Jump Start Your Practice with Recreational Audiology

by Robert M. Traynor, Ed.D., MBA, FNAP & Garry G. Gordon, M.S.

Reprinted with permission from hearinghealthmatters.org

Prior to the COVID-19 Pandemic, competitive market conditions created a concern for practitioners as virtually all manufacturers, big box stores, physicians, hearing aid dispensers and audiologists were all pursuing the same patients. After the Pandemic, most practices will have survived though the hard work of employees and practitioners using creativity and technology skillfully in provision of essential services.  

Hearing healthcare clinicians across the country have demonstrated their value by differentiating their clinics for the “sales operations” by providing valuable assistance to their patients, despite the profound practice adjustments required by the COVID – 19 Pandemic.  As suggested by Swanepoel and Hall (2020) the practice of audiology is going to be forever changed, possibly as a High Touch, Low Touch or No Touch profession as we reconsider procedures long used as the mainstay of the profession. 

Now that the stimulus checks have been received, the Paycheck Protection Program (PPP) and Economic Injury and Disaster (EIDL) Loans are submitted, it is time to think about how to generate patients in the post COVID – 19 period.  

For practices that need a jump start or those that are looking for a market niche should consider the mostly ignored industrial and recreational hearing care markets as they offer tremendous potential.  As most hearing care professionals know, hearing damage is a serious occupational hazard in professions that expose workers to loud impulses or continuous noise. Over thirty million employees work in hazardous noise levels and they are found nationwide in all segments of the industry. Routine places where noise is a hazard in industry are (but not limited to):

• Manufacturing and Assembly
• Distribution Centers
• Military Personnel
• Construction Workers
• Law Enforcement
• Those who work near certain chemicals are also at risk. 

Of course, most occupational hearing loss happens gradually over the course of years, making it difficult to notice. But with appropriate measures, workplace hearing loss is completely preventable. Providing the services to analyze the noise, products to protect hearing and hearing aid products for those with occupational hearing loss can be quite a lucrative, but virtually untapped, market for hearing healthcare.  

Another market totally overlooked by clinics is recreational noise. While we have begun to serve the musicians, services to other components of the recreational market have been lacking. Practitioners often wait until these patients present themselves to their clinic rather than aggressively going after these perspective patients. The following activities can be dangerous for the ears: 

• Industry                                                                              
• Hunting & Target shooting 
• Snowmobiling
• Motorboating 
• Waterskiing or using a personal watercraft 
• Woodworking
• Listening to music

For many years, hearing care professionals were busy enough in their profitable practices that this population was ignored until presenting themselves as hearing impaired for treatment in the clinic. As the competition returns, actively pursuing these patients becomes a major source of well-funded consumers.

Currently, the hearing instrument market continues to demonstrate dramatic changes as a result of new technology, PSAPs, OTC’s, the Internet, direct to consumer and new venues such as Costco, Sam’s Club, Bass Pro, Cabela’s and, recently, issues created by COVID-19.  With such changes within the marketplace, it is reasonable that hearing care providers and product manufacturers need new methods of attracting new customers.

Industrial and Recreational Hearing Care

Is there such a thing as “RECREATIONAL HEARING CARE”?  When hearing healthcare providers get together, it is not uncommon for them to describe their area of expertise as clinical audiology, dispensing audiology, pediatric audiology and, yes in 2020, there are those that describe themselves as industrial and recreational audiologists or hearing care professionals. 

Recreational Audiology has been defined the Academy of Doctors of Audiology as the practice of hearing conservation and consumer education regarding products and services used to enhance and preserve hearing in occupations and environments that may or may not be regulated by governmental agencies.

Rose, Ebert, Prazma, & Pillsbury (2008) found that motor sporting events, jet skis, and all-terrain vehicles that have full throttle noise levels above 100 dB.  NASCAR is another popular sporting event in America, and one of the loudest. Rose and colleagues have demonstrated that noise levels in a seat 150 feet from the racetrack over the course of four hours dosimetry measured an average of almost 101 dBA.  Additionally, 20 feet from the racetrack in the front row, average levels were 106 dBA. You could expect that if a person did not have hearing protection at a NASCAR event, they might walk out with some permanent hearing damage or at least a temporary threshold shift in addition to tinnitus. Numerous trips to the NASCAR track would incur significant hearing damage.   At Folsom field in Boulder, Colorado, a University of Colorado football game has measured sound levels over 100 dB time-weighted average for a four-hour game (Filgor, 2011).  

