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How One Tiny House is Shaking Up Hearing Healthcare feat. Dr. Carla Smiley

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What happens when a devastating cancer diagnosis collides with a lifelong passion for audiology? For Dr. Carla "Brandi" Smiley, it became the catalyst for reimagining how hearing healthcare could reach those most often left behind.

Diagnosed with bilateral hearing loss at age six, Dr. Smiley's path to becoming an audiologist wasn't straightforward. After teaching kindergarten, surviving stage four lymphoma during her doctoral studies, and working across various healthcare settings, she continually witnessed the same problem: barriers to access for underserved communities.

The solution came in an unexpected form during the 2020 COVID lockdown. While watching Tiny House Nation, Dr. Smiley envisioned a fully-equipped mobile audiology clinic that could travel directly to patients. Despite facing skeptical builders and financial hurdles, she persevered, crowdfunding her dream and creating a 15,000-pound clinic-on-wheels designed with intentionality to welcome everyone.

"I've had people who were disheveled and dirty and felt they weren't worthy enough to sit," she shares with emotion. "I tell them, 'This can be cleaned. You are worthy.'" This commitment to dignity drives her work with Head Start programs, assisted living facilities, and veterans' services.

The tiny house clinic goes beyond convenience, it transforms lives. Dr. Smiley recalls fitting hearing aids for a man in end-of-life care whose wife hadn't had a meaningful conversation with him in 20 years. After the fitting, the couple reconnected through their wedding album from the 1940s. "Those moments are why we do this," she reflects.

For hearing care professionals interested in mobile services, Dr. Smiley offers practical wisdom: start by identifying what you're already doing that could be mobilized. With headquarters now in Peachtree City and specialized services including diagnostic ABRs and auditory processing evaluations, she continues seeking grant funding to provide care at no cost to those in need.

Ready to discover how mobile audiology might transform your practice or community? Visit On Site Audiology to learn more about partnering with this innovative approach to hearing healthcare.

Connect with the Hearing Matters Podcast Team

Email: hearingmatterspodcast@gmail.com

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Blaise M. Delfino, M.S. - HIS :

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Blaise M. Delfino, M.S. - HIS :

Welcome back to another episode of the Hearing Matters Podcast. I'm founder and host, Blaise Delfino, and, as a friendly reminder, this podcast is separate from my work at Starkey. You're tuned in to the Hearing Matters Podcast, the show that discusses hearing technology, best practices and a global epidemic hearing loss. I'm your host, Blaise Delfino, and joining me today is Dr Carla Brandi" Smiley.

Blaise M. Delfino, M.S. - HIS :

Dr Smiley, affectionately known as Brandi by family and friends, was diagnosed with bilateral hearing loss by an educational audiologist at the age of six. That audiology visit would forever change her life. She knew at such a young age that she wanted to be an audiologist when she grew up. Dr Smiley's years as an audiologist have afforded her many opportunities within various audiology sectors, including education, public health, the Veterans Health Administration and the Department of Defense. Dr Smiley has traveled to various countries, including Serbia, honduras, romania and India, participating in international missions. These experiences contributed to her dreams of mobilizing audiology services to the hard-to-reach and underserved worldwide. Dr Smiley, welcome to the Hearing Matters podcast. This is absolutely long overdue, but I am so excited and grateful to have you on the show.

Dr. Carla "Brandi" Smiley:

Thank you, so much for having me. Blaise, I'm not going to highlight what you just said in the awesome bio that you just read, so thank you for making me shine. But I will say it started at the age of six. I remember that visit just very clearly and it's something that always stuck with me, and so it was a dream that I had to chase. So I remember going to Valdosta State University for undergrad and really wanting to go after audiology. Well, there was no audiology undergrad. They had communication sciences and disorders, and I knew specifically that I wanted to focus directly on audiology. So I decided to get my bachelor's degree in education. And again, that dream just would always try to attack me and wouldn't leave me, and so I had to figure out after grad school what that step was going to be. So I went to a teacher recruitment fair and I met some people with the AUD program at Nova Southeastern University. My plan was always to get my master's and then get my doctorate. But they, they were saying oh, you can, in four years you can have your doctorate degree. And I was like what is this AUD? And I was just the moment. They said audiology, four years in doctorate. I was on board, and so that's where it started.

