The Unraveling of Hearing Healthcare Delivery, Part 1

Holly Hosford-Dunn
June 10, 2014
Jerry Northern PhD

Jerry Northern PhD

Dr. Jerry Northern is today’s guest editor.  As one of the most active boosters of the Audiology profession, Dr Northern is well suited to take the long view of where we’ve been and where we are headed.   His title says it all.  When he says our survival is at stake, it’s time for everyone to listen up.  


The Sphincter Tightens


It’s been happening around us for the past decade, but the sphincter is tightening more and more around the traditional audiology-based hearing aid dispensing system.   I’m reminded of the story of the fight between the bear and the wolf over a rabbit-meal; it makes no difference who wins the battle to the rabbit – and in our case, audiology is “the rabbit.”

I deem the current unraveling hearing healthcare delivery system as a serious problem for audiologists; I further believe the survival of the profession of audiology is at stake here.  A sentence in David Kirkwood’s recent blog,  attributed to research-analyst Lisa Bedell Clive, comes as no surprise:

“The market is moving away from independent retail, with growth in chain retail and manufacturer forward integration.”

The Way We Were


There was a time when audiologists thought that we owned the hearing aid marketplace. Our growing private offices and our new AuD degrees would be the solution to the public’s malaise and lack of appreciation for better hearing.

Oh sure, we felt the presence of non-audiology providers such as hearing aid specialists and nurses in otolaryngology offices, but because audiology was on the path to independent practitioner status, reimbursement by third-party payers was just around the corner, recognition by state and federal legislators a probable certainty, and our own professional organization (the American Academy of Audiology) would help us reach these goals, in our eyes…the future looked bright.

But the current transition of hearing aids into the electronic commodity markets allows the consumer with hearing loss to buy amplification devices nearly any place these days.


A Tsunami of Converging Forces


Bam!  What happened?  The traditional audiology scope of hearing aid dispensing finds itself the victim of a number of unforeseeable and uncontrollable changes that we did not anticipate and, in fact, we stood blindly by watching the tsunami waves arrive.    Obviously, we didn’t see, or understand, the rampant growth of the converging forces chipping away at our position as the self-stated “owners of hearing healthcare.”

Take a look at these converging forces that have combined in exponential factors to affect our independent practices:

  • Manufacturers’ quest for profits
  • Retail network expansion
  • Buying groups and programs
  • The Internet explosion
  • PSAPs
  • The warehouse invasion

That’s a lot of factors.  Too many to do justice to in a single post.  Stay tuned next week for a discussion of each of the forces listed above and some thoughts, if not solutions, for Audiologists’ survival.


Jerry L. Northern, PhD, is Professor Emeritus at the University of Colorado School of Medicine where he served as head of the Audiology Department for more than 26 years. Dr. Northern is a native of Denver, Colorado USA.  A prolific writer and editor of several professional journals, he has authored a dozen textbooks in the areas of hearing and hearing disorders including six editions of Hearing in Children and three editions of Hearing Disorders. Internationally known for his expertise in pediatric audiology, his professional background includes clinical practice, teaching, medical-legal industry experience, clinical and basic research, as well as consulting in nearly 30 countries. Dr. Northern is a founding member of the American Academy of Audiology and served as the organization’s third president. He has been honored by numerous organizations for his contributions to the field of audiology.

photo courtesy of super stock

  1. Jerry, It’s interesting that your blog was delivered to my inbox just after I had finished watching this video on Mimi from TechCrunch. With the exception of the mistake he makes regarding what audiologists pay for hearing aids, he’s done a pretty good job of analyzing the marketplace and finding a disruptive niche.

    1. Holly Hosford-Dunn Author

      Hi Cindy– it’s interesting that the dedicated version they offer at $40/month/ear comes out to $4800 for 5 years of binaural hearing. I will be interested to learn more about the dedicated version and even more interested to see how the market responds to devices that price out the same as hearing aids but remove the costs to users of loss of time and control.

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