Hearing Matters Podcast: Hearing Aids, Hearing Loss and Tinnitus

From Clinic To Capitol: Elevating Hearing Care with Dr. Amit Gosalia

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In this conversation with Dr. Amit Gosalia, we connect the clinic to the Capitol and show how small, consistent actions can unlock direct access, fair recognition, and better outcomes for patients.

We start with the spark: early licensure battles in Arizona, the evolving relationship between audiologists and hearing instrument specialists, and the shared commitment to higher standards and clear scope. From there, we dig into the Medicare Audiology Access Improvement Act and its three pillars: direct access for patients, practitioner status under Medicare, and reimbursement for services already within scope. Dr. Gosalia lays out a no-excuses playbook for busy clinicians—use your association’s action center, personalize the message, hit send—and explains why stories, not just statistics, flip lawmakers from polite to persuaded.

Leadership becomes the throughline. We talk about the profession’s habit of underselling itself, why state associations hold real power, and how to step into roles without waiting for the perfect time. Dr. Gosalia’s coaching lens turns to growth decisions: know your why, weigh vertical versus horizontal expansion, and avoid cannibalizing your own market. He shares candid lessons on staffing, commute realities, demographics, and the quiet advantage of one well-equipped hub—vestibular, implants, tinnitus, protection—over a scattered footprint.

We close with a clear-eyed view of the future. The path forward is collective and practical: advocate locally, host your representatives, and turn everyday patient stories into policy wins that make hearing healthcare accessible and humane.

If this resonates, follow the show, share it with a colleague, and leave a review with one action you’ll take this month to advocate for better access in hearing care.

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Blaise M. Delfino, M.S. - HIS :

You're tuned in to the Hearing Matters Podcast, the show that discusses hearing technology, best practices, and a global epidemic. Hearing loss. Before we kick this episode off, a special thank you to our partners. Cycle, built for the entire hearing care practice. Caption call by Storenstein. Life is calling. Care credit. Here today to help more people here 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. I'm your host, Blaise Delfino, and joining me today is the one and the only Dr. Amit Gosalia. Dr. Gosalia, thanks so much for joining us back on the Hearing Matters Podcast.

Dr. Amit Gosalia:

Happy to be here, Blaze. Thank you again for inviting me once again.

Blaise M. Delfino, M.S. - HIS :

Dr. Gosalia, this episode is going to be a little bit different because it's not just about hearing healthcare. It's really about what it means to lead, to advocate, and really elevate an entire profession. For our listeners tuned in, Dr. Amit Gosalia has improved the lives of patients, helped clinicians scale their practices, and inspired leaders to really step into their voice. I can absolutely account for that as well. And today, Dr. Gosalia is here to help us rethink really what it means to serve. Dr. Gosalia, I want to dive right in. You really have become one of the most recognizable advocacy voices in our industry. What was the moment or really experience that made you say, I have to step up and I need to speak for this field?

Dr. Amit Gosalia:

Yeah, that's a great question. Thanks for asking that because it's so important. It was back. So I went to school to be an audiologist, obviously, or in the early 2000s. Before that, I actually started in this industry or in this profession working with a hearing aid dispenser in Phoenix. And I worked with her about a year and a half. Eventually I went to take an intro to audiology course at Arizona State University. And I realized very quickly that the knowledge base that I had attained in one and a half years of working was summed up in like 30 minutes of the intro to audiology course. Now, this is way back a long time ago. Obviously, things have changed since then. We have a lot of fantastic hearing instruments specialists who are out there, some who I talk to almost on a daily basis. So that was part of it. So once I learned that, okay, wait, there's these two professions. And, you know, you got this one where in Phoenix at the time it was just a high school degree, and you go and sign up to get your license. And then you had this two-year, two and a half year, at the time, master's degree, and you learned all these things. It was just not only about hearing aids. And I realized that the amount of education that we had in the state of Arizona for both audiology and for dispensers was really not much. I realized, well, something has to be done. And thank goodness in Phoenix at the time, we had some, and we still have some fantastic leaders. And I don't mind name-dropping, but somebody like Georgine Ray, who's a very close friend of mine who I've worked with. She's probably the oldest relationship I have in audiology. She was part of this committee that I ended up joining, and it was a licensure committee. And what we were doing is trying to change the Arizona licensure to include the AUD, because that was just becoming a thing at the time. And within a short amount of time, they all decided to make me the chair of the political action committee. Now, mind you, I was only about two years out of school. And I'd never held a political office before. Not that this is a political office, but you know, I'd never done this. So I organized an event, and that's what really was the impetus or the spark that kind of led me down this path of making sure that audiologists and audiology is well represented.

