Ronen Nazarian MD – Available, Affable, & Able

– Woo! Are we getting close to basically eliminating people being hard of hearing?

– Yes.

– Wow, that’s incredible. I remember when my son had a horrible earache, we were coming back from Disneyland. I started hitting out my doctor friends. They all say hit up Ronen. How did you build that credibility?

– You have to be the three A’s, you have to be available, you have to be affable and you have to be able.

– Hmm.

– The difference between what I do and maybe something that someone does who is like a cosmetic surgeon.

– Mm-hmm.

– You’re changing someone’s appearance, but with hearing surgery, you’re actually changing who they are. When I was a resident, I never even thought I was gonna go into ear surgery, and then I was on that rotation where we did a cochlear implant on a baby.

– Mm-hmm.

– And just seeing that moment made me realize that that is what I was born to do. ♪ LawFlip LawFlip objection your honor ♪ ♪ Turn the, turn the game upside down ♪ ♪ LawFlip LawFlip objection your honor ♪ ♪ Turn the, turn the game upside down ♪

– Welcome to LawFlip, it’s a conversation about law, life, medicine and everything in between. So when I was five-years-old, my father had a terminal prognosis. That meant he was supposed to die, but he survived, and that is one of the reasons why I have the utmost respect for doctors. So guys like our guest today remind me why I have that type of respect. He is a prominent otologist and restorative hearing surgeon at Cedars-Sinai in Los Angeles, one of the hottest hospitals in the world. He gives people the gift of sound, from hearing impaired to being able to enjoy the music of life. He is an inspiration. Welcome to Ronen Nazarian.

– Thank you very much, thanks for having me, Benjy.

– Of course. So don’t forget to follow us everywhere on social media, at LawFlip and subscribe and call us at our new phone number. Ronen, you’re gonna repeat this with me, 1833-LAW-FLIP. Let’s go, 1833-LAW-FLIP.

– 1833-LAW-FLIP.

– Okay, so how are you feeling, man?

– I’m feeling great. Thank you for that warm introduction-

– Yeah, man.

– And introduction that went, that took place behind the scenes.

– Yeah.

– That was very nice.

– Yeah, absolutely-

– I feel good.

– A good time, we got to see each other before filming today and it’s just nice, it’s a late night, it’s toasty, we’re having a good time.

– Mm-hmm.

– And, okay, in layman’s terms, how do you help people hear again?

– So in layman’s terms, if you or someone you know has some hearing loss and they’ve tried hearing aids or they’re over with hearing aids or hearing aids don’t give them any benefit at all, they basically come to me-

– Mm-hmm.

– For an evaluation. And we figure out if they can be candidates for a surgical operation where we can restore their hearing. Now it’s not just about hearing-

– Mm-hmm.

– The ear organ is also responsible for your balance.

– Mm-hmm.

– So most of your balance does come from your inner ear.

– When you say balance, you’re talking about like walking.

– Yeah, just like knowing like how you’re upright or if you have vertigo or things like that.

– [Benjy] Yeah.

– A lot of times that can come from the ear and that’s when I come in as well and we evaluate that and we can treat hearing loss and balance issues, both medically and surgery.

– And you can take someone who literally is hearing impaired completely and turnaround or do they have to have some semblance of hearing in order to be-

– Right. So we don’t call them hearing impaired anymore. That’s kind of fallen out of-

– And here I thought I was doing the right piece.

– Yeah, right, you thought that, right?

– Because honestly I was gonna say deaf, and I was like, no, that sounds wrong. Give me the right way to say it.

– Yeah, so it’s the hard of hearing.

– Hard of hearing.

– HOH.

– That’s how you can write it.

– Okay.

– Hard of hearing.

– We help the hard of hearing.

– Okay. All right, that’s very helpful, okay so-

– Because hearing impaired makes you feel like they have some type of disability.

– Disability.

– And it’s more empowering to just say hard of hearing.

– That’s helpful to know. Okay, so Helen Keller-

– Yeah.

