July 30, 2025 • 43 mins
What happens when the demands of managed care clash with a provider's commitment to gold-standard hearing healthcare? For Jaysee Soto, owner of Altamonte Family Hearing in Florida, the answer lies in striking a delicate balance between business sustainability and patient-centered ethics.
Growing up in his family's New York City bodega, Jaysee watched his parents build relationships with every customer who walked through their door. Those early lessons in community connection now form the foundation of his hearing healthcare practice, where patients aren't just customers, they're extended family. Working alongside his wife Grace, Jaysee has created a practice environment where comprehensive care is the standard, not the exception.
The podcast takes us through Jaysee's unexpected journey from aspiring lawyer to passionate hearing care professional. That pivotal moment when he first witnessed a patient's face light up upon hearing their grandchild's voice clearly? It changed everything. Now he dedicates himself to creating those transformative moments for his patients, taking a full 90 minutes for comprehensive evaluations that far exceed industry minimums.
But this level of care creates tension when insurance and managed care plans don't adequately compensate for best practices like real ear measurement and extensive testing. Jaysee candidly shares his approach to this industry-wide dilemma: strategically limiting managed care appointments while ensuring those patients still receive quality care, implementing service plans that bridge the gap, and planning for growth that maintains standards while increasing access.
What emerges is a refreshing perspective on hearing healthcare economics. Rather than viewing patient care and business viability as opposing forces, he demonstrates how exceptional care creates its own sustainability through patient loyalty and word-of-mouth referrals. Even patients who initially come through managed care plans often return as private pay patients after experiencing the difference that comprehensive care makes.
Ready to discover what ethical hearing healthcare looks like in action? Listen now and learn how leading with heart can transform both patient outcomes and practice success.
Connect with the Hearing Matters Podcast Team
Email: hearingmatterspodcast@gmail.com
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Twitter: @hearing_mattas
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
You're tuned in to the Hearing Matters podcast, the
show that discusses hearingtechnology, best practices and a
global epidemic hearing loss.
Today on the Hearing Matterspodcast, we're joined by JC Soto
, owner of Altamont FamilyHearing in Florida.
Jc's journey into hearinghealthcare was not linear, but
(00:22):
it was purpose-driven.
With a passion for innovationand a heart for helping, he's
built a practice centered inethical care, even in the face
of managed care challenges.
We're diving into what it trulymeans to lead with the heart in
hearing health care.
Jc, welcome to the HearingMatters podcast.
Speaker 2 (00:46):
Thank you.
Thank you.
I'm so excited to be on hereand I have to start before
anything.
I have to start by giving youkudos for building this platform
, having this podcast with somany episodes.
Whenever I'm going on and justscrolling your content, I'm like
this is dedication.
I'm excited to be here and I'vebeen trying.
I told you a little bit behindthe scenes, I've been trying to
start a podcast on my own andit's still not live and I got
(01:08):
little ones at home and runningour practice doing the thing.
So whenever I come on and seeall this content and the
following that you have, I meanI got to give you a round of
applause, credit where it's dueand thank you for having me as a
guest.
Speaker 1 (01:19):
Thank you Absolutely, jc.
I'm humbled.
We are a small but mighty team,is what we say, but I've been
in your shoes running a privatepractice and you and I have been
connected for a couple of yearsnow.
So, honestly, coming from you,thank you so much, that really
does mean the world.
We're going to have a lot offun today because this episode
(01:41):
theme is ethical care in amanaged care world.
A lot to dive into today, solet's jump into it.
Jc, you once thought that yourcareer would lead to law, or you
know a similar field.
What ultimately drew you intohearing healthcare?
Speaker 2 (02:01):
It's a complex one.
It's like out of.
I say it fell from the sky forme.
I always see this story becauseI started working for a company
.
Today they're my competitor.
It was a large organization thathas a lot of retail stores and
I started working for them intheir call center.
But it happened to be in theircorporate office, met the right
people, networked.
I was doing well in there andsomeone there presented this
(02:24):
career choice to me.
They said hey, you know what?
Do you think about going intoan office, becoming a hearing
aid specialist?
I'm a hearing aid specialistand now have my board
certification and I was likeI've never seen a hearing aid in
my life.
Like up to this point, really,I thought that law, like I was
on debate teams in high schooland like I had this law journey
that I thought was where I wasgoing to go and the best thing
(02:47):
that's ever happened to me,because I went into an office, I
met the provider thatultimately became my sponsor.
I got to see you know just theday-to-day lives, like the
people that come in the stories,and once you start hearing
these stories, I'm preaching tothe choir to you.
But for those that don't knowabout in audiology.
Once you change someone's life,like once you hear you help me
hear my granddaughter, you helpme hear these sounds it's just
(03:08):
you're hooked, you're hooked andit's.
I'm lucky to get to do what Ido every day and I never in my
life would have thought thiswould be my career path.
Even my family's like how didyou?
Speaker 1 (03:29):
how did this happen?
You know what I mean.
And it's just it's been thebest and I love it a lot well,
let's, let's pause there becausewhen you and I connected a
couple weeks ago, you wereoriginally from new york, right,
your family's from new york.
Your mother and father owned abodega bodegas, yeah.
So to me it sounds like you'regenetically predisposed to
entrepreneurship, it's always,always, always based always.
What was it like growing up ina small family business?
Speaker 2 (03:47):
We were always in the business every single day.
My siblings I'm one of four,they can all attest to every
single time school was out NewYork City.
My parents didn't want us to beout playing in the streets and
going out and doing all thesethings.
So after school oftensummertime often unless we're
going back to Dominican Republic, which is where I'm from my
background we were in the bodega.
So since I'm like seven oreight years old, I've been a
(04:10):
cashier.
We're seeing all these lives ina bodega.
For those that don't know aboutNew York City, this is where
you get your groceries.
This is under the building.
A lot of people get most oftheir goods there.
So all the people that residein this building come down.
You get to meet all thesepeople, network with all these
people.
My parents both just you knowthey were both very extroverted
and connected with the people inthe community.
(04:30):
So we just I just saw this liketo me that's been the norm and
seeing them do their own thing.
So I've always had that bug inmy head of when I'm working for
someone else, I'm like man, howcan I do this on my own?
How can I do this on my own?
And when my wife and I starteddating, even before audiology.
Before that, she can tell youanything that I've ever done.
I've always thought I've alwayshad this conversation and
conflict with myself of likewait, I can, how can I do this
(04:51):
on my own?
And that's just a chip that Ihave in my head.
So, thanks to my parents.
Speaker 1 (04:55):
So, growing up in a business, you were then, years
later, introduced to hearinghealthcare and, to your point,
the first time you actually helpsomeone on the road to better
hearing.
It's absolutely intoxicating.
Now, what's also veryinteresting and seems to be a
common theme in hearinghealthcare, family practices.
(05:17):
And that's what I think is soincredible about what we do,
because, yes, there are retailstores out there and a lot of
them are wonderful, they providegreat care, but there's a lot
of family private practices inhearing healthcare.
You and your wife, grace, areworking together in the clinic.
What is it like running afamily-centered practice and how
(05:42):
has that dynamic shaped thepatient experience?
Speaker 2 (05:46):
Yeah, it's been not like what a lot of people expect
.
Oh, you work with your wife,that's got to be crazy.
How do you do it?
Not at all, it's been smooth.
Grace is very, also veryextroverted.
She's actually more I would sayeven more empathetic than me
when it comes to our patients,people that are coming in
hearing their stories.
Like she is just one that ifyou met her, I mean she would
chat with anyone and she'sreally, really intrigued in
(06:08):
their life story.
And those are, at the end ofthe day, like what we are
delivering is not just helpingthem hear better, it's the
relationship experience, theimpression that we leave in them
whenever they're going is notjust oh, I bought my hearing
aids at the store, it is.
This is my family that Iconnected to.
So I'm very much that way withmy patients.
I'm invested.
I want to know everything.
We need to know everythingthat's wrong so that we can fix
it.
And in that family is the core.
(06:30):
Like that is what most peopleare going to be complaining
about, or their families arecomplaining about their hearing
loss.
So they open up and when wehear these stories like you
can't help but connect.
So I'd say it really empowersthe patient of knowing here's
these two individuals that areboth caring for me.
And also, you know just when itcomes down to like the ethics
and just having peace of mind oflike here is this family that's
(06:51):
going to be taking care of me,not this manager, not this
supervisor that's overseeing,not this person that's trying to
make this.
You know, commission, andbecause sometimes that's what
you feel at the big, you knowretail stores and you can feel
it in a small practice too.
But you feel at the big, youknow retail stores and you can
feel it in a small practice too.
I'm not saying that the smallpractice is the only way that
you get excellent patient care.
I was once working at a retailchain, but I think that it's
just the extra little confidencethat the patient has where,
(07:13):
like you know, you're connectingwith two different individuals.
And now we have Francesca.
She's our front office personas well, and what we look for
when we're hiring for this roleand as we continue to grow, is
someone who has that core Likeyou have to care.
We don't want someone that'sjust sitting there twiddling
their thumbs, clicking theirpens and just going through the
motions to get that paycheck.
It has to be someone that cares, because my brand, reputation,
(07:40):
who we are, to the people thatwe are meeting every day, that's
gold.
So for me, more than revenue,more than all that because
that's ultimately also how youbecome successful is caring, and
you know, that's how youdifferentiate yourself in the
space, because it's a crowdedspace, but that's our niche, I
would say, is that it's small.
You're not going to see theseseven different providers.
It's me, grace, francesca,small team.
