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The Heart of the Matter: What Does America Really Know about Coronary Artery Disease Treatments? The SoundCure Serenade is a handheld device that is programmed much like a hearing aid using a computer and USB cable. SoundCure, San Jose, Calif, has announced the results of a randomized, multi-center clinical study that found the company’s S-Tones® to be effective at quiet volumes and to be more effective than broadband noise in the reduction of tinnitus. The study, published in this month’s (September 2014) edition of American Journal of Audiology (AJA), found that a majority of patients using the S-Tones® from SoundCure showed a greater reduction in tinnitus perception even at soft volume levels below their tinnitus perception when compared with broadband noise.
Traditional sound therapy treatments have attempted to provide relief by masking the tinnitus with an alternative background sound, such as broadband noise, or by helping a patient to perceive the tinnitus as quieter or less frequent. The study, commissioned by SoundCure, compared tinnitus perception reduction between Serenade’s S-Tones and broadband noise sound, delivered at low volumes. Study co-authors included Christina Stocking, AuD and Carrie Secor, AuD, of State University of New York (SUNY) at Buffalo, and William H. S-Tones can be combined with amplification, allowing for advancement in the treatment of both hearing loss with amplification and tinnitus with S-Tones in one device. Introduction: Tinnitus, the perception of the sound in the absence of an external acoustic source, disrupts the daily life 1 out of every 200 adults, yet its physiological basis remains largely a mystery.
Hearing Aid Source is the go-to clinic in Toronto with the experience and expertise in applying the tinnitus hearing aid solution that is right for you. If you or a family member would like to try the latest tinnitus management hearing aid, please call (416)463-4327 or (416)754-4327 or contact us to arrange a FREE hearing test and trial.
Read how Widex UNIQUE hearing aids performed against their current models in a recent trial. However, as author Joel Barker points out, “Vision without action is just a dream.” Action, therefore, is the goal. This paper discusses how to turn information from a practice benchmark study into action—to help hearing practice owners differentiate themselves from the competition. In September 2013, Siemens commissioned American Opinion Research (AOR) to repeat the benchmark study conducted 1 year prior (see August 2013 Hearing Review).1 The results reflect information gathered from the sample for the year 2012, as well as the first 6 months of 2013. One theory is that more patients are “purchasing” their hearing aids online, promoted by these companies’ lead generation programs. More than half (52%) of those who responded see and manage tinnitus patients, meaning almost half do not. To compete (and win) in today’s market, practice owners should set a goal to have new patients make up at least 60% of total gross revenue. To grow a practice, practice owners need multiple revenue sources with different service-pricing policies for various buying segments. By providing payment options, they are providing value to the end user, which can lead to more profit over the course of the hearing instruments’ lifespan. Practices need to make it a point to learn the facts about the Affordable Care Act (ACA) and how it affects hearing screenings for Medicare recipients.
Another way to differentiate a practice is to provide a unique environment, unlike anything the competition can offer, complete with outstanding patient care. Practice owners should take one day out of the year to put together a simple marketing plan worksheet, decide how much to allocate to marketing, create a plan for the year, and schedule time every quarter to review marketing efforts to measure their effectiveness. Take inventory of target audiences and develop a plan consisting of multiple channels to reach those targets most effectively. Our data showed that practices spread their marketing spend over a wide variety of vehicles, led by printed newspaper ads, followed by printed Yellow Pages and printed direct mail (Figure 5).
Practices need to be sure to incorporate search engine optimization (SEO) and search engine marketing (SEM) tactics like pay-per-click (PPC) into their marketing strategy.
Not too long ago, purchasing a hearing aid simply meant a visit to a local hearing care professional. The sound therapy device offers four tones (two customizable S-Tones, and one custom narrowband and one broadband sound).
However, in most cases, the masking noise must be at least as loud as the perceived tinnitus sound to provide sufficient relief for the patient.
The handheld Serenade device is reportedly available to tinnitus sufferers from hundreds of audiologists and hearing care providers across the United States and United Kingdom. The generation of tinnitus is commonly linked with the impaired functioning of the outer hair cells (OHC) inside the cochlea. Relation of distortion product otoacoustic emission and tinnitus in normal hearing patients: A pilot study.
Impaired cochlear function correlates with the presence of tinnitus and its estimated spectral profile. Investigation of olivocochlear and middle ear muscle reflexes with contralateral suppression of DPOAEs in real time; [abstract]. For practice owners and managers, the data is commonly used as a point of reference, allowing them to compare their own performance against those who responded. Total unit sales for the first half of 2013 were also down compared to the same period 1 year prior. As was the case in 2011, patient referrals remain the most common source of new patients, followed by physician referrals. Practices that have a formal tinnitus rehabilitation program report the program yields an average of 6% of their total business. Marketing spend among all practices in 2012 is varied, with 23% spending less than $5,000 and 13% spending between $50,000 and $300,000 (Figure 2).
We’ll also examine the importance of differentiation in each of these areas to stay ahead of the competition.
