

So it's been a been a bit about a year or so.

Dr. Zack Miller 1:02

Yeah, just starting my second year.

Dr. Dave Fabry 1:04

And uh so practic you have multiple practices, uh multiple locations rather, right throughout Kansas.

Dr. Zack Miller 1:09

Just in Kansas? Just Kansas, uh 31. 31. Yeah, that's a that's a couple. And so uh it's a little it's um they're spread out throughout the state. And um most people, you know, most the employees are have been there for 20 plus years, so um they're pretty self-sufficient. So um I got a great team, so that's that's what uh I've just been almost like a family business for a while. Um, but even though we're not related, we still consider ourselves, you know, a small family. So yeah, yeah.

Dr. Dave Fabry 1:40

And I I can even though Starkey has over 5,000 employees globally, uh, we're kind of a family-run business too, right? You know, privately held, not publicly traded. So our loyalties are the hearing care professional and ultimately to the patient, but also it feels like a family. So yeah, some of us had a an extended family more than others, but but 31 locations is impressive. And uh I really do want to do a little bit of a deeper dive into issues facing uh business owners, practice owners, and and everyone from someone who's got one location to thinking aspirationally, those who are thinking big uh of one day having 31 practices. But uh before we begin, we're gonna we're gonna uh take a deep dive today into private practice and practice owners and business owners. And uh, you know, it's a it's a challenging time to be a business owner today. But uh, you know, before we dive into that, uh talk a little bit about what drew you to audiology.

Zach Miller’s Path Into Audiology

Dr. Dave Fabry 2:38

I love hearing origin stories as to what was the catalyst that caused somebody to uh uh uh choose this as an occupation.

Dr. Zack Miller 2:47

So I it wasn't a plan of mine initially. Um I grew up in southeast Kansas. Um my parents are have been and still are uh hearing aid dispensers, hearing insurance specialists, and they've been doing it for 35 and 40 years. Uh out of high school, um, I went to Pittsburgh State University. I was my plan was to go in pre-med. Um I took my second chemistry class and I was like, this isn't for me. And then I Terry Brewster, the owner of Midwest Hearing AIDS at the time, he was wanting a doctor of audiology on his staff. Um and so I transferred then to Wichita State because they had a they just I was the second class, I think, in their AUD program. So um, and then it just went from there. Uh 2009, I graduated um uh with the AUD and uh started with Midwest Hearing Aids after that, been here ever since. I I've never gone to work like ever hating my job. Like I love going to work every day and love what I do.

Dr. Dave Fabry 3:56

So think about how rare that is. I mean, it took me until I was probably 40 years old before I realized that most people uh go to work thinking about the weekend, to quote the old uh what, lover boy or whatever. Yeah, uh, you know, and and everyone's working for the weekend. But uh but I I have this and I'm a lot older than you, but but I wake up every day, you know, some days sure you're tired or whatever. I mean but but every day I'm I'm kind of excited to get into the office or wherever my office is that day. And and that's rare.

Dr. Zack Miller 4:30

So you know, I know it's uh I tell my wife that all the time, yeah. It's like um I I love going to work. I mean I you never you're gonna see different people every day. And then you know, that's one of the things when I purchased it, I w still wanted to be able I didn't want to sit at the desk and do all of the business owner things. I wanted to still see people work with people. That's where my passion is. Um love to help people, not just hearing, you know, with charity, you know, things. We have a charity, a small charity that we uh run in Kansas. Um uh and we just I just enjoy that. If you yeah, I mean if you don't like or love to help people um and you're into the in this industry, you probably shouldn't be. Exactly.

Dr. Dave Fabry 5:15

I mean, I think that is the central component that drives all of us, whether you're working on our end, where you know, we we we uh you know the the needs of that patient are central to when we're developing technology. And I believe, like you do, that being a player coach is essential. It's the thing that keeps my saw sharp, uh, is that in addition to participating on the RD team and helping to offer input into the next generation of technology, I still see patience because it's really easy to become intoxicated by the the technology that surrounds us. But it's there's nothing that levels the playing field better than sitting across from a patient and getting their uh opinions uh and and hearing their responses to how that technology is working to have an impact on their life.