Speaker 1 (07:57):
A couple of things come to mind.
I remember being in privatepractice and obviously when we
connected, I'm like I grew up ina family practice.
I also ran the practice with mythen fiance, now wife.
We got married while we wererunning the practice and when
you talk about the empathy,autumn was very much the same
(08:18):
way, like Grace, and that issuch a backbone to your
organization because patientsabsolutely pick up on.
You, really do care about myhearing health care and we
always wanted to make sure itwasn't revolving door.
I've been following you onsocial for quite some time, jc,
and just seeing the videosyou're posting and the updates,
(08:42):
your caring attitude and yoursense of humor absolutely always
bleeds through social.
So the reason I bring that upis because I could imagine as a
patient that warm feeling thatyour patients get when they walk
through the door.
And you brought up somethingreally important in a not only a
crowded industry, there's a lotof competition, which
(09:03):
competition is absolutelywonderful because it makes you
better.
But two, in Florida, a lot ofindividuals retire there.
You have snowbirds, so wouldyou say that you, being a
family-owned practice,absolutely is that major
differentiator as it relates tothe competitive landscape.
Speaker 2 (09:23):
When you are a small business owner of any kind.
Not even audiology, like yourconnection to your community, is
the biggest thing.
I mean, when you go to any momand pop, you know you're meeting
the owner, you're seeing themevery day like that, having that
relationship and going back toback.
People look for that,especially the demographic that
we serve For the most part.
I always say that hearing aidsare for people with hearing loss
, no matter the age.
But a majority of what we seeis going to be our geriatric
(09:47):
population and they're very muchabout having that relationship
with you shaking your hand,knowing that you're an honest
person and that you're not justgoing to disappear tomorrow.
People look for that.
Speaker 1 (09:57):
Our patients want to know that you're going to be the
same provider that they'reworking with six months from now
to even a year from now, and,of course, things change.
Life happens.
But I'm so proud of you and soexcited for you because you're
growing and a couple of weeksago so there's a new journey for
(10:18):
Grace as well, which I want youto touch on that.
Yeah, yeah, I'm excited for her.
Grace had said I don't want tosell hearing aids and your
response was it's not aboutselling, it's about helping.
And how do you coach thismindset into your practice
culture?
Speaker 2 (10:34):
Grace is studying right now.
She's doing her InternationalHearing Society book work and
hopefully to become a traineeand do what I do and which I
think is awesome because, likeshe was our front office person
and just seeing all that and shegoes, I don't know.
I think I want to do this, likejust seeing.
I mean it's again.
It's infectious whenever you'reseeing people that are happy
like that and you want to.
(10:54):
That's a party, you want to getinto that party, right.
But her biggest concern was I'mnot a salesperson and so, like
you mentioned, I'm like itdoesn't matter, like we have
solutions for every budget orfor getting down to the number,
but at the end of the day, thesepeople are literally telling
you where it is that they have aneed, like they are scheduling.
You're not knocking on theirdoor.
This isn't you know.
(11:15):
You're not hounding them foranything.
They're coming to you with aproblem.
You have a solution and I'veeven told her when it comes to
numbers, because that's the bigthing.
Let's say, someone does want a$5,000, $6,000 hearing aid If
their hearing loss is callingfor the most support and noise
and all these things.
That technology exists, it ismore expensive, just like if you
want the best laptop on themarket it's going to be more
(11:37):
than the $300 Chromebook theirneeds, their wants and at the
end of the day, it's justpresenting this solution to them
.
And people will remember hey,you remember how you told me
that you were at yourgranddaughter's party or you
went to church and you didn'treally, you weren't
understanding the pastor, youweren't hearing the kids, or you
were sitting there, you feltisolated.
This little thing here is goingto help you because it has X, y
(12:00):
, z and that's literally thelimit or the extent I think that
we should get into when itcomes to tech and when it comes
to specs and all these thingsand I am guilty of being the
nerd that wants to feature dumpand say all the cool things that
there is, but at the end of theday, it's just you bring it
back.
This is what you told me, thisis the thing that's going to fix
(12:21):
it, this is what that costs.
That's it.
You're presenting them thesolution and then it's up to
that person to say you know what?
I can only afford X amount, orthat.
You know.
Thank you for providing asolution.
And I always say this there arepeople that come in and
unfortunately it happens in ourpractice.
There are people that come inthat have so much hearing loss
that a hearing aid is not asolution anymore, that they need
(12:41):
things like a cochlear implant,that they need, you know, maybe
an auditory processing disorder.
We need to refer them out.
There are people that you don'thave a solution for, so
sometimes people are really justhappy to know oh okay, we, I
can't.
You know, there is a thing thatI can purchase.
Yeah, it's pricey, you know allthese things, but there is
something that I can do to havemore quality of life in these
(13:01):
situations.
Speaker 1 (13:03):
Well, we always say listen twice as much as you
speak, right, and this is reallybringing me back because the
importance of the front officestaff.
I always say that the patientcare coordinator is the most
hearing healthcare professionals.
I know, I'm going to say it andI am a hearing healthcare
professional too.
The front office staff is themost important physician in the
(13:26):
clinic, because how can you do ahearing test, fit hearing aids,
without that most importantteam member, greeting the
patients, getting them signedout, things of that nature?
Speaker 2 (13:40):
It's the first impression too.
Speaker 1 (13:41):
It's that impression, it's the impression, oh my gosh
, and I'm so excited for Graceand your team because she
started.
She knows that first line ofdefense of I know what these
patients are going through.
I know what they're asking whenthey call.
I know that they're goingthrough that grieving process.
Maybe they've accepted theirhearing loss and they're at the
(14:03):
point where, like, yes, I needto do something about it.
She knows the importance ofhaving a spouse or a third party
coming with them.
Forget, you know, not becauseit increases help rate Sure, it
does.
But the most important thing isthat patient is bringing a
third party with them for thatemotional support.
Jc, I would always tellpatients when we would bring
(14:25):
them to the audiology suite.
First thing I would say is MrSoto, it's a pleasure to meet
you today.
I want you to know that I amnot here to sell you anything
today.
My goal is to help you make aneducated decision regarding your
hearing health care.
And you know what you couldvisibly see on that patient's
face go from like this to Reliefyeah, yeah, you just took it
(14:49):
off, you just it's that reframeand I don't know if the patient
went to X, y and Z hearingcenter and I don't know if they
felt like they were trying to besold hearing aids.
Yes, there is a transaction,but I'm so excited for this next
gen of hearing healthcareprofessionals.
Love what you're posting online.
(15:09):
I love it because it is helpingyour community, but also so
many others make educatedhearing healthcare decisions and
I learned this and, as I'm sureyou have, the importance of
caring, truly caring.
If you take care of yourpatients, your patients take
care of the business.
I heard that very early on andthen, when you actually see the
(15:32):
Pareto principle in effect,you're like, oh my gosh, we have
so much word of mouth.
Speaker 2 (15:36):
I was having a hard time considering do I get into
social media?
Or putting I mean I'm putting alot of time and effort into it.
By the way, I go by the baldhearing guy on social media.
If you guys, if you have a cellphone, follow me.
The whole goal of that becauseI was like is our target
demographic?
Let's say for the most part,that the geriatric population on
TikTok not so much Facebook,yes, instagram some Is it worth
(16:00):
putting all this time in?
Because again, I got a family,I'm running my business, I'm
doing these things.
The goal was normalize havingconversations about hearing
healthcare.
Sometimes.
My videos are funny, sometimesthey're educational sometimes,
but it's just getting peopletalking and I am.
I'm still growing it and I'mtrying to put the time in, but
I'm.
I love that I'm seeing familiescome in and younger people come
(16:22):
in and say my dad needs to comesee you, my mom needs to come
see you.
I had someone come from twohours away, two and a half hours
away, and it was.
I saw that you're the best atthis and I want to come to you
and I told this person becauseshe needed help.
She did move forward with somehelp, but I told her I'd be
happy to do the evaluation.
I'll give you some options.
I think it may be in your bestinterest to find a provider
that's closer to you, becausehearing aids are.
(16:44):
It's not just like you boughtthe laptop and I'll never see
you again or I'll see you when Ibuy a new one.
No, we see our patients everythree to four months.
There's annual hearingevaluations.
There's programming adjustingit.
There's annual hearingevaluations.
There's programming adjustingit's a lot.
So I had to tell her, like Iwouldn't want you to go home and
go.
Oh no, I got to go back toOrlando to see JC and she said
no.
And this is the thing.
Like I'm humbled.
I actually have a hard time,you know, sharing this.
But she shared like no, likeI've seen everything that you're
(17:11):
doing online.
But I mean, when this personleft, I was almost doing a
backflip.
If I was not 255 pounds, thebackflip would have happened,
because I was really excited andI'm still like that.
It's still crazy to be two anda half hours like that.
That's that made my day.
Speaker 1 (17:24):
Yeah, that's, that's impact.
And, JC, just keep doing whatyou're doing.
And when we initially connectedand we were talking about what
is the story that we want totell to the Hearing Matters
podcast community, it came downto the managed care landscape.
There's a lot of hearing careprofessionals today that are
(17:44):
either bundling, going unbundled.
How are they managing managedcare?
How are they letting thepatients know exactly what their
plan encompasses?
So let's talk about the managedcare landscape.
You've been open about theethical dilemma that it presents
.
Share what that looks like dayto day in your clinic.
Speaker 2 (18:08):
So the conversation in audiology for a lot of us is
how do we get out of thesemanaged care plans?
What some of these plans arepaying does not justify the
level of healthcare that we wantto give to our patients.