Dr. Carla "Brandi" Smiley:

At that teacher recruitment fair I resigned after one year of teaching kindergarten, which I love to go to school full time at Nova Southeastern University and I never looked back After graduating my fourth year. I was doing my fourth year at the Washington DC VA Medical Center, ended up getting cancer during my fourth year stage four lymphoma, and I'm like, oh my gosh, what are we going to do? Am I going to even make it? But the school was so supportive and that was what propelled me to finish my degree. I was, by the grace of God, able to finish cancer-free, continued with the VA for several years, went into educational audiology After that. I know such a different spectrum, but it started at Nova Southeastern University.

Blaise M. Delfino, M.S. - HIS :

And Nova Southeastern University they have an excellent program but also for, if someone's interested in becoming an audiology assistant, dr Smiley. So much to unpack there. You know again, this is our second time speaking and I was unaware that you were a kindergarten teacher. But now, with the educational audiology and your ability to break down those abstract concepts like on-site audiology, we'll get more into that. That is such a gift and I'm excited to learn more from you. It's not often that when you're growing up you learn about the field of audiology, unless you were actually diagnosed with hearing loss when you were going through school at such a young age. Did you ever experience any bullying or anything of that nature? Because you wore hearing aids at such a young age and maybe there was still that stigma?

Dr. Carla "Brandi" Smiley:

So here's the thing they never prescribed hearing aids. Now that I've gone through the program and I learned more about my hearing loss, I understood why At that time hearing aids had not progressed to the point where they were able to really assist with a higher frequency hearing losses, and so I can't relate to that stigma of having hearing loss. I'm always kind of, I guess, parallel to the hearing world. It was my teachers that recognized okay, she's not hearing these things, that she should, or she wasn't responding to those things. So honestly, with preferential seating, my mom being an educator and just staying on top of getting the redundancy after school, I was able to excel in school.

Blaise M. Delfino, M.S. - HIS :

Yeah, that's interesting and I'm happy to hear, with making those accommodations in school and your teachers really rallying behind, because we know today sometimes that's not the case, even with kiddos wearing hearing technology, because teachers have a whole other conversation. Maybe we can unpack that another episode. When it comes to passion for serving the underserved and underinsured communities, where does that come from?

Dr. Carla "Brandi" Smiley:

So it really comes from my parents. So my mom was an educator. She worked in districts that were underserved. So when we had our breaks I was in the neighboring county district just shadowing my mom, shadowing the speech pathologist. If they would have had an audiologist I would shadow them. But seeing them work so hard in this environment with so little funding and oftentimes being under-resourced, I really give credit to my mom.

Dr. Carla "Brandi" Smiley:

And instilling those things in us when we were younger, and then also raising us in the church and going to the prison ministry, going to the nursing homes. It was just ingrained in me at an early age so it was only almost just inevitable for it to happen. In my adulthood it wasn't until I had cancer and I literally remember being in the bed pleading with God give me another chance, I will get this right, I will do what I can to make a difference. And it was after that. The church I was attending, they did medical missions and these opportunities, like the dream, would just attack me and I couldn't shake them and so it just became ingrained in me and just became a part of who I am.

Blaise M. Delfino, M.S. - HIS :

Well, all glory to God, Dr Smiley, and when we talk about living His will, you are absolutely, absolutely doing that and talented, empathetic, which, speaking of empathy, tell me about those experiences working in the prison at such a young age and volunteering there. Tell me about the empathy which you were able to essentially acquire from such a young age and putting yourself in someone's shoes and bringing your services and even passion to those individuals.

Dr. Carla "Brandi" Smiley:

So I give a lot of credit to my mom, but I don't want to discount what my dad did. So he's a Vietnam veteran. I didn't grow up as a military child, but after his stint with the retiring from military, he retired from the Georgia Department of Corrections and so I would kind of shadow my dad going into the prison. I don't recall all of the feelings from that, but I'll tell you one thing I recall about the creativity of the prisoners.

