In Defense of Costco

Am I suggesting that everyone go work for Costco? No, but I think those who do probably deserve more respect than they get.  David Kirkwood

The hearing impaired should be offered the widest possible selection of instrumentation and dispensing models.  One size does not fit everyone.   K. Ray Katz 

Costco has rapidly emerged as the second largest US retailer of hearing aids, building a reputation of low Price and pleasant, efficient commercial service.  Hearing Economics

 

By now, Hearing Economics readers have worked out that Economics encourages efficient markets and casts a gimlet eye on firms and special interest groups’ efforts to control markets.  Hearing healthcare providers qualify as a special interest group because they tend to group together, formally or informally, to plot ways of controlling the markets for hearing healthcare and product delivery.  The Economic View and the Hearing View have never seen eye to eye but disagreement has escalated. Now it’s eye for an eye with the advent of Big Box competitors such as Costco’s hearing aid dispensing program. Try entering “Costco” into the Search Box on our home page and see how many entries pop up — they could form their own blog site.  It’s a war out there.

As an Audiologist and almost-Economist, I argue with myself everyday and never win.  As a private practice Audiologist, I want to protect my livelihood by ensuring that low-cost, high-volume options like Costco go away.  As an Economist,  I know that Costco is not going away because the market wants what Costco is selling.  My Economic Self thinks my Audiology Self is naive and selfish.  My Audiology Self thinks my Economic Self is cold and heartless.  It’s a war in there.  

The Book of Revelations:  How One Audiologist Solved Her Costco Dilemma

Today’s post is a personal journey.  No graphs, no statistics, no equations.  Just my own thoughts as I grappled with the Costco in my own backyard and came to see the Light.

1st Revelation.  The first Costco Audiologist I ever met was a guy who attended our annual Audiology Conferences faithfully.  He was pleasant, self-effacing, and interested in learning.  I would have hired him in a minute. From what I’m told, he is still working at Costco almost 20 years later.  This got me thinking that working for Costco can’t be all bad.  

2nd Revelation.  I was first betrayed while shopping at  Costco.  Pushing the cart, I glanced into the test booth window and there he was, pushing the dispenser’s button.  He was one of the worst patients in our practice — never interested in improving his hearing, always interested in improving his bottom line for our services.  I felt like a bookkeeper after every appointment and a receptionist after every phone call he made to go over everything once more…. but I never felt like an Audiologist when I was “serving” him.  This got me thinking of a few other patients I might nudge toward temptation.

3rd Revelation.  I was next betrayed by an unknown Audiologist in California who I recommended–based on credentials and AAA membership–as the best provider for a friend of a patient.  My patient later reported that the Audiologist had poor people skills but excellent financial skills, to the point that the friend fled to Costco. There, he received satisfactory service and product and lived happily ever after.  This got me thinking that credentials and training only take you so far and maybe Costco’s HR people already had that figured out.

4th Revelation. Loyal patients began bringing in stories of friends and neighbors who were fitted at Costco and “loved” the experience and the providers.  This got me thinking that Costco might single-handedly destroy the old “used car salesman” image of hearing aid dispensing that I’d been futilely sparring with for so many years.  

5th Revelation.  Confined to bed with a terrible cold, I was bored but too sick to work.  AudiologyOnline had an ad for employment at Costco.  I clicked.  What followed was hands-down the most amazingly thorough, thoughtful, uplifting interview process I’ve ever experienced — and all online, at my own pace, with choices of job locations all over the country, full-time or part-time.  This got me thinking that maybe I should ask Costco to do my hiring next time I had a position open.

6th  Revelation.  Another loyal patient came in with custom ear-molds from Costco for his high-end RICs.  This was after we’d made two unsuccessful attempts to get acceptable custom molds from the hearing aid manufacturer. Costco’s price was lower than our cost from the hearing aid manufacturer.  This got me thinking that I should send my patients to Costco for ear-molds   I was already recommending Costco for batteries. Why not molds, too?  Neither one is a revenue generator.  Nothing lost on my side, money saved on my patients’ side.  Could my Audiology Self and my Economics Self finally find common ground?

7th Revelation.  I moved from thinking to action. On the next Costco shopping trip, I introduced myself to the dispensing staff, and successfully pursued the ear-mold question.  They were visibly thrilled to meet me and asked for our cards so they could refer people for cerumen management; also for high-end hearing aids and specialty aids that Costco doesn’t sell.{{1}}[[1]]At the time of writing, Costco only offered Bernafon Chronos (7&9), Rexton (Bridge+12, Insite+1, Cobalt+16), and Resound Forza RIC.[[1]]  This got me thinking two things:  I should have introduced myself a long time ago, and these Costco hearing professionals placed a higher value on Audiology skills than consumers in general.  

8th Revelation.  I was happy for the referrals but confused about their joyous greeting–it’s not like our locale is short of Audiologists.  Their answer surprised, shocked, and embarrassed me.  “We would love to refer to Audiologists, but they say such awful things about us that we can’t find one to work with.”  Really, I am not making that up.  This got me thinking about Principal 7 of AAA’s Code of Ethics:  “Members shall honor their responsibilities to the public and to professional colleagues.”  

9th Revelation.  Costco referred a patient and sent over his audiogram.  The rule in our office is retest to ensure validity; also to fill in gaps and obtain a complete diagnostic battery.  The Costco workup was one of the more comprehensive work-ups we’ve seen in some time.  They may not bill insurance, but they do diagnostic evaluation. This got me thinking that I need to go see their equipment and find out what constitutes a standard test protocol at Costco.

10th Revelation.  Practice revenues rose last month, thanks to Costco.  Use of time improved, too, thanks to Costco:  Fewer ear-molds and batteries, more Bluetooth pairing.  This got me thinking that from the Economic View, it’s Good to be an Audiologist.  

Full disclosure:  Not all Costcos are alike. Other practicing Audiologists may have opposing Revelations.  This post is tainted by the Editor’s admitted bias, contained in her confession:  “I love Costco.  I shop there twice a week. My dogs, cats, and I would starve if it weren’t for Costco. I have bought a piano at Costco.  I have purchased a car from Costco.   I purchase my latte machines from Costco, which is the highest compliment I can give.”