It's usually like the minimumper state and the patient does
not always know this and this isthe tough thing.
Like it's not the patient'sfault, they are ignorant to you
(18:30):
know, whenever they're coming in, what the highest level of
hearing healthcare is.
Things like real earmeasurement that we preach all
day, every day.
For those that aren't inaudiology, that is a way to
validate, to objectively knowthat a prescription is being met
.
Things like hitbox, things likegoing the extra mile in the
hearing evaluation, not justwhat is the minimum legally
(18:51):
required thing per yourlicensing boards, per your state
right?
So whenever an insurance planor these managed care groups,
whether it's a discount plan, aninsurance plan, whenever
they're telling hey, mr Patient,you have XYZ benefit for
hearing aids, often and this isnot always often, it's just
they're taking all of theseextra services, they're taking
(19:11):
it out of the pricing thatthey're charging the patients
for the hearing aids and they'repaying, of course, the
providers less than what theprovider would to our patients.
(19:34):
So this becomes why does MrSmith, who's paying us directly
for the hearing, who's paying usfor the highest level of care,
getting the same level of careas Mrs Robinson?
I don't know, let's just say aname right.
Who came through this insuranceplan?
Who's not paying for thesethings?
Is it morally correct to givethis person all of this extra
care without charging thatperson for it?
(19:56):
And if we are charging, howmuch are we charging?
And then this whole back andforth this is I'm trying to
simplify it as much as I can isa dilemma that we have where
many providers are wanting toget out because they say you
know what, at Altamont FamilyHearing, I want to give the
highest level of hearing healthcare, and this is what that
looks like.
And if these plans are notthey're not going to compensate
(20:17):
us for that then, instead ofproviding less than optimal care
, we either have to pass thosecosts on to the patient or we
have to choose to no longer seethose patients For someone
starting new.
This is where I was going inthe beginning.
If someone's starting theirpractice today, I say you almost
have to join all of thesemanaged cares because you're
trying to get your foot in thedoor.
You're trying to get in yourcommunity, you're trying to get
(20:39):
patients to review you on Google.
And you know, you got to paybills, you got to pay rent, you
got to pay the license, you gotto pay insurance, you got to pay
your staff, all these otherthings, and in the beginning.
Speaker 1 (20:48):
A private pay patient is going to cost you more than
a managed care patient, correct?
Speaker 2 (20:54):
Absolutely, absolutely.
The patient's going to calltheir insurance.
They're then going to say, hey,I need hearing aids in my area.
Here's, you know, altamontFamily Hearing.
They're going to pass that ballto us.
It didn't really cost anythingto the practice to acquire this
new patient which could be acheerleader in your community
for you.
That's how I started, that'show I'm sure most do, but there
does come a point where you'reinvesting in better equipment,
(21:16):
you're investing in betterthings, and these things lead to
better outcomes, and then youstart going wait, I want to do
this for everybody, which is thedilemma that I am in right now
and I'm sure a lot of practiceowners like.
We network a lot with people onLinkedIn and this is a very
common theme amongstprofessionals of do we just all
leave them?
Amongst professionals of do wejust all leave them?
(21:39):
And that's a tough one, becausethere's a lot of people.
What about that patient who hasaccess to Medicare and Medicaid
, which would fully coverhearing aids?
You're saying I'm not going tosee that person?
That person either has to gosomewhere else, or there are
scenarios that people travelfrom like an hour away because
they can't find a provider,because providers are opting out
.
There are people thatlegitimately cannot afford these
services.
Let's say, if they're on agovernment program like Medicaid
(22:00):
, so do they not get hearinghealth care?
If everybody opts out, how muchcan we explain, how much can we
try to make our case to theseinsurance plans for them to
increase what they're paying foror to pay appropriately for the
level of health care that everypatient deserves?
Is that really going to happen?
Like?
That sounds good on paper.
It sounds good on a podcast.
(22:21):
How many people would it take tofight that fight, for them to
go?
You know what?
You're right.
I can only control my domain,which is Altamont Family Hearing
and the level of health carethat we have here and that is
where I'm at with this fight iswho does it make sense for us
financially to see and thatsounds horrible, to say it right
, like as I'm saying this nowsounds like money, greed,
(22:41):
transaction, all these thingsthat could be a trigger.
But I'm supporting staff, I'msupporting my family and I want
to be the best I don't want tobe.
I don't want to deliver servicebecause we're getting paid an
amount for it and then it just,you know it goes back to like
what is really the right thing.
Speaker 1 (22:58):
You know what's the right thing.
I'm so thrilled that we'rehaving this conversation because
we have to have these tough,challenging, hard conversations,
because we are looking to movethe needle in hearing healthcare
as it relates to access,affordability, best patient care
.
We know that a small percentageof hearing care professionals
(23:23):
are implementing best practices,specifically real ear
measurement.
That's why, at Hearing Matters,we're connecting with
professionals from outside theindustry to learn what they're
doing, to say, hmm, how can wechange up our models a little
bit when you are working with apatient?
And this just goes to show howmuch you care about your
(23:45):
patients the fact you're havingthis conversation because
practices all across the UnitedStates are experiencing this.
So what are some of thesesolutions?
You know we talk about knowingwhat your cost per hour as a
clinic owner is so important.
So let's just say that yourcost per hour is $250.
(24:06):
To break even, just keep yourdoor open.
You have to make sure thatyou're making at a minimum $250
an hour.
Right, for those tuned in whoare unaware of what a cost per
hour is as it relates to theclinical aspect of it.
So, jc, what you're saying isbalancing the desire to provide
(24:27):
comprehensive care, like realear measurement, like hit boxes,
you know when reimbursementdoesn't really support it.
How is your team?
Speaker 2 (24:36):
handling this.
Speaker 1 (24:36):
Yeah, yeah.
Speaker 2 (24:39):
We have two buckets.
When that phone rings, it is isthis a person that came from
our marketing efforts that foundus on, whether a mailer,
whether Facebook, whether ourwebsite, whichever?
Is this person coming to usbecause they found us, let's say
, organically online and they'relooking for the best hearing
health care that they can get?
Or has this person reachedtheir insurance and their
(25:01):
insurance said, hey, go toAltamont Family Hearing?
We do split these twoappointments and one of the
things that we have tostrategize in you know, talking
about billable hour and stayingafloat because I want to be in
business for a very long time ishow many of those, how many
patients that come in throughinsurance, through those managed
care that we have to respectthose contracts and see them
(25:22):
through those plans.
How many of those can I see ina week?
One, two.
It used to be five, six, nowit's one or two and these
numbers dwindle because we dohave a priority for those that
are not coming in through thosechannels.
The amount of time so we havean hour and a half hearing
evaluation for both parties thisis one that I'm still battling
with.
Speaker 1 (25:41):
I believe it's a serious investment of time.
It's a lot, but why is thatdepth of care so important to
you?
I?
Speaker 2 (25:46):
think the audio has to be one of the most important
things.
Like, I made it 50% yeah, let'ssay about 50% of it.
There's the fitting withRealEar.
But first you got to find outto get those targets.
We got to do the whole test.
No-transcript person's in thatparty.
(26:25):
When that person's on thecruise ship, the graduation
Thanksgiving table how well arethey going to be able to
understand speech in thepresence of noise?
How much do I need to reducethis noise in order for them to
do well, if they can, if theyhave the ability to do so, to do
well in that environment?
That information helps me findout what's the best thing for
(26:46):
them.
That's how I know what's theright hearing aid to choose.
Like so many times there'speople and I'm sure you've heard
this, you've been in theindustry longer than me and you
have your family in there.
I'm sure you've heard of peoplesay like, oh, hearing aids are
crap.
Or I hear these hearing aidsdon't work.
Or I have this friend whobought this hearing aid and
spent X amount of dollars andthis thing doesn't work.
There's so many reasons whythat could have been.
(27:06):
Like I don't and I hear that inmy community too.
I don't understand it, becausethat's not what we see in our
office.
Like our patients are coming in, they have the opportunity to
say this is good, this is bad.
We have over a hundredfive-star Google reviews and
this is I'm not just saying thisto toot our horn.
What I'm trying to say withthis is we are taking more time
than what is legally required.
(27:26):
We are doing more than what isthe minimum.
All that extra informationmeans better data, better
decisions for the provider tomake the choice for the patient,
the best choice for the patient, and then better outcomes.
I've had like two returns in thelast I don't know three years
maybe.
Like we do not have returns.
That is not a thing here.
Like someone has to pass awayor exchanges happen, like
(27:50):
sometimes someone could say Idon't like this, right, you know
I don't want this aid, or wetry something different.
Returns like that is and mywife Francesca can attest like
that is not a thing that happensin our office.
But we are putting it all like Iam invested in every way the
delivery, the test.
I'm trying to be the best.
I'm not trying to be, eh, butthat takes time.
But patients know that likethey feel that they know when
(28:12):
it's just like oh, mr Smith,you're coming in, just drop off
your hearing aids and in 10minutes we're going to clean
them and check and give themback to you.
The reputation is every timepeople come.
We reputation is every timepeople come, we're sitting down
and we're invested in you.
That time costs money.
Time is money.
So then this just goes back tolike that whole managed care
split and everything else.
Like this is where it becomesdifficult, because the more that
(28:34):
I'm providing, the moredifficult it is to justify the
minimum that some of these plansare paying.
And that's the.
What do I want to be?
Do I want to be the guy that'sjust doing a bunch of hearing
aids through managed care orhaving a higher quality visit
for the patients that are comingin who value their hearing and
(28:55):
are choosing us to help themwith their problem?
