From my perspective, confirmed by talking to people after my talk, there was initial amusement at the thought that chatBRENT was going to give the hour-long presentation, but then discomfort and concern that chatBRENT really was going to give the presentation. I talked to people afterwards about what they thought in that moment, and many said that they were annoyed and unhappy that they were going to listen to an AI talk to them instead of me.

After chatBRENT gave the intro, I stepped in and said that, while adequate, I could have given a much better introduction and, given my decades of experience giving presentations on hearing healthcare to hearing care professionals, I was taking over the rest of the talk. For the rest of the presentation, I explained, chatBRENT would be my assistant that I would occasionally call on to comment when appropriate. Which is exactly how the rest of the presentation went. And I do believe that I could sense not only amusement from the audience on what had just transpired but relief that I was the one who was giving the rest of the presentation, not chatBRENT.

I don’t think the audience’s reaction to all this had anything to do with how much they wanted to hear from me per se, I believe that people have a visceral negative reaction when they know they are being given AI content instead of the ideas and thoughts of a real person. I believe that this is true in business and will prove out to be true in entertainment as well.

Co-founder and Chairman of Netflix Reed Hastings recently said, in a discussion with Reid Hoffman on the podcast Possible, that people want to watch real people in entertainment, they don’t want to watch AI generated entertainment in sports or movies. “I think anything that lives in the emotional realm will be impacted not as much by AI, because we humans react to these things emotionally... So you like to give and get real flowers, not fake flowers. I don't think that's changing just because of AI”. And trust, that safe feeling which is so important in so many interactions, is in that emotional realm where people want real human involvement.

Imagine you are at a bookstore looking at the latest book by Stephen King and there is another book whose cover says it was written by an AI system trained on all of King’s work. Which one are you going to buy? Even better, image that someone gives you a birthday gift of the book by the Stephen King AI instead of the latest one by the man himself, what would you think of that gift?

There is an intangible feeling that comes with knowing that the information that you are receiving—whether business related, news or entertainment—was generated by AI rather than a person. This may change over time, but for now I believe that there is an unstated rejection at some level of AI-generated content.

This raises the business question of under what conditions raw AI-generated content today is accepted without any negative reaction. My instinct, similar to what I saw during my presentation, is that right now people have an adverse reaction to any meaningful AI content being provided unaltered by human thought. What would be a more effective use of AI-generated content in business, I believe, would be to mediate AI content, curating the content rather than passing it on untouched, and incorporating it in your own thoughts rather than having AI be the thought leader.

Who is accountable for decisions made and actions taken where AI is used to provide advice, write reports, make recommendations and the like? There has been a slew of LinkedIn posts recently about the lack of accountability at the leadership level of organisations, and the increased use of AI in executive-level decision-making makes this an even more critical and timely issue.

I’ve spent the past couple of years presenting around the world on how I think AI will be used in hearing healthcare services, focusing on how AI will enhance the capabilities of audiologists rather than replace them. The analogy I have used to help audiologists better understand AI’s role in the clinic is to think of AI as a clinical intern who has a lot of knowledge but is prone to making mistakes and misunderstandings. An intern won’t replace the need for an experienced audiologist’s expertise and responsibilities, nor will the audiologist give critical decision-making responsibility to an intern, but the intern can offload work and provide their own perspective on issues that the clinical audiologist can choose to either act on or ignore.

The key is that the audiologist, and not the intern, is ultimately responsible and accountable for the care of their client/patient. Any work or recommendation that the intern makes must be reviewed and approved by the more experienced audiologist. This is the same with AI in the workplace: any AI system should be treated with no more authority than an intern, where the AI’s work must be reviewed for mistakes, misunderstandings and ill-formed recommendations so that they can be corrected before any damage is done.

Which brings us back to accountability. No leader would ever abdicate accountability to an intern, and no one should do that with AI either. To do so would be to undermine one’s credibility within the organisation, which according to recent reports is already a concern for many executive teams in large organizations.

This can be tricky for people to intuit because the benefit of using of AI at work can be profound and powerful, but no leader should have AI provide critical analysis or advice if that leader can’t identify mistakes made or nuances not understood. To do so would be to abdicate responsibility and accountability.

The quote in the image above, from the book The AI-Driven Leader, describes one of the risks of using AI as a leader and it summarises this whole discussion nicely. The book’s author Geoff Woods describes the role of the user of AI as the Thought Leader and the role of AI as the Thought Partner. This is a nice way of thinking about the role that AI plays in decision-making and critical thinking, as someone to test ideas on or hear suggestions from, and it is not too different from my approach to thinking of yourself as the Accountable Leader and AI as the Knowledgable Intern.

So, next time you use AI for a critical task, think of it as a really smart intern rather than an expert that can overrule or replace your own decision-making.

Almost everyone was surprised by the news last week, and what is causing people to go bonkers, of course, is that this would be the only time that a major hearing retail chain acquired a major hearing aid company rather than the other way around. When Demant announced they were acquiring German retail powerhouse KIND, there was a collective, “Okay, makes sense, good for them.” But a retail chain acquiring a hearing aid company: heads explode.

The fact is that we will have yet another vertically integrated hearing healthcare organization, which raises the obvious question: will the Amplifon acquisition of GN Hearing produce anything substantively different from vertical integrations that already exist in hearing healthcare, such as Phonak and Audiological Care under Sonova? Presumably, the benefits of the acquisition articulated in Amplifon’s press release have existed for years with Phonak and Audiological Care or Oticon and Audika. Retail benefit from insourcing and hearing aid R&D benefit from access to retail insights are nothing new. In an unambitious world, the acquisition will simply produce yet another vertically integrated business with all of the associated complications (e.g., hearing aid sales to non-vertically integrated hearing retail organisations). But there is an opportunity to achieve more.

There are obvious synergies available when one organization owns both a global hearing healthcare retail chain and a global hearing aid manufacturer, impressive opportunities for innovation in both devices and services that would be difficult to achieve without owning both. But Sonova has had all of those same opportunities for years and, to an outsider, has not seemed to have visibly acted on them in any transformative way. Its hearing aid and clinical service organizations have operated as strong but largely independent businesses under the same corporate roof, like KFC and Pizza Hut under Yum! Brands, sharing an owner without meaningfully influencing each other. But could they?

