Friday Audiogram: Pivot, Protect Your Peace, Serve Patients Better

Stuck in a month where nothing clicks and every push feels like quicksand? We unpack a better way with Dr. Brad Stewart, who built a mobile audiology practice, scaled a high-volume vestibular clinic, and then made the hardest call of all: shut it down to protect his health, marriage, and mission. The story isn’t about chasing hustle—it’s about aligning vision, building systems, and choosing patient-first care even when the market shifts under your feet.

We dig into practical pivots that actually work. Brad shares how leadership mindsets from John Maxwell and frameworks like The E-Myth helped him create processes that scale, hire with clarity, and reduce owner dependency. When OTC hearing aids and market turbulence hit, he expanded services thoughtfully, then recognized when the physical therapy model didn’t fit. The result was a lean, “autopilot” hearing practice with strong systems and a team trained to deliver consistent outcomes without burning the owner out.

You’ll hear a step-by-step approach to reclaiming control: the dream practice exercise to define income, role, team, and service mix; reverse-engineering the metrics that matter; and the courage to trade optics for sustainability. We also spotlight mobile audiology for senior living communities—an underserved path that builds grassroots demand, strengthens referrals, and differentiates against big-box retail. If you’re a private practice owner feeling the squeeze, this conversation offers clarity, tactics, and a reminder that flow beats force when vision leads.

Want support building a mobile vertical or tightening your systems? Join the free Mobile Audiology Collective on Facebook for training, tools, and peer insight. If this resonates, follow the show, share it with a colleague, and leave a quick review—what pivot do you need to make next?

Connect with the Hearing Matters Podcast Team

Email: hearingmatterspodcast@gmail.com

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Chapters

• 0:00 Off Months And Flow Versus Force
• 0:24 Pivoting To Meet The Market
• 2:44 Patient-First Mindset And Momentum
• 4:22 Brad’s Leadership Foundations
• 6:41 Building And Closing The Vestibular Clinic
• 8:55 Autopilot Practice And Exit

Transcript

Blaise M. Delfino, M.S. - HIS: 0:00

This is the Friday Audiogram. Let's go. Brad, it reminds me, and I know you have experience with this. You have an off month or things just aren't going the way that you planned them. Because you're trying to go against the universe. How did you, as a private practice owner, navigate those choppy waters?

Dr. Brad Stewart: 0:22

Man, I I've had a lot of them for sure. I think that the I think the key is just being willing to be flexible and being willing to change and to pivot. I had multiple pivots in my practice. I wasn't just a mobile audiologist, not just a mobile audiology practice owner. I ran a vestibular practice with a full physical therapy team at one point. We had a tinnitus clinic. We did a lot of different things. And in many cases, those were us responding to what's happening in our practice and in the market and positioning ourselves to, you know, be the place that patients want to go. So I think that I think not getting entrenched in mindsets and being willing to learn and grow is the biggest key.

Blaise M. Delfino, M.S. - HIS: 0:59

And I love the word there, pivot, because the market, you're not going to tell the market what it needs to do. It's facing the brutal fact, as Jim Collins would say, from good to great, you have to face the brutal facts and pivot accordingly. But again, to your point, keeping the patient's best interest always number one. Because it's interesting the months that you ensure you get rid of that egoic mindset, you put the patient first. Isn't it pretty insane how those months really flow, Brad?

Dr. Brad Stewart: 1:29

100%. When you get where you're in the flow of, as you said, in the flow of the universe, which does sound a little bit woo-woo, but I actually really do believe that energetically, if you're putting out good and you're putting out like, I want to help people, things just fall into place. And it's weird how it happens, but the right conversations happen. You know, a phone call comes through when you're like at that moment where you're like, I don't know if we're gonna have any more patients this month. It just happens, you know? And so it's such a cool thing. And I often forget that that's gonna happen. And so I start trying to force my own will, and that never works.

Blaise M. Delfino, M.S. - HIS: 2:06

Never it Brad, it never works. Being whether your really your entire model is mobile audiology or private practice or vestibular, anything in business in life, being present in the now, you're just gonna flow. It's gonna flow so well. So, Brad, we talk about you mentioned the evolution from mobile audiology to vestibular to having a team. Share with us the Dr. Brad Stewart evolution from mobile audiology to where you are today. It's an incredible story. And I admire what you've been able to do so much. It's really inspiring.