Dr. Zack Miller 6:02

Yeah, and you know, it's you you never stop learning. Like you know, it's like when you're seeing a patient like for a follow-up, or mainly that's where you really dive into some issues they may be having. And I was like, just explain it in your own words. Like maybe I'll learn something too. Yeah, you know, for the next person that may come in and have similar struggles that you're having, you know, if you're having any. Um the hearing aids are much easier to fit now than they used to be because it's just easier to adapt, uh, especially even from the Starkey's Livio product to the Omega, it's night and day. Night and day, night and day.

Dr. Dave Fabry 6:37

And it's really just you know, eight years difference and uh a world of difference. And really never seen anything like it.

Dr. Zack Miller 6:44

Yeah, like thank you. I mean, yeah, it's it's it's fantastic. And um, I don't just say that. No.

Dr. Dave Fabry 6:50

I know you I know you're a straight shooter, and I you know, you brought up Terry Brewster and uh somebody that I knew very well, and I still think of him from time to time. Every time I see a course light, yeah, I think of Terry Brewster. And I and we had a couple of those last night for him and just and just a remarkable mentor, uh I think uh to have worked directly for him. I mean he was a mentor to me, yeah, just informally, as I think he was for a lot of people as a business employees.

Dr. Zack Miller 7:17

I met Terry. Well, Terry hired my dad in 1989, yeah. And uh because he played he played slow pitched softball with Terry. And uh I was the five-year-old that had to go fill up everybody's beers, you know. Um so uh it started from there and then Well, look where you are now.

Dr. Dave Fabry 7:34

So let's for for our listeners who are predominantly audiologists and uh and hearing it's been specialists, um let's talk a little bit about your journey then, you know, from somebody that started out working in the practice and now you're you're the boss. And um,

What Ownership Really Requires

Dr. Dave Fabry 7:49

you know, what what's harder than than you expected about owning a practice and what's easier?

Dr. Zack Miller 7:58

You know, I I have such a I have such a good team uh and you know it is surrounding yourself with good people um that you can trust. Uh that's that's really what makes gonna make you a uh a successful business owner, I think, so far. Um I I got a lot I got a lot to learn. Um but I'm always I'm I'm coachable.

Dr. Dave Fabry 8:26

So you're listening to your team in addition. You're not just telling, you're listening. No, yes.

Dr. Zack Miller 8:31

Uh uh I don't I'm not a teller. Um I give my opinion, but you know, when we come up for things like this, like at Starkey, um everybody can learn from everybody else. Yeah. You know, we I think we have over 430 years total experience on our staff. Um so uh it there's not you can always find out different things like different tips on you know certain fitting issues, you know, things like that. And everybody puts their heads together, and that's when we get that's when we we make strides and and move forward. People get better at fittings, they get better uh communicating with patients in different ways. So you you're always learning. If you're not always learning, then something wrong. Yeah, yeah, you're not listening.

Dr. Dave Fabry 9:13

You know, you can hear. I would say with patients, I can help you hear, but I can't have you listen. And uh, you know, I I like it so much I have a tattooed two ears, one mouth. Uh yeah, you know, because I don't learn anything when I'm talking. Right. I I learn a lot more by listening. And sometimes the newest members of your team can't, you know, they say out of the mouth of babes uh in many cases, but sometimes the new members, you know. A friend of mine, Mike Maddock, uh, talks about you can't read the label when you're inside the jar. And anytime you've been with the practice for more than a year, you're inside the jar and you don't see with that same beginner's eyes. And so I I lean into newcomers to Starkey or or newcomers uh and partners, people like yourself that are partnering with us because they give us sometimes the most valuable insights because uh they're they're outside the jar.

Dr. Zack Miller 10:01

Yeah, outside looking in.