Speaker 1 (28:57):
Let me ask you, because I love different models
in business and there arespecific models that work better
in certain parts of the country, but the number one model is
caring.
Caring is number one, but I'velearned personally when we were
in private practice.
(29:17):
We also ran into that dilemmaas well, and it's more or less.
I think it's such a greatconversation to have because it
shows that you're aware of yourKPIs, your key performance
indicators, that you're lookingat that dashboard, because, jc,
what I'm hearing is I'm nothearing billable hour from you.
I am hearing I want to help asmany patients as possible while
(29:42):
also building a sustainablebusiness that remains active for
my patients to hear the bestthat they can.
There's nothing wrong, in myprofessional opinion, with that
thought process.
I'm curious to know what yourthoughts are on.
Speaker 2 (29:58):
So you're at this typical war that I have right
now.
Speaker 1 (30:02):
Okay, have you considered once Grace and this
might be a great case study onceGrace gets her license, because
I've heard other practiceshiring audiology assistants
you're in a great positionbecause you have a family member
that works there.
She's learned from you and youfrom her.
Have you thought about havingher start with taking care of
(30:23):
all those third-party patients,and what would that model look
like?
Speaker 2 (30:27):
That is right now my goal that annuals, as our annual
patients so even those thathave purchased from us privately
, probably in the beginning,helping me doing those updated
annual tests and the managedcare, because that's going to
expose her to a lot of testsearly on and, like anything else
, I'm an experienced she has toget in there and that would also
(30:48):
free me up so that we can havea better split of hey when
someone's coming in saying Iwant to hear the best that I can
and you know they're a directpatient, not a managed care
patient.
That way we can give priorityBecause I will say, going back
to experience, I've been doingthis over 10 years.
I have way more continuingeducation hours than is required
by my state licensure.
Every single time I'm renewingI want to know I'm the nerd
(31:11):
there.
I'm going to research as muchas I can and because of that
experience people are going tohave more from me in the
beginning of what's the bestchoice of the hearing aid for me
.
So that way we can make surethat the patients that are
coming in looking for thatthey're scheduled with me and
then as she grows, as she hasexperience, then we'll see where
(31:32):
that splits and where we go,but I think that'd be awesome.
One more thing I wanted to touchon when it comes to the managed
care thing, we have a bundledservice, so a lot of practices
that that's, I would say, amajority of what I hear.
I know people are unbundled.
That means when people aretrusting Altamont Family Hearing
and purchasing hearing aids forour current model for five
years, we're cleaning, checking,adjusting, annual testing,
(31:52):
reprogramming, you know, hitboxes, real ear measurement all
these things that we do isincluded in the pricing that
they're paying.
For those that are coming frommanaged care, we do have service
plans.
Another ethical split is, let'ssay, mrs Smith came in for
hearing aids.
We offered what was recommendedfor hearing loss within her plan
(32:13):
, and then we go hey, in orderto have these services that we
think is the gold standard andfor you to have the best hearing
that you can achieve, it'sgoing to cost X amount of
dollars on top of what you'vepaid that business entity
because that's not us.
And then the patient goes well,why don't I just get them from
you?
This happens all the time, thishappens almost every day and we
(32:34):
have to explain to patients.
Well, because I am contractedwithin this insurance plan and
you've come to me through thisinsurance plan legally, per my
contract, altamont FamilyHearing cannot service you
directly.
Speaker 1 (32:51):
I think there's new hearing healthcare professionals
who, when they enter the fieldof hearing healthcare, they're
so excited and then, when you doown the practice you're looking
at okay, well, what does thefitting fee look like?
Is this matching my billablehour?
How many patients do I need tohelp to ensure that from that
financial aspect, it makes sense.
So I think you have a great wayto handle and manage the
(33:13):
managed care.
At the end of the day, we'resaying here this is a human
being across from our table andwhat I'm hearing from you is I
want to help everyone hearbetter.
When we were in practice fulltime.
My mother and father are stillrunning the practice, but I
would call up the differentmanaged care organizations and I
would ask okay, per thecontract, what is included?
(33:34):
Because if you are offering aservice plan, then you know from
a legal standpoint and JC and Iare not providing any legal
advice here by any means, justmake sure you call the insurance
companies that you arecredentialed with.
Specific to managed care, but wewould outline okay, managed
(33:55):
care A includes X, y and Z.
Well, but then it goes back tothe ethical aspect of this is
within my scope of practice.
But let's look at the brightside, because we have to face
the brutal facts right.
The bright side is that whenyou start to help your patients
(34:16):
hear better, we say hear a lifestory.
That news spreads like wildfirewithin your community.
So to me you have a model setin place.
Once Grace starts fittinghearing technology, she'll be
able to see those managed carepatients.
If 20% of your gross revenue isfitting fees and if that can
(34:40):
support your payroll and then80% is private pay rocking and
rolling, but that's not alwaysthe case.
We have some clinics that are50-50, 60-40.
So right now, we're sort ofjust.
This has been a conversation,though, that our industry has
had for many years, and I'velearned.
(35:02):
I feel as though, but I've alsolearned that what is your
market response and how are yougoing to manage your specific
model, because everyone'shearing healthcare model is
different.
But I've learned and you'velearned.
If you give more than what youreceive and you take good care
(35:24):
of your patients, your patientsare going to take care of your
business time and time again,but that just, and I believe, I
believe I've been feeling that.
Speaker 2 (35:34):
So in year five, we're, of course, seeing
patients that we saw in 2020,who, most of the majority like
that is why I'm still inbusiness is managed care in the
beginning, right, like they,especially through a worldwide
pandemic and that's a wholeother subject for a whole other
day, right, but, like so, a lotof these people came in.
They got to know me, they gotto know what I stand for, they
got to know what it is thatwe're providing and their second
(35:56):
time around, like these people,are now in five-year technology
.
Many, you know those would beout of warranty.
Those that are considering neware going.
Now they know me and nowthey're giving us an opportunity
directly versus and they're alittle more informed, because
now they know that could havebeen their first hearing.
And now they know, oh man, Ididn't realize that I'd be
coming this often.
I didn't realize that the endwas every year, because how many
people don't come into theoffice?
(36:16):
You know, I'm sure you heardthis like oh yeah, I got these
hearing aids four years ago.
When was your last hearing test?
Four years?
Speaker 1 (36:22):
ago.
Speaker 2 (36:22):
And what are you talking about?
What are you talking about?
So, and these are things forthose that don't know no, no, I
get my eyes tested every year.
I go to the dentist.
You know, you got to get yourcleanings and all this.
I mean, this is part of yourhealthcare overall.
It is every year, it is notjust every time that you're
purchasing a hearing aid.
So these people are now givingus the opportunity directly,
which I think would be in ourgrowth plan, would be okay.
(36:45):
Now, if Grace is seeing thisarm of our business and I'm, you
know, still busy seeingpatients privately that just
means to, you know, as thosepatients keep coming in for
upgrades, hopefully they, someof them give me an opportunity,
and not just Grace, but you knowit just means growth and scale,
so helping more people.
Speaker 1 (37:15):
And at the end of the day, that's the reputation.
Helping people I'm excited forthat estate right.
Every market respondsdifferently to the same product
and or service.
It's demographics and I think,the old tune of well, everyone
just drop out.
We learned you put your horseblinders on what is best for the
(37:38):
patient, what is best for ourpractice, if the goal is to
build a sustainable business andyou know your numbers and
helping patients who presentwith managed care because at the
end of the day, it's not theirfault, it's not like, oh, you
chose x, y and z managed care.
So I'm sorry, mr smith, I can'thelp you learn to manage it.
(38:02):
This is where it gets fun andexciting, because, my goodness,
maybe Mr or Mrs Smith has afriend who needs hearing
technology and they go, theypurchase privately from you A
lot of us, we fit that same orsimilar product right, but how
do we get that information outthere?
I almost wonder too, jc, youknow, because, again, this is
(38:24):
how the Hearing Matters podcaststarted.
You create a media verticalspecifically for your managed
care patients and you investtime, effort and energy into
creating some sort of videoformat for these patients,
because I'm all about transferof information, process of
duplication.
Let media do the rest for you,especially for those follow-ups,
(38:48):
for the cleaning videos, thingsof that nature.
Getting creative with themanaged care is best for your
patients helps your top andbottom line.
Top and bottom line of businessis people.
Jc, you've been so graciouswith your time.
I really appreciate you joiningus on the Hearing Matters
podcast.
My final question for providerstuning in who really do feel
(39:09):
the tension between care andcost what is your message to
them when it comes to stayingethical, staying passionate and
staying in the fight?
Speaker 2 (39:24):
At the end of the day , I think the and this is the
conversation that I continue tohave with myself.
I hope this advice helps you aswell is why do we do what we do
?
And it's to help people hearbetter.
That is, sometimes we get lostin compensation and the cost of
living is going up every singleday.
(39:44):
Every single person's feelingit.
We can get hung up on numbersand all these other things, but,
like you said before, the morepeople that you help, the more
that you're going out there likethat's gonna come back to you
and I really believe in that.
Like I've been experiencingthat in my life and there has
never been a point in my lifethat I've helped somebody, that
I've just selflessly put loveand energy into a person, that
(40:07):
somehow that did not come back.
And I do think that when itcomes to this, there's a lot of
frustrations and if you'resitting there, sitting here,
crunching numbers like me andgoing like man, this just
doesn't make sense.
Or we feel like we're gettingbeat up by these managed cares.
