It was a simple email question. What did I think about direct-to-consumer online hearing testing and hearing aid sales?
My fingers hovered over the keyboard to reply, but then I lowered my hands. What did I really think about this?
Not too long ago I would have answered, without hesitation, that a web service could not meet the needs of a person with hearing loss. How could anonymous staff on an arms-length website provide the necessary supports – technical, practical and emotional – that are crucial for successful hearing aid use? Hearing loss has a powerful impact on quality of life, and hearing health care has to go beyond technology to include counselling and other communication strategies.
But what about the person who cannot access those supports, which can carry a hefty price tag, or who has difficulty getting out to the audiologist’s office? It’s estimated that only 20%-25% of people who could benefit from hearing aids actually use them, which means that millions of people with hearing loss are living without communication supports that could boost their quality of life.
AARP and the American Speech-Language-Hearing Association (ASHA) recently polled Americans, 50 years and older, on their attitudes around hearing loss. Nearly two-thirds of respondents said concerns about cost and lack of health insurance prevented them from pursuing treatment for hearing difficulties. But a similar number said that their hearing loss didn’t require attention, which was ‘easy to hide.’ On the other hand, 70% said they would do something about their hearing loss if they felt it was affecting their relationships.
It’s clear that a great deal of confusion and stigma clings to hearing loss, along with a pervasive reticence to discuss a private issue.
It was only a matter of time before innovators stepped forward with web solutions for the masses. One direct-to-consumer online hearing aid company claims to offer a more convenient, private, and affordable system for people considering hearing aids. The traditional hearing health care world is in an uproar and I’m twisted into an opinion pretzel.
There are benefits and drawbacks to both service options. The need for hearing health services has exploded and service providers, regardless of their delivery model, will succeed only if their goal is a satisfied client who communicates well.
Education and information: If you’re selling hearing aids, give us the back story and the front story. Yes, we need to know the signs of hearing loss, but most people already get that, otherwise they wouldn’t be on the web looking for information. We need to understand the big picture, including the fundamentals of hearing loss and the scope of assistive technology.
Comprehensive Hearing Testing: My son took the web service’s 5-minute hearing test. It was very basic and didn’t include speech discrimination testing. He was asked how he felt about his hearing and ability to communicate. Can you understand speech in a noisy environment? Not particularly well, but who can? Apparently he has a slight hearing loss and was advised to follow up with a hearing health professional (HHCP). The kid can hear a pin drop on the other side of the city.
A veteran of the torture chamber (hearing booth), I admit to trying to memorize the hearing test words (Say the word ‘baseball!’, say the word ‘keep!’). Is that any sillier than an incomplete hearing test? With visions of bank-breaking $3000 hearing aids dancing before my eyes, I want a comprehensive test, thank you very much.
Hearing Aid Affordability: Although many professionals and consumer advocates agree that much of today’s technology is overkill – most of us don’t need all the super-aid bells and whistles – a good hearing aid is still the first and most important step in reclaiming good communication. The new online service offers lower-priced hearing aids and, if their promise holds, who can argue against that? Hearing aid service providers need to step up and find a way to make hearing aids and other assistive devices more affordable; otherwise, the 75%-80% of people with hearing loss who are not darkening their doors, will remain un-aided, poorly-aided, or using someone else’s service.
Professional Services: I’m nervous about any service option that bypasses the valuable exchange of information between an HHCP and client. Nearly 75% of the AARP-ASHA poll respondents said that if they were to seek hearing help, it was critically important to them to use a highly trained hearing healthcare provider, but that the internet is a key source of information.
Can we truly choose a hearing aid online in the same way that we buy clothing? Buying a dress doesn’t require counselling or a user manual. I see a cute, affordable dress, and I click in my credit card number and mailing address. If it doesn’t fit, or the color makes me look bad, I return it. How in blazes is a someone shopping online for their first hearing aid supposed to make an informed decision on which hearing aid model is best, or to effectivly evaluate how well it’s working?
Counselling, Fitting and Follow-up Care: I’ve never read a how-to manual that’s better than a knowledgeable HHCP who not only answers my questions, but anticipates them. A proper fit and properly-programmed hearing aid takes time, although the process now is a marvel of modern technology. All I really need, though, is an HHCP with patience.
HHCP: There, it’s in. How does my voice sound to you?
Client: Do you always breathe so loudly?
HHCP: Yes I do. But my voice?
Client: Somewhere between Donald Duck and a vampire.
HHCP: (adjusting program) Ok how’s that?
Client: You’re better, but my voice is Niagara Falls.
HHCP: We’ll adjust the venting…
Client: How many adjustments before things sound good?
HHCP: As many as you want, or when your brain gets used to it, whichever comes first.
Client: Thank you, I love you.
Could I ever love a web-based hearing help program? Maybe, if it gave me good service. But coming soon, I hope, is a fusion of personal and online hearing health services that will encourage more people to adopt hearing aids for a fully-engaged, communication-rich life.