Dr. Dave Fabry 10:03

So what's easier about this? Relying on the team, is that what you'd say?

Dr. Zack Miller 10:08

Um I don't know what would be easy about it. Um they make it easier, yeah, yeah, for sure. And uh, you know, I had a cr after uh Terry Brewster passed away, uh Chris Spencer bought the bought the practice. Um I learned and and I owe a big thanks to him. Um he's really what made this happen and made it possible. Uh he wanted to keep the Midwest Hearing Aids culture. Um he knew if somebody else bought it or he was bought out by you know a bigger entity. Um it just the employees would be in trouble. Right. Uh they wouldn't, it's just you Kansas is a different animal. Yeah. Um you get you patient our patient relationships are what makes it make us successful. You know, we have very close relationships with our with our patients. Like last year my dad was even a a pall bear at one of our patients' funerals. That was just that was pretty cool. Yeah um just that they trust they trust you. Boy, I mean yeah, it's uh existing patients are our biggest our biggest business, you know.

Dr. Dave Fabry 11:17

Well, and

Service That Cannot Be Commoditized

Dr. Dave Fabry 11:18

to that then let's follow up on that just a bit and say, you know, what's one thing that you think that Midwest Hearing stands for and that you endorse that cannot be commoditized? We all worry about what we're doing being commoditized. There's threats from everywhere, from over-the-counter hearing age, sure, you know, low-cost uh competitor or something like that, someone who's got a different focus. But what's one thing that you s would say characterizes Midwest hearing and and something that cannot be commoditized? Patient service.

Dr. Zack Miller 11:48

Yeah. That's that's it. Um, you know, you don't survive unless especially most of our locations are in small towns, you know, we're talking eight, nine thousand people, something like that. Um you're not gonna last right if you don't treat people the right way.

Dr. Dave Fabry 12:06

Well, and and to that end, then if if a patient comes in and tested, not sold, yeah, um, you know, and walks out uh because they're let's say they're they're kicking tires, you know, they're price shopping. Yeah. And um what do you do? Does that happen ever? I mean, in some of these smaller towns, you guys probably are the the dominant name, so that you have that that authority, but but in those areas where you do get tire kickers, yeah, uh w and and they walk out, what do you do to win them back? Do you wait for them or do you do you follow up with them? Oh, I'll follow up with them.

Dr. Zack Miller 12:39

Usually I'll follow up, uh I'll give them a week or so. Um some depending on the read I get on them when they're in there. But following up and just just treating I mean you can get a read on a on a patient um and just know if they're gonna be if they're gonna be back or um or they're not ready.

Dr. Dave Fabry 12:59

Or they're not ready. Maybe they're maybe they're using price as that first objection, but they're really not ready. And you kind of learn.

Dr. Zack Miller 13:07

Yeah, and I and I'll just tell them that. I'm like, I'm not gonna try to talk you in to a trial. Like um, I will explain how what you will be missing in the future, possibly, you know, and what it can lead to, untreated hearing loss, you know.

Dr. Dave Fabry 13:22

Well, I think it really is understanding and and really leaning in, listening and observing that patient. Is it really about price? Right is it because they're not ready? And I think sometimes you build trust by allowing the instead of focusing, so many people focus in a practice on tested, not sold, and they try to reduce that number as much as possible. But I think in some cases you do better if you really recognize from your experience, yeah, and you have, like you said, trusted staff that that um recognize when a patient truly isn't ready, and you tell them that you know, come back when you're ready.

Dr. Zack Miller 14:01

Yeah.

Dr. Dave Fabry 14:01

Right. That that may be the best recruiting tool for bringing them back.

Dr. Zack Miller 14:05

I totally agree with that. I mean, and they appreciate that too, because they don't want to be pushed.

Dr. Dave Fabry 14:10

Well, and a lot of like you said, a lot of these towns are are smaller, people talk to each other, yeah. And and they don't want a high pressure sale. I mean, uh, in the sense, but you're always by by being honest with them and just uh calling them out on saying, just come back and see me when you're ready. Right. You're you're you're showing to them that you care about where they are in their journey.

