Hearing Matters Podcast

Policy in Action: How Bridget Dobyan is Advancing Hearing Healthcare

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Bridget Dobyan, Executive Director of the Hearing Industries Association (HIA), joins us to share her remarkable journey from childhood hearing loss to becoming a powerful advocate for hearing health policy. Diagnosed with cholesteatoma at age 8, she experienced sudden hearing loss at 11 when the condition severely damaged the bones in her middle ear. But rather than letting this define her limitations, Bridget used it as a foundation for understanding the issues she'd later address as a leader in hearing healthcare policy.

We explore the fascinating differences between traditional hearing aids, cochlear implants, and bone-anchored devices, while dispelling outdated perceptions about hearing technology. Today's hearing devices are sleek, sophisticated, and Bluetooth-enabled—a far cry from the "beige bananas" many still picture. Yet despite technological advances, hearing health remains severely undertreated, with millions of Americans neglecting annual hearing evaluations.

The conversation shifts to HIA's groundbreaking "Hear Well" campaign, which has generated over $23 million in earned media through positive, stigma-busting messaging. For Better Hearing Month this May, they're launching "Happy Dance 2.0," offering hearing professionals free, downloadable assets to spark vital conversations about hearing health.

Whether you're a hearing care professional looking for practice resources, someone experiencing hearing difficulties, or simply interested in protecting your hearing health, this episode offers valuable insights into how addressing hearing loss connects directly to overall wellbeing, professional success, and quality of life. Visit hearing.org today to access free campaign resources and join the movement to make hearing health a priority.

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Blaise Delfino:

Thank you to our partners. Sycle: built for the entire hearing care practice. Redux: the best dryer, hands down. CaptionC all by Sorenson: Life is Calling: CareCredit: Here today to help more people hear tomorrow. Fader Plugs: the world's first custom adjustable earplug. Welcome back to another episode of the Hearing Matters Podcast. I'm founder and host, Blaise Delfino, and, as a friendly reminder, this podcast is separate from my work at Starkey. You're tuned into the Hearing Matters Podcast, the show that discusses hearing technology, best practices and a global epidemic hearing loss. I'm your host, Blaise Delfino, and joining us today is Bridget Dobyan.

Blaise Delfino:

Bridget is the Executive Director of the Hearing Industries Association, where she leads the organization's strategic initiatives and advocacy efforts. Prior to this role, she served as HIA's Director of Public Policy. Bridget has a diverse background in nonprofit leadership, federal and state government affairs and legislative policy. She previously worked on Capitol Hill as Legislative Director for US Representative Dave Trott of Michigan, advised the Michigan Senate on policy matters and managed government affairs for a Washington DC-based energy efficiency advocacy organization. She holds a JD from Michigan State University College of Law and a BA in Poli Sci from Saginaw Valley State University. She is a member of both the State Bar of Michigan and the DC Bar.

Blaise Delfino:

Now a little bit about the Hearing Industries Association. Hia was formed in 1955 and serves as a forum for hearing aid manufacturers, suppliers, distributors and hearing health professionals. Their members are responsible for the majority of the over 5 million hearing aids that are purchased in the United States on an annual basis. Today, hia remains the only association in America to represent hearing aid technology. Bridget, welcome to the Hearing Matters podcast. We are so thrilled and excited to have you on the show.

Bridget Dobyan:

Blaise, thank you so much. Happy to be here. That was quite an intro. You make me sound so impressive.

Blaise Delfino:

Well, it is an impressive background, Bridget, and I couldn't help but think reading that bio. Thank you so much for all you've done and continue to do for our industry, because we honestly couldn't think of anyone better to take this charge and lead the way. So, truly thank you. And as a hearing care professional, I can absolutely vouch for how helpful HIA has been. And we'll get into a little bit of the history, Bridget, of HIA, but you have quite the story as well. Bring us back to the beginning of your hearing loss journey. You know when you were first diagnosed and what do you remember most about that experience?

Bridget Dobyan:

It dates back quite a ways. You know, I as a kid I had constant ear infections, constant ear problems. I was always in seeing my pediatrician for it, you know, having the regular hearing tests just through him, until he realized that there was something that was a little more, a little deeper, that was going on. So when I was probably about eight years old, I was referred to an ENT and I always get a kind of a kick out of this. My first ENT, dr Loudon, and I always get a kind of a kick out of this.

