This is an interesting question that each person with a hearing loss asks. If not the person with the hearing loss, then surely a family member such as a daughter or son asks the question. It is a larger question than just googling an audiologist or hearing aid dispenser. There are many considerations: convenience to a person’s home or work, confidence or trust in the provider, the issue of price and what is included in the price. But, ultimately, the choice lies in the face to face meeting face to face with the provider and having all your questions answered before you place the order.
Some consumers depend on their friends’ experience and advice. Others depend on their primary care physician’s recommendation. Others shop around and take the time to visit several offices before making a final determination. Others are limited to insurance coverage and contracts. Some unions will pay a portion of the hearing aids at certain offices. Overall, it is not an easy decision to make.
As a consumer, I want to be comfortable with the provider. I may be unusual, but I have “interviewed” physicians before I made my final decision on who I want to trust with my health. When I was told by one physician I couldn’t do that because they couldn’t bill for the appointment, I choose not to use that particular physician as my primary care doctor. I wanted someone who would take “extra time” with me, if my situation warranted it. I didn’t want to be told that my seven minutes were up.
As an audiologist who sells hearing aids, I also want people to feel comfortable in my office. I do not want it to be so “medical” that it is off putting. I believe in taking the time to make sure a person is hearing well before they leave my office. Some people may perceive my “chit chat” as unnecessary. However, I usually do a number of tricks such as turn my back, and change the subject to see if the person responds appropriately and is still with the conversation. I turn my head, talk softly and ask a crazy question such as “What did you eat for breakfast?” This tells me several things. I am checking memory which will affect the details of my instructions to the person. It also tells me if they heard this off-beat question and can answer it. Even if they say, “Hmm, I don’t remember what I had for breakfast”, I know they heard the question and was thinking about it.
I want consumers to be referred by their family and friends who have found our services helpful, comfortable, and affordable. I want the primary care physicians to automatically refer every 50 year old for a baseline hearing test. I want pediatricians to refer children who failed their school hearing screening. I want patients to refer others to the practice.
Some insurance companies are aggressively encouraging people to purchase hearing aids through their discount programs. The implication is that hearing aids are devices that can be worn without any maintenance or follow-up care. Insurances are looking at hearing aids like an arm brace. You purchase it and use it.
Hearing aids are very sophisticated devices. Some insurance companies will sell you hearing aids “pre-programmed” to fit your hearing loss. The assumption is that the hearing aids are programmed to “correct” your hearing loss that is determined by the audiogram or hearing test. There are many other factors that determine how hearing aids should be programmed.
Most of the software designed to program hearing aids sets the hearing aids to “target” or the optimum hearing for a person’s hearing loss. Personally, I have found that most first time hearing aid wearers find this setting too loud and uncomfortable. I know that hearing aid manufacturers do not believe that, based on their studies, but I have found this to be true of most of my first time wearers.
There is a well-documented phenomenon known as Uncomfortable Loudness Level. It is important to test this so the maximum gain can be reduced so environmental sounds will not exceed this level for the wearer. On most audiograms, the level is not routinely tested. Many seniors have “recruitment” or the abnormal growth in loudness. This affects the maximum gain output and needs to be adjusted on hearing aids for a person with recruitment.
These are just some of the factors that need to be considered by the audiologist and hearing aid dispenser as they are programming the hearing aids for the wearer. These are factors that a mail-order hearing aid do not take into consideration. And, for the adjustments to be made, the hearing aids would need to be mailed back to the factory for adjustments. How is the hearing aid wearer to know about these items and ask for those adjustments?
As a professional, I believe the patient receives the best care from a local office. Purchasing hearing aids via the mail is ultimately not in someone’s best interest. Being able to have regular follow-ups and cleanings is key to the success of wearing hearing aids. Being able to talk about your experiences in different situations gives
important information to the professional so they can re-program your hearing aid for better hearing and better clarity. Find a local provider who you feel comfortable with. Find a local provider who has good office hours to accommodate your schedule and who listens to you. Find a local provider who has experience fitting hearing aids. Hearing aids need regular professional cleanings. You will need an annual hearing test to monitor your hearing. If your hearing changes, you will need your hearing aids re-programmed.
I believe most “first fit” algorithms underfit rather than over fit. Most manufacturers allow you to choose NAL NL1 or NL2 … Which will likely be too loud for most first time users, unless the software allows the audiologist to set the age, gender, and experience level for NL2… Most don’t. Anyway most of the default first fit prescriptive methods are very conservative, and this is done to increase acceptance and drive higher sales.
As a consumer and a person with a background in technology, I expect my audiologist to be able to answer technical questions and to be able to communicate technical information from the hearing aid adjustment software. I expect to be educated about my available options, programs, and hearing aid capabilities.
My personal experience is that the majority of audiologists are not able to do this.
Without this kind of communication, none of the other factors (hours, communication style, etc.) really matter.
Most audiologists know very little about different kinds of hearing aids tecnology. They usually work with a specific branch and this a great problem for costumers with different difficulties
Abram: I have been fiiting hearing aids since 1970. Maybe because I come from the age of the analog, I do not “trust” technology to be the end all and be all. I usually trust the patient to tell me if their voice is too loud, or my hand clap is too loud. Sometimes I can see them jump, so I know it is too loud! I would rather a patient leave my office with the hearing aids turned down softer than what they “need” based on someone’s algorithim. I would rather they say “I am hearing better, but… I need more.” I still believe most “first fits” are too loud.
Francisco: Most audiologists have their”favorite’ manufacturers, this is true. But, they should be willing to learn about other options and at least be aware of them so they can talk intelligently about other manufacturers options.
If you go to a Franchise such as Miracle Ear or Beltone, then most of the hearing instrument specialists only know their particular manufacturer’s information. But, most audiologists should have a working knowledge of the major companies and what they have to offer. Or, it is a phone call away!
Mike: Personally, as an audiologist, I have very little interest in all the technical aspects of the aids. I want to know”how they help my patients hear better and communicate better.” I can give them information if they want. I have no trouble looking it up or steering them in the right direction. I have even arranged phone conversations with factory people and patients so they can ask all the technical questions and get the answers.
I understand the rationale each manufacturer has in developing the software. That, is more important to me than the technical aspects. I am more interested in why certain manufacturers make choices to have their hearing aids function in noise, or in quiet, or how the mikes “rove” for speech, or compression, and maximum power output, etc. These all make a huge difference in the patient hearing speech clearly. And, then of course, each hearing loss is different, which requires different programming adjustments. These are all the fun part of my job. I hope your audiologist finds it fun too!
If you live in the UK your hearing aids are fitted by which ever audiologist is on duty that day. Follow up appointment lasts 10 minutes and is, mostly a pointless customer satisfaction questionnaire. (My aids are a new model and the person I saw knew very little about them, so no follow up adjustments).
I’m lucky first fit seems to work just fine, but I’m not surprised many aids live in draws.
As for going Private, thats just not British (We moan bitterly at parting with money for dentists and prescriptions)
Finding an audiologist who focuses on patient outcomes and satisfaction is essential. Unfortunately most satisfaction surveys are conducted in house and don’t allow for benchmarking against other providers, which means that patients cannot use the results to help make their choice.