Dr. Zack Miller 14:30

Right. And you know, the the saying around there a lot of times that may be everywhere, is like um uh, you know, if they if they have a good thing, they won't they'll tell one person if if they have a bad experience and tell everybody.

Dr. Dave Fabry 14:45

And I would say I would add a corollary to that because you mentioned, and thank you for your partnership, but you mentioned the difference between Livio to now Omega AI um and the way that technology has been improving. That the the the issue is today um the technology is uh is uh capable of uh accomplishing remarkable things, but it still is ultimately that caring. Uh it it's it still doesn't fit itself. Right. And you know, and I think the the caring uh that of the professional to understand and recognize what is the for particularly for first-time users, right? Exactly. What are their concerns? What what are they uh so many times just uh shutting up and listening to especially if they have uh a family member come with

Why Family Should Join Visits

Dr. Dave Fabry 15:32

them. Is that a standard of care in your typically do you advise if they have a family member to come along with them? Absolutely.

Dr. Zack Miller 15:38

We're what's the advantage of that? Well, uh so many times patients will come in and they don't think they have a hearing loss, you know. They're in there, if they come by themselves, they're forced in by their spouse, but then the spouse or third party doesn't come in. And so they basically, I mean, how many times have you tested it and they'd be like, okay, I'll just go show this to my wife? Like they're not they're not saying anything. Right. Regardless. Never, yeah, yeah. They're just gonna be like, eh, I I'm fine. He said I was fine. Yeah.

Dr. Dave Fabry 16:07

Or there's nothing I could do right now, or nothing that needed to be done right now. And and but when you have that family member there, number one, you can observe where are they? You know, is it is it the is it the family member that's bringing them in, got them by the ear literally almost figuratively, or maybe even literally bringing them in. Uh uh or or or where are they? And and I think so much can be gleaned by having a family member or a colleague or close friend come in with them to talk a little bit about their experience, and then just watching those two interact really helps a lot. I mean, and then also doesn't give them that out to say, well, I gotta talk to my husband or I gotta talk to my wife.

Dr. Zack Miller 16:43

Right. And you know sometimes, you know, it especially if the the patient themselves uh isn't saying much, but the the spouse is, um you almost sometimes you almost end up and I try not to, but you almost end up focusing on the on the spouse, but you know, you you gotta it's both though. I always tell uh patients that the hearing aids aren't just for you. Yeah. They're for the people that you communicate with the most and care about the most and talk to every day.

Where Midwest Refuses Shortcuts

Dr. Dave Fabry 17:12

So well, so okay, so you talk about the fact that from a standpoint of best practice, and best practice is a popular topic among private practitioners that everyone's dealing with sort of combining best practice with the need for innovation and looking at things a a little differently. So what's you you talk about, you know, advising, recommending that if they bring in a significant other uh to that initial consultation, that's that's a part of encourage practice. Yeah. When you get down to the nuts and bolts of testing that you're doing and things like that, what's um what do you where do you refuse to cut corners clinically, even if it takes more time or you know costs in terms of revenue? Is there anything that that that is you won't it's such a central part of your culture or your core that you won't cut corners because you find that although it may impact and takes a little longer, or it may even have a revenue hit, that you find that it it's part of that culture that's built into Midwest hearing.