This is where innovation theory comes in. Large organizations are typically resistant to change, and the more successful they are, the more deeply entrenched that resistance becomes. Phonak and Audiological Care, for example, have had ample time to leverage their joint ownership to achieve something genuinely new but, from the perspective of an outsider like me, they mainly run the companies as business as usual, where 1+1=2 for Sonova rather than something greater. This is not surprising. It is the normal behaviour of mature organizations that optimize themselves for predictable performance. But there is a key that becomes available for a limited period that can temporarily unlock the door to innovation in even the most change-resistant organizations. That key appears when there is a major transition: a new CEO, a significant shift in market dynamics, or an M&A. And it is only available for a short time before the organization reverts to its usual behavior. Critically, that same key is now available simultaneously for two of the major hearing conglomerates.

For the soon to be formed Amplifon – GN Hearing, the acquisition will be a major inflection point that will provide a window of opportunity for significant new initiatives that would be difficult to accomplish in either organization under normal circumstances. But that time frame is limited. Once the companies get back to what they believe to be normal operations, they will likely revert to their usual resistance to change, making innovation from the synergies more difficult to implement.

At Sonova, the arrival of Eric Bernard as CEO represents another kind of inflection point. His restructuring presentation earlier this week explicitly highlighted a tightening of the link between hearing retail and hearing aid development, a virtuous circle of clinical insight informing hearing aid design which then enhances retail performance, and so on. This is the synergy that Sonova has always had available but not visibly accomplished. If they had, then that synergy opportunity wouldn’t only now be articulated as a strategic priority after years of joint ownership. The timing of Sonova’s strategic change creates an interesting parallel: Sonova’s new CEO is trying to unlock synergies from an existing structure, while Amplifon has the opportunity to unlock similar synergies through their acquisition.

There’s a lot of speculation on what will result from the Amplifon – GN Hearing deal, with doomsayers predicting lasting damage to the hearing health landscape, others worrying that Amplifon will meddle in the hearing aid business to its detriment, and others treating it as just another vertically integrated structure. For me, the acquisition creates an inflection point, which produces a short-term opportunity for innovation that would be difficult to implement at any other time. What we will find out over time is whether Amplifon’s leadership views the integration opportunity in the same way, noting that Amplifon’s press release focused mostly on financial benefits rather than leaning into transformational opportunities or an ambitious innovation plan. 

So, this week we had Sonova tell us that they are going to finally leverage their years-long vertical integration to produce new innovation in hearing healthcare, while last week Amplifon told us of their intent to create a new vertical integration while not explicitly calling out the (short-lived) opportunity to leverage that integration to create hearing healthcare innovation in a completely new way. For me, the most interesting question is whether Amplifon – GN Hearing will end up like existing vertically integrated hearing health organizations or we will see true innovation coming from the unique opportunities that can only exist with jointly owned hearing aid and hearing retail companies.  

This was our second business model (we had already had one major pivot in our business, with one more pivot to come), based on the idea that anyone could take an online hearing test and create what we called their “EarPrint” that could then be entered into TVs, mobile phones, stereos, etc to compensate for that individual’s hearing loss. Sound ID’s business model was to produce the EarPrint technology and service, and to license technology that would compensate for hearing loss based on the EarPrint to major consumer electronics companies to embed into their consumer audio products.

We pitched the idea to many of the major mobile phone companies of the time. One company that gave us an immediate Yes was Nokia. They were the market leader and most innovative mobile phone company at the time, and they spend considerable resources on early development of new competitive ideas. The team that we worked with on this was quite excited about the idea—everyone we talked to there had an aging relative that they wanted to help use their company’s products.

We worked with this team at Nokia to create a working prototype of a real-time multiband compression system that processed telecom audio according to the EarPrint of the user (we didn’t use NAL-NL1 at the time to determine compression parameters from the EarPrint; my memory is that we developed a fitting prescription designed specifically for telephony signals, for which NAL-NL1 was not appropriate).

We created a working prototype with Nokia and successfully trialed the prototype with people with hearing loss. This brought us to the pivotal point for transferring prototype technology into product development, which was  Nokia’s annual “science fair” where different groups displayed the outcomes of their research and innovation projects to Nokia executives who went around looking for the next great thing they should introduce to the market.

None of us from Sound ID were at this event, but we were told by the partners we were working with that the conversation with executive decision-makers went something like this: “Interesting. So how many of our customers have hearing loss that would benefit from this? Only 5%? Hmmm…” Meanwhile, one of the other prototypes on display was a technology that allowed users to customize their ringtones, with the conversation with decision-makers going something like this: “So how many of our customers might want to customize their ringtone? Everyone? And we could charge $1 per ringtone? Genius!”

To be honest, while disappointing, this was not a surprising outcome. Ours was an idea well ahead of its time, and proper timing is critical for innovation to succeed. It would take another decade before I found myself at the headquarters of the next dominant mobile phone manufacturer, this time in Silicon Valley instead of Helsinki, having discussions about implementing technology in their phones that would help people with hearing aids to better hear their phones. That conversation did lead to a market success, and of course now there are many companies successfully embedding hearing loss compensation into general consumer electronics products. Timing is everything.

(Sound ID employees from GN ReSound included Rodney Perkins, Chas Pavlovic, Susan Whichard, Andy Atamaniuk, Benny Johansen, Nick Michael)

What delighted me is that the founder of ReSound, Dr. Rodney Perkins, would give a plaque to all of the founding employees at his Silicon Valley startup companies that said "Make It Happen" to inspire his employees with the entrepreneurial spirit to strive to succeed; to not to just talk about what needed to be done to overcome barriers and achieve success but to actually take ownership and "make it happen" themselves.

The recipients of this "Make It Happen" plaque and spirit included those who were the first employees of the hearing aid company ReSound that he founded in the mid-1980s in Redwood City California, the same company that now is headquartered in Ballerup Denmark that I visited today.

I wrote almost 20 years ago about Dr. Perkins' (Rodney's) entrepreneurial philosophy and how "make it happen" embodied so much of how he created his 16+ MedTech startups in Silicon Valley, so won't repeat my thoughts here:
https://thoughtfulinnovation.wordpress.com/2006/03/04/make_it_happen/

I think that Rodney would be happy to know that ReSound--the company that he started over 40 years ago, that has moved headquarters halfway around the world and grown to over 10x the size since both Rodney and I left ReSound--has maintained his spirit of innovation to call on all employees to "Make It Happen".