Dr. Carla "Brandi" Smiley:

There's some very smart and creative individuals that are in the prison that it's almost like their passion is as confined because they're confined in that prison. I would see individuals create the most amazing purses from genuine leather, embossed and engraved the most beautiful designs, and that always stood out to me the most amazing artist in this prison. Their passion, trapped with their body and that's something that's always just stood out is like okay, you can have that passion, but don't allow your passion to be confined where it's hoarded right. God gives you these talents to be given to the world, so thankfully, my dad was able to gift those things they were making so that their talents could be given to the world. I'm not in a physical prison, but if I don't allow my passions to go forth and I hoard them, then, of course, then I'm confining them, so it's very important for me to release that.

Blaise M. Delfino, M.S. - HIS :

When you and I first connected, you said there's a unique landscape really when it comes to access to hearing health care. What gaps did you see, dr Smiley, firsthand you know in your work with schools, veterans or other groups with schools, veterans or other groups.

Dr. Carla "Brandi" Smiley:

Yeah, the gaps are ever-present. It's a common thread. So, from the educational standpoint, at one point I was providing services to nine districts and there were some that were more affluent than others. So the resources look different. Every kid in one area might have access to the DHH program and have ear level direct microphones to use in the school system, whereas other ones it was more of a burden to the teachers. They didn't have that DHH support because they were under resourced or they didn't have the funding to go forth and make sure that their classrooms were equipped with direct microphone system, and so there was definitely that disadvantage based on the lottery where the child was placed.

Dr. Carla "Brandi" Smiley:

Similarly, in the VA they're homeless veterans, so they don't have the physical access to get to the VA medical center. It would always be a challenge for them, and so annually we would do like an event for homeless veterans and they would bus them over to get the care at that one particular VA Medical Center. We've seen them change. Now we have telehealth, now we have mobile VA vans, so we've seen that progression. But these were different. Lacks of access and things that barriers, that prevented access, that I would see across the board.

Blaise M. Delfino, M.S. - HIS :

I feel like we have an opportunity now to leverage the technology with which we have today to even provide more access, not being afraid of telehealth, not being afraid to be different a little bit. And the tiny home of audiology onsite audiology is different. So you are a believer in access and bringing that access to the underserved. Genetically predisposed to being a go-giver we talked about when we first connected. You're absolutely a go-giver and it's our belief that when you give authentically, that's when you really make that big splash in your community.

Blaise M. Delfino, M.S. - HIS :

Dr Smiley, I'm really curious to know because, being a former private practice owner myself, I know firsthand what goes into showing up for your patients day in and day out and what we as hearing healthcare professionals do. It's a lot, right, like in clinic, it's a lot. You could have a patient who's a first fit, then a follow-up, and you're constantly switching code switching too. But I'm curious to know really what inspired you to take that leap from traditional role where you know things are comfortable, you know the day in, you know the day out, no problem, you have the flow down. You're actually expanding. You know offices currently.

Dr. Carla "Brandi" Smiley:

Yeah. What's ironic is I never had the passion to do private practice. My goal was to be an educational audiologist and retire. That's all I saw. I have seven aunts that were in education. They all worked their years and retired. That was my goal.

Dr. Carla "Brandi" Smiley:

It was when COVID happened 2020, and I was at the time working as an educational audiologist and the schools closed and I had about a month to just sit with my thoughts. I've never sat ever since grad school. I was working, so I never really sat with what is it that you want to do? What is it that made you happy? I realized that I was not happy. I love the kids, I loved what I did, but again it was like that prison. I was given a job description, told by people who are not audiologists this is what the department looks like, this is what you're to do, and that was it. And I wasn't happy because again, I saw all these gaps. I remember one night I couldn't sleep because I'm like, what am I going to do? And a couple of weeks were going back. I'm not happy, I can't quit my job.

Dr. Carla "Brandi" Smiley:

And so I turned on the television and Tiny House Nation was on and the episode was little John was building a rap studio on foundation in a tiny house format that was a replica of his house. And they panned in and I saw this booth that looked like an audiology sound booth. It literally just grabbed me what if I could build something mobile like this? And so I started researching, thinking certainly this had been done before. You know, I don't have to reinvent the wheel. And it was empty. I couldn't find anything, and so that's when I realized you're going to have to be the blueprint for this and you're going to have to figure it out. And I just did not release that dream until it became a reality. But that's the moment where it's like, okay, I thought about other bills that were easier Schoolies, rvs, all these different things, even haulers but I'm like you have to do something different.