It is interesting that our culture is proud that Arrowhead Stadium, home of the Kansas City Chiefs football team holds the Guinness Book of World Records loudest noise level recorded in a September 29, 2014 night game with the New England Patriots at 142.2 decibels.

According to Meinke (2020) other forms of recreational noise may even be more common. Approximately 46% of adult males and 13% of adult females reported firing a gun at some point in their lifetime on the 2007 U.S. National Health Interview Survey.  

 

In 2015, the US Fish and Wildlife Service recorded that 14.8 million hunters purchased permits and, in 2010, 1.7 million youths were hunters (Families Afield, 2010). Over 20 million Americans used firearms in target-shooting related activities in 2011 (Southwick Associates, 2013). Men, women and children all shoot for fun or sport.  Mienke & Colleagues (2009) measured these levels under controlled conditions, where they position one microphone near the left ear of the shooter, since most shooters are right-handed. She further describes that the peak sound pressure level (SPL) at this location will depend on several factors, one of which is the proximity of the muzzle or gas escape location to the ear. Pistols have shorter barrels than rifles or shotguns and result in high peak levels. 

Their observations indicated that it is not uncommon for pistols to have levels in the 160 to 170 dB range (Table 1).  Not only was there existing threat of a progressive noise induced hearing loss, but now with the modifications of firearms to include muzzle brakes and porting there are numerous reports of acoustic traumas  in the form of an instant hearing loss with tinnitus.

Although virtually ignored by practitioners, Wolski (2005) & Gordon (2020) concur that the market for hearing protection in industrial and recreational markets such as, manufacturing, aviation, musicians, law enforcement, auto racing, motorcycles, hunting and shooting sports is more than 60 million individuals. Approximately, 47% of those consumers will admit to a noticeable hearing loss. While some of these patients will eventually present themselves for hearing care on their own, specializing in industrial and recreational hearing impairment could have incredible positive results that could revitalize the most struggling practice.

A world leader in recreational audiology since the 1980s, Garry Gordon and his company, EAR, Inc., have initiated and enhanced the areas of both industrial and recreational audiology. Attending numerous shows such as National Rifle Association, Shot Show, and other industrial and recreational exhibitions frequented by hunting, shooting, motorcycling, law enforcement, musicians, etc., he and his colleagues discovered an extremely high incidence of noise induced hearing loss and consumers with the financial capability to purchase customized hearing products in the booth at these meetings.  

The early exposure to this market led to the development of the National Ear Care Plan (NECP) one of the first hearing product buying groups for audiology clinics.  While NECP was eventually purchased by HEAR USA, it was the first to utilize the services of 2500+ board certified audiologists that provided professional services to individuals and/or large industrial clients such as Bethlehem Steel, Motorola, United Airlines and many more.

Where Will Practices Find These Patients

Clinicians interested in this market need to know where and how to access this market the types of products and services are of interest to them. While many of these patients are interested in visiting the clinic, the greatest opportunity for access to this market is through outdoor tournaments, product shows, rallies where venues are permitted.

Examples would include Sturgis Motorcycle Rally, Grand American Trap Shoot, National Sporting Clays. Additionally, trade shows often exceeding 80,000 attendees such as the National Rifle Association, SHOT SHOW, Rocky Mountain Music Festival and many others.  And an interesting factor to include into this opportunity is several hearing healthcare manufacturing companies such as Lucid/Etymotic, Persona, Phonak, 3-M, Honeywell and others are displaying at these events.  

If audiologists want a piece of this opportunity it would serve them well to have representation at such locations.  In other words, toot your horn and make the markets aware of your expertise, skill and product line. Or as it has been said, having the best mouse trap in town is only the first step.  You also need to make sure your potential customers know about it and where to buy it.  