Dr. Zack Miller 18:14

You know, it's um you spend time, take your time. Yeah, you know, they're not just a number. Yeah, you know, they're they're your patients. They're they're ending up treat them like your family members, like you would your family. And that's that's where you don't cut corners. Yeah, like you you focus on the patient and give them your time. Don't try to theoretically run them through like cattle. Um, you know, get to know them. You know, that's you're gonna have the most success that way, they're gonna feel comfortable saying what they need to say, how they need to say it. And you just establish that rapport with them, and then that's that's what leads to success, and and that's what leads to confidence, you know. Um being confident uh about what you're doing and what you're dispensing um is 95% of it, you know. It's uh I don't know where I got that number, but you know, it's you know what I'm saying. Yeah, I uh but it's uh and e anymore, especially you know, with Starkey and the Omega AI, um it's it makes our job so much easier. It's a smoother sounding hearing aid. Um it's not as harsh for the you know, with those steep sloping losses. Um it's easier to get used to. It's a quiet hearing aid. We hear that all the time, especially from existing patients. Like, this thing's quiet. You need to turn it up. I'm like, let's give it a spare see how the clarity is, yeah, you know. Um and they and they love it.

Dr. Dave Fabry 19:48

Is there

Omega AI Results In Real Life

Dr. Dave Fabry 19:49

a favorite feature of Omega AI that you find? Uh either something that the that it's built in, like a feature like you know, the DNN 360 or something within the app that the patient is using that you find is is uh really resonates with patients? Um or clinicians?

Dr. Zack Miller 20:08

Yeah. Um the edge mode plus and and in noisy environments, especially. Um, that's where I noticed it, like restaurants. Um, you go to edge mode and you have three three choices there. Yeah um, but that's the the 24 technology is I've talked with some other uh not colleagues but other dispensers in Kansas and some of them, you know, they're not doing the 20s 24 technology very much. And I talked to them a couple weeks ago. I was like, you're missing the boat. Yeah, like uh there's a big difference between that 16 technology and the 24, especially with the spatial awareness and the DNN 360.

Dr. Dave Fabry 20:46

DN360, you know, where patients that I'm working with will say they hear more, but they are hearing more clearly. Right. Even though they're they're hearing more of that spatial all around, that gives them that confidence, that localization, and that awareness of sound, not only that the sound is present, but where it's located. Right. Um, that's very different than anything they've worn previously.

Dr. Zack Miller 21:09

Yeah. Um, it's just a it's a clearer sound. I've I was talking with the team earlier in the earlier session this morning uh with Aaron. Um, and you know, even patients that have struggled in the past that that haven't, you know, this the Omega was the second hearing aid they tried for this certain patient, and their recruitment is really bad. Yeah, and they were they they started with Olivio, and then I I she kept it, and I you know, I don't know how many follow ups I did with her. I was like probably close to 30. And um, she just could not wear it. And then she came in and and tried the Omega, um, and she was able to tolerate it, although she was on her crowd setting with edge mode reduced noise the whole time.

Dr. Dave Fabry 22:00

So really and I think that that's let me let me put a pin in that. I want to I want to come back to that because well, no, let's address that first. Like one thing that I'm finding, and I'm curious whether you're you're finding this, is that using the personal all-around program for those unfamiliar with our technology, that's the all-around uh uh setting that people in wear the majority of the time. But then often people will program manual programs that they can use situationally. Yes. But what I've found lately with, and again, I I'm a big believer in the 24 technology, not just because it's higher technology tier, because you know that that top tier, it's better. And and that ability to have those patients have not only the DNN 360, but then to have the uh three different levels of edge mode to be able to enhance clarity or improve comfort. Right. Um I'm migrating away from manual programs to using personal plus edge mode for those patients who can handle it. And I'm astonished at how many patients that you might think, oh, this 80-year-old, you know, they're not going to use the app. Well, you can do it just on the hearing aids. But yeah, but many now, uh many more than what we thought previously. Maybe as my birthdays get more and more numbered, uh I I I take this a little defensively, but the 80-year-olds can handle using the app with uh personal plus edge mode, and even those that can handle using the different edge mode of the three settings uh in lieu of using manual programs. Are you seeing that at all?