– Famously both hard of hearing and blind, she said, blindness cuts us off from things, but deafness cuts us off from people. I know we’re not using deaf anymore, but-

– Yeah.

– How much psychological pain are your patients in when they come to you?

– That’s one of my favorite quotes actually, so I’m glad you found that, and it’s very true. So what you see is that the patient is cut off from the world around them, from the people around them. And most of the time when patients come to me, it’s not just them coming to me, it’s more their family members that are coming along with them because I don’t know if you had anyone in your family who is hard of hearing, but a lot of times it’s frustrating for everyone around that person.

– Around them, yeah.

– Right, and I know that from when I was a kid, I had several people in my family who were hard of hearing and the whole family was involved with that pathology.

– Mm-hmm.

– It didn’t just affect that relative, it affected everyone around them.

– Yeah, and it’s interesting. Those were like the big, the really big relational challenges, but then you start to think about other things, like what happens if you’re in a dark room. How do you deal with this in a work context? It permeates, I mean, you never hear the toilet flush. I mean-

– Right.

– Literally permeates every single aspect of your life. What are some of the things maybe that you’ve seen or that you know just from-

– Yeah.

– So much treatment that they experienced that maybe the rest of the world isn’t considering.

– You forget how much you rely on the subtleties of communication, right? So just things like, uh-huh, just hearing that. if you miss that, you might lose a conversation or someone might interpret… If you don’t get those little audio cues, you can be lost in a complex conversation. And then people might think that, is this guy stupid?

– Mm-hmm.

– Is this guy not following me? Like what’s wrong with them? And a lot of times hearing loss, or at least traditionally hearing loss was, it would go together with maybe some lack of intelligence.

– Mm-hmm.

– And that’s actually not true at all.

– Sure.

– Right, it has nothing to do with intelligence, but because-

– It’s genetic, isn’t it?

– Yeah, and someone with hearing loss might just get lost in the conversation, and you might just interpret that as lack of intelligence, but in reality they’re just lost in a conversation because they can’t hear you.

– And what’s crazy about what you do is, it’s so much about timing, right, because 50 years ago, somebody that was hard of hearing, they basically have to live with it, as far as I know. Now the same person, he’s just lucky enough to be-

– Yeah.

– Born now.

– Yeah.

– How grateful are you to the science that’s allowed you to be able to do this?

– That’s what inspired me to go into this field because it’s probably the only field in medicine where you can restore someone’s sense. Okay, I don’t think you can do that to any other of your senses. You can fully restore a sense that you might be missing. I tell my patients all the time, you’re so lucky to be alive in a time where no matter what degree of hearing loss you have, something can be done for it. I think that’s just crazy like. And you’re right 50 years ago that wasn’t the case.

– Yeah.

– Or 40 years ago or whatever like. We’re living in a time now that no matter what degree of hearing loss you have, we can do something about it. And that’s kind of reassuring to my patients. I have patients that have progressive hearing loss and they’re scared. They’re like, should I start learning how to sign?

– Hmm.

– And you don’t have to anymore. Back in the day you might’ve had to, or if your child was born deaf, you definitely need to put them into a sign language school. That’s not the case anymore. If your child is born deaf, you can definitely give him a cochlear implant and they can go to a regular school and get the same jobs that everyone else gets.

– Wow!

– We’ve had people that grew up to be debate champions, telemarketers, no matter what, anything that,

– Requires hearing.

– That requires hearing.

– A lot of us, we have challenges that we experience our whole life. And so, for me I’ve had challenges where I’ve seen every specialist, I’ve gone to every place and you just get frustrated and you never believe that there’s actually gonna be a solution for you. I got to imagine there are people whether maybe they didn’t have access to because of funds, maybe they didn’t have-

– Yeah. access to it because the science wasn’t there.

– Yeah.

– When they come to you, there must be a sense of distrust, a skepticism that like, yes, I’ve been told a million times before, this hearing aid is gonna help me, this-

– Yeah.

– How do you deal with that skepticism? Because, I mean, it’s obviously-

– Yeah.