Blaise M. Delfino, M.S. - HIS :

It has to be different, and that was the goal.

Blaise M. Delfino, M.S. - HIS :

Thank you for sharing that story, because there's more to it, though. So you dared to be different. You thought haulers, you thought all of these other possible prototypes. What was the next step? Because you had told me that you crowdfunded, which is very, very challenging to do Because oftentimes, you know, with a crowdfunding opportunity, when businesses launch a crowdfund, it can either do well or it might not gain any traction. So what were the steps to gain traction there? How did you make it happen? Bring us through the crowdfund and then actually building this tiny house.

Dr. Carla "Brandi" Smiley:

Okay. So again, it's just a thought at this point, right? So I watched this video. I'm writing notes. It's just a thought at this point, right? So I watched this video, I'm writing notes, it's attacking me. But then I realized I don't have money to build this. I'm like what, how am I going to build this? And so I talked to my husband about it. I'm like this is what came to me. He thought it was brilliant and went to my mom about it. And I and my mom said let's pray and ask who to ask for it, Because I knew that God did not give me that desire to put me in debt and then make the burden of building the dream overtake me, right, Because then I wouldn't be able to give the gifts cheerfully, right? And so we prayed and it was about 37 people that came on our list that we reached out. I came up with a crowdfund, like a campaign, found like that, what I was wanting to build in a dental format and let them know okay, I want to do this in a hearing format. And, honestly, almost all of them just immediately were like yes, yes, yes. And it was small amount, larger amount, but it all came together so that I was able to build it debt-free, and I'm forever grateful.

Dr. Carla "Brandi" Smiley:

After that crowdfunding, though, it's like okay, now we have people on a board. They're coming alongside the mission. We have to get this done, and so at this point, it's like creating mood boards. What does this look like? Because I couldn't find anything. Could it physically be done with a legit sound booth in there? Because we have to look at the aerodynamics, we have to look at logistics. Can this be done? I had an entire builder the first time that dropped the project because they didn't think they can do it, and I cried because I'm like I know that God gave this to me, and so I had to find someone in a whole different state and pay extra. It was more money for the state-based transfer, but it was not easy coming up with this blueprint. There were times I didn't think it would be done.

Blaise M. Delfino, M.S. - HIS :

In those roadblocks again, we have a lot of hearing care professionals who are private practice owners, even some students. How important was maintaining that grit in making this happen. Like your why, dr Smiley was absolutely so strong that you must have said I know I have such a good feeling that this is going to come to fruition. What was that process like and what did you lean into? Did you lean to other colleagues to get you through that difficult time? Because when the builder says I can't do this, you're like, oh my gosh, like my dream is forget it. What was instilled in you to keep moving forward?

Dr. Carla "Brandi" Smiley:

So unfortunately, at the time I didn't have the colleagues to lead on to because I wasn't aware of the mobile audiology group. I didn't know all of these things existed. So I was reaching out to people outside of the field of audiology. So there was a PA that created a tiny house clinic for just physical medicine in Nebraska. I sent her a message. She didn't respond to almost eight months later. So I'm still trying to figure things out, waiting on this response.

Dr. Carla "Brandi" Smiley:

So it's very challenging not having that to lean on and really having. I'll tell you what it taught me to truly lean on the Holy Spirit when he gives you the desires of the heart. There were times, like I said, I felt like I couldn't do it, but it took me back to what you said about the talent. Do I want to use my talent or do I want it to let it to dry up, or do I want it to be given to someone else, to take what I know God has given me and see it done in someone else's hand? And I didn't want that, not for me, not for the notoriety of doing this, but I just know it was something special he gave to me at that moment and so that was really the most important part. But after I did everything, after I was able to release what was put inside of me, that's when the village came and I still, every day, am relying on that village.