Blaise M. Delfino, M.S. - HIS :

And Dr. Gusali, you talk about taking your own experience, working at this practice, and getting your curious on, if you will, because you were thinking, like, hmm, is there a way for me to get better? And if there's anything I've learned from you, it's pushing the boundary of getting better each and every day. I remember a conversation you and I had about, I want to say four and a half, five years ago. And it was when I was a private practice owner. And you were really just shedding a lot of great light on, listen, Blaze, as an up-and-coming private practice owner, this is what I'd love for you to know. And I love that you've always been so passionate, not only about building your own practice, but the industry as a whole. And that's really what advocacy is about. Let me ask you this because we haven't had many conversations about this specifically. But when you were talking about in Arizona getting the AUD added to the licensure board, but you were at a time where the AUD and the HIS kind of going head to head. And I feel like that does still happen, unfortunately, today. What was that like then? And you talk about talking to hearing instrument specialists today. You have the utmost respect for them. What was that like back then when you started this advocacy journey?

Dr. Amit Gosalia:

Yeah, you know, that's a good question. And it's always tricky to dive into some of these topics because obviously, you know, these are great people on both sides. Sorry to use that phrase. But in this situation, you know, we've got fantastic HISs, we've got fantastic AODs, obviously. And the the thing is that back then it was different. And I say back then as if I'm talking about, you know, back when movies were 50 cents, but the reality is that uh back in the early 2000s, it was very different. And I still remember we went to the Arizona State Legislature in Phoenix in downtown to go testify in front of the legislature about, hey, this is why we need to expand the continuing education. And all the audiologists were on one side of the room in the audience section, and on the other side, there was a bunch of hearing instrument specialists or hearing aid dealers, whatever terminology they were using. And they weren't happy. And they weren't happy because we were expanding their educational requirements as well, which at the end of the day is all about patient care. So I remember getting some messages, and it wasn't, I'm sure the other ones, other audiologists that were there were getting messages as well. But I had received a couple of messages from dispensers telling me how much they hated what I was doing and I was gonna make their lives so much more difficult. And I come from a very pro-educround, and I thought, you know, I don't understand how you have a leg to stand on if you're gonna say I should do less education to be a better person. That doesn't make sense to me. And I don't think that would make sense to anybody. Fast forward to today, 2025, and I don't just mean now, I mean over the 10 past 10 or 12 years, I've changed, at least my opinion, because I've seen it. I've seen it in action. We have fantastic dispensers. I mean, you're one of them, Rachel Garcia in Texas, you know, JC Soto and Florida. There are some amazing hearing instrument specialists who I talk to all the time, and I have so much respect for them because they, you know, they know the rule, and we all know our scopes of practice is. You know, for example, as an AUD, I know I can't prescribe medication. I can't go in there and remove a PE tube out of an eardrum. For example, even though I know I can do it, I can't do it, so I don't do it. And similar roles with dispensers. And I think the great thing is that back then it was a little bit trickier and there was a lot more tete, if you will. Now I don't see that as much. We still see it a little bit here and there, and sometimes there's some conversations that happen. But I think it's, you know, I hope that it's just, you know, mainly for the good of patient safety and patient, you know, quality of life stuff.

Blaise M. Delfino, M.S. - HIS :

I love the fact that raising the bar not only for audiologists, but hearing instrument specialists as well, because at the end of the day, it affects patient outcomes 100%. Dr. Gosalia, advocacy can feel pretty overwhelming for busy clinicians because let's be real here, if you work in a clinic or you are a private practice owner, you're pretty darn busy. What are some of like the simplest, highest impact advocacy actions any provider can take today?