While industrial and recreational audiology can change the world for hearing healthcare professionals, it is paramount to understand marketing changes necessary for these consumers and how to turn them into loyal practice patients. Further, if these relationships are positive these patients will refer their friends, relative, others that are in industry or sportsmen that can connect with large industrial accounts.  In other words, consider that your practice is a fishing pole and pretend your credentials and experience are a fishing pole and your knowledge is choosing the correct bait. From here, think about the type of fish you want to catch, where to locate them and how to retrieve them.  

Industrial and Recreational Audiology offer tremendous opportunity as well as emotional and financial satisfaction. The current COVID-19 global pandemic has temporarily interrupted these opportunities.  However, once the current situation is under an acceptable degree of control, the industrial and recreational markets will rebound even better than before.  This will offer consumers seeking specialized hearing protection products and hearing aids the opportunities they need to find them.   

Bottom Line

As a result of the myriad of issues caused by COVID-19 practice patterns and modification are going to change drastically.  As we move into mostly technologically roadworthy Baby Boomers as patients there will be even more changes as they are computer literate, use smart phones, Bluetooth and other.  Hearing care professionals can no longer simply wait in the clinic and hope for patients to come to them, this post COVID-19 period is the time to find and create new markets for the services and products of independent hearing healthcare practitioners. 

As the market, patients, procedures, practice patterns and other changes occur in hearing healthcare, consider the move to industrial and recreational audiology for jump start, practice expansion, or just to add well deserving, well-funded patients to your practice. 

As Warren Buffet says, “Opportunities come infrequently. When it rains gold, put out the bucket, not the thimble.”   This is an irresistible opportunity.

References

• ASHA (2019).  Audiology Information Series: Home, Community, & Recreational Noise, American Speech Language Hearing Association, Retrieved April 14, 2020.
• Families Afield. (2010). An initiative for the future of hunting. Retrieved from Families Afield, April 26, 2020.
• Flamme, G.A., Wong, A., Liebe, K., & Lynd, J. (2009). Estimates of auditory risk from outdoor impulse noise II: Civilian firearms. Noise Health, 11(45), 231–242.
• Fligor, B. (2011). Recreational NIHL: A Summary of the Evidence, Audiology Online, Retrieved April 14, 2020.
• Gordon, G. (2020).  Incidence of Industrial and Recreational hearing loss.  Personal communication, April 23, 2020.
• Lankford, J.E., Meinke, D.K., Flamme, G.A., Finan, D.S., Stewart, M., Tasko, S., & Murphy, W.J. (2016). Auditory risk of air rifles. Int J Aud, 55(S1), S51-S58.
• Meinke, D. (2017, March). 20Q: A shot of prevention – hearing loss from recreational firearm noise. AudiologyOnline, Article 19626.  Retrieved from www.audiologyonline.com, April 26, 2020.
• Meinke, D.K., Finan, D.S., Soendergaard, J., Flamme, G.A., Murphy, W.J., Lankford, J.E., & Stewart, M. (2013). Impulse noise generated by starter pistols. Int J Aud,52(S1), S9–S19.
• Meinke, D.K., Murphy, W.J., Finan, D.S., Lankford, J.E., Flamme, G.A., Stewart, M., Jerome, T.W. (2014). Auditory risk estimates for youth target shooting. Int J Aud, 53(S1), S16-S25.
• Murphy, W.J., Flamme, G.A., Finan, D.S., Zechmann, E.L., Lankford, J.E., Meinke, D.K., & Stewart, M. (2012, October). Noise exposure profiles for small-caliber firearms from 1.5 to 6 meters. Paper presented at 164th Meeting of the Acoustical Society of America, Kansas City, MO.
• Rasmussen, P., Flamme, G., Stewart, M, Meinke, D., & Lankford, J. (2009). Measuring recreational firearm noise. Sound and Vibration, 14-18. 
• Southwick Associates. (2013). Target shooting in America report. Produced for the National Shooting Sports Foundation. Retrieved from Firearms Industry Trade Association, April 26, 2020.
• Swanepoel, D. & Hall, J. (2020). Making Audiology Work Post COVID-19 and Beyond., Hearing Journal, Online Edition, April 21, 2020, Retrieved April 27, 2020.
• Wolski, C. (2004). Recreational Audiology. Hearing Review:  hearingproductsreport.com, Vol 57. pp 6-     10., Retrieved from EAR, Inc., April 25, 2020.