Audiology

20 Questions: Gregory Frazer, AuD



Dr. Gregory Frazer of Pacific Eye and Ear Specialists owns several hearing clinics in the Los Angeles area, including Hearing Associates, Inc., West Coasty Hearing & Balance Center, Pacific Hearing, Inc., and Pacific Hearing & Balance, Inc., as well as serves as director of audiology at Pacific Eye and Ear Specialists Inc.
After earning his bachelor’s degree in speech pathology and audiology from CSU Sacramento, Frazer got his master’s degree in audiology at University of Utah, then earned his doctor of audiology at Wayne State University. He then earned a clinical doctorate in audiology from Arizona School for Health Sciences.
Dr. Frazer’s employment has included serving as chief audiologist at Otology/Audiology Clinic Midwest Health Center, Pulec Ear Clinic, and Olive View Medical Center. He was also previously a clinical instructor in the Department of Head & Neck Surgery at UCLA, CEO/president of Hearing Care Associates, vice president of business development at Sonus-USA, Inc., and facilitator of the University of Florida AuD program.
Currently, he is a professor at AT Still University AuD program, adjunct professor for San Diego State University’s and UC San Diego’s AuD program, and clinical adjunct faculty at University of Texas-Dallas. He is a member of the American Academy of Audiology, California Academy of Audiology, American Speech & Hearing Association, American Academy of Otolaryngology-Head & Neck Surgery, International Hearing Society, Academy of Doctors of Audiology, and American Tinnitus Association.
When did you first decide to become an audiologist? Why?
In 1970, I worked for the U.S. Postal Service in Sacramento, Calif., while going to undergraduate studies. I met a group of deaf people hired to work in a noisy area and work on a letter sorting machine. I took a sign language class so I could communicate with them, and learned about speech pathology and audiology. I was pre-med before that. Also, my father had hearing loss, so I wanted to learn more about hearing. The real key was my mom, who worked for CSU Sacramento and suggested speech pathology and audiology as a growing profession for the future, due to the upcoming aging Baby Boomers.
How and why did you choose the school you went to?
I went to CSU Sacramento because I came from a family of modest means and could not afford to go to a UC campus, even though I had a scholarship. Our family did not believe in doing anything you could not pay for, so loans were not considered. So, I went to the local college. They had a speech pathology program, and so did many other CSU campus’s, but only one UC (Santa Barbara) had a program.
What surprised you the most about your audiology studies?
I liked that there was a medical/science base (anatomy, physiology, diagnosing and treating hearing loss/balance disorders, etc.), as well as an instrumentation base.
If you had it to do all over again, would you still become an audiologist? (Why or why not? What would you have done instead?)
Yes. But if I hadn’t, I would have gone to law school, real estate, or medicine (ENT). I have always loved law and loved investing in real estate. My father was a real estate broker, so I learned a lot from him. I would have liked to practice law, since I see so much fraud and abuse, and government does nothing about it. As far as ENT, under current Medicare guidelines, audiologists do not have direct access to patients, but must get referrals from MDs. This has caused a pandemic in the treatment of hearing loss, since only 25 percent of patients needing hearing aids obtain them. MDs get one lecture on hearing loss and balance, and are supposed to be the gatekeeper for those disorders. However, 90 to 95 percent of hearing disorders do not require medical or surgical treatment. They just require an audiological evaluation and hearing aids, which is what audiologists do. However, we never get the patients, since many MDs do not refer for evaluation and treatment.
Has being an audiologist met your expectations? Why?
Yes, and no. I thought we would have direct access by now.
What do you like most about being an audiologist?
I like being able to help people hear better and help their balance and dizziness problems. I like working with people.
What do you like least about being an audiologist?
Reimbursement from insurance companies is a nightmare. They underpay, say they did not receive a claim, deny proper claims, etc. Getting paid for what you do in a timely fashion is not easy. Also, worker’s compensation in California is a nightmare. You have to deal with third party administrators who know nothing about what you do, arbitrarily and capriciously reduce claims to the cost of the hearing aids you provide (no profit), and to appeal is a nightmare that takes months or years.
What was it like finding a job in your chosen career field? What were your options and why did you decide what you did?
I started meeting with all of the MDs and other audiologists years before graduation, so I had a lot of options when I graduated. I went back to California where I came from. After I went for a master’s at the University of Utah, and a PhD at Wayne State University in Detroit, I obtained an AuD from AT Still University in Mesa, Arizona. I believe I was the first audiologist to have both a PhD in audiology and the AuD. I ended up taking a position after graduation at an otology clinic in Los Angeles. I did that as a way to get to California, but also because I liked the medical aspect of working with an ENT. However, I soon learned that I was an entrepreneur and needed to go into private practice.
Describe a typical day at work.
My typical work day starts at 5 a.m. when I wake up. I get coffee and a donut to bring to the office, and I leave for work at 6 a.m. and arrive by 6:45 a.m. I leave early since I live in Los Angeles, and if I don’t leave by 6 a.m., it can take two hours to get to my office even though it is only 25 minutes with no traffic.
I write reports from the previous day, do my billing, review the patients coming in for the day, program hearing aids for delivery, conference call with the east coast for businesses I co-own and professional organizations/universities I teach or work with.
I see patients from 8 a.m. to 6 p.m. or 9 a.m. to 6 p.m.
At the end of the day and during the day, my fourth-year mentee and I discuss patients, write reports, do billing, interpret test results, call patients to see how they are doing with dizziness treatment programs or new hearing aids, return patient calls, etc.
Do you work with mid-level providers, and if so, what kind(s)?
In the past I have worked with hearing aid dispensers, but I do not at this time. I currently share office space with ENT physicians and two ophthalmologists. They are excellent, caring physicians and good surgeons. There is also one physician assistant who is excellent as well. Our philosophy has always been to help mentor and train medical students, physicians, audiologists, PAs, nurses, etc. I am on faculty of three universities, and I take two to three fourth-year AuD students each year to mentor.
