What did you just say?
She did not plan it this way, but Dr. Theresa Cullen could not have chosen a more fertile location for her audiology practice than Cape Cod. Consider that the average age of residents here is among the oldest anywhere in the nation.
But it’s not just the retirement community that furnishes her patient database. It’s increasingly the wave of baby boomers arriving years ahead of retirement to chisel second or third careers.
They’re often not even 60 years old, but as the rock-and-roll generation, they are encountering unprecedented hearing difficulties. Among those ages 45 to 64, hearing problems have jumped 26 percent. The damage is not all rock induced. It’s also tied to power lawn mowers, hair dryers and even rush-hour traffic.
“What was a rather modest profession when I first discovered it now is booming,” said Cullen. “The demographics are making it one of the top careers. Today, about 30 million people are hearing impaired. In the next decade, that number could double to 70 million.”
Such a clinical analysis, however, betrays Cullen’s passion and compassion for her profession and patients. If she’s situated at the right place and the right time, that is due as much to good fortune as to crafty planning.
The roots of her medical career extend back to Flint, Michigan, at a time when she watched the painful deterioration of her city’s auto economy through the steely eyes of her hard-working father.
“My father was selfless. I can’t imagine how difficult it must have been for him getting up every morning for 40 years and working in the same Buick production plant, the repetition year after year. My father ingrained in me this advice: Do what you love.”
When she left home to attend Central Michigan University, Cullen gravitated to psychology and gerontology, but it was at the beginning of her junior year that she experienced “love at first sight.”
“I was typing a paper for an audiology graduate student. I knew immediately that I had found my life’s pursuit.”
What commanded Cullen’s attention – and subsequently crafted her practice – was the inherent joy of altering someone’s quality of life. Often, they are modest stories about modest people. There was the woman who dropped out of the garden club because she could not hear her colleagues, part of her slow withdrawal from the pursuits she loved.
“I remember giving her a demonstration of a hearing aid. When I turned it on, she actually started to cry, stood up and hugged me,” Cullen recalled.
It’s not only that initial sense of victory; it’s the particular cadence of her work. In most cases, Cullen fosters a long-term relationship with patients. There’s the need to monitor future hearing loss or complications; the challenge of adjusting or replacing hearing aids, of sharing rapid technological changes influenced by digital computerization.
“It may seem corny, but it’s mostly about relationships,” she said. “There’s a quote from Mother Theresa that I had framed to sit on my desk: ‘Let no one ever come to you without leaving better and happier.’”
Don’t get the wrong idea, however. Cullen is committed to her business. That’s why she returned to school for a doctorate from Vanderbilt and Central Michigan universities. “I felt I owed it to my patients to stay current with the latest advances in amplification,” she said.
In doing so, however, she never left the Cape, her Hyannis practice or her two children – despite a rigorous three-year program. She even found time to join a woman’s rowing team that competed regionally.
Technology, technology, technology
Cullen’s doctorate (Au.D.) is testimony to a different technology, the Internet, and the impact broadband is playing across the Cape to spur productivity among virtually every kind of business.
Her courses were taught by the some of the field’s top experts. Classmates were spread across the nation and world. When she took exams, they were mailed to librarians at Marstons Mills, who served as proctors.
“I was able to go to college in my pajamas with a cup of coffee in my hand,” she said. “To combine this with my practice and kids, I had to stay up late at night and get up early in the morning. I carried my textbooks in the car and read them while waiting for the school bus to pick up the kids.”
“I could type a paper and simply e-mail it to my professors as an attachment. I was able to capture their expertise no matter where they lived. We even had a special chat applet that we could log onto with a password. Audiologists from all over the world were in my class – from Japan, Alaska and, of course, Vanderbilt. We were able to pick each other’s brains across time zones.”
As proud as she is of her doctorate, Cullen points even more to the example she hopes she instilled in her two teenage children. “They put my report card on the refrigerator. I wanted them to understand that learning is a lifetime endeavor.”
Cullen also appreciates that the doctorate represents a competitive edge to be carefully marketed.
Her Hyannis practice on Barnstable Road has a patient database of nearly 4,000. She’s just begun to service Nantucket and Martha’s Vineyard once a month. While many patients are in their 70s, Cullen is fascinated by the baby boomers. “They want instant satisfaction. If you can provide a product to enhance their lives, they won’t hesitate to spend the money. They want the latest technology.”
A top-of-the-line hearing aid – with a virtually invisible microchip and controlled remotely from a wristwatch – could cost as much as $3,600. More modest but still state-of-the-art aids cost between $1,600 and $4,000. Hearing aids can come with cases that match multiple outfits; they can recharge at night so users don’t have to change batteries anymore.
‘No one really wants what I provide’
“In some ways, I have to be very realistic,” said Cullen. “No one really wants what I provide. There’s a stigma associated with hearing aids. You don’t have someone knocking on my door saying, ‘Boy, I hope to get a hearing aid today.’”
Once again, however, she sees another technological revolution about to aid her profession – mobile telecommunications. They not only are miniaturized, but they are becoming trendy. “You have Bluetooth, iPods. They’re virtual extensions to people as they walk down streets, stand in airport lines. The stigma is disappearing,” she said.
Technology aside, Cullen is convinced business success depends on listening to the patient. “I am focusing foremost on that individual’s lifestyle. I must match my technology to his or her quality of life. Two patients may have the same diagnosis, but they may need different instruments based on how they live.”
“It’s funny, but listening is the key to my professional success as an audiologist,” she said.
Balance between work and family
As a single mother and self-employed businesswoman, there have been times when Cullen just “wanted to get into the fetal position under my desk,” she joked.
“They don’t teach business class in our curriculum. In this field, many audiologists fail because they’re so involved in patient care. They tend to say, ‘You don’t have a check today, that’s OK; pay next time.’ You don’t learn cash flow in college.”
But she has persisted because of a strong sense of responsibility for her three employees and two children.
“I have focused first on having a great accountant,” she said. “I get excellent advice. I also take advantage of respected manufacturers that can lend marketing support.” Cullen also depends on special software designed just for audiology practices. It lets her personally handle all receivables, even as she employs a part-time bookkeeper for accounts payable.
All the dedication to her practice does not interfere with a commitment to her son, a freshman at Barnstable High School who is taking flying lessons and plans on a career in business, and daughter, a junior, who is on the BHS state volleyball championship team. “My staff and patients know that I will leave here at a certain time to make her games.”
“You look at your kids and you realize you’re not going to get that time back. I don’t want to have that regret.”
Originally published in the March/April 2007 issue of Cape Business.
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