Dr. Amit Gosalia:

So I think the first thing is recognizing who do you need to talk to and what do you need to support? So, coming from the audiologist side, I'll share, you know, the audiology stuff. So, for example, there's a bill in Washington that we've been working on. All three national audiology organizations have come together, which is kind of rare. We we rarely see all three. Usually it's one by themselves or two. This is one that all three audiology organizations and a bunch of other organizations have actually supported. So it's called the Maya Bill, M-A-A-I-A. So that's actually called the Medicare Audiology Access Improvement Act. It actually has three tenets. The first one is direct access. I think everybody that's watching this would probably agree that you don't have to go see a primary care physician for them to say, okay, yes, you can go get a hearing test. That's ridiculous. It's outdated. So the first tenet is to be able to provide direct access so we can provide better hearing and balance care to our patients without any speed bumps or barriers. Number two, when we first joined CMS, the Center for Medicare and Medicaid Services, when we first did that many decades ago, we kind of let them dictate a lot of things instead of us telling them what needs to be there. So, for example, audiologists are currently listed as suppliers at CMS, suppliers, versus a physician. Well, there's one in between called a practitioner. So the second tenet that we are promoting, and it will get passed at some point, is that we are no longer suppliers, but that we are practitioners under Medicare. Number three is we have the ability under our scope of practice to do serumen removal and oral rehab and some other services. We should be able to bill and not only bill, we can always bill. We also should be able to collect payments from CMS. So the idea is that those are the three tenets. And, you know, there's many, you know, ways for us to support that, you know, as a busy clinician. Number one, very simply, is going on to one of our national organizations' websites and literally, for example, the American Academy of Audiology, AAA, they have a legislative action center. You can go there, you click on this little window. I was just showing this to my student the other day. You click on this little window that talks about Maya, it takes you to another page. It has some text already pre-written. So if you don't want to write anything, it's already pre-written saying the pros of this bill. You just put your name in there, you put your zip code or your address, it'll find your representatives to send it to. And you basically hit send. It can't get any easier than that. Okay. So that's, you know, you talk about busy clinics. I'm a partner in our clinic in LA and we're super busy. And then I also run three other companies on the side. So I'm the busiest person, one of the busiest people around. And I find time to make sure that I go on those sites and I will edit the text because I like to add my own flavor and then submit it. And that's the easiest thing you can do. And don't get me wrong, Asha has something. I know IHS has links as well. So, you know, whatever your leadership is promoting to help you as a provider doing the things that you need to be able to do to take care of your patients, you gotta support it. There's no question. You have to support it. And you have to do just do the bare minimum.

Blaise M. Delfino, M.S. - HIS :

Dr. Gosalia, thank you so much for bringing up the Maya bill. For our listeners tuned in, that is a bipartisan bill. I mean, how do we continue to communicate to our policymakers that hearing healthcare, it's not just about audibility, it's not just about turning our hearing aids on and hearing to the best that we can, but it's about quality of life, relationships, long-term health. Bring us through that. How do we communicate this or continue to?

Dr. Amit Gosalia:

So I think the bottom line is you know, we have all the statistics like the ones you just mentioned. I feel uh obviously that's very relevant, very important information. I find that telling stories about patients hits even closer to home. So back in 20, I think it was 2018 or 2019, I can't remember, I was in Washington, D.C. for a conference and we did some lobbying. And I had an opportunity to meet with Kamala Harris when she was a senator at the time. She was there, and again, it doesn't matter if the person is Republican or Democrat, I went in there with the mindset of, okay, I'm gonna, I'm gonna wow these senators and representatives with all this data. And when I did, it really didn't hit home. What hit home were stories. And so the next time I went to lobby, instead of just sharing data saying, hey, look at all these Americans, these are your constituents, we got to help them. Instead of that, I started telling stories. And one of the stories I like to tell, and it's not really a story, it's more of an example. And I'll say, now picture this. Uh, so an example, we have a representative here, he's my representative for wherever our clinic is. His name is Brad Sherman, and he's a Democrat. And so we went, I went to his office and I walked in and I said, So I want to, I want to ask you a question. Imagine your mother lives 55 minutes away from my office, and now she makes the trip all the way to my office for an appointment for a hearing test. And I have to tell her, or our team has to tell her, hey, we don't have the referral from your primary care doctor to do a hearing test. That means now she has to go to her primary care doctor, go back home, and eventually at some point come back to my office for a hearing test. Let me tell you what a hearing test involves. I look inside their ears, I do a quick test of their eardrums, I run through some air pure tones. Of course, I'm saying these terms because Blaze, you know these and most of your listeners do, but those that don't, an air pure tone test is heck phones or inserts, and you push a button when you hear beeps. Then we do some speech testing, we do some speech and noise testing, we'll do some more objective measures and maybe a couple of other tests, and that's it. There's nothing invasive about what we do. Nobody gets hurt. There's no bleeding involved as long as we know what we're doing. Um, I'm kidding. So the idea there is it's not a very difficult thing, and there's no patient safety issues here. Now, would you rather your mother came in and I took care of her on that first visit because she made this trip all the way out? Or do you think she needs to go through all these hoops just to come in and get a hearing test? And 100% of the legislators, senators, representative that I talk to will say, obviously, it sounds like that you should just take care of them. And I'll say, Great, I agree. Co-sponsor this bill. That's the easiest thing you can do. There's hundreds of audiologists, hundreds who are making these same connections with the policymakers, the folks that make the impact. You know, it's we know we know the side effects of untreated hearing loss. You know, we know that there's a high risk of un you know, folks that have untreated hearing loss. There's a high risk in adults that they could, okay. I don't want to, I don't want to sugarcoat this or even uh uh exaggerate it, but there's a potential that there's some cognitive decline issues that can happen, right? We know that there's some social isolation things that happen. We know that there's anxiety that can occur, there's depression. So these are things that we want to avoid. I mean, we talk about this on a national scale. We know that you know the Alzheimer's Association has statistics on how many people have Alzheimer's and dementia and how it just it is they suffer through these things. So, what can we do, even if it's the littlest thing, what can we do to help? We could have these conversations with legislators. Now, I don't, I'm not saying that everyone needs to go to Washington, DC. I understand that most can't make that trip, right? Whether it's financial, whether it's time, whether it's whatever. The reality is that you can find time when they're on what's called recess, right? So they're back home. So a couple of years ago, I was working with a group of students here in California, along with the California Academy of Audiology, and we created this Google uh document, and we created a list of every representative in the state of California, and we DVD it up into different areas of California, and we found audiologists who were in those areas, and 100% of them we were we were gonna go out and visit. Last second, things got stalled. Of course, I'm so busy and I screwed up. Long story short, we never did it. However, we still have the data. The data was basically here's the representative, here's where their office is, here's their contact information, here's when they're in town, and here are the steps to get into their office. Now, what most people don't realize is your representatives, they want to come to your office. They want to come to your office, they want to get photos, they want to show the community that, hey, they are involved in the community, they are supporting these good things that we are doing on the ground. So whether you go to their office or you invite them to your office or you do an event, I know some people do open houses or ribbon cuttings or whatever events you're gonna have. Invite the policymakers, give them an opportunity to speak, because of course these folks love to speak. Let them speak, you know, say a few words, give them a hearing test, take a photo, you know, while you're doing autoscopy or whatever else. They want to be involved in this. And so it's not hard. Having these conversations is not hard. You know, I hate to use a phrase, but they're just like you and me. They are just like you and me. Okay. It's just their position is supposed to be to represent us in the community and they work for us, right? It's not all the other way around that I should be begging them to do things, they should be begging us as the community, saying, Hey, what can I do to support you?