To increase revenue, practices must have a robust strategy in place to stave off the competition and attract new patients. They can start out by segmenting customers based on referral sources, then develop a strategy for different payors, taking into account the level of technology sold.
Referral programs are a simple way to attract new business while positioning a practice as the go-to provider in its market.

Whether an independent dispensing practice or a medically based practice, physicians represent an opportunity for additional referrals. They should educate physicians in their area on the new research on hearing loss and diabetes, falls, cardiovascular disease, cognitive decline, and other disease states (see Taylor and Tysoe on page 22). There’s nothing wrong with selling RICs, but to stay competitive, in-the-ear (ITE) instruments should make up at least 20% of product offerings. Diagnostic services and tinnitus treatment are points of differentiation that also may result in additional revenue streams.
Only half of our benchmark study participants see or manage tinnitus patients, while those with a formal tinnitus program have extremely low penetration rates (6%). Practices should consider augmenting tactics by focusing on the people they want to get in front of. An office should contain posters, infographics, and other collateral that tell patients you care about their overall well-being. For example, adding a practice listing on Google Places is a quick and free way to get found easily. New healthcare provisions, insurance companies, retail outlets, Big Box stores, and a growing online marketplace all present real and formidable competition.
SoundCure’s FDA-cleared Serenade® device provides S-Tones that are modulated at a specific rate, and are designed to provide relief at volumes softer than a patient’s tinnitus, thus reducing their sound burden.
In those reporting a reduction in their tinnitus, 2.7 times (270%) the number of patients reported a greater tinnitus reduction with S-Tones than with white noise. The information provides a visual snapshot of where they are in relationship to their peers and a glimpse into where they would like to be in the future. In fact, nearly 70% of all respondents were independent hearing care professionals (HCPs), mostly small to mid-size in staff size and number of locations (Figures 1a-b).
For example, third-party payors have unbundled dispensing fees whereas traditional dispensing fees often include cost of goods sold (COGS), professional fees, and profit. These findings are consistent with data presented by the Hearing Industries Association (HIA).3 However, many practices did report increases in ASPs, revenue, and unit sales for the first half of 2013. From 2009 to 2013, Costco’s hearing aid revenue grew on average 26%,5 while during the same period, Sam’s Club also increased its number of stores that sell hearing aids.
Fewer than half of all practices follow up with patients on a quarterly or semiannual basis; 41% don’t follow up at all.
The bulk of marketing dollars is spent on printed materials, and almost 60% don’t perform Internet or social media advertising. If we look at our study results, we see that on average new hearing instrument wearers made up 46% of total gross revenue. The growing number of third-party payors into the hearing care industry already requires a strategy for unbundling.
Our benchmark study revealed that patient referrals are the most common source of new patients (24%), followed by physician referrals (17%, Figure 3).
Practice owners need to ask, “Am I providing a personalized experience that will make them want to tell others? By establishing an ongoing dialogue, practice owners can position themselves as trusted resources and partners while helping physicians preserve their own patients’ health and safety. So, if the reason a practice only sells RICs is because fitting custom instruments is “a hassle,” then their product offering is not much different than the store down the street.
Invisible hearing instruments—tiny completely-in-canals (CICs) with wireless connectivity—and even custom hearing protection are game changers in themselves. While not every hearing care practice is qualified to perform a full range of diagnostic services, it’s important they advise patients on the services they can provide, from testing and fitting to verification and follow-up. If this wasn’t the case, then high-end shopping outlets and boutique businesses would no longer exist. Are patients receiving a modern, robust counseling tool to actively engage them in the decision-making process?
Out of the roughly 40% who do budget marketing dollars, less than 30% of them (29%) have an actual plan in place. There is certainly still a place for traditional advertising vehicles like print newspapers and direct mailers. It’s a quick and easy way to distinguish your practice from the others, giving credence to the personalized service that cannot be found elsewhere. A Pew Research study10 revealed that nearly 55% of people age 65+ use the Internet every day—and that number is growing steadily.
An online presence and outreach can define success—so practice owners need to invest in it wisely.
If HCPs want to stay competitive and relevant, and attract new patients, they need to level the playing field. Tinnitus treatment and the effectiveness of hearing aids: hearing care professional perceptions.
Interventional audiology: partnering with physicians to deliver integrative and preventive hearing care.
The S-Tones are customized to each patient’s tinnitus, and are reportedly unique to the SoundCure Serenade device. In addition, the average tinnitus reduction was 1.9 times (190%) greater for S-Tones compared to noise within 2 minutes of hearing the tones. Objective: The objective of the investigation was to study the features of Distortion product OtoAcoustic emissions (DPOAE) in a group of tinnitus patients with normal hearing and to find out whether there is any difference in DPOAE findings in the tinnitus patients with normal hearing and in persons with normal hearing with no complaint of tinnitus. According to different reports, 85-96% of patients with tinnitus present with some levels of hearing loss and only 8-10% have normal hearing. Almost three-quarters of respondents (73%) identified themselves as an owner of the practice. About 6 in 10 practices evaluate their marketing efforts and most respondents (76%) do not know their marketing cost per appointment. Those against unbundling should consider this: if they are already taking third-party referrals (eg, Hearing Planet or AARP), they are by nature unbundling.