Blaise M. Delfino, M.S. - HIS :

So the tiny house audiology clinic was built. Mm-hmm, you see it for the first time. Audiology clinic was built. You see it for the first time. What are you feeling? What are the emotions? Bring us back to that moment.

Dr. Carla "Brandi" Smiley:

So my husband and I found a storage facility where we were going to house it and we remember seeing the driver bring it down the road and he was sending pictures throughout the whole building process. But there was nothing like that moment for you to see those mood boards and all of the Pinterest ideas really come into fruition. It's indescribable how that felt. It's like, I think, at that moment I realized I can do anything that I put my mind to, as long as I'm in partnership and this is what makes my business, I think, plan a little different in partnership with the Holy Spirit. I cannot do it alone, and that's just part of the business.

Blaise M. Delfino, M.S. - HIS :

The ultimate surrender. The ultimate surrender.

Dr. Carla "Brandi" Smiley:

Absolutely, absolutely.

Blaise M. Delfino, M.S. - HIS :

And how hard the waiting period, oh my God. But you were in the desert, Dr Smiley, and there's so many entrepreneurs out there in our industry that are in that desert of. I just opened my clinic. It's not taking off. I don't know what to do. And take it from myself and Dr Smiley lean into those groups, because you had said you were unaware of that mobile audiology clinic. Dr Smiley, to bring you back, I told you.

Blaise M. Delfino, M.S. - HIS :

I grew up in the hearing healthcare industry and the model, the first model that I really saw was my mother getting in her car and driving to the different nursing homes. So to me I always thought oh, that's mobile audiology, yes, it is On-site audiology. Took that to a whole other level and it sounds to me you just kept that why? At the forefront of everything that you were doing, because all of these closed doors were just again strengthening. This is what I'm meant to do. This has been put on my heart. I need to help the underserved community and this is just such an inspiring, inspiring story, oh my gosh.

Blaise M. Delfino, M.S. - HIS :

So you first see the tiny house. You and your husband must have just been beside yourselves. I mean, this is you're talking, not only financial investment, and thank you to all the crowdfunders out there, but emotional the time you see this tiny house, which is 15,000 pounds. I did my research. That's heavy. It's heavy. You see this for the first time, Then what heavy. You see this for the first time, Then what? So you have the tiny house, the mobile audiology clinic. What was the next step? What community were you going to serve? What was your first big event? Did you have like a ribbon cutting for it, or something of that nature.

Dr. Carla "Brandi" Smiley:

So it was a lot of steps after that. So when he delivered the tiny house, it was really much of the shell, with the ship lapping, all of that done and the booth inside, but there was no character to it, right, and the goal for the tiny house was it to be welcoming and inviting to anyone. Like when we take, we don't care about your background, we wanted you to feel welcome, we wanted you to feel seen, and so to put that intentionality into the design. So I reached out to a friend that was a designer and we went to work on the design of the inside.

Dr. Carla "Brandi" Smiley:

After that, while we were doing all that, it was doing the outreach, going to Head Start centers, going to early intervention centers, senior centers and really putting it out there that we want to give the service and for your patrons it would be no charge to them, that it was very important to be able to do that at no charge to these people in the underserved area.

Dr. Carla "Brandi" Smiley:

And so the first group to really attach to that was a Head Start group with 27 centers and that's where we really went to work. They had 1,500 kids across the 27 centers and that's where we were able to partner and provide those services to them. And that's where we really began to see the impact, because we built it with intentionality to serve anyone, regardless of physical challenges, cognitive challenges. We wanted it to be a one-stop shop if needed be, and so we had the visual reinforcement, audiometry, we had the Flex VRA with the LCD screen it's ADA, accessible for people who have physical challenges, and so we were able to see firsthand at this event that we can do this, we can provide that care, regardless of what is considered limitations, to make sure that we can, you know, meet their needs.