Bridget Dobyan:

My first ENT, dr Loudon, which I always thought that having loud in the name of an ENT it was kismet. It was meant to be that he would become an ENT. So with the guidance of Dr Loudon and the treatment of Dr Loudon, that's when we discovered that I actually had claustrotoma, you know so growths in the ear, and it was remarkably invasive in my case. We knew that by the time they figured out that was going on, that I would likely lose the hearing in my left ear. So at that point I'm probably nine years old, 10 years old as I'm going through this, you know, figuring out what closteotoma is, which an eight or nine year old, doesn't really know what that is, talking with my doctor and I knew that the hearing loss would come. And sure enough, when I was 11, one day it just cut out. I was at school and all of a sudden I heard a little bit of ringing in my ear and then it was gone.

Blaise Delfino:

Wow, scary.

Bridget Dobyan:

Well, I knew it was coming, so props to my medical team that they had, you know, fully apprised me. That was what would likely happen, you know. And in between all of that there were multiple surgeries to actually remove the claustrotoma and I think it took four surgeries in total. At that point they were joking that they should just put a zipper in behind my ear, make it easier to access and keep removing. After they removed the closteatoma, there was a lot of cleanup work to do. Certainly, there was scar tissue, there was a lot of problems, and at that point they realized that the closteatoma had essentially eradicated the hearing bones, completely destroyed the hearing bones in my middle ear.

Blaise Delfino:

So, bridget, speaking of the hearing bones, they are the smallest bones in the body the malleus, incus and stapes and they take that acoustic energy and transfer it into mechanical energy. So those bones were compromised. What was your journey like? Adapting to hearing loss and then eventually moving forward with a bone anchored hearing aid?

Bridget Dobyan:

I don't remember it completely changing the way I went about my day. You know, we of course had conversations with my teachers, just so they were fully apprised. It was actually a while before I went the Baja path. At that point I'd been referred to a specialist down in the Detroit area with the Michigan Ear Institute, dr Jack Cartouche, and he had developed a prosthetic bone, and so we actually tried to do an implanted prosthetic bone to see if we could, you know, gain that function again. And it did not take, unfortunately, you know. So we tried a few things in between until we realized mostly my parents realized that it just wasn't going to work and so we had to start talking about hearing technology and based on, you know, my closteotoma, the damage that had been done to my middle ear, at that point the prevailing opinion would be that, the bone anchored, hearing aid would be the way to go.

Blaise Delfino:

So how old were you when you?

Bridget Dobyan:

eventually moved forward with the Baha or the bone anchored hearing aid. Yeah, at that point.

Bridget Dobyan:

I was a teenager, so it'd been a few years in between losing the hearing, trying the prosthetic implant and then moving forward on the hearing technology. And there were a couple of additional surgeries that were in there because, you know, just to make it even more fun. Not only did I have the claustrotoma issues, but I also had holes in the balance canals, and so they were going in to patch those because I had dizziness issues, which is not uncommon, of course, for people with hearing loss.

Blaise Delfino:

Bridget, this is and being that young and experiencing the dizziness, experiencing the hearing loss, especially unilaterally. Bring us through the experience you had with those dizzy spells being so young. What was that like?

Bridget Dobyan:

That was probably the hardest part of everything. The hearing loss, as I recall it didn't actually bother me that much. I sort of adapted to it and figured out I would turn my head a lot, I knew where to sit, knew where to stand, knew how to adapt to that. But the dizziness, I mean that would kind of take you out of nowhere and it took a while before you actually take that surgical route to patch those canals. And you know, out of those only two are easily accessible and to access the third one would have been a very invasive surgery that goes in at actually the base of your skull to get to that point. So we opted not to do that. So it was. You know, try a low sodium diet first. You know it's trying to go through these lifestyle changes before you take that next step to actually have the surgery. So I think the dizziness was arguably worse than the hearing loss, for me at least.

Blaise Delfino:

And having gone through all of that for lack of a better term so young in your age allows you now, today, I'm sure to really yes, see through the Hearing Matters podcast. So they might be asking you know what's the difference between a hearing aid, cochlear implant and a Baja? Well, if we start with the most familiar hearing aids, so these are devices that you'll, you know, wear in or behind your ear and they amplify sound and then send it through your natural hearing pathway. So your outer ear and middle ear need to essentially be intact, and this is very I'm using very elementary terms here. So think of, with hearing aids, it's like you're turning up the volume around you, but it's a lot more sophisticated than that.