Sometimes, like at the end ofthe day, it's like listen, this
person that's coming into youroffice is trusting you,
connecting with you, and theyknow people.
(40:28):
You're going to help them Overtime.
Somehow that's going to comeback to you.
But yeah, just coming back tothe root like this is why we do
it.
It's helping people and they'retrusting you for that.
Help Educate them and then overtime you know that somehow that
revenue is going to you, knowit's going to multiply because
they know a person, they're in achurch, they have a family
(40:49):
member and if none of thathappens, you just made that
person's day, you just helpedthem reconnect.
Speaker 1 (40:54):
Jc thank you so much for your honesty heart and your
leadership.
You know conversations likethis are what push hearing
healthcare forward and remind usof why we do what we do.
To learn more about JC and hisclinic, visit Altamont Family
Hearing.
That's A-L-T-A-M-O-N-T-Efamilyhearingcom.
(41:15):
And until next time, hearlife's story.
You're tuned in to the Hearing Matters podcast, the
show that discusses hearingtechnology, best practices and a
global epidemic hearing loss.
Today on the Hearing Matterspodcast, we're joined by JC Soto
, owner of Altamont FamilyHearing in Florida.
Jc's journey into hearinghealthcare was not linear, but
(00:22):
it was purpose-driven.
With a passion for innovationand a heart for helping, he's
built a practice centered inethical care, even in the face
of managed care challenges.
We're diving into what it trulymeans to lead with the heart in
hearing health care.
Jc, welcome to the HearingMatters podcast.
Speaker 2 (00:46):
Thank you.
Thank you.
I'm so excited to be on hereand I have to start before
anything.
I have to start by giving youkudos for building this platform
, having this podcast with somany episodes.
Whenever I'm going on and justscrolling your content, I'm like
this is dedication.
I'm excited to be here and I'vebeen trying.
I told you a little bit behindthe scenes, I've been trying to
start a podcast on my own andit's still not live and I got
(01:08):
little ones at home and runningour practice doing the thing.
So whenever I come on and seeall this content and the
following that you have, I meanI got to give you a round of
applause, credit where it's dueand thank you for having me as a
guest.
Speaker 1 (01:19):
Thank you Absolutely, jc.
I'm humbled.
We are a small but mighty team,is what we say, but I've been
in your shoes running a privatepractice and you and I have been
connected for a couple of yearsnow.
So, honestly, coming from you,thank you so much, that really
does mean the world.
We're going to have a lot offun today because this episode
(01:41):
theme is ethical care in amanaged care world.
A lot to dive into today, solet's jump into it.
Jc, you once thought that yourcareer would lead to law, or you
know a similar field.
What ultimately drew you intohearing healthcare?
Speaker 2 (02:01):
It's a complex one.
It's like out of.
I say it fell from the sky forme.
I always see this story becauseI started working for a company
.
Today they're my competitor.
It was a large organization thathas a lot of retail stores and
I started working for them intheir call center.
But it happened to be in theircorporate office, met the right
people, networked.
I was doing well in there andsomeone there presented this
(02:24):
career choice to me.
They said hey, you know what?
Do you think about going intoan office, becoming a hearing
aid specialist?
I'm a hearing aid specialistand now have my board
certification and I was likeI've never seen a hearing aid in
my life.
Like up to this point, really,I thought that law, like I was
on debate teams in high schooland like I had this law journey
that I thought was where I wasgoing to go and the best thing
(02:47):
that's ever happened to me,because I went into an office, I
met the provider thatultimately became my sponsor.
I got to see you know just theday-to-day lives, like the
people that come in the stories,and once you start hearing
these stories, I'm preaching tothe choir to you.
But for those that don't knowabout in audiology.
Once you change someone's life,like once you hear you help me
hear my granddaughter, you helpme hear these sounds it's just
(03:08):
you're hooked, you're hooked andit's.
I'm lucky to get to do what Ido every day and I never in my
life would have thought thiswould be my career path.
Even my family's like how didyou?
Speaker 1 (03:29):
how did this happen?
You know what I mean.
And it's just it's been thebest and I love it a lot well,
let's, let's pause there becausewhen you and I connected a
couple weeks ago, you wereoriginally from new york, right,
your family's from new york.
Your mother and father owned abodega bodegas, yeah.
So to me it sounds like you'regenetically predisposed to
entrepreneurship, it's always,always, always based always.
What was it like growing up ina small family business?
Speaker 2 (03:47):
We were always in the business every single day.
My siblings I'm one of four,they can all attest to every
single time school was out NewYork City.
My parents didn't want us to beout playing in the streets and
going out and doing all thesethings.
So after school oftensummertime often unless we're
going back to Dominican Republic, which is where I'm from my
background we were in the bodega.
So since I'm like seven oreight years old, I've been a
(04:10):
cashier.
We're seeing all these lives ina bodega.
For those that don't know aboutNew York City, this is where
you get your groceries.
This is under the building.
A lot of people get most oftheir goods there.
So all the people that residein this building come down.
You get to meet all thesepeople, network with all these
people.
My parents both just you knowthey were both very extroverted
and connected with the people inthe community.
(04:30):
So we just I just saw this liketo me that's been the norm and
seeing them do their own thing.
So I've always had that bug inmy head of when I'm working for
someone else, I'm like man, howcan I do this on my own?
How can I do this on my own?
And when my wife and I starteddating, even before audiology.
Before that, she can tell youanything that I've ever done.
I've always thought I've alwayshad this conversation and
conflict with myself of likewait, I can, how can I do this
(04:51):
on my own?
And that's just a chip that Ihave in my head.
So, thanks to my parents.
Speaker 1 (04:55):
So, growing up in a business, you were then, years
later, introduced to hearinghealthcare and, to your point,
the first time you actually helpsomeone on the road to better
hearing.
It's absolutely intoxicating.
Now, what's also veryinteresting and seems to be a
common theme in hearinghealthcare, family practices.
(05:17):
And that's what I think is soincredible about what we do,
because, yes, there are retailstores out there and a lot of
them are wonderful, they providegreat care, but there's a lot
of family private practices inhearing healthcare.
You and your wife, grace, areworking together in the clinic.
What is it like running afamily-centered practice and how
(05:42):
has that dynamic shaped thepatient experience?
Speaker 2 (05:46):
Yeah, it's been not like what a lot of people expect
.
Oh, you work with your wife,that's got to be crazy.
How do you do it?
Not at all, it's been smooth.
Grace is very, also veryextroverted.
She's actually more I would sayeven more empathetic than me
when it comes to our patients,people that are coming in
hearing their stories.
Like she is just one that ifyou met her, I mean she would
chat with anyone and she'sreally, really intrigued in
(06:08):
their life story.
And those are, at the end ofthe day, like what we are
delivering is not just helpingthem hear better, it's the
relationship experience, theimpression that we leave in them
whenever they're going is notjust oh, I bought my hearing
aids at the store, it is.
This is my family that Iconnected to.
So I'm very much that way withmy patients.
I'm invested.
I want to know everything.
We need to know everythingthat's wrong so that we can fix
it.
And in that family is the core.
(06:30):
Like that is what most peopleare going to be complaining
about, or their families arecomplaining about their hearing
loss.
So they open up and when wehear these stories like you
can't help but connect.
So I'd say it really empowersthe patient of knowing here's
these two individuals that areboth caring for me.
And also, you know just when itcomes down to like the ethics
and just having peace of mind oflike here is this family that's
(06:51):
going to be taking care of me,not this manager, not this
supervisor that's overseeing,not this person that's trying to
make this.
You know, commission, andbecause sometimes that's what
you feel at the big, you knowretail stores and you can feel
it in a small practice too.
But you feel at the big, youknow retail stores and you can
feel it in a small practice too.
I'm not saying that the smallpractice is the only way that
you get excellent patient care.
I was once working at a retailchain, but I think that it's
just the extra little confidencethat the patient has where,
(07:13):
like you know, you're connectingwith two different individuals.
And now we have Francesca.
She's our front office personas well, and what we look for
when we're hiring for this roleand as we continue to grow, is
someone who has that core Likeyou have to care.
We don't want someone that'sjust sitting there twiddling
their thumbs, clicking theirpens and just going through the
motions to get that paycheck.
It has to be someone that cares, because my brand, reputation,
(07:40):
who we are, to the people thatwe are meeting every day, that's
gold.
So for me, more than revenue,more than all that because
that's ultimately also how youbecome successful is caring, and
you know, that's how youdifferentiate yourself in the
space, because it's a crowdedspace, but that's our niche, I
would say, is that it's small.
You're not going to see theseseven different providers.
It's me, grace, francesca,small team.
Speaker 1 (07:57):
A couple of things come to mind.
I remember being in privatepractice and obviously when we
connected, I'm like I grew up ina family practice.
I also ran the practice with mythen fiance, now wife.
We got married while we wererunning the practice and when
you talk about the empathy,autumn was very much the same
(08:18):
way, like Grace, and that issuch a backbone to your
organization because patientsabsolutely pick up on.
You, really do care about myhearing health care and we
always wanted to make sure itwasn't revolving door.
I've been following you onsocial for quite some time, jc,
and just seeing the videosyou're posting and the updates,
(08:42):
your caring attitude and yoursense of humor absolutely always
bleeds through social.
So the reason I bring that upis because I could imagine as a
patient that warm feeling thatyour patients get when they walk
through the door.
And you brought up somethingreally important in a not only a
crowded industry, there's a lotof competition, which
(09:03):
competition is absolutelywonderful because it makes you
better.
