How’s the Water or What Sea Are We Swimming In?

Editor’s Note: In considering the problems audiologists face today because of commoditization, it’s important to look at the role that manufacturers play. I want to preface my remarks by saying that in the 40 some years I’ve been in private practice, I’ve had wonderful relationships with the manufacturers used in my practice. Good products, great customer service and support for the products. We provide their products to our patients and they make sure we can do that well.  –Angela Loavenbruck, Ed. D.

The crabby audiologist takes a look at our friends (the manufacturers), advertising, and the ubiquitous “hearing health provider” moniker – commoditizers all.


My patients routinely express amazement when they watch me call a hearing aid manufacturer in the middle of a problem fitting, get an immediate response from a real person, an immediate connection, with virtually no wait time, to an audiologist, and as much help as I need solving the problem. We also appreciate the in house training we get for new products or software.

That said, the bottom line is that manufacturers are businesses; they are not our friends.

We pay for the services provided by manufacturers and we have to remember that the same services are being provided to other provider entities like the VA and big box stores who are paying far less for products than we do in our offices and clinics.

An Audiologist By Any Other Name Is… Not An Audiologist

lightWhile we are seeing excellent training materials from manufacturers for audiologists which encourage us to differentiate ourselves by emphasizing the professional services we provide, we must also be aware that the manufacturers created the term “Hearing Care Professional”. This generic title is designed to mask the enormous education, training and expertise differences between hearing aid dispensers and audiologists.

Check the websites of every manufacturer and see how many times the word audiologist appears. In my opinion, the manufacturers use of the Hearing Care Professional term increases the commoditization of audiology services by strongly suggesting to consumers that dispensers can provide the same services as audiologists, including rehabilitation and counseling.

I recently saw a job description for a dispenser from major hearing aid franchise that stated that its in house training program would enable the dispenser to provide rehabilitation and counseling services to consumers. However, the ad made clear that the position was really a sales position, and that the most important skill was “closing the sale” to a “prospect”.

Retail Competition

Every manufacturer has a presence in retail operations that view the hearing aid fitting process as basically a sales activity. The more that audiologists see themselves as Hearing Care Professionals, the greater the chance that product, rather than audiology services, will be primary.

Some manufacturers are creating large retail networks that will, or already do, directly compete with independent private practices.

When you have retail operations selling brand name products (at a profit) for the same amount that private practices are paying manufacturers for the same products, you have to wonder which side of the coin manufacturers are betting on.

I have always believed that the value of the services provided in our office is what makes patients seek us out and stay with us for many years. But is there a point where the service/expertise/value message will simply be drowned out and private offices find themselves catering only to a “luxury” crowd?

How do third party providers make any sense of the marketplace? Third party insurance coverage of hearing aids is all over the map. I often wonder from whom these companies get their information and their actuarial data about hearing aids and the services needed to make them work for people.

Mixed Messages to Consumers and Audiologists

To highlight the differences between our offices and retail operations, audiologists are being encouraged to unbundle fees for services and products and to emphasize the value of our services.   At the same time, we (and our patients) still find ourselves in a sea of discount hearing aid advertising for both local retail settings and online settings, often for the same products we are using. 9892679-Several-colorful-arrow-street-signs-with-words-Free-Save-Discount-Sale-representing-advertising-mess-Stock-Photo-1

Every manufacturer is also represented in online sites which create another profit making business between the manufacturer and the audiologist. These entities set up provider networks and decide the fees that audiologists should be paid, or lead the consumer to believe that an online hearing care provider can provide all of the professional services necessary for a successful hearing aid fitting.

How confused are consumers about the marketing messages they see? Do these activities lead consumers to trust the hearing healthcare delivery system, or to approach it with caution? Does the mistrust contribute to the delay between consumers noticing hearing problems and doing something about it?

images-3And given the absolute truth that the performance of hearing aids in difficult listening situations remains an enormous challenge for consumers and audiologists alike, how are online and/or less educated dispensers going to help consumers cope with the communication problems that remain after even the most skilled fitting process.

Can We Change the Message?

These are questions we all should be asking of ourselves and of our manufacturing colleagues.

I think the best business relationships are those where illusions of friendship are replaced by respectful acknowledgement that our mutual consumers are best served by coordinated messages – something sorely lacking in the sea we’re swimming in at the moment.





  1. I have had HAs for 15 years biggest disappointment is the lack of being able to adjus anything but volume. Have always been amazed with alll the new features ( now have starkly IPhone capable aid’s). That you go to the Dr they adjust the in a totally silent room and have no idea how it sounds and ask how’s that??? The you leave and walk out into the wiorld and its so loud you rip em out and cuts. Let’s do a fitting out along the street!!! It like buying a Cady with the best sound system and the dealer removes all the knobs but the volume.

  2. I just want to learn more I have had SS for over 15 years now and have had hearing aids they really don’t work real well it is to the point I hate them b/c it is like hearing threw a pipe :-(

    1. Hello Linda – I do hope you will consider consulting an audiologist about the problems you are having. If you would like to email me privately I will refer you to an audiologist in your area. Angela Loavenbruck

  3. Audiologists brought this commoditization upon themselves, going outside the scope of your traditional fields of diagnostics and auditory rehab. What’s more, the United States is the only nation that does not recognize the “hearing aid audiology” profession. Instead, you saw the profit margins and decided you wanted a piece of the pie.

    You bray about how “the manufacturers created the term ‘Hearing Care Professional.’ This generic title is designed to mask the enormous education, training and expertise differences between hearing aid dispensers and audiologists” but you also fail to grasp the simple fact that according to Kochkin in MarkeTrak VIII that when best practices are followed the satisfaction rates between hearing aid dispensers and audiologists are virtually identical.

    What’s more, given that only about 30% of audiologists follow the best practice of Real Ear Measurement vs 100% of Costco fittings verify their fitting, in fact there is a much higher probability a user will be satisfied at the Big Box than by the audiologist at the ENT or in private practice.

    I guess we can call this “commoditization of Best Practices.”

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