On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
As a private practice owner of six practices, I need to make sure everything is billed and collected. I also plan marketing and public relations for our practices. I also have to make sure everyone is happy and their needs are being met. I have to work each night until 6:30 or 7 p.m., because if I leave earlier, it takes me two hours to get home. So, I stay and do paperwork and billing and mentor a fourth-year student.
For 10 years, I facilitated all of the AuD courses for the University of Florida, and for two years I taught two classes at night for AT Still University.
Now, I work nine to 10 hours a day seeing patients, and another two to four doing paperwork. That does not include the eight hours or more on the weekend. So, my average is about 60 to 70 hours per week. I get about five to six hours of sleep a night. I take four to five weeks off a year, not counting two conventions for a week as well.
Are you satisfied with your income?
I am satisfied with my income. However, I wish I could make more since I have no retirement and I have one daughter starting college and a son starting high school.
If you took out educational loans, is/was paying them back a financial strain?
I did take out small loans. However, I also worked all through high school and 10 years of college. My loans were very small and I paid them back quickly. I actually saved enough to put a down payment on a home six months after moving to Los Angeles.
In your position now, knowing what you do – what would you say to yourself 10 years ago?
I would say don’t sell to corporate audiology chains. I have found that they do not make the same decisions about patient care as a private practitioner. I would sell to another audiologist, even if it means taking less money. You need to make sure that a good audiologist will take care of your patients the way you did. It is not all about making money from people. If you are a good audiologist and take care of patients the way you would want to be treated, the referrals will come and so will the money.
What information/advice do you wish you had known when you were beginning audiology studies?
I wish I knew the way that audiology actual is. The universities have one view, but the reality is far different. Having to pay rent, overhead, payroll and suppliers every two weeks can be stressful. However, the independence of private practice is worth it for many.
From your perspective, what is the biggest problem in healthcare today?
The biggest problem in health care today is the insurance companies and accountable care organizations (ACO). They want to keep healthcare private and for-profit. Instead of all of the money going to providers and healthcare for patients, the money goes to shareholders, CEOs and other high-level corporate executives. The new trend is ACOs.
Large hospital chains will employ MDs and other providers to control a city or state, etc. for profit. This will destroy patient choice and cause providers to go out of business or work for the ACOs. These same groups already have patients wait two to three months for an appointment. It is not about good patient care. It is about owning the medical care in an area. These ACOs could not survive if they were not able to obtain contracts from insurance companies that pay twice what a private practice provider gets reimbursed. However, if you own the hospitals in an area, then you can demand and get paid what you want. Sounds like a monopoly. The patients are the ones who lose in the end.
Where do you see audiology in 10 years?
I see private practice audiology ending and audiology being controlled by large corporations or insurance companies or ACOs. Audiologists could prevent this and control their own destiny, but they join small groups for product discounts and don’t care about the future. If they only banded together in one large group, they could control their profession and destiny.
What types of outreach/volunteer work do you do, if any?
I have provided free audiology and hearing aids to the Venice Family Clinic for the past 10 to 15 years. The Venice Family Clinic is the largest free clinic in the U.S.
I also volunteer to lecture to medical residents on hearing loss, dizziness, and hearing aids, and volunteer to lecture three to four times a year to seniors on the same topics.
I am also a partner in a group called AuDNet, the Audiology Network. We are an audiology cause funding organization. Our members purchase hearing aids from our group, and the profits go to funding projects that create a demand and recognition for audiology care of hearing and balance problems. We also fund PBS announcements, materials for high schools to let them know about audiology, etc.
Do you have family? If so, do you have enough time to spend with them?
I have a wife who is an AuD and she handles billing/collections, paying bills, health insurance, payroll, employee issues, etc. She is very organized and sets up systems. She also helps to train audiologists, and sees patients one or two days a week.
I am a certified Olympic coach in taekwondo, and trained and went to tournaments for 14 years with my children. They are black belts and they have been five-time California state champions. My daughter has been U.S. champion three times and my son one time and he was third two times. They are fantastic children in every way.
I have also coached my son in soccer for five years, and we have won many championships together.
We do one large family vacation a year together (Africa, Europe, Japan, Canada, Mexico, etc.), and a few small ones as well (snow skiing, water skiing, summer camps, etc.). We all like each other, and usually travel with another family or two.
I do wish I could spend more time with them, but I have spent a lot more time than most parents with my children. I make family and friends a number one priority.
Do you have any final piece of advice for students interested in pursuing audiology as a career?
The future of audiology in one sense is bright. Ten thousand Baby Boomers turn 65 each day for the next 19 years, and 35 to 50 percent will need hearing and balance care. However, I don’t believe private practice will be an option unless direct access passes with Medicare, and audiologists get smart and join one large organization to control the future of audiology.

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    Dentist
  • February 21, 2012
I would like to give my respects to Dr. Gregory Frazer. Not only he has several clinics that he has to supervise I am sure, but also he finds time to volunteer, helping people in need who can't pay and also lectures and does charity.
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    Enzo
  • January 5, 2013
Audiologist don't have directly access to patients, how does one venture out about setting up his/her own clinics as Dr. Gregory Frazer that have sustainable business?

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