But two, in Florida, a lot ofindividuals retire there.
You have snowbirds, so wouldyou say that you, being a
family-owned practice,absolutely is that major
differentiator as it relates tothe competitive landscape.
Speaker 2 (09:23):
When you are a small business owner of any kind.
Not even audiology, like yourconnection to your community, is
the biggest thing.
I mean, when you go to any momand pop, you know you're meeting
the owner, you're seeing themevery day like that, having that
relationship and going back toback.
People look for that,especially the demographic that
we serve For the most part.
I always say that hearing aidsare for people with hearing loss
, no matter the age.
But a majority of what we seeis going to be our geriatric
(09:47):
population and they're very muchabout having that relationship
with you shaking your hand,knowing that you're an honest
person and that you're not justgoing to disappear tomorrow.
People look for that.
Speaker 1 (09:57):
Our patients want to know that you're going to be the
same provider that they'reworking with six months from now
to even a year from now, and,of course, things change.
Life happens.
But I'm so proud of you and soexcited for you because you're
growing and a couple of weeksago so there's a new journey for
(10:18):
Grace as well, which I want youto touch on that.
Yeah, yeah, I'm excited for her.
Grace had said I don't want tosell hearing aids and your
response was it's not aboutselling, it's about helping.
And how do you coach thismindset into your practice
culture?
Speaker 2 (10:34):
Grace is studying right now.
She's doing her InternationalHearing Society book work and
hopefully to become a traineeand do what I do and which I
think is awesome because, likeshe was our front office person
and just seeing all that and shegoes, I don't know.
I think I want to do this, likejust seeing.
I mean it's again.
It's infectious whenever you'reseeing people that are happy
like that and you want to.
(10:54):
That's a party, you want to getinto that party, right.
But her biggest concern was I'mnot a salesperson and so, like
you mentioned, I'm like itdoesn't matter, like we have
solutions for every budget orfor getting down to the number,
but at the end of the day, thesepeople are literally telling
you where it is that they have aneed, like they are scheduling.
You're not knocking on theirdoor.
This isn't you know.
(11:15):
You're not hounding them foranything.
They're coming to you with aproblem.
You have a solution and I'veeven told her when it comes to
numbers, because that's the bigthing.
Let's say, someone does want a$5,000, $6,000 hearing aid If
their hearing loss is callingfor the most support and noise
and all these things.
That technology exists, it ismore expensive, just like if you
want the best laptop on themarket it's going to be more
(11:37):
than the $300 Chromebook theirneeds, their wants and at the
end of the day, it's justpresenting this solution to them
.
And people will remember hey,you remember how you told me
that you were at yourgranddaughter's party or you
went to church and you didn'treally, you weren't
understanding the pastor, youweren't hearing the kids, or you
were sitting there, you feltisolated.
This little thing here is goingto help you because it has X, y
(12:00):
, z and that's literally thelimit or the extent I think that
we should get into when itcomes to tech and when it comes
to specs and all these thingsand I am guilty of being the
nerd that wants to feature dumpand say all the cool things that
there is, but at the end of theday, it's just you bring it
back.
This is what you told me, thisis the thing that's going to fix
(12:21):
it, this is what that costs.
That's it.
You're presenting them thesolution and then it's up to
that person to say you know what?
I can only afford X amount, orthat.
You know.
Thank you for providing asolution.
And I always say this there arepeople that come in and
unfortunately it happens in ourpractice.
There are people that come inthat have so much hearing loss
that a hearing aid is not asolution anymore, that they need
(12:41):
things like a cochlear implant,that they need, you know, maybe
an auditory processing disorder.
We need to refer them out.
There are people that you don'thave a solution for, so
sometimes people are really justhappy to know oh okay, we, I
can't.
You know, there is a thing thatI can purchase.
Yeah, it's pricey, you know allthese things, but there is
something that I can do to havemore quality of life in these
(13:01):
situations.
Speaker 1 (13:03):
Well, we always say listen twice as much as you
speak, right, and this is reallybringing me back because the
importance of the front officestaff.
I always say that the patientcare coordinator is the most
hearing healthcare professionals.
I know, I'm going to say it andI am a hearing healthcare
professional too.
The front office staff is themost important physician in the
(13:26):
clinic, because how can you do ahearing test, fit hearing aids,
without that most importantteam member, greeting the
patients, getting them signedout, things of that nature?
Speaker 2 (13:40):
It's the first impression too.
Speaker 1 (13:41):
It's that impression, it's the impression, oh my gosh
, and I'm so excited for Graceand your team because she
started.
She knows that first line ofdefense of I know what these
patients are going through.
I know what they're asking whenthey call.
I know that they're goingthrough that grieving process.
Maybe they've accepted theirhearing loss and they're at the
(14:03):
point where, like, yes, I needto do something about it.
She knows the importance ofhaving a spouse or a third party
coming with them.
Forget, you know, not becauseit increases help rate Sure, it
does.
But the most important thing isthat patient is bringing a
third party with them for thatemotional support.
Jc, I would always tellpatients when we would bring
(14:25):
them to the audiology suite.
First thing I would say is MrSoto, it's a pleasure to meet
you today.
I want you to know that I amnot here to sell you anything
today.
My goal is to help you make aneducated decision regarding your
hearing health care.
And you know what you couldvisibly see on that patient's
face go from like this to Reliefyeah, yeah, you just took it
(14:49):
off, you just it's that reframeand I don't know if the patient
went to X, y and Z hearingcenter and I don't know if they
felt like they were trying to besold hearing aids.
Yes, there is a transaction,but I'm so excited for this next
gen of hearing healthcareprofessionals.
Love what you're posting online.
(15:09):
I love it because it is helpingyour community, but also so
many others make educatedhearing healthcare decisions and
I learned this and, as I'm sureyou have, the importance of
caring, truly caring.
If you take care of yourpatients, your patients take
care of the business.
I heard that very early on andthen, when you actually see the
(15:32):
Pareto principle in effect,you're like, oh my gosh, we have
so much word of mouth.
Speaker 2 (15:36):
I was having a hard time considering do I get into
social media?
Or putting I mean I'm putting alot of time and effort into it.
By the way, I go by the baldhearing guy on social media.
If you guys, if you have a cellphone, follow me.
The whole goal of that becauseI was like is our target
demographic?
Let's say for the most part,that the geriatric population on
TikTok not so much Facebook,yes, instagram some Is it worth
(16:00):
putting all this time in?
Because again, I got a family,I'm running my business, I'm
doing these things.
The goal was normalize havingconversations about hearing
healthcare.
Sometimes.
My videos are funny, sometimesthey're educational sometimes,
but it's just getting peopletalking and I am.
I'm still growing it and I'mtrying to put the time in, but
I'm.
I love that I'm seeing familiescome in and younger people come
(16:22):
in and say my dad needs to comesee you, my mom needs to come
see you.
I had someone come from twohours away, two and a half hours
away, and it was.
I saw that you're the best atthis and I want to come to you
and I told this person becauseshe needed help.
She did move forward with somehelp, but I told her I'd be
happy to do the evaluation.
I'll give you some options.
I think it may be in your bestinterest to find a provider
that's closer to you, becausehearing aids are.
(16:44):
It's not just like you boughtthe laptop and I'll never see
you again or I'll see you when Ibuy a new one.
No, we see our patients everythree to four months.
There's annual hearingevaluations.
There's programming adjustingit.
There's annual hearingevaluations.
There's programming adjustingit's a lot.
So I had to tell her, like Iwouldn't want you to go home and
go.
Oh no, I got to go back toOrlando to see JC and she said
no.
And this is the thing.
Like I'm humbled.
I actually have a hard time,you know, sharing this.
But she shared like no, likeI've seen everything that you're
(17:11):
doing online.
But I mean, when this personleft, I was almost doing a
backflip.
If I was not 255 pounds, thebackflip would have happened,
because I was really excited andI'm still like that.
It's still crazy to be two anda half hours like that.
That's that made my day.
Speaker 1 (17:24):
Yeah, that's, that's impact.
And, JC, just keep doing whatyou're doing.
And when we initially connectedand we were talking about what
is the story that we want totell to the Hearing Matters
podcast community, it came downto the managed care landscape.
There's a lot of hearing careprofessionals today that are
(17:44):
either bundling, going unbundled.
How are they managing managedcare?
How are they letting thepatients know exactly what their
plan encompasses?
So let's talk about the managedcare landscape.
You've been open about theethical dilemma that it presents
.
Share what that looks like dayto day in your clinic.
Speaker 2 (18:08):
So the conversation in audiology for a lot of us is
how do we get out of thesemanaged care plans?
What some of these plans arepaying does not justify the
level of healthcare that we wantto give to our patients.
It's usually like the minimumper state and the patient does
not always know this and this isthe tough thing.
Like it's not the patient'sfault, they are ignorant to you
(18:30):
know, whenever they're coming in, what the highest level of
hearing healthcare is.
Things like real earmeasurement that we preach all
day, every day.
For those that aren't inaudiology, that is a way to
validate, to objectively knowthat a prescription is being met
.
Things like hitbox, things likegoing the extra mile in the
hearing evaluation, not justwhat is the minimum legally
(18:51):
required thing per yourlicensing boards, per your state
right?
So whenever an insurance planor these managed care groups,
whether it's a discount plan, aninsurance plan, whenever
they're telling hey, mr Patient,you have XYZ benefit for
hearing aids, often and this isnot always often, it's just
they're taking all of theseextra services, they're taking
(19:11):
it out of the pricing thatthey're charging the patients
for the hearing aids and they'repaying, of course, the
providers less than what theprovider would to our patients.
