Sound Business Sense

With Robert Traynor, Ed.D., MBA, FNAP

Developing a General Management Strategy

The late Peter Drucker, the father of modern management said in Mid-20^th century language (Cohen, 2001):

“Leadership is the lifting of man’s vision to higher sights, the raising of a man’s performance to a higher standard, the building of a man’s personality beyond its normal limitations.” 

So far, in our management discussion, we have reviewed types and styles of management. While these are rather straightforward, Drucker also would have certainly concurred with the complex variables involved in the creation and implementation of management strategies involved in the administration of audiology clinics.  Traynor & Taylor (2026, in press) present a model created by Burrow et al (2016) that organizes these variables in categories for consideration when developing a management strategy.  This model considers that each practice has strategic differences according to the business, work, management, and the overall business environment in which the practice resides (Figure 1). 

The Business

Consider the type of business as audiology, where there are varied sizes and types of clinics.  Some clinics specialize in hearing instruments, others offer general audiological services including educational services, aural rehabilitation, central auditory assessment, tinnitus treatment, cochlear implant follow up care, and a myriad of other services.  The practice venue has a direct effect on management strategy as each has its own specific set of demands.  Practices may be independent, within ENT clinics, general hospitals, schools, government and other

clinics.  Each of these operational settings will have unique advantages and limitations within the market which must be considered when assessing and securing financial resources.  These strategies might require adjustment according to economic changes including interest rates, inflation, and other often unseen circumstances, thus, most developed strategies need to be flexible and able to adjust accordingly.

The Work

Managers must be prepared to supervise the work of both clerical and professional employees.  These employees are individuals that have varied backgrounds, educational levels and aspirations, each requiring a specific management focus.  For example, the management of routine clerical tasks, such as answering the phone, and organizing files and charts, are quite different from the management of professionals conducting various clinical procedures.

Most managers realize that the job satisfaction among clerical employees is essential to practice success as they represent the “face of the practice” to the marketplace.  They see the patients first, interact on the phone, and routinely manage purchases at the counter. It is fundamental that the “face of the practice” is always as positive as possible.  Listening to these essential employee’s needs will lead to success on the business side of any clinical operation as when they become involved in, and part of certain decisions, loyalty will be built.

On the professional side as the practice grows, efficiency, continued quality, and movement toward employee goals becomes essential to continued success.   Some will be experienced clinicians while others will be new hires, full time, part-time, or temporary hires, each with their own objectives for success.  Strategically as the management system is implemented and modified over time, each of these types of employees must be accommodated to ensure lasting quality of clinical services. 

Employees must be provided with state-of-the-art supplies and equipment that supports innovative evaluation for treatment, with updates periodically. It may also be necessary to add additional new assessments, such as extended high frequency audiometry, distortion product otoacoustic emissions, sophisticated objective testing, routine speech in noise testing and other emerging procedures to meet best practice standards.    

A small, one location clinic will present very different management challenges compared to a multi-location, multi-layered enterprise. As practices grow and more layers of supervision are necessary, it may be essential to shift to an administrative type of management.   In addition to additional employees to manage, larger organizations have greater equipment needs and space maintenance issues as well as administrative matters, such as vacation, commissions and benefits, which become more of a concern as the business grows to numerous locations. Growth also requires decisions regarding promotions of professional employees into management which not only adds to the efficiency of the operation but allows professionals to keep moving toward their aspirations.

The Business Environment

This component pertains to the characteristics of the business environment. The characteristics of an audiology practice can vary according to its practice focus.  For example, the management of a hearing focus practice is quite different from a diagnostically oriented practice where one type is product focused and the other is service focused.  In a diagnostically oriented practice, the emphasis might be conducting only those evaluations that are reimbursed by Canadian Medicare.

While in Canada audiologists are recently becoming more product focused, this type of practice might be more oriented toward marketing. Increased competition from instrument manufacturers, big box stores, direct to consumer, government programs and insurance companies, as well as stigmatic cultural changes, have altered the business environment for privately owned clinics worldwide. 

Managers must be prepared with an effective strategy for today’s competition while recognizing that future competitive challenges including political, legal and regulatory issues will greatly modify the audiology business landscape. For example, Canada has just approved the Apple AirPod Pro 2 for sale later this year, likely the beginning of over-the-counter (OTC) products in the Canadian market.  While changes occur that may cause business disruption, they often create unseen opportunities that should be explored, as seen in the US OTC legislation that was a marketing boom for audiology practices.  Managers should have the flexibility to offer products and services that will compete in these unseen opportunistic markets as they arise. 

No matter the country, audiologists possess an acute sense of social responsibility.  As clinicians, our businesses ethically focus on efforts that benefit society. It is not unusual for clinics to provide hearing care services to the needy.  It has become increasingly important to consumers worldwide to purchase products from companies that take steps to contribute to the welfare of society and the environment.

The Management

Management approaches depend on the needs of the practice owner. These have been discussed  in previous columns as:

• Types of management: classical, administrative, behavioral and quality, or a combination of these types.

• Styles of management: autocratic, paternal, democratic, laissez-faire, and walking around, or a combination of these styles.

Their implementation of any of these management types or styles depend upon the clinical setting, its size, clinic focus, goals, and objective, as well as the number and type of employees.  In large organizations it may be necessary to use a number of managers in an administrative model that endures efficiency. In smaller clinics a simple direct management style by the owner may be more effective.  In either situation, managers and their subordinates must be on board with practice philosophy and its organizational system. 

In summary, the ultimate goals of clinical management, either complex or simple must be to:

• Demonstrate commitment to the current and future success of the practice.
• Take responsibility for developing and implementing plans to achieve the goals of the practice.
• Identify the resources the practice requires to fulfill patient needs and ensure that these are available when and where they are necessary.

• Ensure organization and coordination for the work of the practice with methods that achieve efficient and effective operations.

• Recognize the importance of employees and balance their needs with those of the practice.

• Monitor activities and results to identify ways and means to improve the practice.

Brian Taylor (2026, in press) quotes the cattle rancher, cyberlibertarian, and Grateful Dead lyricist – in his opinion, a true “Renaissance Man”, the late John Perry Barlow:

“Avoid the pursuit of happiness. Define your mission and purpose and pursue that.” 

 There is no better place to pursue that ideal than as a clinical audiologist who is leading a team, all rowing in the same direction, making the world a better place.

The next few columns of Sound Business Sense will address the importance, concepts, and procedure involved in pre and formal business planning.

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References

1. Burrow, J.L, Kleindl, B.A. & Becraft, M.B. (2016), 14^th Edition.  Business Management. Mason, Ohio:  South-Western Cengage.
2. Cohen, W. (2001). Drucker on Leadership: New lessons from the Father of Modern Management.  San Francisco, CA: Jossey-Bass-Wiley.
3. Taylor, B. (2026, in pres).  Essential Business Principles for Audiologists as Clinical Managers.  In R. Traynor & B. Taylor (Eds), Strategic Practice Management, 4^th Edition.  San Diego, CA: Plural Publishing.
4. Traynor, RM & Taylor, B. (2026, in press).  Strategic Practice Management, 4^th Edition.  San Diego, CA: Plural Publishing.