Blaise M. Delfino, M.S. - HIS :

This is just incredible, dr Small. You know, I know it's been a couple of years since it was first released, but it's so important that we continue to raise awareness of on-site audiology because mobile audiology again you went, we talked back to the traditional business model and there's nothing wrong with that traditional business model. But to make more of an impact in your community, consider even just getting in your car and visiting your local nursing home, because some of those patients number one we have a loneliness epidemic. The importance of hearing healthcare is so, so important. Dr Smiley, you had shared an instance where you hosted an event with onsite audiology with the tiny home mobile audiology clinic, mm-hmm, and you really talked about making sure that people feel seen and valued, and not less than. Why is that such a central part of your mission?

Dr. Carla "Brandi" Smiley:

I just feel like it's a part of who I am. So many years I felt as a professional, even as a person, that perhaps I wasn't seen as I desired to be know. Having to change my hair to fit a certain aesthetic or having to do this to be in the status quo, and it just makes you feel like you're not enough, you're not worthy, and so that's what was very important about building this that you feel worthy. I've had people that were disheveled and dirty and felt like they weren't worthy enough to sit. I'm like disheveled and dirty and felt like they weren't worthy enough to sit. I'm like this can be clean. This is nothing. You are worthy. Your time, your presence here is worthy. So it's just very important for me to make sure that and this brings tears in my eyes because no one should ever feel that way but everyone is welcome. It doesn't matter finances. We'll find a program that works for you, and that's just the goal to make sure people feel seen to pay that forward.

Blaise M. Delfino, M.S. - HIS :

The gift of hearing is something a lot of us unfortunately take for granted, because it's a sense that you don't really see and until it's gone you don't really know how it affects you. I remember during my undergrad studies my father's an audiologist as well and we did hearing screenings in an underserved part of the community and perspective how important that is and you had that perspective ingrained in you from such a young age and that's what I also hope to instill in my son the importance of treating everyone with respect and how important is that in our industry, dr Smiley I talk about this all the time where our industry is so different from so many other medical industries, because you really do create these relationships, these professional relationships with your patients. It's incredible, after an event with the tiny house, maybe some of our listeners, tuned in, might have a question about like aftercare, follow-up care. What does that look like? How do you help people take the next steps? Because you're one person, you go there, you have a team. What does that aftercare look like?

Dr. Carla "Brandi" Smiley:

So I really rely heavily on the resources that I have at the agencies Because again, I think I talked to you about this A lot of our care is business to business. That helps me as a solo entrepreneur because I can't do everything by myself, so it helps me delegate some of those tasks to the agencies at hand. Our goal is to have standard operating procedures and policies for every type of agency that we go to. So for the Head Start, we may start off with the screenings, but it's very important that we partner with the parents so they know their options, so they know we're coming back in two weeks If you'd like your child to have a comprehensive evaluation.

Dr. Carla "Brandi" Smiley:

This is what we're providing on this day and then have a resource of local providers that can be able to assist them for more surgical needs or if they need hearing aids and so forth, because some of these agencies are about three to three and a half hours away, so of course I can't be there all the time. So we want to work with what's local If it's an assisted living facility or independent living facility coming up with a plan where we're going there quarterly and we have it on the schedule so that now we're coming for screenings or hearing aid checks or ear cleaning, and then if they want more personalized care, that they have that option to have mobile brought to them, but that would be more at their expense and, you know, having a service plan for that. So every type of branch of on-site or our nonprofit tiny house hearing clinic has its own standard operating procedures.

Blaise M. Delfino, M.S. - HIS :

For fellow hearing care professionals who are interested in offering mobile services. What practical advice would you share? Like right now they're just in private practice and they're like you know what I want to maybe take half a day, one day a week, one day a quarter, one day a month, whatever it is. I want to go out and I want to bring my services to my community. What are some first steps they could do and some practical advice?

Dr. Carla "Brandi" Smiley:

I'm just going to go back to when I was working for someone else and I was trying to come up with a strategic plan to exit. Figure out what you're doing and how you can mobilize that and make things more accessible. You have everything that you're doing at your fingertip, so come on out with a plan with how can I make this more accessible? I mean, we're already doing it. We just have to, you know, make it in a way where we're bringing it to other people. I think a lot of people overthink you know mobile, but it's basically what you're doing just making it more accessible. And that's the thing is just figuring out a package that will work for you.