This shows us the continued power of word-of-mouth (WOM) advertising while demonstrating the need to actively engage referral sources. Am I educating them in the latest diseases and comorbidities associated with untreated hearing loss?” They need to have a plan in place to follow up with patients on a regular basis. They should consider providing services as both a bundled package and a la carte, depending on the payor and performance level of the instrument.
Yet, many are reluctant to include tinnitus treatment as part of their services, despite tinnitus therapy being available in so many instruments.7 Practice owners need to familiarize themselves with hearing instruments that have built-in tinnitus therapy treatment. Are they being educated on comorbidities, the latest wireless accessories, and how to use their t-coils?
In our survey, respondents easily ranked these highest among concerns over the next 3 years. One of the most effective ways to do this is through differentiation—regardless of which manufacturer they choose to do business with. Results were compared with previous data and confirmed that, even when played at what the patient perceives to be very soft levels, therapeutic S-Tones offer greater tinnitus reduction than noise. In this last group, the isolated presence of tinnitus indicates that it may be an initial first symptom of diseases that are only diagnosed after the onset of hearing loss. So despite all the great technology packed into today’s hearing instruments, we’re still not improving our new patient penetration rate!
More than 40% of respondents indicated they perform zero follow-up with customers after the fitting (Figure 4). By positioning themselves as tinnitus specialists, they’re providing a service that differentiates them from the competition.
What about an aural rehabilitation program, which has been associated with long-term acceptance and lower return rates?8 These are the conversations HCPs need to be having with patients. Practices need to stop focusing solely on how they’re going to compete on price and instead compete on value and service—and on marketing (once they have a budget and plan in place)! The subject group consisted of 16 ears of patients, in which 6 subjects were having tinnitus in both ears while 4 subjects were having tinnitus only in one ear. The origin of tinnitus in this group is still more obscure than in those with concomitant hearing loss. It helps them build a better relationship, increases their chances for referrals, and will lead to more satisfied patients who are “customers” for life. All subjects were aged between 20 to 60 years with complaint of tinnitus with audiometrically normal hearing.
Control group was comprised of 16 audiometrically normal hearing ears of persons who were age and gender matched with the subject groups and had no complaint of tinnitus. If the OHC of the human cochlea are to be involved in the generation of tinnitus, testing of otoacoustic emissions (OAEs) could provide a reliable means of recording OHC dysfunction. DPOAEs can be recorded with better reliability at higher frequencies than transient evoked OAE. Result and conclusion: It was observed that the amplitudes of DPOAE were significantly lower in tinnitus patients than that of persons without complaint of tinnitus, at a frequency of 1281-1560, 5120-6250, 7243-8837 Hz, which imply that decrease of DPOAEs amplitudes may be related to the presence of tinnitus. At the beginning of the study, random selection of patients with tinnitus of different age groups and both gender was done during the period of 6 months (January 2012 to June 2012). Study group Consisted of 10 patients, aged ranges between 20 and 65 years complaining of tinnitus with audiometrically normal hearing, among them six were having bilateral and four were having unilateral tinnitus (n: 12 + 4 = 16). Control group Consisted of 16 normal hearing individuals without tinnitus with pure tone average <25 dBHL in the better ear. Recording was done from 16 ears of the selected patients with tinnitus (the study group) and 16 ears of audiometrically normal hearing individuals without tinnitus (the control group). There are some differences in the mean DPOAE amplitude levels between the study and the control groups.
Tinnitus in turn, which is an unpleasant sound, may act as a noise which resulted in a decrease of the DPOAEs amplitudes due to increase in the internal ear noises heard by the patients as ringing noises. This noise is one of the factors that result either in the absence or decrease in DPOAEs amplitudes.
In the presence of these results, tinnitus masker could be a good solution for the relief of annoyance resulted from tinnitus.
Here, we would like to focus one more fact that a decrease of the DPOAE amplitude is not only a result of a cochlear insult.
Efferent innervation of OHC is by the olivo cochlear neural pathway which is comprised of efferent neurons that travel from the superior olivary complex in the brainstem to cochlear hair cells.
Measurements of efferent effects on OAEs have been made with efferent activity evoked by brainstem shocks or by sound in the opposite ear. Various investigations have supported the conclusion that medial olivo cochlear system activity turns down the gain of the cochlear amplifier. DPOAE suppression is greatest when using contralateral stimulation tones close to primary tone f2. However, in our present study, we successfully determined a statistically significant difference in three frequencies out of eight total tested frequencies. More information can be obtained using a larger sample size which will add to the knowledge about the possible link of OHC functioning and tinnitus.
Thus, it can be hypothesized that there is an association between tinnitus and reduced cochlear OHC activity which indicate that the OHC of the cochlea are involved in the generation of tinnitus. However, studies with larger patient series would be required in order to strengthen the hypothesis.

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