You Don’t Have a Time Problem. You Have a Staffing Problem.

Let me paint a picture of what used to be a pretty normal day in my clinic.

You walk in, and there are already walk-ins waiting. Phones are ringing. A hearing aid didn’t show up for a fitting. An earmold is missing. Your PCC called in sick.

And it’s not even 9:15 yet. You’re already behind!

The rest of the day? It’s a scramble.

You’re squeezing in troubleshooting between patients, calling manufacturers whenever you can find a minute, leaving chart notes half-finished (again), and telling yourself you’ll get to follow-up calls tomorrow.

Except tomorrow looks exactly the same.

Meanwhile, your schedule is booked out two weeks. Patients are waiting longer than they should, and when they finally get in, you’re rushing the parts that actually matter.

Not the testing.

Not the programming.

The conversation.

And honestly, that’s the whole job.

The Lie We Tell Ourselves

Most audiologists respond to this by thinking, “I just need to manage my time better.” Or, “I need to be more efficient.”

I thought that too.

It’s not true.

You cannot “optimize” your way out of a broken staffing model.

I learned that the hard way. Working 60 hours a week with three young kids at home. That’s not a productivity issue. That’s a system that isn’t working.

Why Hiring Another Audiologist Didn’t Make Sense

I looked at hiring another audiologist. Most of us do at some point.

But when I really looked at the numbers, it didn’t pencil out. We weren’t even breaking even with the schedule we had because I wasn’t seeing enough revenue-generating appointments.

My time was tied up in things that didn’t actually require me.

So adding another audiologist into that same system? It wouldn’t fix anything.

It would just duplicate the problem.

The Shift

I’ll be honest, I waited too long to hire audiology assistants.

I had all the same concerns:

·         It’s going to be expensive

·         Training will take forever

·         What if the quality drops?

·         Am I going to lose control of the patient experience?

Most of that ended up being wrong.

Once we got intentional about training and really defined what their role was (we used structured programs like the Assistant training at Audiology Academy to help), things started to click.

Our assistants now:

·         Do hearing aid orientations and reinforce counseling

·         Handle orders, repairs, and manufacturer follow-up

·         Stay on top of recall and patient communication

·         Help keep the day from completely falling apart

And the biggest change?

I stopped doing things that, frankly, I shouldn’t have been doing in the first place.

What Actually Changed

Before this shift:

·         Patients were waiting about two weeks to get in

·         I was staying late almost every day finishing notes

·         Walk-ins would throw everything off

·         Counseling felt rushed, like I was just trying to get through it

After:

·         We opened up more revenue-generating appointments

·         I’m not staying late like I used to

·         Walk-ins don’t derail the entire schedule

·         I actually have time to sit with patients and talk

I’m thinking of one patient, a retired teacher, who used to come in frustrated every single visit. She’d say, “I still can’t follow conversations with my grandkids.”

And if I’m being honest, those visits used to feel rushed (and frustrating). Make an adjustment, reassure her, move on.

Once I had more support, I was able to slow down and actually work through real-life situations with her. Not just with a tweak in settings, but to talk about expectations, listening strategies, all of it.

At her next visit, she said, “This is the first time I feel like someone actually helped me figure this out.”

That stuck with me.

Because that kind of interaction doesn’t happen when you’re running behind all day.

Let’s Talk About the Real Objection

I hear this all the time:

“We can’t afford an assistant.”

I don’t agree.

What I see more often is practices choosing not to while quietly paying for it in other ways:

·         Lost appointment slots

·         Delayed care

·         Lower treatment acceptance

·         Burnout

Our assistants don’t just “help out.” They contribute.

They bring in revenue through things like service plans and point-of-sale items. They free up the schedule so I can do the work that actually drives the practice.

We didn’t just get more efficient.

We grew.

The Pushback

There’s also this concern about “scope creep.”

I don’t see it that way at all.

If anything, before we had assistants, I was the one working outside my scope, spending time on tasks that didn’t require my level of training.

When assistants are trained well, they don’t blur the lines. They reinforce them.

The Part Most People Avoid

You can afford an assistant.

What’s harder to admit is that the current model, where everything runs through one person, is the real problem.

Being constantly busy isn’t the same as being effective.

And it’s definitely not a long-term growth strategy.

The Truth

The biggest lie I hear in private practice audiology is:

“I don’t have time to train someone.”

Because until you do, you’re the one carrying all of it.

And the longer you wait, the more it costs you—in time, in energy, in patient care.

At some point, it’s not about working harder.

It’s about building a system that actually works.

About the Author: Dr. Nichole Kingham, AuD, ABA, F-AAA 

Dr. Nichole Kingham is a Doctor of Audiology (AuD), licensed in the State of Washington and board-certified by the American Board of Audiology (ABA). She is also a Fellow of the American Academy of Audiology (F-AAA). As the owner and clinical leader of Eastside Audiology, Dr. Kingham is committed to delivering evidence-based, patient-centered hearing healthcare to individuals and families throughout the greater Seattle area, including Woodinville, Everett, Mill Creek, Renton, and Issaquah. As Chief Education Officer at Audiology Academy, she is "all-in" when it comes to Audiology Assistants and incorporating them into Audiology practice.

Expertise and Experience 

• Clinical Focus: Dr. Kingham specializes in comprehensive diagnostic hearing evaluations, complex hearing aid fittings, and the integration of advanced hearing technology to support real-world communication success. 

• Practice Leadership: As a private practice owner, she brings a unique perspective that combines clinical excellence with a commitment to long-term patient outcomes and ethical care delivery. 

• Credentials: Dr. Kingham earned her Doctorate in Audiology (AuD) and maintains active board certification through the American Board of Audiology, reflecting her commitment to the highest standards of clinical care.