A Question of Loyalty

Even though it is a work of fiction, Fredrik Backman, in his recent book Beartown (Artria Books, New York, NY, 2016), considers an interesting concept.


There are few words that are harder to explain than “loyalty.”  It’s always regarded as a positive characteristic, because a lot of people would say that many of the best things people do for each other occur because of loyalty. The only problem is that many of the very worse things we do to each other occur because of precisely the same thing.


It should come as no surprise that there are nuggets of wisdom in many places.  All one has to do is be open to their discovery.  This one got me thinking about loyalty in audiology, or in medicine for that matter, although I am not qualified to speak to the medical aspects.  You can do that for yourselves if you dare.

There would appear to be certain considerations in audiology that are related to the ideas of loyalty.  The first, and most likely the one that occurred to you, is the loyalty of your patients.  I know that many clinicians wish that patients remain loyal to the clinician or clinic, but I am not sure why they think they deserve that loyalty.  There are probably many rationales (read: excuses) that they could offer, but those might just fall under the “problem” category that Backman notes above.  Just because a patient is served by any clinic or clinician does not assure that they will promote, speak well of, or return to that clinician or clinic in the future, even though that’s what many may ask and expect, but often do little to deserve. 


Loyalty in Audiology Practice


When I was in clinical practice, several manufacturers hoping that they could assure my loyalty for purchases of their products approached me.  Many times I could have sold my continued business for their reduced prices.  I don’t think that I jeopardized my clinical standards when I considered these offers, but it may have undermined the concept of my loyalty if my patients had known what I was considering. After all, loyalty should run in at least two directions. 

I had some patients who stayed with me through the years and some who searched for services elsewhere.  I didn’t think to ask why they stayed or left. I probably should have.

I suspect that every patient who enters the office of any “medical services” supplier expects to receive timely, state-of-the-art, complete services, at a reasonable price.  Having received such treatment, one would seem to have a better chance of earning patient loyalty than if the patient received less.  As a patient, I think I would have little inclination for loyalty if I had received a cursory evaluation and pure tone test, followed by a sales pitch. Perhaps patients should make some demands from those to whom they will be loyal. When they don’t, the concept seems to lose some its value. Value is also lost if “loyalty” is defined by only one of the participants, as might be evident in a recent trade-journal advertisement for patient financing services. Could one ask for much loyalty on the part of the lending institution?


If I were a hearing-impaired person seeking help for my hearing problem, I would have done a little research into methods, devices, and services.  I would probably show up in an office with a pretty good idea of what’s what. So, I would expect to be evaluated in a manner that generated an understanding of my problems (data based), and offered various, validated methods of lessening my difficulties.  I would expect to be able to find or be informed of the “real information” needed to make a good decision. 


I would likely be skeptical of claims of a “big sales event”, a “study” needing a certain small number of participants, a brand-new technology that promises to fix my hearing problems in a way no other can, and claims of the wonderful successes of other users. 

I would grant my loyalty to any clinician who tested me thoroughly, explained the problems I experience with clearly presented data, and then outlined a process for helping me with my loss. I would hope that the addition of “extras” or options for any device or service would be justified in terms of cost and benefits.

All this delivered, then that clinician has a shot of obtaining my loyalty to that practice, my referrals of my friends, and my return in later years.

By way of disclaimers:

  1. There are clinics and clinicians who practice in this manner. They are quite successful.
  2. I can’t hear as well as I was once able. My audiologist practices in this manner. My loyalty to that practice has been earned.
  3. I am not an overly demanding patient.

About Mike Metz

Mike Metz, PhD, has been a practicing audiologist for over 45 years, having taught in several university settings and, in partnership with Bob Sandlin, provided continuing education for audiology and dispensing in California. Mike owned and operated a private practice in Southern California for over 30 years. He has been professionally active in such areas as electric response testing, hearing conservation, hearing aid dispensing, and legal/ethical issues. He continues to practice in a limited manner in Irvine, California.

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