Blaise Delfino:

If someone has a more severe or profound hearing loss, especially if understanding speech is tough, even with powerful hearing aids, that's where cochlear implants come in, and these are surgically implanted devices that bypass the damaged parts of the inner ear and then send sound directly to the hearing nerves. And finally, we have the Baha, which is the bone anchored hearing aid. Now this technology works differently. So, instead of sending sound through the earaha, which is the bone anchored hearing aid, now this technology works differently. So, instead of sending sound through the ear canal, it sends vibrations through the bone to the inner ear, and it's a great option for patients with chronic ear infections, conductive loss or even single sided deafness. So, bridget, did I get that all correct?

Bridget Dobyan:

You did, you did. Yeah, I think that the Baja technology is absolutely fascinating and it kind of blows people's minds when I talk about it because it's a little bizarre. Right, it's a titanium screw that's implanted in your skull. So that's one surgery, and then there's, of course, a recovery time. Then they make sure that the screw is actually solid in the bone at that point, before you're then fitted with the processor, which is just, you know, a simple small box. It's about the size of your thumbnail and that snaps onto the titanium screw, and then it's bone conduction at that point. So you essentially hear it in your head. I always describe it as sort of the tuning fork effect. I think most of us in music class when we were kids, right, your teacher would go around and would ding the fork and then put it to your head or put it to your temple, and it's that same type of sensation.

Blaise Delfino:

The evolution of technology. Do you notice a difference in terms of sound quality? Of course we have. You know it's vibrations through the skull, but can you personally tell a difference between when you were first fit with bone anchored hearing aids to today?

Bridget Dobyan:

Yes, I can, and I've actually only had two processors in my entire time of using Abaha. Two processors in my entire time of using Abaha. That's mostly my fault. I pretty much rode that first one until it was technically obsolete. When I went in for my upgrade a few years ago, my young audiologist who was pretty fresh out of school she looked at my old processor and she actually couldn't figure out how to open up the battery compartment because it had changed so much.

Blaise Delfino:

Hey Bridget, can you show me how to do this please?

Bridget Dobyan:

I briefly questioned whether I would stay at that practice or not. Now she's fantastic and that's a testament to the product itself. But when I finally did upgrade, it was a significant difference, from the sound quality to the connectivity, to even the battery life with it. It was a significant improvement.

Blaise Delfino:

And for consumers tuning in. When you mention connectivity, what do you mean by that?

Bridget Dobyan:

So Bluetooth streaming I think again one of the craziest features with the Baja, and Bluetooth is pretty standard with hearing aids at this point across the spectrum, which is incredible because we're all kind of attached to our phones for better or for worse. But it's great that I can listen to music, I can take phone calls, I can listen to my podcast and again it's in my head because it's bone conduction. So when I try to convey that concept to different people, they're like wait a minute, you can actually just hear it in your head. I said, yes, I'm taking this phone call in my head, right?

Blaise Delfino:

Which, again, we live in the most socially connected demographic. So when we feel and hear that connection especially if you present with a hearing loss, you feel more immersed and connected in your everyday conversations. Now, bridget, we briefly shared your biography so impressive. You are an attorney and you have deep policy expertise working at the state, federal and advocacy levels. Living with hearing loss, it can be deeply emotional at times and isolating. I mean we are absolutely experiencing a loneliness epidemic. Can you share how it shaped your personal and professional journey and really what it's meant to you to thrive in such high impact spaces despite the challenges? Dr?

Bridget Dobyan:

Yeah, absolutely. I think it's really important to note that everyone's experience is vastly different and in my experience, I was incredibly blessed to have supportive parents that had great insurance, that got me into the right professionals, that built the medical team around me, the professional team around me that sought out the best of the best and were able to do that and then made sure that even to this day, my mom still gives me a call. She says are you using your Baja, are you wearing your Baja? And so it's making sure that I had that support system around me so that it just became normal. It's just an everyday part of my life. It wasn't this standout part of my personality and it wasn't a struggle because it just became so ingrained Get up, plug it in, go to school, do your thing.