Blaise M. Delfino, M.S. - HIS :

I will tell you I don't own a private practice anymore, but I am licensed in the state of Pennsylvania and almost a year ago got licensed in South Carolina.

Dr. Carla "Brandi" Smiley:

Okay.

Blaise M. Delfino, M.S. - HIS :

If I meet someone out or if there's a neighbor who says Blaze, you know I have hearing problems. That's when I'll have the conversation and if I have the time, I will say you know I have hearing problems, that's when I'll have the conversation and if I have the time I will say you know, here's a local provider you can absolutely go to. I've read the reviews. There's so many great providers in this area. Pc-based audiometry has been a game changer for that mobile audiology aspect and I you know, having that traditional model when I was in Pennsylvania, sure, patients came to us. When you go out to the community, whether it's a lunch and learn, whether it's mobile on-site lunch and learn with a independent living, it's so nice to connect with those individuals who might be lonely, maybe they don't have family around them, and you're passionate about what you do and maintaining that connection. I can't describe it, but the feelings that we are able to feel helping people with the gift of hearing is indescribable, amazing, incredible.

Dr. Carla "Brandi" Smiley:

Yeah, and I think that's the thing that fuels it. I'm going to share a quick, just story of when I went to a home. This parent the children reached out to me to fit their parents with hearing aid at end of life. The wife had not talked to her husband, had a nice, meaningful conversation for 20 years, but they had this amount of time left, you know, in the calendar. And so we went and we did the fitting and they were getting to know each other again. They got married in like the 1940s. So I asked them, I said go get your wedding album and tell me about your story, and for them to be able to converse and go through these photos and look at each other again with so much love, because that connection of conversation had been lost for so many years. Those moments are why we do that and it makes it different than coming into, you know, the four walls. I have that as well. But it's so different having that connection, it's almost like you become a part of their family.

Blaise M. Delfino, M.S. - HIS :

Exactly, yeah, and it's that functional communication I want to know. We talk about balance, being a balanced leader, being a balanced individual. How do you balance the clinical business? You know logistical demands of running a traditional clinic and also a mobile audiology business model. What does that look like?

Dr. Carla "Brandi" Smiley:

We're still figuring out some things, you know, that's just reality. But my goal is to automate as much as possible. You know, using the electronic EMR, having processes where I can easily connect with my patients because sometimes I may be on the road, so having that in the most safe and cyber compliant way, just delegating tasks. So I have people who do my social media trying to automate as much as possible. The caveat is, when you built something like this, you become a little protective because you want someone to love it as much as you. And I have to get out of that Blaze. I have to because I have to. It's too much.

Blaise M. Delfino, M.S. - HIS :

But the goal also was it's too much. I'm smiling because I get it. It's too much, I totally get it.

Dr. Carla "Brandi" Smiley:

But we don't want our dreams and what's so beautiful to become a burden, right? We don't want the mechanics of everything to go against our mission, and so it's important for me to find that team so that we can delegate I haven't figured it out yet, but we are but to make sure that things are balanced, where it's not burned out and it's not burdened. So that's the goal. Ask me again next year.

Blaise M. Delfino, M.S. - HIS :

You're doing incredible you really are and the tiny house? This was originally launched in 2022. Correct, so three years. Dr Smiley, the impact you've made. I'm excited for your continued success and success. The best definition I've heard is success is the progressive realization of a worthy ideal.

Dr. Carla "Brandi" Smiley:

Wonderful, love it.

Blaise M. Delfino, M.S. - HIS :

Notice how it's not like, it's not monetary. You are successful because you're following the dream that was put on your heart, the vision that was put in you Absolutely amazing. Let's talk about solopreneurship. It's lonely. We're already in this loneliness epidemic, so let's throw solopreneurship on this and really see. You know how we're feeling at the end of the day? How do you stay connected and continue to grow? You know, professionally.

Dr. Carla "Brandi" Smiley:

I am just so grateful for our profession. Before I felt like I was in my own little silo if I was at the VA or with educational audiology. I stayed with those groups. When you become a private practitioner, you really have to find your people, and there's a book I can't remember the author called Find your People, and these are one of the things that she was talking about is just finding that village to support you in these seasons, and so some of the Facebook groups that have been pivotal.