Dr. Zack Miller 23:34

Yeah, um I we talked about that this morning too. Okay, uh, I actually brought that up. I was like, I've had more patients that I've programmed, just left it on personal. That's all I gave them. A lot of times they don't even use edge mode. Yeah. Uh it's just personal. It's just personal and they just they just let it go. Yeah. Um, but that don't like when somebody comes in and they're like, uh, I don't want to mess with the phone. Yeah. I was like, I don't want to hook that up to my hearing aids. I was like, well, let's just try it. Yeah. Um actually a lot of times I don't even bring it up at the first one, at the first at the initial fitting. I I mean I tell them about it and the feature is there. But I said, let's let's concentrate on hearing better first. Yeah. Some people get so wrapped up in the app that they forget why they got the hearing hearing aids in the first place. Right. But so then you just start simple. I mean, those people that oh, I'm never gonna use my phone, I don't look at it. They come in, you know, six months later and they're out in the waiting room watching YouTube on the city.

Dr. Dave Fabry 24:37

I know, I see it all the time. I love that. That just that warms my heart.

Dr. Zack Miller 24:41

You know, yeah, yeah, that's it's cool though. I mean, because then then it that's a game changer. Yeah. Oh, yeah.

Dr. Dave Fabry 24:47

Once you open it up to streaming and then they realize what what the world opens to them for, not only for phone calls, but YouTube videos and audiobooks and everything else, and they're hearing it uh you know, programmed for their boss.

Dr. Zack Miller 25:00

And I wasn't, I'm not trying to downplay the phone, it's a it's essential in my opinion. Um but uh they they don't know what they're missing when they're baby steps. You start with baby steps, like you said.

Dr. Dave Fabry 25:10

Meet them where they are and then take them where you know they can go. And you just gave me, you know, I'll have to talk to Karen Speth and our marketing colleagues, because I think Omega AI, it's personal. Uh it'd be a good tagline, you know, because you just said it eloquently. We're taking it personal. Yeah.

unknown 25:25

Yeah.

Dr. Dave Fabry 25:25

I mean, we say you don't hear with your ears, you hear with your brain. Right. And you know, we're we're often still fitting the peripheral loss, but uh that's one of the things that Uchin Bomeck, our CTO, has been very clear on is you know, we're really thinking about uh binaural fittings. I mean, our technology has been optimized for the input coming from both ears, and in particular that DNN 360, it can be fit for one-sided losses, um, but but it's optimized to think about not only the peripheral loss, but what goes on when you get to those higher pathways. And those are really the challenging patients. And I guarantee you that when going back to the original comment about when someone's happy, they tell their family, when they're unhappy, they tell the town. Yeah, I would say that the the the newer technology, when you have a patient who's delighted with your service and our our technology, they'll tell a lot more people. Right. And uh when you convert those, you know, you stay on top of always trying to I I've got a couple patients that I work with there, the ones that are the really tough ones to bring around, yeah. Um, if you convert them, they become your biggest advocates. Oh, yeah. So you talked about the difference from Livio AI to to Omega AI and the the remarkable improvements in the technology in your hands then to best meet the needs of the patient. Right.

AI Fear Data Logging Wear Time

Dr. Dave Fabry 26:46

Do you see in Kansas in these 31 practices, is there AI fatigue that we're all um uh overwhelmed a little bit by AI? My toothbrush has AI in it. And uh uh, you know, it is how do you how do you separate the technology from what your role in in marrying that technology to meet the need of the patient?

Dr. Zack Miller 27:10

And you know, sometimes you'll have those paranoid agents about AI and they're scared of it. Um so they don't know there's AI in it sometimes, you know?

Dr. Dave Fabry 27:22

Yeah, and I don't think they need to.

Dr. Zack Miller 27:24

They don't care necessarily. Yeah, they don't it's it's it's a different than uh a hearing aid AI is different than you know a perplexity or a chat GPT. Yeah. It's uh it's not they're not the same, obviously. So um, but it you know it just it freaks some of them out. And uh that the change scares them. And um so we just just stay calm with it, don't worry about it. It's not it's not tracking your every move. It you know, it's just like when you when you uh pull up data log and a follow-up, they're like, wait, you're you're tracking, you you see where I go? Yeah, it's a live 360 hearing. Yeah, no, it's DN 360.