Blaise M. Delfino, M.S. - HIS :

They've got two eyes, two ears, and a mouth as well. And I love how you have in the past, but even now currently with West Valley Hearing Center, taking that modern approach and inviting these elected officials to your office because I also love the fact of creating that doc for when they're on recess. And I hope other hearing care professionals tuned in right now do the same in your state because how important is that? I remember we had Senator Mario Scavello, we had him visit our office and we did the tour, we sat down with him, and that turned into then him and his team inviting my father, who's also an audiologist, Dr. Delfino, to sit on his legislative report. His TV crew came in. We filmed it in the office, and we didn't realize, like, oh, how much traction would this gain? And this was when OTC was finalized, if you will. And we had so many patients come in. Saw you on Senator Scavello's legislative report. Thank you so much for all you're doing for the community. And we were just like, how much of an impact is this? Going to make. Like, we're very passionate about this. But that one visit, Dr. Gosalia, turned into this. What I believe personally and professionally, I'm still on that advocacy train and will be for the remainder of my career. Like audiology, it's like we're getting jabbed and right hooked every which way. Now is the time for us to really band together as hearing care professionals and put our foot down and say, we are hearing care professionals. This is our scope. This is how we help our community members not only hear better, but also live better. Dr. Casali, we talk about leadership. You, of course, have been a subject matter expert in our industry for quite some time. And you were very vulnerable with me on a phone call, like I said, about five years ago, as it relates to your own financial journey. And like a light bulb kind of went on, and you got in the right lane, and you were so encouraging because you were like, Blaze, I want you to learn from my mistakes, so you don't have to make those. And I would say they're lessons learned, right? So you have encouraged countless, countless, countless clinicians to open new locations, grow their practices, or really get on stage and teach. Why do you think so many audiologists today underestimate themselves?

Dr. Amit Gosalia:

Yeah, you know, I talk about this a lot, and I don't know if everyone agrees with this statement, but and I'm not even sure how to say it. I think the reality is that we as audiologists, as a profession, we act like we have a low self-esteem about our profession. So if you look at the behaviors of somebody that has low self-esteem, and I can tell you, I come from that low self-esteem background, and I always tried to overcome it by doing things to make sure that I wasn't singled out. However, in audiology, I find that most of us don't get trained in leadership. And a lot of audiologists, and I'm not saying they're bad audiologists, so those of you that are listening that hear this statement, I'm not picking on you. But if you're gonna go work for an odolaryngologist and you are treated like they're tech, that's not good, right? I mean, that's not what a professional audiologist should be. We need to stand up for ourselves, we need to stick up for ourselves. You know, I've kind of made a little headway towards working with Asha a little bit. I met with Donna Smiley, and she's fantastic. And I also feel like audiologists, we should have our own organization, and we do. It's called the American Academy of Audiology. I understand we're stronger together, but speech pathology is one profession. Audiology is a very different profession, and different scope as well. Different scope, scope as well, right? I'm not gonna try to, you know, I don't do any speech pathology, right? I do nothing with speech pathology, but you know when to refer. Well, if I yeah, 100%, right? But at the same time, I know when to refer to a physical therapist and I know when to refer to a neurologist. So the way that I look at it is we have to stick up for ourselves. We got to have a backbone. And unfortunately, you know, you ask the question, we do underestimate ourselves that no, oh, we can't. We got to rely on somebody else. And I don't have a good answer on why that is. I've had some thoughts in the past. However, the reality is that we don't have a lot of great leaders. And here in California, I can tell you that every election slate