Enquirer Consulting Group

Reachable Buyer Map

Prepared for Jon Akers · Otolith Labs · United States · August 2026
From the outside, Otolith Labs reads as evidence-led. Breakthrough designation, hundreds of subjects studied, a clean safety record. That earns the room with a clinician, and it says nothing about how many rooms you can get into. This map is the second half: the clinical roles that sit between a dizzy patient and a device, the settings those roles work in, and roughly how many of each exist in the US.
Neurology and headache medicine
The specialty that owns vestibular migraine as a diagnosis, and therefore the one that decides whether a device belongs in the treatment pathway at all. Headache-focused practices are a small and well connected subset, which cuts both ways: slow to reach at random, fast once a few of them are convinced.
Who signs: practice owner or managing partner, medical director, headache program lead, and in larger groups the clinical operations director.
14,000 to 17,000
US neurologists in clinical practice, sitting inside far fewer practices than that number suggests
Otolaryngology and neurotology
Where the patient lands when the complaint arrives as dizziness rather than as headache. The neurotology subspecialty inside it is small and highly visible to itself, so it behaves less like a market and more like a named list of a few hundred people.
Who signs: managing partner, neurotologist or otologist, practice administrator, and the department chair in a hospital setting.
9,000 to 12,000
US otolaryngologists in practice; the fellowship-trained neurotology layer inside it runs to a few hundred
Audiology and balance testing
The people who run vestibular testing and see the same patients repeatedly over months. Rarely the prescriber, frequently the person whose opinion decides what the prescriber offers next, and the layer most likely to hear a patient say that nothing has worked.
Who signs: clinic owner, lead audiologist, balance lab director, and in multi-site groups the regional clinical manager.
13,000 to 16,000
US audiologists in practice, spread across a larger number of clinic sites than clinicians
Vestibular rehabilitation therapy
The setting where a patient spends the most hours, and the one left out of device conversations most often. Vestibular rehab is a credentialed specialty inside outpatient therapy, so the relevant sites are a small fraction of the number opposite and can be identified by credential rather than guessed at.
Who signs: clinic owner, director of rehabilitation, lead vestibular therapist, and at multi-site groups the VP of clinical services.
30,000 to 40,000
US outpatient physical therapy sites in total; the vestibular-credentialed slice inside it is small and identifiable
Hospitals, health systems and academic balance programs
Slow, committee-driven and worth it, because one decision covers many sites at once. Academic balance and dizziness programs are the smallest group on this page and among the most useful, since they publish, they train the next generation of neurotologists, and they are individually nameable.
Who signs: service line director, department chair, the value analysis committee, chief medical officer, and the director of clinical research on study work.
6,000 to 6,200
US hospitals, consolidated into roughly 400 to 500 systems; academic balance programs number in the low hundreds
Veterans health facilities
The largest single concentration of dizziness, tinnitus and vestibular complaints under one roof in the country, with audiology capacity already built in. Long to enter and durable once entered, and reached through named clinical leads rather than a general inquiry line.
Who signs: chief of audiology and speech pathology, chief of surgery or ENT, the facility research coordinator, and prosthetics services on device supply.
Roughly 160 to 180 medical centers
plus more than a thousand outpatient sites attached to them; a named list rather than a market

Where the openings are

1
The person who diagnoses is not the person who recommends. A vestibular patient usually passes through primary care, then neurology or ENT, then audiology, then rehab, and each of those is a different seat with different reading habits. A channel built around one specialty reaches a quarter of the pathway and then stalls. The pathway itself is the targeting plan.
2
Regulatory standing is credibility, not distribution. Breakthrough designation tells a clinician the device is serious. It does not tell them the device exists. The three clinician groups above come to somewhere between 36,000 and 45,000 named people in identifiable practices, and awareness inside that layer gets built one named person at a time, on a schedule. That is a mechanical job rather than a scientific one.
3
This category is bought at a moment. A new balance program, a neurotologist hire, a system standing up a dizziness clinic, a rehab group adding vestibular credentials. Those moments are visible from outside to anyone watching the whole market, and invisible if you are waiting to be found. Watching several thousand named practices for a trigger is precisely what an outbound unit is for.
Built from public registries and national clinical workforce data, counts banded deliberately. Clinician counts describe people in practice rather than the number of sites or employers they work across, and the subspecialty layers inside each group are described rather than counted, because no public register separates them cleanly. It describes the market rather than your business, and there is nothing to buy at the end of it.
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