I am feeling quite wonderful about the long-lasting impact that someone can have from small beginnings, and how the spirit of a company can, unknowingly perhaps, persist for such a long time and continue to be embodied by a completely new generation of employees.

The definition of being in denial is refusing to accept reality. In the hearing health field, it’s common for a person to be in denial about having a hearing loss before getting their hearing tested.

But once someone has seen their audiogram and had explained to them that they have hearing loss, it’s rare that they deny that fact. What’s more common is that they evaluate the proposed solution and decide it’s not the right fit for them—at least not yet. This is not being in denial, this is classic consumer choice.

We don’t accuse someone of being in denial if they choose not to wear reading glasses for mild vision changes, or if they opt not to use Invisalign for crooked teeth. They may simply not think that they have a need for these products, or they may prioritize comfort, cost, aesthetics, or convenience.

To bring it back to hearing health, if someone decides not to buy a companion microphone that could help them hear better in noise, this is not being in denial. Nor is the poor uptake of OTC hearing aids a result of people being in denial. It is simply the result of complex human decision-making based on perceived wants and needs.

Perhaps we as a field are the ones “in denial” about the fact that not everyone with hearing loss perceives a need for help, and that many with minimal hearing loss want solutions to help with their speech-in-noise difficulty. By shifting our thinking about getting people to "overcome their denial" to more deeply understanding the different hearing needs and decision-making reasons of different segments of people, we could better design and match hearing solutions more effectively and to more people.

We at ReSound had been caught off-guard in 1996 by the launch of digital hearing aids by both Widex and Oticon. While ReSound had been perceived as the technology lead in the hearing aid industry for the first half of the 1990s (of course, I’m biased in this opinion), we were forced to scramble in the second half of the decade to avoid being made irrelevant by the rapid advancement of digital signal processing in hearing aids.

To jump-start our own development, we partnered with a small but powerful digital development firm Audiologic and Danish hearing aid company Danavox, owned by GN, to leap frog our competitors’ technological advancement. The successful transatlantic development of the world’s first fully-programmable digital hearing aid and at that time the most sophisticated hearing aid ever developed, marketed as the Digital 5000 by ReSound and Danalogic by Danavox, showed the success that the partner organisations can achieve by working together. I can only assume that GN was bolstered by this success in their decision to acquire ReSound and merge it with Danavox. While no corporate merger is without its pain, the successful outcome of the merger was evidenced by the subsequent development and launch of the world’s first open hearing aid in 2003, the ReSound Air.

Fast forward 25 years later, and here I am at GN ReSound global headquarters in Ballerup, Denmark. I am here for GN’s annual conference that showcases their active research to internal stakeholders (and key external advisors and partners), and what I’ve seen is amazing. At the time of the merger back in 1999, I believed that the future held great potential for innovation in hearing aids and what we at GN could accomplish, but I never came close to imagining the level of sophistication of the research and innovation that exists at GN today. 

The work we did back in the late 1990s that resulted in the financial success from the Digital 5000 likely kept ReSound out of the very large graveyard of hearing aid companies that failed to sustain early success. While I was lucky to have played a role in how ReSound brought innovation to hearing healthcare back then, I am enormously happy to see how that success allowed the organization to grow into one with an R&D that is over 10 times the size of what we had back then, with over 10 times as many people who are just as enthusiastic and passionate as we were to develop innovative solutions that help people with hearing loss. Being a part of that innovation trajectory gives me a sense of joy for having been a part of this one organization that has and continues to change the world, and makes me think of all of my colleagues back then who also played a critical role in bringing GN Hearing to where it is today.

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Many years ago, I was helping to raise money for our latest round of funding at a Silicon Valley hearing device start-up. I was visiting potential customers to get their opinion on our product idea and was joined by a venture capitalist (VC) who was considering investing several millions of dollars into the company and leading the investment round. Before his firm invested, however, he wanted to be sure that there was a market for this product and that people were excited about it—hence the visits to potential customers to get their opinions on the business idea.

In those meetings, I presented a slide deck that our exec team had put together to explain the company's business plan and product concept, along with data that we had collected to support the product benefit for people with hearing loss. On one day, we visited a busy audiologist at her clinic, where she generously gave us an hour to talk about the technology, with the VC there to observe how the clinician responded to the idea. The next day, we visited a prominent research audiologist at a busy university clinic who also gave us an hour of his time for us to go through the same slides, the VC again listening to how the product idea was received.

At the end of that week, I met with the VC to discuss what his thoughts were on investing in our company. He was enthusiastic about the responses we had received--thankfully--but he pointed out something that I still remember today. He told me how he was surprised that I used very different language and emphasized different points when I talked to the clinical audiologist compared to when I talked to the research audiologist. He was used to seeing people give the same presentation, sometimes verbatim, over and over again regardless of who the audience was, and he was complimenting me on how I adjusted my talk track to the audience. When talking to the clinician, I emphasized patient benefit, practical integration of the device into clinical practice, and how the product would benefit clinical services overall. To the researcher, I used the same slides but emphasized the details of the patient data we had collected, how the results compared to those of other published studies, and the scientific basis behind the technology design. Why I was surprised by the VC's comment was that, to me, I was simply having a natural conversation in each meeting and focused on who I was talking to, and I was not reciting a script each time. I realised then how important—and how unusual—it is to tailor presentations and conversations to each audience’s interests.

Soon after, I experienced an extreme example of not tailoring the narrative to the audience at all. I was with the executive team and we were pitching our business plan to VCs at probably the 50th VC office that we’d been to in two months. We typically have an hour for these meetings, but this time the VC began by apologising and saying that he only had 20 minutes, so could we please jump to the main points that he needed to know. My colleague, who led the first part of the presentation in these sessions, proceeded to start at the beginning of our deck with the exact same talk track that we had used in countless other hour-long pitches. He spent the first 10 minutes going over the executive team’s experience, then switched to explain the global statistics of hearing loss, until the VC apologised for having to leave, got up and left us alone in his firm’s conference room not even halfway through the deck and our pitch. We hadn't even gotten to the description of the product we had developed.