– Fair for them to have it.

– There is definitely a lot of snake oil-

– Mm-hmm.

– Being sold out there.

– That’s just always been like that. When they come to my office, it’s more like, well, we didn’t know something like this existed. Nobody told us, we’ve had hearing loss for 20 years and nobody told us that this might be an option.

– What do you attribute that to? Is it just a lack of education around it?

– I bet most of the viewers right now when they’re listening, maybe they don’t know anything about, if you say the word cochlear implant, I don’t think most people know what that means.

– That’s true, I kind of didn’t know that either.

– Yeah, but if you think about it, if you ask your parents, if they knew anyone in their neighborhood who was deaf or who would sign, your parents will probably tell you that they definitely knew somebody like that growing up. You and I basically don’t know anyone really. I don’t know if you know anyone From growing up-

– I just figured.

– That was-

– Yeah.

– Hard of hearing like that.

– So is this the type of thing like, are we getting close to basically eliminating people being hard of hearing?

– Yes.

– Wow!

– So it can happen. Now it’s also a sensitive subject though because the deaf community does have this identity and-

– Just stop you real quick.

– Yeah.

– You referred to deaf community, is it okay? So is deaf, is that okay?

– So you can say the deaf community,

– Uh-huh.

– But I don’t know if it’s okay to call someone deaf.

– Got it, got it, got it.

– That different people are.

– Sure.

– Sensitive

– There’s a spectrum.

– Sure, sure, sure.

– But the deaf community traditionally, they had this identity and sense of pride and it was a culture.

– Mm-hmm.

– And in the deaf community everyone signs and the deaf community was very proud to say that deafness is not a disability.

– Mm-hmm.

– And they actually would come in opposition to a lot of the doctors who did research early on to do cochlear implant surgery-

– Wow!

– And things like that that would get rid of deafness.

– That’s fascinating.

– And they would come and protest, and they basically thought of this surgical operation as experimental.

– Mm-hmm.

– And that we’re trying to change them from who they are.

– That’s so interesting.

– And that you should be Proud to be deaf.

– Like there is a community around people being healthy overweight, like don’t try to force people to be a healthy body weight.

– Yeah, right.

– So that’s so interesting.

– So there was a lot, I mean, maybe in the eighties and nineties there was a lot more than it is today, but there is a lot of empowerment in that community. And it’s hard sometimes to get through because there’s a lot of pride there.

– Hmm.

– And if you have a child, if you are deaf and you have a child who is deaf, it’s hard to get that child to get a cochlear implant.

– Why?

– Because the parent is very proud of being deaf and they don’t see it as a disability.

– Wow!

– Because with sign language, you can basically do, you can do anything.

– Wow!

– So the good thing is, is that 90% of children who are born deaf are born to normal hearing parents. So usually-

– So this is a big struggle. There are people that are deaf, they’ve had to experience that their whole life. And they are unwilling based on a variety of factors to provide that to their children because they have come to accept it.

– They’ve either come to accept it or they’re scared of the surgery.

– Yeah.

– Usually that surgery has to be done on the child when they’re one-year-old.

– Mm-hmm.

– And sometimes the parent that’s too much for them to undergo-

– Yeah.

– This type of surgery and they hold off, but the main thing is, is that 90% of the kids who are born deaf, they have normal hearing parents. And most of the time those parents do wanna go ahead and do the surgical operation, so their child can hear and live a normal life, but there is still 10% of deaf children who are born to deaf parents. And of those people, how many people opt to do it?

– It’s hard to get those people to

– Boy, that’s fascinating.

– But it is changing, the culture is changing.

– Yeah.

– Where did someone get to make as much of a impact on someone’s life as you get to do? What type of weight does that carry when you perform the procedure or,

– Yeah.

– And also, how does it feel to be able to give that blessing?

– It feels great, I can’t really describe it or show it. It’s hard to show how you can make someone hear. I really try to portray that to my friends and people on social media, but it is such a rewarding feeling when you turn someone who is basically turned off from the world and you turn them back on into the social world.