Dr. Carla "Brandi" Smiley:

Odd Boss has been very pivotal. I admire so many of those private practice audiologists. Part of my balance, though, was I would always compare myself to their success, but you said the correct definition of success, so I had to pull back a little bit from some of these groups so that I wouldn't get lost in the mission. So Odd Boss is still great. Love those people, love what they're doing. Mobile Audiology Collective are all mobile audiologists doing mobile their way. Great group, the APD support group they have great, you know. So just finding that connection, getting involved in your local association.

Blaise M. Delfino, M.S. - HIS :

Your groups have, you know, made a way for me to be myself, feel comfortable and get support from of make you feel like, oh, I'm not, I don't really have it, I'm not making it happen, but I think oftentimes that could definitely be the ego. It's a private practice, I mean, I found myself doing that a little bit, but very quickly you learn like, all right, this practice has been around for 15 years. So I'm in year one of this new model that we're implementing. Instead of comparing, why don't I collaborate? And, to your point, leaning into that mentorship, because it's almost like oh, let's, you know, I want to compete, compete. There is so much to go around for everyone to.

Dr. Carla "Brandi" Smiley:

I like collaboration versus competition, but I don't know, I've learned that's just a better way to go, dr Smiley, I've learned that's just a better way to go.

Blaise M. Delfino, M.S. - HIS :

Dr Smiley, let's say you were to give a commencement speech to new audiologists. There's some new audiologists that are, you know, they just graduated, maybe they just started in a new setting or they're looking for new positions. What would you want?

Dr. Carla "Brandi" Smiley:

them to hear about serving underserved communities? That's a good question. My whole, I guess, speech to them would be just appreciate people for who they are. We're all the same, we all bleed the same. You have special gifts that have been put inside of you to help make someone's life better, right? So taking that and being able to pour into them so that they can have a better life, and, I think, not being afraid that your dream may be different, because that difference in a dream may be just what they've been looking for, right, that head starts in her. My difference in dream was something that they didn't know they needed, but was what they were looking for. So, just seeing people for who they are human being, being compassionate, empathetic, and taking those gifts that's been put inside of you to make a difference.

Blaise M. Delfino, M.S. - HIS :

We're wrapping up shortly and you know. Thank you so much for being so gracious with your time, but I have to know what is next for the tiny house clinic and how can we hearing healthcare professionals really support your mission?

Dr. Carla "Brandi" Smiley:

Well, thank you so much for asking. As you know, we have expanded our offices, so we're now have a larger office in Peachtree City, which is our headquarters, but our goal is really just to go after grant funding so that we can provide these services at no cost to these people in underserved areas. So you can find out more by going to our website, wwwonsiteaudiologynet, and backward slash tiny house hearing. That is our nonprofit and you can see all the different programs that we have for veterans, for the community, so church communities as well as students, and we would love for you to partner with us if you have resources, pointing us in that direction. But our goal is to really provide that service so that they don't have to be concerned with the cost of those services.

Blaise M. Delfino, M.S. - HIS :

And Dr Smiley speaking of services. Before we wrap up, tell us about the other services that you provide, like ABR, apd testing. You know why is this work so important to you.

Dr. Carla "Brandi" Smiley:

So all of these services are offered because, again, they're underserved areas, under resource. So we provide the diagnostic ABRs for children who may fail their ABR screening at the hospitals. There are not a lot of pediatric audiologists in our areas that provide that testing, so we want to be able to provide that service, be able to communicate with the state via the state database all of the Babies Can't Wait coordinators to make sure that those services are granted. Also, auditory processing there are not a lot of specialists in Georgia so we want to make sure we're always providing that education to ourselves, investing in our education and certification so that we can effectively provide those services in the state of Georgia as well we can effectively provide those services in the state of Georgia as well.

Blaise M. Delfino, M.S. - HIS :

Well, dr Smiley, thank you so much for dedicating your time joining me on the Hearing Matters podcast. Again, we had Dr Carla Smiley from Onsite Audiology join us on the Hearing Matters podcast. Keep hearing and listening well, and until next time, hear life's story.

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Blaise M. Delfino, M.S. - HIS

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