I am reminded of these events because we are launching a communications development training program at the National Acoustic Laboratories for NAL researchers. With practice at conferences and meetings, most researchers are good at communicating their work to other researchers knowledgeable in their field, but many of those researchers are not trained to communicate well to people who don’t have domain knowledge in their field of expertise. Worse, most researchers are not trained at all on how to communicate to non-researchers, who are typically only interested in what problem is being solved and what the benefit is rather than the details of the protocols or data. Learning to tailor one’s “talk track” is important in non-academic environments where one must convey one’s work to people with varied backgrounds, expertise and interest.

Here are 3 tips for getting better at communicating your work to different audiences.

1. Know your content deeply. Know what you want to say well enough that you don’t rely on a script or even on slides to talk about it. If you really understand your content, you should be able to adjust how you talk about it from very high-level to very deep in the details, depending on the audience. Memorize details so that you can use them when necessary, don’t memorize exactly what you will say.

2. Know your audience’s interests. Know who your audience is well enough that you can guess what their interests are. If you are invited to give a talk, ask about the expertise of the people who will be in the audience. If you are talking to one person or a small group, find out what their background and expertise is. Someone with an IT background will be interested in very different details about technology than someone with a medical background. If you are talking to a reporter or media, ask who their audience is and what their story is for.

3. Know when to adapt. Adjust your talk track as necessary in situ. Particularly with small audiences, you should be noticing what parts of what you are saying is interesting to them and what isn’t. Pay attention and don’t just march through your speech regardless of the response. If their questions are mainly on certain areas, spend more focus on that area. Which, of course, requires that you have conquered tip #1 and know your content well enough that you can pick and choose what information to share.

The inventor and project lead, the late Fred Waldhauer, got his inspiration for amplitude compression of audio as a solution when driving one night listening to the radio in his car. Noting the difficulty he had hearing the radio when the window was down, he started thinking about how to solve the audibility problem he was experiencing with the radio (mulitchannel compression). After talking to people like Jont Allen and Edgar Villchur and realizing that the radio audibility in noise problem was similar to audibility problems caused by hearing loss, Fred created a team at Bell Labs in 1984 and started designing a two-channel wide dynamic range compressor ASIC for hearing aids.

After several years of development, Bell Labs decided to shut down Fred's project. Rodney Perkins, an otologist and medical device entrepreneur in Silicon Valley who at the time had a stealth startup called ReSound, heard about this and flew out to Bell Labs to negotiate the acquisition of the technology. Rodney not only ended up acquiring the technology in 1987, but importantly acquired the rights to offer jobs to some of the Bell Labs team to work at ReSound and also acquired the rights to use the Bell Labs name in marketing of the technology (think: Intel Inside). Rodney asked his friend Andy Grove, then CEO of Intel, what the best way was to convince Bell Labs employees to quit their job in New Jersey and move to California to join his ReSound startup. Andy's advice: fly them to California in the middle of winter. Rodney successfully recruited four employees to move to Redwood City, California to continue development:Fred, Vincent Pluvinage, Carlos Baez and Margaret Farrell (who married Vincent after moving to California!).

Hearing aids in the 1980s were cheap transistor devices that provided linear amplification with peak-clipping. What made ReSound such a great example of innovation in action is that, at the time of their first product launch in 1990, very few people thought that multichannel compression was a good idea. There were many prominent papers published by respected hearing scientists showing that compression had no advantage over linear processing, and most of the thought leaders in the hearing aid and hearing loss field believed that compression was worse than linear processing for hearing loss compensation--it distorts the signal and reduces envelope cues, for god's sake! I suspect that Jont Allen's involvement in the development of the chip at Bell Labs and his understanding of cochlear mechanics had something to do with the team's persistent belief that multichannel compression was going to produce a superior solution. As with any great invention, there was a litany of people telling ReSound that their idea was wrong and not going to work. Meanwhile, Jont enjoyed going to hearing aid conferences and generating interest in what was coming from ReSound by telling people that Bell Labs had spent more money on the design of the ReSound chip than the annual sales of all hearing aids in a year–warning that a juggernaut was coming.

When ReSound launched its first product, the company also challenged the status quo in its approach to the market. ReSound priced their product at least twice the price of the next most expensive hearing aid (every one saying: you can't do that, you'll fail), and required audiologists to purchase proprietary equipment needed to program the devices and become certified before they could receive ReSound hearing aids to fit (again being told: you can't do that, you'll fail). Rodney and team basically did everything that the industry at the time told them was the wrong thing to do. And, of course, every decent hearing aid in the world today now has multiband compression.

It is difficulty today to think that people at one time believed that linear peak-clipping hearing aids were a better solution for people with hearing loss than ones with multiband compression. Producing a solution that everyone thinks won't work, ignoring common wisdom and meeting new unmet needs, transforming an industry, and eventually seeing your the solution become a commonplace and de facto standard: all characteristics of truly great innovators embodied by the original ReSound team.

I chose to locate the center in Berkeley for the opportunity to work with UC Berkeley professors Erv Hafter and the late David Wessel, the former because of his spatial hearing focus and engaging scientific mind, the latter because of his creative approach to audio processing for music. This proved valuable as work with Erv led to our seminal research (Sarampalis et al, 2009) showing that hearing aid technology can reduce listening effort, while our collaboration with David led to the self-fitting tool SoundPoint.

I hired the first two researchers for the center before it opened in December 2004: Sridhar Kalluri out of the University of Maryland and Deniz Başkent out of the House Ear Institute--both incredibly talented individuals who I knew had the potential to make an impact quickly in our research (and I wasn't wrong). We spent the first month working in a sparse multi-desk postdoc room across the hall from Erv Hafter's office on the UC Berkeley campus while we waited for renovations on our center to be completed.

I spent several days that month in Erv's office debating how we might test whether hearing aids reduced cognitive load--what material should we use (words, nonsense sentences, meaningful sentences) what paradigm should we use (reaction time, dual attention task, pupillometry). Ultimately, Erv and I ended up writing a grant to fund the hiring of Tassos Sarampolis to lead this project. Tassos created a car driving simulation for the first experiment to test the effect of hearing performance on driving accuracy. When that didn't work out, we settled on the more traditional cognitive load measures of reaction time and dual attention tasks. Ultimately, we ended up proving that signal processing similar to both hearing aid noise reduction and directional microphones reduced listening effort, a major breakthrough in understanding hearing aid benefit.