– It’s just incredible.

– The difference between what I do and maybe something that someone does who is like a cosmetic surgeon.

– Mm-hmm.

– You’re changing someone’s appearance, you’re changing something functional, but with hearing surgery, you’re actually changing their brain a little bit. You’re turning them on back into the hearing world, you’re changing their way of life. You’re not just changing the way they they look or the way they function, you’re changing who they are.

– Wow, that’s incredible. I remember when my son had a horrible earache, we were coming back from Disneyland, had this amazing day, and like earache starts to explode. I started hitting up my doctor friends, they all say, hit up Ronen. How did you build that credibility?

– It’s a lot of friendships over the years trying to not, never trying to burn any bridges, always being available. And I don’t know what they say to lawyers, but to doctors they say, when you’re starting a practice, you have to be the three A’s. You have to be available, you have to be affable and you have to be able.

– Mm-hmm.

– Okay, those are the three A’s. And I don’t know if you can apply that to law.

– Yeah, you can apply it to anything.

– But if you’re always available, you’re affable, you’re likable and you’re actually able, like you, they not only come to you to get treatment, but they actually get results. That news spreads pretty fast.

– Yeah.

– And you get to be successful.

– Yeah, that’s amazing. And what other types of things have you learned that you put into practice every day? Because I mean, I actually came for a consult with you.

– Yeah.

– And it’s just a full on professional, top-notch, the moment you get there, and you just have this personal attention that you give.

– Yeah.

– But you also like I say, I usually only have people on here that seem happy with what they do.

– Yeah.

– There are probably people that do what you do and still aren’t happy.

– Yeah.

– What do you do to make yourself happy?

– So, that’s a very good question. And that from early on, I said, what do I do to not get burnt out? Right, burnout is a big problem right now. It’s a big problem for a lot of professionals. And I’m sure a lot of lawyers get burnt out.

– We know that for sure.

– So I went, after I graduated residency fellowship, I said, what is the magic formula to not getting burnt out? And I thought to myself, I said, I still wanna be a doctor, I love being a doctor. And what is the 20-year-old me gonna think about me of who I am now? Is the 20-year-old me gonna be proud of the doctor that I am today. What was the driving force for me to go into medical school? What did I want when I said, I wanna be a doctor?

– Hmm.

– And I’m trying to live that life. And I think that’s maybe the secret to not getting burnt out. The other thing is I really try to separate the business

– Yeah.

– From the care.

– How do you do that? And we talked about this a little bit. We’re both in legacy businesses, medicine.

– Yeah.

– It’s hard to change things. I’m a lawyer-

– Yeah.

– It’s hard to change things. How do you operate a good business-

– Right.

– And be a good doctor?

– So I don’t chase the money. So basically I just go every day to try to give good care, to do what’s right for the patient, to do what’s best for the patient, to make sure that I have the environment that gives me the best results, and then the rest follows.

– And what do you do about the challenges of bureaucracy, of insurance and Medicare and this and that?

– So that’s why I’m kind of in the practice setting that I’m at right now. I’m not in a high volume practice setting. A lot of doctors now are doing a volume business because with insurance reimbursements going down, the only way to really fight back is to see more and do more. And I’m just trying to fight that and just see a certain number of patients per day, not rush the visits when I come in to see the patient. And try to keep it low volume and quality care.

– Mm-hmm.

– And I can leave at the end of the day and be happy with what I did. I didn’t rush anyone, I got to give him the treatment they deserve, I took my time, and good care equals good results.

– Yeah.

– And that’s an advertisement on its own

– Yeah.

– Because the patients that walk out with the good results are walking advertisements.

– Absolutely. The cost, so we talked about this a little bit before, about how there are people that are listening to this, or they come into your office and they’ve never even heard of cochlear implants. What do you do to address the high cost, likely high cost, I’m assuming there’s a high cost of these surgeries.

– [Ronen] Yeah.

– How is your community dealing with the poor communities that just don’t have access to this stuff?