for the California Academy of Audiology, there's usually only one person on the election slate. It's not a real election. It's just do you agree that this person should take the spot? Right. And I'm not picking on CAA. That's not what I'm saying. I'm saying that audiologists in general, in a state where there's over 3,000 audiologists or some number like that, that there's only 200 something that show up at the state conference, and even in that same number, or maybe a little bit more, are members of your state organization. We have to do a better job of taking charge. I mean, if if somebody says, Oh, I don't have the time, right? Like earlier you said that, you know, we're busy people. Well, guess what? A lot of our odd bosses, our private practice owner colleagues that we know, they're in leadership. And you can't tell me that your nine to five job, you're busier than a private practice owner who's working 80 to 100 hours a week. You're not. I'm sorry. And that's why we see a lot of educators who are in leadership, which is great. Okay. You'll see a lot of folks that are ENT audiologists, they're on leadership because they find the time. And then in private practice, I feel, at least I'll speak for myself only, I know how to juggle my time. I know that if I have five minutes here, I can take care of something within the five minutes and then move on to the next task. I also know that out of a whole year, it's 12 hours of work. 12 hours of work a whole year. You can put that in a day and just say, I'm gonna take a day off and do the 12. Well, we can't. You got to have meetings one hour a month. Well, that's 12 hours, guys. It's not difficult. You don't have to be the president, you don't have to be the vice president. You can join a committee, you can be a committee member, you can get on to help support the policies that we're putting forth on the state level. You know, I talked about AAA and Asher earlier. Your state organizations are the strongest voices for us because nationally, our national organizations who I support, they don't, they can't change our state rules. Our state associations are paying lobbyists to do that. So you have to be involved in your state organization and then get into leadership. You know, our audiologist, her name is Dr. Lisette Montez. She was in the first cohort at Cal State Northridge, Cal State University Northridge. They started an AUD program. She was in the first group. And she came in as a second year doing her rotation in my office. And then we brought her on as our fourth-year student. And now she's been a full-time audiologist with us for about two years. Two years outside of her schooling, she ran and she got elected to be the president of our California Academy of Audiology. Her term, I think, starts now or pretty soon. That is incredible. And I love it because number one, she is a strong voice, she's a strong person. She learned about leadership, you know, from me. I've trained her on leadership. I told her why it's important, and she went on and did it. She asked me, should I do it? And I said, absolutely. She's like, Don't you think I should wait like four or five years? I'm like, why? Why wait? If you feel strongly, and I already know she was gonna make a she was gonna be a fantastic president. I said, go for it. And she did. And I know she's gonna love it. I know there's some there's some growing pains. But she's already president of our state association. And every student that rotates my office, we do a whole week where when they're coming in, we spend time during our lunch break, any breaks, and all we do is focus on leadership. And most, I won't say all, but most of the students I've rotated through have taken part in the student academy of audiology, whether it's nationally or the state level. They've gone on to be involved in their state leadership wherever they're they've moved to. So it's important that us as preceptors or leaders spread that word, right? If you know somebody is surrounded by leaders, they become a leader. It's like going into the room. If you're the if you're the smartest person in the room, you're in the wrong room. I mean, I I've been in rooms where I'm like, whoa, I think very highly of myself. That sounds very egotistical of me, but I do. And uh confidence. It's confidence, right? So I go into these rooms, and sometimes I'll walk into these rooms and I'm like, whoa, I'm in the correct room because I don't know what the heck these guys are talking about.

