A hearing aid is unlike any other medical device, and the highly complex process involved in learning to use it is also unique.
An Oscar de la Renta wedding dress from brides.com
The uniqueness of the fitting process makes it difficult to explain to new patients. There is no “average” or “typical” fitting that you can point to as an example.
Hard-of-hearing people come to see us because they need to solve a problem, like hearing their spouse. They are not interested in the new features in hearing aids. They just want to “hear.”
The act of getting hearing aids is complicated by irrational fear and negative biases. How would you feel if you were going sky diving for the first time later this week? Would a discussion on the new technology used to prevent accidents make you feel better, or would it scare the hell out of you and cause you to cancel your appointment to ski dive?
A LEARNING PROCESS
Consider Susan, who needs to hear her colleagues at work and understand what is said at important discussions on the job. So, the driving force behind her actions relates to job security. She starts shopping for a hearing aid, but getting the device is only a means to an end, not the end.
If our discussion with Susan is devoted to “the product,” we do her a great disservice.
As hearing professionals, we understand that hearing happens in the brain, not the ears, and we realize there is a learning curve involved that strongly influences the outcome of the hearing aid fitting. As patients wear hearing aids over time, their hearing improves with use. Let me prove my point.
Consider two points in time: (1) one month after getting the hearing aids and (2) one year after getting the hearing aids.
If we do our job properly, Susan will hear the people she has meetings with at work better in a year than she does at first. That is because it takes the brain time to adjust to the new sound. It also usually takes several adjustments to the fitting to get the system working to its maximum potential. In addition, we need to help Susan learn to select the proper program and to adjust the volume and other controls appropriately.
BUILDING A RELATIONSHIP
When we first see Susan, we introduce her to the product. But, more importantly, we start to build a professional relationship with her that will last many years. We also help her get over pre-established ideas about hearing aids.
Susan, like most new users, believes “old people” get hearing aids, and she does not want to see herself as “old.” She is also aware that hearing aids often “whistle.” She has heard that nobody likes them.
Viewed from the patient’s point of view, these biases have little to do with the “product.” The patient’s negative perception is associated with hearing aid use, not with the instrument itself.
A hearing aid by itself is useless, just like a pacemaker in a box. Problems like feedback relate to service not product. A conscientious, competent professional can eliminate feedback. But you can’t take the aid out of the box and expect it to automatically eliminate feedback. If I do my job well, Susan’s hearing aids will not whistle. If I attend to her concerns about the appearance of the product, she will have hearing aids that are not visible. No one will know she is wearing them.
So, if discussions about “product” are not the best way to introduce hearing aids, how should we talk to people about the process of getting hearing aids?
CONSIDER THE SIMILARITIES
I suggest that you draw a comparison between buying hearing aids and buying a wedding dress. Consider the similarities:
A wedding dress costs you (the consumer or patient) a lot of money, like hearing aids.
You are likely to spend a lot of time shopping for them.
Your purchase decision is strongly influenced by esthetics and style.
This is a major event in your life. After all, how often do you get married or get your first hearing aid?
In the purchase process, you are influenced by the style, color (shades of white), and design, and you want the process of buying and using the dress or hearing aid to be joyous.
When you decide on the right choice, the work has just begun. You need to have either a dress or a hearing aid fitted. You go in for several “adjustments.”
You want to be sure your purchased item “works.” You want to be able to walk and move in the dress, without fear of falling down on your way down the aisle the dress. It is critically important to avoid disaster on your wedding day. Most importantly, you want to be happy, excited, and thrilled during this great event in your life.
One year later, if you wear the dress again, you will need to have it cleaned and re-adjusted. People change. The dress needs to be modified to match the person you have become.
We need to be careful when we talk to patients about hearing aids. We need to tell them the unvarnished truth: Hearing aids are expensive, and you will have to work hard at first as you learn to use them. You will have to come back to the office several times for adjustments, and you may not like how your voice sounds the first few days you wear them.
In our introductory talk, we need to lay the foundation for success. We need to spark positive emotions: hope, excitement, and expectations for a positive future…just like a wedding dress.
Thanks Bob, for a fabulous article which sums up so many of the concerns that new users have on their initial visit to the office. Your wedding dress analogy is superb.
You could have mentioned the majority are likely to get a lot more use out of a hearing aid than a wedding dress.
And just like a wedding dress that ends up in the closet never seeing the light of day again, so often do poorly fit hearing aids.
Thank you for being so straightforward in saying that hearing aids are costly and would require patients to adjust to the difficulty when they first get them. This should alert Grandma who’s finding it harder and harder to hear every day, but is afraid getting a hearing aid would not only painful but also cause ringing in her ears. Thus, I’d suggest I accompany her to her local ear doctor so she could get fitted with a really small model that wouldn’t affect how her ears feel or how young she looks for her age. It’d be best, too, if I could go with her for several days of adjustment, so she could get used to her new hearing aid until she’s comfortable enough on her own. Thank you very much!