– Believe it or not, cochlear implants are covered by most insurances.

– Okay. What about like Medical like the state-sponsored type insurances?

– Medical does, it’s a little bit tougher-

– Yeah.

– To get approved, but Medicare approves-

– Okay.

– Cochlear implants if you meet the right criteria.

– Right.

– Most private insurances will also approve it, every now and then we do have to, we get people who have no insurance and we have to figure out a good price for them, but the main cost of that type of surgery is the implant. So when you have insurance, it’s nice.

– Mm-hmm.

– But sometimes when you don’t have insurance, that cost can be pretty, pretty high like-

– Prohibitive.

– It’s like the cost of a car,

– Yeah.

– To get the surgery it’s like buying an Acura.

– It’s fascinating, I did not know before this interview that there is like that you could theoretically end loss of hearing for people.

– Yeah.

– But to the extent that it still exists because obviously it still exists, there’s still people that are unwilling to get the surgery. Maybe they’re not, they can’t get it for one reason or another. How can we as people and we as a society be more sensitive to those who have a loss of hearing, like what do we do?

– It’s a big problem because you think it’s tough to get them to get surgery, but it’s also tough to get someone just to admit that they have hearing loss and to get a hearing aid. So think about that, so there’s a, maybe I was reading an article where like 50 to 80% of people who can qualify to get a hearing aid, don’t get a hearing aid.

– Hmm.

– Okay. So then imagine out of that group of people, the people who actually need the surgery.

– Hmm.

– It’s even less. It’ very tough to get somebody to admit that they have, someone who used to hear before, for them to admit that they have hearing loss and that they need treatment for it. There’s a stigma behind it, there’s a big stigma behind it because everyone thinks that hearing loss means that you’re getting old. And if you wear a little hearing aid, then that’s a sign that you’re an old-

– Mm-hmm.

– That you’re old now.

– Sure.

– That you don’t count anymore. So people really fight that, so.

– I’ve seen these videos that you do, they do these incredible videos like basically like the story of them coming to you and then they get the implant and then they hear for the first time. Is there like one moment that stands out to you like one of the greatest moments that you’ve had when the first time they heard, one of your patients heard something? Actually the first time that you ever performed it, and then you saw that they were able to hear something later.

– Yeah, that’s how I got into it to begin with. I was a resident, I never even thought I was gonna go into ear surgery or hearing laceration surgery. I thought I was gonna be like an oncologist or something.

– Mm-hmm.

– Or like a plastic surgeon or something like that. And then I was on that rotation where we did a cochlear implant on a baby.

– [Benjy] Mm-hmm.

– And I actually got to go on the activation, and it was-

– Activation is when you actually like test to see-

– When you turn it on, yeah.

– Yeah.

– And just seeing that moment made me realize that that is what I was born to do.

– Incredible, incredible. Okay, Deal of the Week. If you need any help, and just like we talked about before, if you need help, do something about it. If you need help in business, get a coach. So in my old life, I would have said, what is this bullshit about a business coach? What is this? Don’t need a business coach, just work your ass off, but these days I’m a much more evolved person. Okay, Ronen. Look at that beautiful smile. We were waiting to get that beautiful smile.

– Ah!

– So I’m open to self-improvement in any way, shape or form. Welcome Jim Glantz. We hired this guy at the recommendation of my friend, Josh Walter. This guy, he came to us at the beginning of the pandemic, we had a bunch of challenges and this guy he’s just super-skilled, experienced, and he’s really helped us tremendously. And I wanna give a shout out to him, he is my Deal of the Week. I’ll give a link to anybody who wants his contact information. And I just recommend you, if you have any challenge in your life: hearing, weight, business, whatever the hell it is, go get the help if it’s out there, and it’s generally out there.

– Ronen, what is your Deal of the Week?

– So I’m gonna give a little bit of a selfish deal of the week.

– That’s what we do here, we’re all about ourselves.

– It’s corona time, it’s like-

– Yeah, we got you.