Blaise Delfino:

Bridget. When you're a teenager at this point did your classmates have difficulty understanding, maybe, what it was you were wearing? How did you bridge the gap between educating your fellow classmates on? I have hearing loss and this is a bone anchored hearing aid that I wear. How did you educate your classmates on that and did you experience any pushback? If you're comfortable sharing, because I mean you're a teenager and it's like you know, sometimes you know kids at that age. They don't really understand or could be possible. You know bullying or something like that. Did you experience any of that?

Blaise Delfino:

None, that's so good to hear.

Bridget Dobyan:

And again, I know that my experience is not everyone's experience with a Baja. A benefit of it is that you know I'm wearing it right now and you can't see it, even when your hair is up and you're looking straight on. You honestly have to be looking at me directly from the side to even notice it. But I've never hidden it either. I think that it's a really cool piece of technology that helps me fully function in my everyday life. So I've never had a problem wearing it. Never had a problem explaining it. So I've never had a problem wearing it. Never had a problem explaining it. Because, again, the concept of a bone anchored hearing aid just kind of blows people's minds. They say that's actually very cool and for a brief moment you almost see a glimmer that they want one too.

Blaise Delfino:

Well, and today we have the bone anchored headphones. I mean, I don't have a pair. I'd love to get a pair, but I've experienced what they sound like and it's pretty, pretty amazing. And you know if you've received a hearing evaluation, you know part of best practice is testing bone conduction. So if you currently wear hearing aids and you're getting your annual hearing evaluation, chances are your hearing care professional is testing bone conduction. So you've experienced that sensation of hearing, that tone in your head. Bridget, I asked you about, you know, going through school with a bone anchored hearing aid and there was a statistic released around 2017, 2018, 2019. So I've got my basis covered there and I can link this study. But untreated hearing loss, it was said, is linked to over a billion dollars of lost US earnings. Now, that could be miscommunication. That could be education level. You know, what advice would you personally give to young professionals or students who present with hearing loss, who might be questioning whether they can pursue these big goals like law, like leadership, like advocacy?

Bridget Dobyan:

Oh, that you absolutely can, and you don't have to make hearing loss your entire personality or your entire struggle. This is a value add at the end of the day.

Blaise Delfino:

So you are the executive director of the Hearing Industries Association and you and I surprisingly first met at the HIA annual meeting a couple of weeks ago in DC and we got to talking and I was like Bridget, we have to have you on the Hearing Matters podcast. And first and foremost, I have to congratulate you and Lindsay and the entire team at HIA for a first class event. It was just unbelievable. So, being the executive director of HIA, how has your personal experience with hearing loss influenced the way that you lead and advocate for better hearing health policy?

Bridget Dobyan:

So when I came into this industry, I actually didn't know that this entire world existed, from the professional associations to the consumer advocacy groups all the way up to the industry trade association. I met my predecessor for a coffee, just to meet her. You know, a standard DC networking and you know by the end of this conversation I just happened to mention that I have hearing loss and use a Baja, and she couldn't believe it either. So not knowing that all of this was out there and this entire system and network that is so collaborative actually exists. I think that shows us that we have a lot more work to do to be engaging people with hearing loss, their families and professionals along the way. I mean, there are times that I go to different conferences and conventions at the state level and at the national level and people still don't know exactly who we are and what we do. So we need to do a much better job at conveying that message.

Blaise Delfino:

Again, as I previously stated, we are the most socially connected demographic to ever exist. And, bridget, a couple of weeks ago I gave a presentation on hearing protection and, of course, hearing loss. And weeks ago I gave a presentation on hearing protection and, of course, hearing loss and the importance of protecting your hearing, and et cetera, et cetera. And I asked the crowd. I said, okay, for those of you who saw the dentist this year and got your teeth clean, raise your hand. Pretty much everyone raised their hand. That was good to see. And then I asked about vision. Same thing. I asked about hearing.

Blaise Delfino:

There was like two or three people that raised their hand who had seen or gotten an annual hearing evaluation and that to me was like we have so much more work to do and we have such an opportunity to raise awareness of hearing health care. Bridget, a conversation that you and I had a couple of days ago was there's 44 million Americans who present with hearing loss on an audiogram and then there's another 26 million Americans who present with difficulty in noisy situations but present with normal hearing on an audiogram. And when we talk about access to hearing health care, in my professional opinion, there is not enough hearing care professionals in the country to serve all of these individuals. Is this a conversation that HIA is having to raise awareness not only of the technology and the importance of visiting a hearing health care, but also encouraging students to get into the field?