Dr. Dave Fabry 28:03

Yes, but but we're not tracking what you're saying where you're going, we're following you. Yeah, and as a medical product, we you know we we don't do that, but yeah, the data logging is just helping you. Uh do you use data logging uh in follow-up appointments to sort of drive and personalize what what what features are you looking at within the data logging that is mo that are most essential, if you will? Um number one, wear time. Yeah, you know, uh and what's a where what's what are you seeing now for average wear time in your patients?

Dr. Zack Miller 28:36

Probably anywhere from eight to twelve hours. Yeah. Um I think it's been creeping up. It has, it it has. Um, I mean, they're just easier to wear.

Dr. Dave Fabry 28:45

Yeah, you know, they're not as like you said, they're quiet, yeah.

Dr. Zack Miller 28:47

They're not as harsh, like the high, the high frequencies aren't they, you don't have people saying, Oh, it's way so it's way too tinny. I'm hearing that less and less now. Um but they're still getting the clarity without that. I mean, you're gonna have those, you know, normal hearing, then at th at 3K they drop down to 70. Yeah, and those are hard patients to fit, especially in the past. Um, but they're easier to fit now. Yeah, uh, they can they can adjust and adapt to it a little quicker and um they have they have better luck with it.

Dr. Dave Fabry 29:16

Yeah, so do you scroll down to what I would call page two? Uh like in the old Google searches, you know, page two of the data logging, which is down in the lower left-hand corner where it shows the environments, the percentage of time that they're in the different environments. All the time. How does that shape conversations that you have with patients?

Dr. Zack Miller 29:33

I mean, is it depends on what they come in and the issues they may have. Um I've been having trouble at work, you know, or with understanding clarity uh or understanding speech and noise. And you look down there and like, well, they've been in they've been in speech and noise 30% of the time, quiet never, you know, and then you'll have some people that'll come in there and quiet 80% of the time. And and you want to see like, hey, how many times is it switching to directional? Yeah, you know, and you can see the percentages there. It just helps helps me as a clinician figure out what's helping them and where they're what features they're using or not, too, and what we what we could do to to improve upon it. Yeah so excellent.

Repairing Trust After Bad Fits

Dr. Dave Fabry 30:20

So coming down to just a couple rapid fire questions, and then we ran out of time, and this this has been a great discussion, yeah, and it flew by.

Dr. Zack Miller 30:27

It did, I enjoy it.

Dr. Dave Fabry 30:28

Yeah, one thing you'd fix in our profession overnight if you could, you just had a magic wand. What's one thing you would you would fix about uh the the discipline or the practice of for an audiologist or dispenser?

Dr. Zack Miller 30:41

But the thing I would like to fix, um I the when you have when I have some people that uh patients that come in, um they've tried hearing aids before, they won't get what they need uh because of the previous experience they had and it put a sour taste in their mouth. Um so have having more audio audiologists and hearing instrument specialists that care. Yeah. Um I you know, it there's a big difference like if when you don't relate, not to beat a dead horse here, but when you don't relate to the patient, um, and then it it it's a detriment to that patient the rest of their life because they won't I mean sometimes they'll come around, but if not, you know, they they'll end up just settling for a lesser technology than what they really need because of the programming issues that were done previously.

Dr. Dave Fabry 31:37

Um I think that's such an important point. I mean, because we you know, we we talk about meeting the patient where they are, but words matter. And when a patient and a patient can lock into just a part of what you think you're trying to convey to them about they're not ready for amplification or their hearing loss isn't severe a lot, but a lot of times you're undoing a a past negative experience because people say, Oh, well, hearing aids won't help your hearing loss, and they hear, well, hearing aids will never help your hearing loss.

Dr. Zack Miller 32:03

Yeah.