– There’s no deals out there.

– That’s amazing.

– But I’ll give you a selfish deal. We did open up a new office location. So if anyone watching wants to get ear exam, a hearing test or ear cleaning, I’ll do it on the house all through October.

– That’s incredible.

– Just call the office and say that you were sent by LawFlip. Just say LawFlip. And call this number down here, 323-433-7744. That’s our Miracle Mile office, I just started working there.

– [Benjy] Incredible.

– And I’ll see you free of charge for hearing tests and hearing exam and ear cleaning.

– Amazing.

– So, Deal of the Week.

– That is incredible.

– I said it’s valid until the end of October, but I think this is gonna air like at the end of October, so it’s valid till Thanksgiving, okay. Just call the Miracle Mile office, I will take care of you. Just say LawFlip, good till, no.

– [Benjy] Till Thanksgiving.

– Good till Thanksgiving, okay. Don’t come after Thanksgiving. As a offer-

– You should not come a day after Thanksgiving, that deal will not be

– Offer is available while supplies last. And the supply is me.

– That’s incredible, okay. We’re on to at Legal Tip of the Week. It’s sponsored by Smith & Benowitz. It’s a great law firm, at least I’m gonna say it. Okay, so it’s a personal injury, employment and class action law firm or the hottest law firm in the country. And I know that because I don’t know. I don’t know

– Because you know that.

– Because I know that. Okay, so-

– Because you are.

– Because we are. Okay, so as long, here’s my legal tip of the week. As long as you reasonably believe, reasonably believe that your employer is doing something illegal and you complain about it, you cannot be fired for that thing, that would be called retaliation. So retaliation is when someone like punches you and you knock them out, right. So that’s what retaliation is. If you go to your employer and you say, I’m complaining about A, B and C, even if it turns out not to be illegal, they can’t fire you for it. If someone does retaliate against you, God forbid, you know who to call.

– [Ronen] Nice.

– Ronen, thank you so much for joining us. Truly is inspiring. It was definitely serious, but in between I got to see that beautiful face, have a few laughs. We appreciate that. I want you to tell the people, where do they find you, online and anywhere else, and any parting words.

– You can best find me online on Instagram, just put in earDoctorla.

– Oof, that’s a hot handle.

– And you’ll find me. Yeah, eardoctorla, @eardoctorla.

– Dude, that’s amazing.

– And you can call the office if you want, 323-433-7744. That’s my new location in Miracle Mile. And I love to see you.

– Okay, amazing. Thank you so much. We will see you next week, LawFlip, do that. ♪ LawFlip LawFlip objection your honor ♪ ♪ Turn the, turn the game upside down ♪ ♪ LawFlip LawFlip objection your honor ♪ ♪ Turn the, turn the game upside down ♪ Okay, they’re asking, where they could find us? So for LawFlip, it’s @LawFlip and; for Smith & Benowitz, our law firm, which does personal injury, employment and class actions, you could find us @SmithBenowitz and; for the personal stuff, like where you’re really gonna find the juicy stuff @BenjySmith and, @WagesGuru and for Louis. Oh, so LawFlip is produced, directed and edited by the young legend, Arian Tabibian; visual effects and compositions by another young legend, Oren Azad; intro music provided by Pen Practice. Pen Practice, what is it? Premium instrumentals for upcoming artists by the music industry’s top producers. For more info, visit I had so much fun recording the intro song with my man, Hilton ‘Deuce’ Wright. Looking forward to hearing more and more from Penn Practice. So the LawFlip identity, this hot logo that you’re looking at created by Garret Whisten and Travis Nagle. Special thank you to Shai and Seth from the Horowitz Marketing Agency. And lastly this podcast is made available by Smith & Benowitz for educational and entertainment purposes only. It is only intended to provide general information and opinions about legal and other concepts and is not intended to be used as a source of legal advice or relied on for legal advice. By listening to this podcast, you understand that no attorney client relationship is being formed between you and Smith & Benowitz or any of its attorneys. This podcast should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

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