Neal Viemeister, who passed away in 2020, trained me to be a scientist. I came to his lab after finishing my PhD in electrical engineering at the University of Michigan, where my research applied digital signal processing to auditory neural processing. Neal's lab in the psychology department of the University of Minnesota was (arguably) the top psychoacoustic lab in the country at the time. What helped with the transition from engineering to psychology was the way in which Neal applied signal detection theory to his thinking about the performance of the human auditory system, along with his rigorous and mathematical approach to basic auditory perception research. Neal helped me discover that while engineering is about solving problems, science is about identifying important questions and developing elegant solutions to gather data that can answer them.

Neal engendered robust scientific debates in his lab. Every week those of us in his lab would argue over our ideas on the function of auditory perception and the meaning of our latest data, and Neal would bet a cookie on who was right if he disagreed with our hypotheses. He didn't care if he was right or wrong in these situations but enjoyed the debate and working through the theoretical arguments. Neal wasn't dogmatic about his scientific beliefs, but he made us deeply justify why our theories made sense and our experiments were the right ones to answer our hypotheses. He would always frame these discussions with a razor-sharp application of logic--imagine applying the "five whys" to scientific debate. Neal let us explore our ideas while he nudged us towards the best ways to design experiments, still letting us figure things out for ourselves.

There was no one I was more eager to talk to at scientific conferences than Neal because he would bring clarity to how the latest research fit into our current world-view of hearing science and provide meaningful alternate explanations for findings that were presented, often illuminating gaps in thinking, flaws in experimental design or missed hypotheses by the researchers at the conference. Debating science with Neal was a joy that I continued long after I left his lab to join the hearing aid industry.

If Neal was responsible for the scientist part of me, then Rodney Perkins was responsible for the entrepreneurial side. Rodney is one of the most successful medical device entrepreneurs in Silicon Valley. I was privileged to work at three companies that he founded (ReSound, SoundID and Earlens), help him start one of them and significantly grow another. Rodney has founded a dozen (and counting) medical device companies in Silicon Valley, all resulting from his finding unmet needs in hearing health and developing solutions that often benefited other fields of health care.

Rodney embodies the prototypical entrepreneur. He identifies unmet needs and continually iterates ideas for solutions until he comes upon one that not only works but is practical and implementable in medical practice. When we were applying Bluetooth technology to hearing aid technology at SoundID in 2002, Rodney explained that most innovation in the Valley resulted from finding technology and solutions in one field and applying them to another; the secret for success was identifying those opportunities and timing it so that the resulting solution can be successfully commercialized. Rodney emphasized that you need to have a deep understanding of unmet needs in health care so that you can always be on the lookout for possible solutions emerging in other fields.

Being in meetings with Rodney almost always exposed me to the creative process in action. Rodney would offer idea after idea on how one might solve the problem being discussed, never focusing on the obvious or easy fix but on creative solutions born out of new ways of thinking about the problem. He constantly sketched new ideas and solutions to problems in his notebooks, which were incredible to see, and created an endless resource for scientists and engineers to investigate and prototype solutions.

In addition to seeing the innovation process firsthand with Rodney, I also observed the stoic nature required to be successful in the startup world. In a world known for hot-headed CEOs and egos causing chaos within their companies, Rodney dealt gracefully with every setback. Whether it was technical setbacks in a prototypes, challenges with VC funding, or any of the hundred issues that arise when starting and building a company, Rodney took everything with a calm demeanor. Yet he was persistent in driving progress towards what he wanted to accomplish, continuing to push where others might give up and focus on something else. This ethic was embodied in a plaque that he gave to early employees in his startups which read "Make It Happen", encouraging everyone to find and implement solutions to problems, to accomplish yourself that which is important and not stand on the sidelines waiting for someone else to do it. As Rodney said many times and as he embodied himself, the hard part of innovation and entrepreneurship isn't developing ideas; what is the difficult and challenging part is the execution and bringing the ideas to the market for people to use--making it happen. He instilled this ethos in people around him: to not wait for someone else to solve problems that you see, but to solve them yourself. I took this to heart in 2004 when I realized that there was an unmet need in the hearing aid industry for a translational research center: a place that would take basic hearing science and translate it into solutions for audiologists and those with hearing loss. I took inspiration from the Make It Happen plaque sitting on my desk, and from years of watching Rodney make it happen, and wrote a business plan for such a venture and sent it to all of the major hearing aid companies. A year later, I opened the Starkey Hearing Research Center in Berkeley, California–I made it happen.

Thank you, Neal Viemeister and Rodney Perkins, for the inspiration and guidance that you've provided me in my career, which would not be what it is today without your impact.

On July 3 2013, Douglas C Engelbart died. He was the inventor of, among other revolutionary computer advances, the computer mouse, and his history is worth considering for what it says about innovation.

In 1968, Engelbart made the first public demonstration of the mouse at a computer conference in San Francisco in front of over a thousand of the world’s top computer scientists. The public introduction of the mouse at that presentation, today called “the mother of all demos”, had little impact on the acceptance or use of the mouse at that time. In fact, the computer mouse languished for over a decade at Xerox’s Palo Alto Research Center until Steve Jobs saw the mouse during a Xerox PARC visit and in 1984 introduced the mouse to consumers with the Macintosh. Jobs knew that acceptance of the mouse by consumers would be difficult, though, so he eliminated cursor keys from the Mac to force consumers to use the mouse as the only means of moving the cursor. “Jobs did not believe that the customer was always right; if they wanted to resist using a mouse, they were wrong.” (Steve Jobs, p. 137).

The facts that the computer mouse did not naturally get accepted upon its public display in 1968 and that consumers in 1984 had to be forced to use the mouse define two of the top challenges to innovation: (i) customers can’t tell you what innovation they want, and (ii) customers will be resistant to innovation that changes their current way of doing things.

Henry Ford famously said of his development of the car, “If I had asked people what they wanted, they would have said faster horses.” Customers are well known to be unreliable sources for innovative ideas and for assessing the value of innovative ideas because their only point of reference is what they already know—they can’t tell you that they need something new unless it is an obvious modification to what already exists. This makes sense when you consider that one of the key characteristics of innovation is risk: if customers are asking for a technology, there’s no risk-taking in giving it to them and therefore there’s no innovation being created. No one was asking for multiband compression in 1989, and the introduction of wide dynamic range compression in hearing aids was initially rejected by experienced hearing aid wearers; they wanted more gain, having only experienced linear hearing aids, while compression actually provided less! No hearing aid wearer ever said that they want their next hearing aids to have frequency lowering—in the early 2000s, most hearing aid experts predicted that frequency lowering would not have value in a hearing aid—yet today frequency lowering has provided benefit to hundreds of thousands of people with severe high-frequency hearing loss.