Bridget Dobyan:

Yeah, this is a conversation that, across the hearing health space, everyone's having and everyone's having together, because it impacts all of us. Again, from the professional perspective, from the consumer perspective certainly, access or coverage of hearing health care from both a professional service perspective as well as from devices we need to make sure that consumers actually have professionals that they can reach, professionals that they can see in their communities. So this is certainly something that we all are working on together.

Blaise Delfino:

Excellent, Bridget. You work closely with policymakers and stakeholders really across the country. How do you use your own story when raising awareness at that level and do you find that it resonates with decision makers?

Bridget Dobyan:

I do, I do. There is still lingering stigma around hearing loss and around hearing aids, and so you know, with the devices themselves, a big part of what HIA has done and continues to do is making sure that there are accurate representations of hearing technology. We know that hearing tech has been in the news a lot more, and usually the pictures that media sources are using they don't actually reflect what's out there on the market today.

Blaise Delfino:

What do you mean, bridget, the big beige banana hearing aids are? They're not aesthetically pleasing, yeah.

Bridget Dobyan:

Maybe some people have an affinity for them, but it's. I mean, there's something for every, every style, every choice. You know the different form factors of hearing devices, so there's the accurate representation piece of this within the media. But then there's also leveraging my personal story, which I mean before this. I'm not out there just telling people I have hearing loss. I just go about my day and I adapt and I do what I need to do. But in this position I feel like I have a really unique opportunity, being still relatively young and being able to show a different face of hearing loss, where I haven't experienced the stigma, where I have seen that there is this overall, you know, well-being and improved quality of life. And again, the tech is just very cool.

Blaise Delfino:

Yes, it's not only cool but it's advancing and innovation is happening at such a rapid pace, especially as we lean into artificial intelligence. Now, bridget, you had mentioned campaigns and misrepresentation, with media outlets using photos of old hearing technology and the styles. Today they're still behind the ear hearing aids, they're still full shell in the ear hearing aids, but we now have different color options. Right, and we were talking a couple of days ago and, of course, years ago. About six years ago, hia first initiated their Hear Well, stay Vital campaign. Today it is now referred to as the Hear Well campaign. I will speak as a former private practice owner when this campaign was launched and the assets were shared with hearing care professionals, because I don't want to steal the thunder here, but we use the assets that your team provided to the entire nation to use during Better Hearing Month and beyond. So, the Hear Well campaign it has absolutely been a cornerstone message for HIA. How has the campaign evolved over the years?

Bridget Dobyan:

Yeah, so the campaign, as you mentioned Blaze started in 2019.

Bridget Dobyan:

And it was really in anticipation of, and in advance of, the new OTC over-the-counter hearing aid rule, and there were concerns that consumers would be confused with this entirely new channel coming into the market and what it meant.

Bridget Dobyan:

How do you assess your hearing loss? What are the different options that are available for treatment? Even rolling it all the way back to the most simple of concepts, which is see a hearing professional first, rule out any underlying medical conditions or causes for the hearing loss, perhaps it's something just as simple as cleaning the earwax out of your ear and you actually don't need any type of hearing loss treatment at that point. So the campaign was developed in its early stages with HLAA, which is the Consumer Advocacy Group, the Hearing Loss Association of America, and then, along with our professional partners, the Audiology Professional Associations, aaa, ada, asha, the dispensers with the International Hearing Society and so many more of our partners, to really develop this consensus resource that would provide those fundamental questions that deal with hearing loss what is an audiologist, what is a hearing aid specialist, what is an ENT, and what are the different types of treatment options available from there?

Blaise Delfino:

I love it and raising awareness really of what an audiologist and a hearing care professional is, because my father is an audiologist and I just mentioned this in a recent episode of there would be individuals who asked him oh, you're an audiologist, you change out car radios. Like how far, bridget, we've come. But I love how, in response to OTC or over-the-counter hearing aids, which again increases access, increases accessibility to better hearing, of course, if that is the route you as a consumer feel as though is the best route for you, absolutely consult with a hearing care professional first to rule out any possible etiologies. Now, bridget, this year specifically it is May we are celebrating Better Hearing Month. What makes this year's focus especially relevant for consumers and hearing care professionals as it relates to the Hear Well campaign?