(19:34):
So this becomes why does MrSmith, who's paying us directly
for the hearing, who's paying usfor the highest level of care,
getting the same level of careas Mrs Robinson?
I don't know, let's just say aname right.
Who came through this insuranceplan?
Who's not paying for thesethings?
Is it morally correct to givethis person all of this extra
care without charging thatperson for it?
(19:56):
And if we are charging, howmuch are we charging?
And then this whole back andforth this is I'm trying to
simplify it as much as I can isa dilemma that we have where
many providers are wanting toget out because they say you
know what, at Altamont FamilyHearing, I want to give the
highest level of hearing healthcare, and this is what that
looks like.
And if these plans are notthey're not going to compensate
(20:17):
us for that then, instead ofproviding less than optimal care
, we either have to pass thosecosts on to the patient or we
have to choose to no longer seethose patients For someone
starting new.
This is where I was going inthe beginning.
If someone's starting theirpractice today, I say you almost
have to join all of thesemanaged cares because you're
trying to get your foot in thedoor.
You're trying to get in yourcommunity, you're trying to get
(20:39):
patients to review you on Google.
And you know, you got to paybills, you got to pay rent, you
got to pay the license, you gotto pay insurance, you got to pay
your staff, all these otherthings, and in the beginning.
Speaker 1 (20:48):
A private pay patient is going to cost you more than
a managed care patient, correct?
Speaker 2 (20:54):
Absolutely, absolutely.
The patient's going to calltheir insurance.
They're then going to say, hey,I need hearing aids in my area.
Here's, you know, altamontFamily Hearing.
They're going to pass that ballto us.
It didn't really cost anythingto the practice to acquire this
new patient which could be acheerleader in your community
for you.
That's how I started, that'show I'm sure most do, but there
does come a point where you'reinvesting in better equipment,
(21:16):
you're investing in betterthings, and these things lead to
better outcomes, and then youstart going wait, I want to do
this for everybody, which is thedilemma that I am in right now
and I'm sure a lot of practiceowners like.
We network a lot with people onLinkedIn and this is a very
common theme amongstprofessionals of do we just all
leave them?
Amongst professionals of do wejust all leave them?
(21:39):
And that's a tough one, becausethere's a lot of people.
What about that patient who hasaccess to Medicare and Medicaid
, which would fully coverhearing aids?
You're saying I'm not going tosee that person?
That person either has to gosomewhere else, or there are
scenarios that people travelfrom like an hour away because
they can't find a provider,because providers are opting out
.
There are people thatlegitimately cannot afford these
services.
Let's say, if they're on agovernment program like Medicaid
(22:00):
, so do they not get hearinghealth care?
If everybody opts out, how muchcan we explain, how much can we
try to make our case to theseinsurance plans for them to
increase what they're paying foror to pay appropriately for the
level of health care that everypatient deserves?
Is that really going to happen?
Like?
That sounds good on paper.
It sounds good on a podcast.
(22:21):
How many people would it take tofight that fight, for them to
go?
You know what?
You're right.
I can only control my domain,which is Altamont Family Hearing
and the level of health carethat we have here and that is
where I'm at with this fight iswho does it make sense for us
financially to see and thatsounds horrible, to say it right
, like as I'm saying this nowsounds like money, greed,
(22:41):
transaction, all these thingsthat could be a trigger.
But I'm supporting staff, I'msupporting my family and I want
to be the best I don't want tobe.
I don't want to deliver servicebecause we're getting paid an
amount for it and then it just,you know it goes back to like
what is really the right thing.
Speaker 1 (22:58):
You know what's the right thing.
I'm so thrilled that we'rehaving this conversation because
we have to have these tough,challenging, hard conversations,
because we are looking to movethe needle in hearing healthcare
as it relates to access,affordability, best patient care
.
We know that a small percentageof hearing care professionals
(23:23):
are implementing best practices,specifically real ear
measurement.
That's why, at Hearing Matters,we're connecting with
professionals from outside theindustry to learn what they're
doing, to say, hmm, how can wechange up our models a little
bit when you are working with apatient?
And this just goes to show howmuch you care about your
(23:45):
patients the fact you're havingthis conversation because
practices all across the UnitedStates are experiencing this.
So what are some of thesesolutions?
You know we talk about knowingwhat your cost per hour as a
clinic owner is so important.
So let's just say that yourcost per hour is $250.
(24:06):
To break even, just keep yourdoor open.
You have to make sure thatyou're making at a minimum $250
an hour.
Right, for those tuned in whoare unaware of what a cost per
hour is as it relates to theclinical aspect of it.
So, jc, what you're saying isbalancing the desire to provide
(24:27):
comprehensive care, like realear measurement, like hit boxes,
you know when reimbursementdoesn't really support it.
How is your team?
Speaker 2 (24:36):
handling this.
Speaker 1 (24:36):
Yeah, yeah.
Speaker 2 (24:39):
We have two buckets.
When that phone rings, it is isthis a person that came from
our marketing efforts that foundus on, whether a mailer,
whether Facebook, whether ourwebsite, whichever?
Is this person coming to usbecause they found us, let's say
, organically online and they'relooking for the best hearing
health care that they can get?
Or has this person reachedtheir insurance and their
(25:01):
insurance said, hey, go toAltamont Family Hearing?
We do split these twoappointments and one of the
things that we have tostrategize in you know, talking
about billable hour and stayingafloat because I want to be in
business for a very long time ishow many of those, how many
patients that come in throughinsurance, through those managed
care that we have to respectthose contracts and see them
(25:22):
through those plans.
How many of those can I see ina week?
One, two.
It used to be five, six, nowit's one or two and these
numbers dwindle because we dohave a priority for those that
are not coming in through thosechannels.
The amount of time so we havean hour and a half hearing
evaluation for both parties thisis one that I'm still battling
with.
Speaker 1 (25:41):
I believe it's a serious investment of time.
It's a lot, but why is thatdepth of care so important to
you?
I?
Speaker 2 (25:46):
think the audio has to be one of the most important
things.
Like, I made it 50% yeah, let'ssay about 50% of it.
There's the fitting withRealEar.
But first you got to find outto get those targets.
We got to do the whole test.
No-transcript person's in thatparty.
(26:25):
When that person's on thecruise ship, the graduation
Thanksgiving table how well arethey going to be able to
understand speech in thepresence of noise?
How much do I need to reducethis noise in order for them to
do well, if they can, if theyhave the ability to do so, to do
well in that environment?
That information helps me findout what's the best thing for
(26:46):
them.
That's how I know what's theright hearing aid to choose.
Like so many times there'speople and I'm sure you've heard
this, you've been in theindustry longer than me and you
have your family in there.
I'm sure you've heard of peoplesay like, oh, hearing aids are
crap.
Or I hear these hearing aidsdon't work.
Or I have this friend whobought this hearing aid and
spent X amount of dollars andthis thing doesn't work.
There's so many reasons whythat could have been.
(27:06):
Like I don't and I hear that inmy community too.
I don't understand it, becausethat's not what we see in our
office.
Like our patients are coming in, they have the opportunity to
say this is good, this is bad.
We have over a hundredfive-star Google reviews and
this is I'm not just saying thisto toot our horn.
What I'm trying to say withthis is we are taking more time
than what is legally required.
(27:26):
We are doing more than what isthe minimum.
All that extra informationmeans better data, better
decisions for the provider tomake the choice for the patient,
the best choice for the patient, and then better outcomes.
I've had like two returns in thelast I don't know three years
maybe.
Like we do not have returns.
That is not a thing here.
Like someone has to pass awayor exchanges happen, like
(27:50):
sometimes someone could say Idon't like this, right, you know
I don't want this aid, or wetry something different.
Returns like that is and mywife Francesca can attest like
that is not a thing that happensin our office.
But we are putting it all like Iam invested in every way the
delivery, the test.
I'm trying to be the best.
I'm not trying to be, eh, butthat takes time.
But patients know that likethey feel that they know when
(28:12):
it's just like oh, mr Smith,you're coming in, just drop off
your hearing aids and in 10minutes we're going to clean
them and check and give themback to you.
The reputation is every timepeople come.
We reputation is every timepeople come, we're sitting down
and we're invested in you.
That time costs money.
Time is money.
So then this just goes back tolike that whole managed care
split and everything else.
Like this is where it becomesdifficult, because the more that
(28:34):
I'm providing, the moredifficult it is to justify the
minimum that some of these plansare paying.
And that's the.
What do I want to be?
Do I want to be the guy that'sjust doing a bunch of hearing
aids through managed care orhaving a higher quality visit
for the patients that are comingin who value their hearing and
(28:55):
are choosing us to help themwith their problem?
Speaker 1 (28:57):
Let me ask you, because I love different models
in business and there arespecific models that work better
in certain parts of the country, but the number one model is
caring.
Caring is number one, but I'velearned personally when we were
in private practice.
(29:17):
We also ran into that dilemmaas well, and it's more or less.
I think it's such a greatconversation to have because it
shows that you're aware of yourKPIs, your key performance
indicators, that you're lookingat that dashboard, because, jc,
what I'm hearing is I'm nothearing billable hour from you.
I am hearing I want to help asmany patients as possible while
(29:42):
also building a sustainablebusiness that remains active for
my patients to hear the bestthat they can.
There's nothing wrong, in myprofessional opinion, with that
thought process.
I'm curious to know what yourthoughts are on.
Speaker 2 (29:58):
So you're at this typical war that I have right
now.