“Customers don’t know what they want until we’ve shown them,” said Jobs. This is because customers often don’t realize that they have an unmet need until a solution appears. Humans are adept at finding and getting used to workarounds to problems so they don’t realize that the potential for an improved solution exists. Proctor & Gamble employees once conducted consumer research about the user-friendliness of their detergent boxes. Their customer focus groups did not reveal any problems, but one of those customers was observed to keep a screwdriver beside their box of Tide. Why was the screwdriver there, the P&G researchers asked? To open the box of Tide, replied the customer, not recognizing that they had so gotten used to a workaround to a problem with P&G’s product that they were unable to recognize the opportunity for improvement. This is why superstar innovators like IDEO, the world’s top design firm, rely on customer observation rather than focus groups for their breakthrough customer insights.

Some innovations are accepted right away by consumers but, like the computer mouse, many take time for people to recognize the benefit that the innovation provides. This is not unlike acceptance of gain by first-time hearing aid users, who initially don’t want their full gain prescription and are satisfied with insufficient audibility but eventually learn to value the full gain prescription that meets the needs of their hearing loss.

As technology advances—with wireless technology accessories, new signal processing features, advanced user interfaces, connected hearing health—you will be faced with these innovation challenges of how to get your patients to accept innovation and to accept the change in behavior that some innovation requires. You yourself will also be faced with this challenge as new tools for fitting your patients are created and new hearing health solutions for better meeting the unique needs of your patients are developed. Similar to the introduction of innovation throughout history, many of the innovations that will be introduced to your business may not be obvious solutions that you have been asking for and may require a change in your process with patients. When the new computer mouse of the hearing aid field is introduced, will you give it a try and see if it benefits your business and your patients?

The talk is in two parts:

Nike’s United We Rise commercial takes film of Marvin Gaye singing the Star Spangled Banner at a 1983 NBA game and intermixes it with footage of the American Olympic basketball team preparing for the games. The effect, for me, was mesmerizing.

The appeal of the commercial, of course, is Marvin Gaye. To be able to take a national anthem and make it so different, so soulful, and so memorable is stunning even today. I can’t even imagine what the reaction was in 1983, although I know that Jose Feliciano almost ruined his career doing something similar at a baseball game in 1968.

What makes the Nike commercial so memorable? Let’s consider it within the context of Made To Stick, one of the more insightful commentaries on marketing of the past several years. In their book, Chip Heath and Dan Heath (brothers, one of whom is a Stanford Business School professor) outline the qualities of what makes a message (or commercial) sticky—what makes people remember a message and want to tell others about it, or in my case want to watch it over and over again.

The Heaths identify six characteristics that make a message sticky. Let’s examine the Nike commercial with these principles in mind:

1. SIMPLICITY. The commercial’s message is simple enough: Gaye brought greatness in his own way to  honoring America, and the Redeem Team is going to do the same, in a way that will be memorable for ages. With style, and with a whole lot of coolness.

2. UNEXPECTEDNESS. Needless to say, associating Marvin Gaye singing the national anthem with the Olympic basketball team was quite unexpected. Check.

3. CONCRETENESS. Well, I’m not so sure what’s concrete about this commercial. Certainly it’s meant to embody Nike’s Just Do It, but without knowing that slogan already one would have a difficult time pulling that from the images. I’m going to rule that the commercial doesn’t capture this principle.

4. CREDIBILITY. I believe that part of what Gaye brings to this commercial, believe it or not, is credibility to the USA basketball team. Gaye was a world-famous music icon who had recently had a hit with “Sexual Healing”, yet he chose to open an NBA game with a moving rendition of the national anthem that was as likely to hurt as help his career. Gaye took an American-born music genre and honored his country by applying his incredible talents in that genre to his national anthem. The American team had the ability to take an American-born game and apply their incredible talents in that game to honoring their country. The question pointed towards the USA basketball team as they entered the Beijing Olympics was whether they’d put their NBA stardom on the shelf during the Olympics and focus on representing America against the best of the rest of the world to the best of their ability. In today’s star-driven society, it’s easy to imagine a Kobe saying, “What’s the point? I’ve already achieved greatness in the greatest basketball league in the world.” Well, let’s consider what Marvin Gaye would say to that…

5. EMOTIONS. Music has a way of touching people’s emotions unlike any other art form. Not only was Gaye's performance masterful, when have you ever heard a national anthem transformed into a pop-art-form performance that preserved the spirit of the original anthem? There’s a reason that some of the most memorable (sticky) commercials have featured memorable music. Recent JC Penny commercials come to mind. This VW commercial from several years ago is said to have caused the significant posthumous revival of Nick Drake. And, of course, there’s Apple’s iPod commercials.

6. STORIES. Well, there isn’t a strong narrative here. The message is more implied, as I’ve outlined above. I’m ruling that they didn’t meet this one as well.

So, that’s four out of the six Sticky principles achieved by this commercial. Not surprising that it stuck with me.

Given the nature of this blog, I’m forced to consider: was Marvin Gaye’s performance innovative? Given the requirement of economic value that many of my innovation colleagues require for something to be considered innovative, I suppose not. This Nike commercial, however, undoubtedly is.

Todd Mintz has a wonderful recount of his attendance at the NBA game in which Gaye performed. Below is the 60–second Nike commercial that I watched so many times on my Tivo (there’s 150 second version available on YouTube as well). And below that is film of the original Marvin Gaye performance. Enjoy.

Nike ad:

[youtube http://www.youtube.com/watch?v=UgpBJna3V0k&hl=en&fs=1]

Original performance:

[youtube http://www.youtube.com/watch?v=QRvVzaQ6i8A&hl=en&fs=1]

The Olympics are always inspiring with the amazing results achieved by the competing athletes. It's easy to look at someone like Michael Phelps and decide that he provides no inspiration for the average person because he has been groomed for over a decade to excel at this event due to his extraordinary natural talent--and the reality is that yes he has.