Bridget Dobyan:

So, blaise, what I'm really excited about with Better Hearing Month this year is it is serving as the launch for the next iteration of HIA's PSA campaign and PSAs. We've built these also since 2019, and it's been incredible the earned media value of this campaign. And what's unique about PSAs is that it's not device focused, it's not technology focused. It's a public health announcement, essentially, and it focuses on the importance of addressing your hearing loss and seeing a hearing professional. That is the message at the end of each one of these PSA spots, and what we found with our PSA campaign is that positive works, positive messaging, fun messaging. We saw that with the last version of the campaign, which was Happy Dance. In two years of running that campaign, it resulted in over $23 million of earned media just within that campaign.

Blaise Delfino:

Wow, $23 million of earned media, bridget, that is incredible.

Bridget Dobyan:

And it's all around the importance of seeing a professional and addressing your hearing loss. It's a great message, one that's easy to understand, and so, with this next version, which we have very creatively termed Happy Dance 2.0, to continue that positive messaging, we got a little weird and we got fun and the best part with these video spots. We have seven 30 second spots and we have six 15 second spots with this messaging and all different videos and imagery. There's a puppy in one of them. We have found that people.

Blaise Delfino:

Everyone loves puppies.

Bridget Dobyan:

Right. People love puppies, so these will all be available on the hearingorg website for all of our partners to utilize as well, not just within the PSA space.

Blaise Delfino:

So again, that is hearingorg and any hearing care professional. Bridget can download these assets and then reuse them on their own clinic websites and social media.

Bridget Dobyan:

Absolutely so. Hearingorg. It's an unbranded resource, so we not only have the PSA videos, but we have an additional video library that has testimonials from hearing care professionals, from consumers themselves. We have a veteran-focused video series as well. We have social media graphics, tiles, pretty much everything you can think about. It's all completely free to use, downloadable and you can utilize it in your own practice resources.

Blaise Delfino:

And Bridget, being that we are in Better Hearing Month, our hearing care professionals can use these assets throughout the year, and I'm thinking for those hearing care professionals who say, oh, I don't really like social media, I don't like to be on there, that's totally fine. Use these assets and you can program them into your social media and, of course, raise awareness of better hearing. So thank you and HIA for introducing these assets, because not every hearing care professional is comfortable behind the camera. They might want to be behind the scenes, and these assets allows you to raise awareness while also feeling more comfortable if you're not comfortable posting on social media. Now, bridget, my last question for the day. First of all, love your passion. Thank you so much for all that you do for the industry. How do you hope hearing care professionals and consumers will use the PSA assets to spark more conversations around hearing health?

Bridget Dobyan:

Thank you Within that question hit the nail on the head. It's about sparking the conversation. We know that from previous versions of the market track research study that HIA sponsors and that comes out about every two to three years, we know that a lot of consumers take that step forward based on a recommendation from a professional which makes sense, but also from friends and family. So even if you yourself don't have hearing loss or don't wear hearing aids or use hearing aids, you can still share these messages with friends and family. And even if social media isn't necessarily your jam, you can also download. We have postcard resources that have you know, funny quips and clips that again make the conversation around hearing health much more engaging. Right, it continues to de-stigmatize the issue. It makes it just a part of your overall health and wellbeing the issue.

Blaise Delfino:

It makes it just a part of your overall health and well-being. Bridget, thank you so much, for you know not only sharing your journey, but your heart behind the work that you're doing. So thank you so much for joining us on the Hearing Matters podcast today.

Bridget Dobyan:

Thanks so much for those listening.

Blaise Delfino:

whether you are a hearing care professional, someone with hearing loss or simply someone who cares about the health and vitality of your loved ones, now is absolutely the time to lean in. The Hear Well campaign is not just a slogan. It truly is a movement, and it's one that reminds us that hearing health is essential to living fully, aging well and staying connected to what matters most. So here is our challenge to you, the listener Visit hearingorg, download the campaign assets, share them on your social media channels, bring them into your clinics, conversations and communities. Use your voice to amplify the message, because when more people hear well, more people thrive. Let's keep raising the volume of hearing health together. And again, bridget, thank you so much for joining us on the Hearing Matters podcast.

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