Dr. Dave Fabry 32:03

Or, or, you know, some other statement that we kind of throw off that the patient focuses on, especially if they're sort of ambivalent as a new user about whether they don't like that they have a hearing loss, they're not wild about thinking about hearing aids. And if now someone has said, okay, well, hearing aids aren't going to help you, they'll hear that and stick with it. And it and and yeah, that would be one thing is not just to throw off some of those quick statements if you've come to the end with a patient that you haven't figured out the solution to their problem.

Dr. Zack Miller 32:34

I've seen that a lot. Like there's I had a patient who's been my patient for 10 years, but when he first came in um where he got his previous hearing aid, uh um said you don't need one for the uh the the other side. Oh yeah. Um I mean his his uh you know word wreck was was poor, but you know, he still had usable hearing in that ear. You know? Um and when he when he got that second one, when he got the set from me, I was like, just try it. If you don't think it's gonna work, then you know we'll figure that out. And he loved it. And he's he's hasn't left ever since, and he's on his second set now. Fantastic. And uh, you know, he he loves it. He comes in, he's one of my he now he's one of my buddies, and uh we just come in and there's a lot of BSing that goes on sometimes with some of these people. They're it's not BS.

Dr. Dave Fabry 33:27

Yeah, it's I mean just the relationship building.

Dr. Zack Miller 33:29

Yeah, it's I mean talking BS, you know. Yeah, just you know, come in and sometimes that's that's all they have to do.

Dr. Dave Fabry 33:36

Some certain people have to do, so they they just want to go in and have a good laugh and have fun and bring for someone in these patients, maybe the best uh socialization of that week. Yeah, you know, they come in. Oh, yeah. There have been times where I'm like, well, is there anything we need to do? No, hearing it's working great. Yeah. Uh and I'm thinking, why are you here? But but they're here because they enjoy visiting with you.

Dr. Zack Miller 33:55

I mean, and if I have the chance to have fun while we also help them hear better, sign me up. I'm all in there.

Dr. Dave Fabry 34:04

Yeah.

Dr. Zack Miller 34:05

Yeah.

The One Divider For Future Practices

Dr. Dave Fabry 34:06

So last question then. Five years from now, what will separate thriving practices from those that are struggling? You know, you're a year into the ownership, but you've been a lot longer, you're steeped in this business. But five years from now, what would you say is going to be one defining thing that will separate the haves from the have nots?

Dr. Zack Miller 34:27

Man, it's just uh it I hate to go back to it, but it's patient care. Yeah. Like um the people that will treat them treat their patients right and try to relate to them and listen, like you've been saying. Um those are that's what's gonna separate people. That's what'll separate Midwest hearing aids from everybody else, too. I mean, one of the one of the slogans we use is you know, Midwest hearing aids, there is a difference. There is a difference, you know. Um there's a difference in in uh coming to us as opposed to, you know, possibly some big box stores or other practices. Um and you but you gotta make that difference. Right. Um and you make that difference by relating with the patient and serving them how you would want to be served yourself.

Dr. Dave Fabry 35:15

Yeah, so it so well said, and and with Starkey, we believe very strongly in the prescriptive model of care because we believe uh at our core that our technology in the professionals' hands delivers optimal results.

Dr. Zack Miller 35:30

And you know, uh just to uh um I think coming to the I went to the CEO summit um and I've never seen the culture of Starkey be any better. Like it's wow, thank you. It's uh statement. I mean, I've I've been around for um 16 years or so, but um you have it's a different feel now when you go to the business summit and and you know things like that. And uh I don't uh I don't beat around the bush.

Dr. Dave Fabry 36:05

I really don't know because it's the strongest compliment you can give. I think it's because we now have uh absolutely leading technology, uh, but we have a great team, uh both our team at Starkey, but also our providers.

Dr. Zack Miller 36:23

And that shows and that rubs off too when you come when you come to these uh like the business summits and CEO circles and things like that. Um it's contagious.

Dr. Dave Fabry 36:33

Can't say it any better myself. So, Zach, thank you very much for this conversation. It was really great. Thanks for having me at all. Um tune in for the next episode and uh hope you enjoyed this as much as I did. Thanks so much and keep listening.