What is easy to ignore in Michael’s life-story, however, is that he has worked extraordinarily hard to get to the position that he is in. Unbelievably extraordinarily hard. And so has every athlete at the Olympics. They've found what they are good at and have worked extraordinarily hard at doing their best at it. This is not only the secret of successful athletes in all sports but also the secret of successful entrepreneurs and technologists worldwide, and a model of success that can be accessed by anyone: find what you are good at and work extraordinarily hard at it. Don’t be lulled into the job model that has been created for those who work at something that merely defines something they can do. There is an unspoken job model that is not taught in school and never really discussed, but it is a model for those who find themselves in the unique position of being able to work at what they are best at:

If you resonate at your job, ring it as hard as humanly possible.

I am constantly amazed at talented people who have the ability to do great things in their professions...yet they don't achieve greatness because they treat their job like the average job that they’ve been taught to expect: working nine-to-five (well, nine-to-six is the norm these days) and only do what they are asked to do.

Finding what you are good at and working as hard as you can at that is, frankly, a luxury that most people don't have. Most people aren't able to spend their salaried time doing what they do well—most people just work to make a living no matter what the job. Being paid to do what you do well is an opportunity that perhaps one can only truly appreciate at the end of one's career—to be thankful for being paid to be best at exactly what one is in fact best at. The satisfaction of this unique situation is not about being paid for it, of course; it's about being judged at what one does best and being given the opportunity to excel at what one does best. If one takes that opportunity, that is.

That opportunity, of course, defines the lives of Olympic athletes. And nothing defines them more than matching their talents to their training and working as hard as they can to be best as they can. In the spectacular finish of the American 400m freestyle relay, the finish of Jason Lezak was spectacular: his performance seemingly pre-destined for the history books, and an achievement celebrated worldwide. Yet what’s not seen nor appreciated by the Olympics viewers is the incredible—and I mean incredible beyond what most people can ever imagine—incredible work ethic that Lezak executed to put himself in the position to be able to make one of the most amazing comebacks ever.

Randy Pausch, the Carnegie Mellon professor who became an online sensation when he gave a Last Lecture after being diagnosed with pancreatic cancer (and who passed away soon after), provided simple yet insightful advice about achievements and work ethic:

The brick walls are there for a reason. The brick walls are not there to keep us out; the brick walls are there to give us a chance to show how badly we want something. The brick walls are there to stop the people who don't want it badly enough. They are there to stop the other people!

Work hard. Work harder than others. Work hardest if you are really good at it. Challenges simply exist for you to overcome then if you are up to it.

Most people complain about their jobs and the perceived difficulties and obstacles that they experience. This tip is for the few of you who want to be able to look back on your career with sanguine satisfaction rather than a melancholy attitude towards all that you simply put up with: the brick wall is there for a reason, so let your colleagues complain about it while you scale it, put it behind you, and face new challenges that few ever progress far enough to even come up against.

The video/audio content on the site is organized by category and varies from Entrepreneurship to Science to Visual Arts & Film to (of course) Innovation.

The videos aren’t as mind-changing as as the incredible TED talks, but are definitely worth spending time with.

As a sample, check out this discussion on innovation and R&D breakthroughs:

Christensen spends the first half of the lecture reviewing the basic concepts of his first book: the process of disruptive innovation.

Here’s a tip for those who don’t want to watch the video or read his books: if you find yourself in a business that is happily conceding low-margin commodity business to small start-ups and happily retreating to the more lucrative high-margin business, be careful or you may end up as one of Christensen’s case-studies on extinction by disruptive innovation (you will never forget this lesson if you watch Christensen’s video).

I love the way that Christensen phrases his preventive medicine for avoiding extinction by disruptive innovation: create a division that is given an unfettered charter to kill the parent—imagine that mission statement on a conference room wall!

Christensen’s prediction for the future of health care (which begins around the 38–minute mark of the video) is that it will experience disruption due to three emerging technologies:

• molecular diagnostics,

• imaging technology,

• high-bandwidth telecommunication.

Part of his message is something that I heard biotech guru Steve Burrill talk about a couple of years ago when predicting future trends in biotech: that better diagnostics will allow health care professionals to treat causes rather than symptoms. I’ve talked about how my field of hearing impairment will go through a similar transition, with better diagnostics allowing us to identify the physiology behind different hearing loss etiologies and provide individualized treatments. This falls under the general theme of individualization in health care, a future trend not only in my field by in health care in general.

For the rest of Christensen’s thinking on innovation opportunities in health care, check out the video—it’s worth the time.

Such errors are a common occurrence in movies and television—accuracy in details play a secondary role to the story, and the vast majority of the audience has no idea whether the details are accurate or not. Pilots may object that the location of landing gear switches are not accurately portrayed in a movie, but does anyone else really care? (I recall the howls of protest that arose as outraged chess players complained about inaccuracies in the portrayal of competitive chess in the charming and under-rated movie Searching for Bobby Fischer—seriously, does anyone really care that the players weren’t writing down their moves, or that the games were actioned-up? Chess players worldwide should have been grateful that such a beautiful portrayal of the game was the framework for such a great family film).

Thus, it was with surprise that I read a recently published article in the New Yorker on speech recognition by John Seabrook that provided an interesting and accurate tour of speech recognition, with brief asides on on a variety of related fields—the physiology of speech production, the physiology of hearing, prosody of speech—all tied together by the promise of computer-based communication that HAL presented in 2001 when the article’s author was  a little kid. I was also surprised to see a popular magazine reference John Pierce’s Acoustical Society letter Whither Speech Recognition, a scathing throwdown on the field of speech recognition in 1969 by the then executive director of research at Bell Laboratories (in this highly debated letter, Pierce criticized the state of speech recognition research at the time for having a “scarcity in the field of people who behave like scientists and of results that look like science.”) I highly recommend reading this New Yorker article for anyone with an interested in the topic.

One odd aspect of the story is that it ends with a discussion of a company called Sound Intelligence, which has developed audio sensor technology that detects violent activity on city streets for use by police. The company is cited as an example of the successful application of the work that Seabrook detailed on detecting emotion in speech. An engineer of the company, whom I heard speak about their technology last year, is quoted as saying that the Sound Intelligence grew out of auditory modeling research at the University of Groningen and its application to separating speech from background noise. It’s unclear to me how much the success of the technology requires complex auditory models or any of the science and technology the article had detailed up to that point. While I applaud Sound Intelligence’s success, the inclusion of their technology as the coda to an otherwise great review of the speech recognition field makes for an empty conclusion. I’m sure that the folks at Sound Intelligence, however, would disagree with me completely.