Blaise M. Delfino, M.S. - HIS :

Yeah, but that's how you get better, Dr. Gosalia. And you are humble enough to also know that you have the confidence to know, okay, I know my stuff. I'm successful. Success is the progressive realization of a worthy ideal. It's not just about the financial aspect of it or how many locations you have, but you're humble enough to say, I know my stuff, but I can also get better. And when you talk about leadership, at the end of the day, leaders lead. You continue to lead an industry that we do have such potential, such opportunity to really continue to position ourselves as thought leaders in overall hearing and wellness. There's so many questions I have as it relates to you leading, but also coaching others. When you mentor a provider who dreams of expanding, and let's talk about expanding, not only expansion of maybe a practice location, but even expanding their own leadership abilities. What is the first question that you usually ask them?

Dr. Amit Gosalia:

Yeah, I guess the the primary question is why do they want to expand? You know, I know there's a lot of people out there who say, oh, learn your why, know your why. Yeah, that that's that's true in the situation. Are you expanding because your market needs you to expand? Are you expanding because you think more locations will actually bring you more money? Are you expanding because you have too many providers in one location? Are you expanding vertically or horizontally? Are you expanding? What do I mean by that? Are you expanding horizontally into numerous locations? Or are you investing in the single location that you have? Now I've gone through both. I've actually had multiple locations before I sold those clinics and moved to Los Angeles. And here in Los Angeles, I and listen, I still think about it about opening a second location or maybe a second and then maybe a third location, but it all comes back to well, why am I doing why would I want to do that? And I go right back to back to my baseline that you know what? I want to invest in this one clinic, and we've made it bigger and we've expanded it, but it's one location. And we have three audiologists in one location, and we've, you know, we've added vestibular. So we have a whole vestibular lab. We do cochlear implants, we do tinnitus, we do hearing aids, we do monitors, we do earplugs, we're working with sound gear quite a bit, with hearing protective devices. We're a pretty well-rounded clinic. We didn't we know that we're not gonna have a solution for every single patient that comes in, but we want to make sure that we understand that we have enough in our clinic to take care of 99.99% of the people that come in. So why do I need another location? In LA, it's very tricky because driving five miles can take you an hour. So there is the idea that, yeah, maybe I should open a clinic. You know, for example, we're in Woodland Hills. We had this opportunity to open in Beverly Hills. And as much as my mindset said, yes, I gotta open in Beverly Hills, because that's, you know, I'm a Beverly Hills kind of person, I want to do that. But then I realized, wait, why did why am I doing that? Is it to expand access to the current patients we have? No, none of our patients live in Beverly Hills. I talked to a bunch of physicians and they're always asking me, when are you moving to Beverly Hills? When are you coming to Beverly Hills? I'm like, there are 10 audiologists in Beverly Hills. No, there's nobody here. I'm like, well, too bad for those folks that are not doing their job of marketing to all these primary care docs, physicians who are there, right? Internal medicine physicians who are reaching out to me. I'm 45 minutes away in LA traffic. Patients should not be driving to us, but they do because I've made connections with these physicians. So I look at that why. And so, you know, for me personally, yeah, there's still gonna be that little thing in the back of my head that says maybe I should open a second location there. But the why is the probably the biggest, most important thing that we, you know, that I will try to find out.

Blaise M. Delfino, M.S. - HIS :

So if you And you talk about self-auditing, like you know that now. Like, would the doctor Amit Gosalia 15 years or 20 years ago be thinking or asking that same question, or would he just have done it? I would have done it, right? So not knowing what I know now, and I get it.

Dr. Amit Gosalia:

You know, my dad used to tell me these things, and I hear it from patients. You know, everyone has advice. Sometimes you have to learn, you know, the mistakes versus being told what the mistakes are. Now, I knew that in my old office I had expanded to multiple locations, and when I did, they were pretty close to each other. I could literally drive to my other office and come back within 20 minutes. And I realized I was basically just cannibalizing my own, you know, market. So, you know, knowing that now, looking back at it, I will always tell people if you're gonna open a second location, number one, knowing the why, which we just talked about. Number two, and if this is more practicality, how far away is it? Are you really serving the community that needs you? Because there's a community here, it's all very young folks. There's a very small, and I'm not saying that hearing loss is only age-related, but it's a very small demographic for what we do. And I had another audiologist that I coached, and she was looking in this area. And when I did the demographics of that area, I said, this is not a good area for you to move into. But she really liked it because it was a newer area, it was clean, it was modern, and I agree, it looked great. Business-wise, I don't know if that would have been a good choice. And we decided, we as an she and I both decided that wasn't a good place to put your money. So, really understanding that. So, again, it all goes back to the why, why are you doing it? I know that if I open an office in Beverly Hills, I don't have staff that are gonna drive. Now, I live very close to Beverly Hills. I actually went door to door to this location I was looking at. It was eight minutes. So that's great for LA. But my staff coming from the valley, which uh, you know, I'm not assuming everyone knows the geography here, but coming from the valley, that would be like an hour drive, right? So it's not a good, that would not be a good thing for me to do.

Blaise M. Delfino, M.S. - HIS :

Experience really is the greatest teacher. And I love the fact that, you know, you've been coaching for so many years. I remember we had at one point, it was three locations, and yeah, that was stressful. And it was stressful from a scheduling standpoint. And like, here's the thing Pennsylvania, it snows. Rescheduling patients is like one of the most stressful situations when you have multiple locations, because when you have that one snowstorm that affects all the locations, okay, good luck. So so yeah, that now it's obviously consolidated to that one location. But Dr. Gosalia, I'm sensitive to your time. Where do you believe the field is heading over the next decade?