Dr. Brad Stewart: 2:43

Oh, thanks. You know, I think when I very first started my practice, I had kind of indoctrinated myself into this world of like leadership. I saw John Maxwell speaking at a conference when I was a first-year audiologist, and it was really inspiring to like see how growing yourself as a person can have such an impact on your financial life, on your business life, on your professional life, personal life. And so when I went into starting my own practice, my number one goal was I want to learn how to be a good leader and I want to learn how to be a good business owner. Like I was focused on that growth over, I mean, I wanted to grow as a clinician too, and I did, but really focused on the business side. And so, really early on, I started bringing on additional clinicians. I read a book called The EMyth. No, it was one of the first business books I read. And so I was in this mindset of like, I need to create systems around the business. I need to make this thing where it's like we've got systems and processes for everything that we do so that we can just like add people into this ecosystem and it just works. And so early on, I added providers so that we could serve more senior living communities. We got up to where we were serving about a hundred senior living communities around Dallas Fort Worth. Our profession has been going through some turbulence in the past decade or so. And so, about five years ago, it was actually when the OTC bill initially was kind of proposed and passed. And I saw changes coming. And so I figured that expanding our services would be important. So I actually ended up opening this vestibular clinic with the franchise, frankly, having to relearn how to be a vestibular audiologist. I hadn't done it since graduate school. And we were inviting the hardest, most challenging cases into our clinic from day one. So it was trial by fire. So we ended up building that vestibular program up to we had 12 employees. We were serving a couple hundred patients a week. It was a pretty busy practice. And at the time, my wife and I were running the practice together, and it was incredibly stressful. Physical therapy is a totally different business model. It's very like efficiency and time oriented, and you're trying to like just see as many people in the shortest amount of time as possible. And I just frankly, I didn't really enjoy running that business. It was just not a business model that I enjoyed, and it was stressful and it was affecting our relationship. And, you know, we made a really hard decision at the beginning of 2020. We decided that we were going to close our vestibular practice and just refocus on hearing. And so I had to give seven employees the notice that we were going to be letting them go. And then we actually had a couple more people leave on their own after that. However, the timing, I mean, our last employee left our vestibular practice in March of 2020. And so we had this kind of like perfect timing where we could regroup and we had like a tenth of the overhead that we used to have. And we could regroup. And COVID kind of actually, in the case of our practice, gave us an opportunity to take a breath and re-reevaluate like what do we want to be as a practice? And so we really just refocused on, I had this kind of like small team. We had an audiologist that was an extern with me. And so she knew exactly, you know, kind of how I wanted things operated. And so I ended up basically turning it into more or less an autopilot practice where I would come in maybe a couple of days a week and see patients if there were people on my schedule that wanted to see me. But more or less that practice just ran on autopilot for a couple of years. And then in December of 2021, I decided to sell the practice and become a practice consultant and help other practices help more patients.

Blaise M. Delfino, M.S. - HIS: 6:12

Brad, your story is incredible because you've lived it. You started mobile audiology, vestibular understanding and having the grit to start something that you've never done before with the vestibular model, but also having the humility of saying, you know what, this is affecting my health, the relationship with me and my wife. I'm not going to give that up for the stress of this practice. And I really admire your decision making there because I think that there's a lot of private practice owners out there right now, especially now following the pandemic, that are stressed. And if we were to take a step back, you've lived it, you understand the stress, the evolution from mobile audiology to actually selling a private hearing healthcare practice. What would your advice be to the providers right now who are still running private practices and love doing what they do, but are stressed to the max? How can they handle that? What do they do?

Dr. Brad Stewart: 7:16

Anytime I start working with a practice owner, one of the first things we do is this dream practice exercise where we just kind of like step back and imagine if I could wave a magic wand and create my ideal practice where I'm earning the income I want to earn, I have the team I want to have, I'm doing the work I want to do. What does that look like? And then we actually put metrics on that and then we reverse engineer it and we say, where are we now? And how do we get there? You know, I think that it's so easy to lose sight of what your vision was when you got started because you've just kind of been reacting to whatever happened. And when you're reactive and you're just kind of like responding as things pop up, that takes you in a direction that maybe you didn't mean to go. Or maybe five years ago you thought you wanted to build an empire and now you realize you just want a small lifestyle practice. And so I think you're right. You do have to have the humility to do something that might look like failure from the outside in order for you to live the life that you want to live.

Blaise M. Delfino, M.S. - HIS: 8:12

Absolutely. And the word that you use there was vision. And I'm a huge fan of Gino Wickman, talks all about vision. He has this vision traction organizer, huge fan of that because you have to have a vision. It's like when you were driving and your windshield is blurry, you're not gonna see too well, right? So what you had, Brad, was vision with the mobile audiology and constantly you built the foundation. You're a great leader, you know how to build teams, be an effective leader and scale. You know, we were just talking to Dr. Jason Leindecker, and he was like, Well, we want to grow. He's like, actually, no, we want to scale. And it comes to the transfer of information process of duplication for any audiologists who are interested in starting up a mobile audiology vertical and they want to connect with you. How can they connect with you? And what are some of the consultative services that you can offer, not only to them, but other private practice owners as well? Because I really love what you're doing.

Dr. Brad Stewart: 9:14

Totally. Yeah, thank you. So, probably the best thing to do is we have a free Facebook group called the Mobile Audiology Collective. And in that group, I share kind of some of the things that I've learned. And we've got a lot of audiologists in there that are doing that same type of work. So it's a great free community that you can join to learn from people that are out there doing it right now. That would be a great place to start. I do teach people how to build this program. I have a couple of programs where I teach you how to market to retirement communities because I think that's a really under served and underutilized kind of grassroots marketing approach for practices. And then if you wanted to start a full fledged mobile practice, I can help you with that too. But join the group, get to see what's in there, and then yeah, we can have a conversation.