People often make irrational decisions when money is involved. They’ll go out of their way to save 25 cents, say by driving around and around looking for a parking meter with time remaining, yet immediately after blow that much and more without a thought ($4.50 for a latte, anyone?).

Dan Ariely explores such irrational behavior in his book Predictably Irrational. Ariely is a business school professor at MIT, and much of the book describes simple yet ingenious experiments he’s conducted that demonstrate over and over again the consistently illogical behavior of people when making choices. This field of research, known as behavioral economics, stems from the ground-breaking research of Daniel Kahneman and Amos Tversky’s that won Kahneman the Nobel Prize in economics (I’ve been citing Kahneman for years in my talks on cognitive attention and effort, but it seems that every week for the past year I’ve read Kahneman’s name referenced in a different news story, book, or magazine article. Behavioral economics seems to be the hot topic these days). Ariely’s experiments demonstrate the fascinating ways in which people repeatably make decisions that appear to be contrary to common sense.

Ariely details, for example, the powerful allure of something being free. People’s choices change dramatically when items change from being effectively free (costing one cent, for example) to being actually free (costing zero cents). For example, he tells how Amazon’s customers bought more books on average once Amazon started shipping for free on purchases greater than $25—the increase in customer spending far exceeded the amount that they were saving on the free shipping, but they gladly spent more on books to get shipping for free. More puzzlingly, Amazon saw this behavior exhibited worldwide except in France. Was this because the French were more logical in their purchasing behavior? No. The country manager in France decided not to make shipping free but to reduce it to one franc, or 20 cents, which wasn’t a small enough shipping amount to change people’s purchasing behavior. Is 20 cents really a significant amount when buying a $20 book? No. Is a shipping cost of 20 cents effectively the same as 0 cents? For most people,yes. But when the manager in France reduced Amazon’s shipping charge from 20 cents to Free, French customers suddenly increased the amount of books they purchased per order by the same amount as the rest of the world.

The reason that I am writing about Predictably Irrational is to contest an explanation that Ariely gives for his first example, and one of the most interesting, of irrational behavior. In the example, Ariely describes an offer that I’ve seen before but never understood, which made me even more interested in his explanation (and my alternative one).

Ariely noted an ad in the Economist magazine that offered three different types of subscriptions:

1. an electronic subscription for $59;

2. a print subscription for $125;

3. a print and electronic subscription for $125.

That’s right, the price for a print-only subscription was the same as the price for a print&electronic subscription. Why would they bother offering the print-only option when it was clear that no one would select it because they could get both the print&electronic versions for the same price? Being the good researcher that he is, Ariely decided to run some experiments to determine if there was a reason why the Economist made this offer (Ariely’s ability to set up simple experiments to provide insight into unusual behavior is fascinating).

Ariely asked two different groups of students to make a selection among a choice of Economist subscriptions, but each group were given a different list of options. One group was given the same three selections that the Economist offered. The percentage of students who selected each option was as follows:

1. electronic: 16%

2. print: 0%

3. print&electronic: 84%

No one chose the print-only option (not surprisingly). This begs the question of why one would offer that option at all (the same question that motivated this experiment).

For the second group, the unchosen print-only option was removed and only the electronic subscription and print&electronic subscription were offered (still priced at $59 and $125, respectively). One might expect results similar to those from the previous group (16% for electronic and 84% for print&electronic) since there wasn’t any interest in the print-only option that was removed. The results for this second group were as follows:

1. electronic: 68%

2. print & electronic: 32%

Without print-only as an option, the number of people interested in the print&electronic option dropped from 84% to 32%! In other words, by offering an option that no one wanted, 52% of the people changed their preference from electronic-only to print&electronic at a $66 higher cost. What’s going on here?

Ariely’s explanation was that people need a basis for comparison when evaluating whether a deal is a good one or not, and from this comparison they make their decisions. With a similar item for comparison, they can assess the value of an item and determine whether that item is a good or bad deal. He gives a couple fascinating examples where the choices that people make are biased by the presence of a similar and inferior alternative. If people are choosing between A and B, they will choose A more often if there exists a third alternative similar to but inferior to A, and they will choose B more often if there exists a third alternative similar to but inferior to B. Having that third alternative allows people to say to themselves, “I can’t judge whether A or B is a better choice, but I know that A is better than this similar third alternative, so A must be a good deal.”

Ariely suggests that this is why the selection for print&electronic is high when print-only is offered for the same price—the print-only option gives people an alternative from they determine that print&electronics is a better deal, and that drives their choice.

I believe, however, that there’s another possibility for these results: people are more likely to select the print&electronic option in the presence of a print-only option because of the Free phenomenon. Let me explain.

Ariely’s explanation is partly correct: in the absence of knowing the cost of the print-only subscription, people cannot judge whether the combined subscription is a good deal or not. Maybe print-only was $66, and the cost of print&electronic was simply the sum of the costs of the individual subscriptions ($59+$66=$125). Or maybe print-only was $100 and getting the combined subscription would save $34. Or maybe print-only was also $50 and $125 for print&electronic was a rip-off. No one can tell whether both together is a good deal in the absence of a print-only option—in that, Ariely is correct.

The fact that the print-only and print&electronic options are priced the same, however, suggests another explanation for the large difference in behavior between whether or not the print-only option is offered. Ariely made the convincing case later in his book that getting something for free can have a hypnotizing allure on people’s decisions. Providing a print-only option at less than $125 probably would not be enough to drive such a large percentage of people to change their selection from print-only to the more expensive print&electronic option—the print-only option had to be priced at exactly same same price as print&electronics so that the electronics version was free if they chose both. It was the identification of something free that made such a large percentage of people select the print&electronic option. This is similar to the phenomenon observed by Amazon: 20–cent delivery didn’t change behavior but free delivery did. Given the convincing case that Ariely made for this free effect, one would probably have predicted that people would switch their decision from the electronic-only option to the print&electronic option when they discovered that the latter choice would get them the electronic version for free.

So, now you know why so many ads offer free cheap items if you purchase an expensive product A free month of HBO if I get the Lifetime Triple Gold package of cable—sign me up!