Dr. Amit Gosalia:

We always look at what are the threats to our profession. Now I can tell you, I'm old enough to remember. I know I sound like an old man now, but I'm old enough to remember back in the day we had a company called Songbird. Songbird came out with this instant fit, basically, device. They look terrible, but they fit inside your ear, and you had preset matrices on how they would sound. So you would do the hearing test on the patient, you'd find the matrix that was closest to their hearing loss, and you would sell these for I don't remember how much they cost, and then they would just use those, and after a certain amount of time, it was long enough ago, I can't remember, the battery would die, and they'd come in and they'd buy another one. People were up in arms at that time saying, our profession's done. Now, this is 2001, okay? That's 24 years ago. Then came Hearing Planet. Hearing Planet was the original, you know, kind of middleman, third party. This was not an insurance thing, but they were an online company where you would buy the hearing aids for a discount and then they would pay the providers a fitting fee. Not knowing any better, I participated in the beginning and very quickly within six to 12 months realized this is garbage. I'm spending more time with these people and I'm not getting paid anymore. We were all up in arms saying our profession's over. That was like 2004, 2005. This keeps happening. This keeps happening, right? The reality is that our profession is only gonna grow. It's only gonna grow because you know, you you already hit it on the head that AI is one thing. Third-party payers are one thing. These discount companies online, people are slowly starting to recognize that there's no, there's not a real big discount there. Yeah, you're paying less up front, but in the long run, you're paying way more. So, I mean, we have data. I mean, I have data to support this that we have patients who have bought hearing aids, I won't name them, but they buy these online, you know, they buy these hearing aids online, they get the hearing aid, they have to do this telehealth, and they don't like doing the telehealth. They can't connect, they can't, there's no in, there's no personal touch on those appointments. Then they come in to see me. I've got a fee schedule, I'm gonna charge you for seeing me. And we have two examples that we've used in teaching practices where within a year and a half of seeing these two patients, then I've only used these two as an example, they paid more after they paid for the hearing aids and paid me than they would have if they just paid me directly in the beginning. Right? So we are a bundled practice, and so we generally will bundle all the services for our patients and sure. So, yes, there is a higher upfront cost, but I'm one of those practitioners, doctors who says, you know what, I would rather see you more than less. Yeah, my time is valuable, but it's valuable only because you make it valuable. And I want you to come in numerous times. So we see our patients all a lot of times. I have a patient who comes in once a month, and my staff are like, Why does he keep coming in? I'm like, Well, listen, he's coming in because he needs the help and he's part of this program. We're gonna see him once a month, and I don't care.

Blaise M. Delfino, M.S. - HIS :

And maybe, maybe he's lonely. I mean, we go into the the loneliness epidemic.

Dr. Amit Gosalia:

Yeah, there's so many things, but the reality is that the the care part of it is important, yeah. So that that touch point, these patients need to have that communication, and that's why we're 2025, and I just did the numbers three weeks ago, and I think we've already been on on track. We are 150% above 2024. Why? We didn't do anything different. We're seeing more and more patients coming in saying, Hey, I want to buy real hearing aids, and they'll come in with a brand of hearing aid that we actually work with. They'll say, Well, truth be told, you have real hearing aids, but they don't think it's a real hearing aid because they bought it online. The future of audiology is very strong. I tell every student they see it. We're seeing patients, you know, we're a month out on scheduling, we're busier than ever.

Blaise M. Delfino, M.S. - HIS :

Dr. Casalia, what is the one message you hope every hearing care professional takes away from this conversation today? We have to work together to make this profession stronger.

Dr. Amit Gosalia:

We have to fight off the threats together. And every single person listening to this has to do more to strengthen our profession. Dr.

Blaise M. Delfino, M.S. - HIS :

Castalia, I appreciate, as always, your radical candor. Thank you for everything that you have and continue to do for this incredible field of audiology, hearing, healthcare. You're tuned in to the Hearing Matters podcast. Until next time, hear life's story.

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Blaise M. Delfino, M.S. - HIS

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