Speaker 1 (30:02):
Okay, have you considered once Grace and this
might be a great case study onceGrace gets her license, because
I've heard other practiceshiring audiology assistants
you're in a great positionbecause you have a family member
that works there.
She's learned from you and youfrom her.
Have you thought about havingher start with taking care of
(30:23):
all those third-party patients,and what would that model look
like?
Speaker 2 (30:27):
That is right now my goal that annuals, as our annual
patients so even those thathave purchased from us privately
, probably in the beginning,helping me doing those updated
annual tests and the managedcare, because that's going to
expose her to a lot of testsearly on and, like anything else
, I'm an experienced she has toget in there and that would also
(30:48):
free me up so that we can havea better split of hey when
someone's coming in saying Iwant to hear the best that I can
and you know they're a directpatient, not a managed care
patient.
That way we can give priorityBecause I will say, going back
to experience, I've been doingthis over 10 years.
I have way more continuingeducation hours than is required
by my state licensure.
Every single time I'm renewingI want to know I'm the nerd
(31:11):
there.
I'm going to research as muchas I can and because of that
experience people are going tohave more from me in the
beginning of what's the bestchoice of the hearing aid for me
.
So that way we can make surethat the patients that are
coming in looking for thatthey're scheduled with me and
then as she grows, as she hasexperience, then we'll see where
(31:32):
that splits and where we go,but I think that'd be awesome.
One more thing I wanted to touchon when it comes to the managed
care thing, we have a bundledservice, so a lot of practices
that that's, I would say, amajority of what I hear.
I know people are unbundled.
That means when people aretrusting Altamont Family Hearing
and purchasing hearing aids forour current model for five
years, we're cleaning, checking,adjusting, annual testing,
(31:52):
reprogramming, you know, hitboxes, real ear measurement all
these things that we do isincluded in the pricing that
they're paying.
For those that are coming frommanaged care, we do have service
plans.
Another ethical split is, let'ssay, mrs Smith came in for
hearing aids.
We offered what was recommendedfor hearing loss within her plan
(32:13):
, and then we go hey, in orderto have these services that we
think is the gold standard andfor you to have the best hearing
that you can achieve, it'sgoing to cost X amount of
dollars on top of what you'vepaid that business entity
because that's not us.
And then the patient goes well,why don't I just get them from
you?
This happens all the time, thishappens almost every day and we
(32:34):
have to explain to patients.
Well, because I am contractedwithin this insurance plan and
you've come to me through thisinsurance plan legally, per my
contract, altamont FamilyHearing cannot service you
directly.
Speaker 1 (32:51):
I think there's new hearing healthcare professionals
who, when they enter the fieldof hearing healthcare, they're
so excited and then, when you doown the practice you're looking
at okay, well, what does thefitting fee look like?
Is this matching my billablehour?
How many patients do I need tohelp to ensure that from that
financial aspect, it makes sense.
So I think you have a great wayto handle and manage the
(33:13):
managed care.
At the end of the day, we'resaying here this is a human
being across from our table andwhat I'm hearing from you is I
want to help everyone hearbetter.
When we were in practice fulltime.
My mother and father are stillrunning the practice, but I
would call up the differentmanaged care organizations and I
would ask okay, per thecontract, what is included?
(33:34):
Because if you are offering aservice plan, then you know from
a legal standpoint and JC and Iare not providing any legal
advice here by any means, justmake sure you call the insurance
companies that you arecredentialed with.
Specific to managed care, but wewould outline okay, managed
(33:55):
care A includes X, y and Z.
Well, but then it goes back tothe ethical aspect of this is
within my scope of practice.
But let's look at the brightside, because we have to face
the brutal facts right.
The bright side is that whenyou start to help your patients
(34:16):
hear better, we say hear a lifestory.
That news spreads like wildfirewithin your community.
So to me you have a model setin place.
Once Grace starts fittinghearing technology, she'll be
able to see those managed carepatients.
If 20% of your gross revenue isfitting fees and if that can
(34:40):
support your payroll and then80% is private pay rocking and
rolling, but that's not alwaysthe case.
We have some clinics that are50-50, 60-40.
So right now, we're sort ofjust.
This has been a conversation,though, that our industry has
had for many years, and I'velearned.
(35:02):
I feel as though, but I've alsolearned that what is your
market response and how are yougoing to manage your specific
model, because everyone'shearing healthcare model is
different.
But I've learned and you'velearned.
If you give more than what youreceive and you take good care
(35:24):
of your patients, your patientsare going to take care of your
business time and time again,but that just, and I believe, I
believe I've been feeling that.
Speaker 2 (35:34):
So in year five, we're, of course, seeing
patients that we saw in 2020,who, most of the majority like
that is why I'm still inbusiness is managed care in the
beginning, right, like they,especially through a worldwide
pandemic and that's a wholeother subject for a whole other
day, right, but, like so, a lotof these people came in.
They got to know me, they gotto know what I stand for, they
got to know what it is thatwe're providing and their second
(35:56):
time around, like these people,are now in five-year technology
.
Many, you know those would beout of warranty.
Those that are considering neware going.
Now they know me and nowthey're giving us an opportunity
directly versus and they're alittle more informed, because
now they know that could havebeen their first hearing.
And now they know, oh man, Ididn't realize that I'd be
coming this often.
I didn't realize that the endwas every year, because how many
people don't come into theoffice?
(36:16):
You know, I'm sure you heardthis like oh yeah, I got these
hearing aids four years ago.
When was your last hearing test?
Four years?
Speaker 1 (36:22):
ago.
Speaker 2 (36:22):
And what are you talking about?
What are you talking about?
So, and these are things forthose that don't know no, no, I
get my eyes tested every year.
I go to the dentist.
You know, you got to get yourcleanings and all this.
I mean, this is part of yourhealthcare overall.
It is every year, it is notjust every time that you're
purchasing a hearing aid.
So these people are now givingus the opportunity directly,
which I think would be in ourgrowth plan, would be okay.
(36:45):
Now, if Grace is seeing thisarm of our business and I'm, you
know, still busy seeingpatients privately that just
means to, you know, as thosepatients keep coming in for
upgrades, hopefully they, someof them give me an opportunity,
and not just Grace, but you knowit just means growth and scale,
so helping more people.
Speaker 1 (37:15):
And at the end of the day, that's the reputation.
Helping people I'm excited forthat estate right.
Every market respondsdifferently to the same product
and or service.
It's demographics and I think,the old tune of well, everyone
just drop out.
We learned you put your horseblinders on what is best for the
(37:38):
patient, what is best for ourpractice, if the goal is to
build a sustainable business andyou know your numbers and
helping patients who presentwith managed care because at the
end of the day, it's not theirfault, it's not like, oh, you
chose x, y and z managed care.
So I'm sorry, mr smith, I can'thelp you learn to manage it.
(38:02):
This is where it gets fun andexciting, because, my goodness,
maybe Mr or Mrs Smith has afriend who needs hearing
technology and they go, theypurchase privately from you A
lot of us, we fit that same orsimilar product right, but how
do we get that information outthere?
I almost wonder too, jc, youknow, because, again, this is
(38:24):
how the Hearing Matters podcaststarted.
You create a media verticalspecifically for your managed
care patients and you investtime, effort and energy into
creating some sort of videoformat for these patients,
because I'm all about transferof information, process of
duplication.
Let media do the rest for you,especially for those follow-ups,
(38:48):
for the cleaning videos, thingsof that nature.
Getting creative with themanaged care is best for your
patients helps your top andbottom line.
Top and bottom line of businessis people.
Jc, you've been so graciouswith your time.
I really appreciate you joiningus on the Hearing Matters
podcast.
My final question for providerstuning in who really do feel
(39:09):
the tension between care andcost what is your message to
them when it comes to stayingethical, staying passionate and
staying in the fight?
Speaker 2 (39:24):
At the end of the day , I think the and this is the
conversation that I continue tohave with myself.
I hope this advice helps you aswell is why do we do what we do
?
And it's to help people hearbetter.
That is, sometimes we get lostin compensation and the cost of
living is going up every singleday.
(39:44):
Every single person's feelingit.
We can get hung up on numbersand all these other things, but,
like you said before, the morepeople that you help, the more
that you're going out there likethat's gonna come back to you
and I really believe in that.
Like I've been experiencingthat in my life and there has
never been a point in my lifethat I've helped somebody, that
I've just selflessly put loveand energy into a person, that
(40:07):
somehow that did not come back.
And I do think that when itcomes to this, there's a lot of
frustrations and if you'resitting there, sitting here,
crunching numbers like me andgoing like man, this just
doesn't make sense.
Or we feel like we're gettingbeat up by these managed cares.
Sometimes, like at the end ofthe day, it's like listen, this
person that's coming into youroffice is trusting you,
connecting with you, and theyknow people.
(40:28):
You're going to help them Overtime.
Somehow that's going to comeback to you.
But yeah, just coming back tothe root like this is why we do
it.
It's helping people and they'retrusting you for that.
Help Educate them and then overtime you know that somehow that
revenue is going to you, knowit's going to multiply because
they know a person, they're in achurch, they have a family
(40:49):
member and if none of thathappens, you just made that
person's day, you just helpedthem reconnect.
Speaker 1 (40:54):
Jc thank you so much for your honesty heart and your
leadership.
You know conversations likethis are what push hearing
healthcare forward and remind usof why we do what we do.
To learn more about JC and hisclinic, visit Altamont Family
Hearing.
That's A-L-T-A-M-O-N-T-Efamilyhearingcom.
(41:15):
And until next time, hearlife's story.
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