The Changing Landscape of Hearing Healthcare Technology and Delivery: Interview with Geoff Cooling & Steve Claridge

Amyn Amlani
Welcome to This Week in Hearing. My name is Amyn Amlani and I have the privilege of serving as your host. For today’s webcast, I have the privilege of having discussions with two notable and well respected international colleagues as we consider hearing products, traditional and evolving changes in service delivery, and consumer perception and experiences as they seek to improve their quality of life. Please welcome Geoff Cooling and Steve Claridge. They’re co founders of HearingAidKnow.com and Audiology Engine. They’re both writers and hearing care bloggers. So welcome, gentlemen. Thank you. So Steve, you’re the first one on my screen here. So why don’t you tell us a little bit about yourself, please?

Steve Claridge
Yeah, so I’ve been wearing hearing aids since since I was about mid teens. My parents first noticed that a hearing loss when I was about five, took me to a local hospital, got some really big bulky analog aids, which were horrible and whistly. No good. But it wasn’t till I was about sort of late teens, mid 20s, where my hearing progressively got worse to the point where I realized that couldn’t actually get on without them. So up until that point, I was kind of put in not wearing them. But since then, so since I was about 20, up to now 47, I’ve been wearing a lot of different hearing aids in that time plus

Amyn Amlani
So you have a lot of experience with the products and potentially with the patient journey and in and I’m very curious to hear as we have these discussions and as things are starting to evolve in the industry, what your perceptions are, because 1) you’re an insider, but you’re also an outsider because you know what’s going on, but then you also need the product and the services in order to hear

Steve Claridge
Yeah, I think it’s definitely an interesting time at the moment. I think we’ll talk about it again in a bit but I think with the changes the OTC and all that kind of stuff, I think it’s a good time for the consumer.

Amyn Amlani
Yeah, yeah, absolutely. And then of course, everybody knows Geoff cooling, you know, you and all your blogs, it’s it’s one of the things that I look forward to on a daily basis. And I think I’ve read almost everything that, that you’ve that you’ve written a huge fan, and I’m looking forward to having you on here, Geoff, and so, share a little bit about you for the audience, if you would, please.

Geoff Cooling
It’s funny, I’m a big fan of your stuff. Like, it’s like every time I come on with somebody, it’s like a love fest. It’s like, “I love your stuff”. And I’m really, really big fan of your stuff in relation to, you know, the economics of hearing and like Yeah, really, really love it whenever you write an article in relation to it. So who am I? Fat Irish bloke, very irritating, been involved with the business since I think 2006 qualified as a hearing care professional in Ireland. Did a bit of work in the UK. And then I worked for Widex as basically a country sales manager for a couple of years, split with them in 2014. Worked with Steve ever since. So really did, I suppose I’ve always been fascinated with technology. But I’ve always been fascinated with the psychology of the interaction between the professional and the consumer, as a byproduct of that, I suppose. Change in consumer wants and needs. So it made sense to get involved with Steve from from a lot of different points of view, and get involved with Hearing Aid Know. So we’ve been working together now since middle of 2014 Steve, eh?

Steve Claridge
long time, isn’t it?

Geoff Cooling
So he said to him last year, early this year, like it’s seven years… don’t divorce me!

Amyn Amlani
And that’s funny, though, you guys have a really, really unique website, I know that you have some books and things on there, there’s some really cool content and if you haven’t accessed the website, and we’ll put the we’ll put the link down here at the bottom when we actually publish the video. Folks should really, really go out and see what you have on there. It’s a very unique perspective and one that I respect and a lot of times I agree with you – there’s a couple of times I don’t agree with you, Geoff, but you’re not bigger than I am. So you know, like you got a few pints and then I’ll tell you what, I really think

Geoff Cooling
I’m a pussycat. Yeah, sometimes I mean, ooh, sometimes I have, shall we say “pushed the envelope” and put some, but more often than not, it’s it’s true kind of frustration to be honest with ya. I think that my attitude has evolved as well over the over the period of time that it you know, got to be involved with the industry but also that I’ve been involved with HearingAidKnow and before I would have said that I was probably an advocate for the independent hearing care profession, but now to be honest with you in the last couple of years it feels like to be honest with you I’m more an advocate for people with hearing loss and so I want you ever and yeah, no, I think it’s it’s it’s not quite schizophrenic or it’s But yeah, I think I would think my attitude has changed slightly but yeah, it’s been an interesting journey like really fascinating journey. And again, like Steve, I’m hearing aid wearer so there’s that kind of thrown into the mix as well as being a professional so yeah, no, it’s been fascinating.

Amyn Amlani
Yeah, yeah. Well let’s let’s dive into this let’s talk about products first and then we’ll move into your comment about patients and I absolutely agree with you. You know, I’m kind of in the same boat more or less advocating for the consumer and we’ll get to that in just a minute. But let’s talk about products so both of you are hearing aid wearers, both of you have seen changes in the industry – my first question is: are hearing aids in 2021 better than they were five to seven years ago?

Steve Claridge
Yes, he actually yeah, I think it always surprises me so I mean through Hearing Aid Know, I get quite a lot of trials of different products so I tend to like wear something for six months or a year and then you know so, ReSound giving you a trial of ONE, so I upgrade and it always surprises me every time I think somewhere the same hearing aid per year and you sort of get used to that and you think well that’s that’s my reality now that’s where hearing aids are at you know, and it’s good you know, like five years ago I was hearing well happy with that and thought well this is it you know, every time a new iteration comes out, I’m constantly I shouldn’t keep being surprised but I’m constantly surprised about how you know it’s not huge improvement, improve when each time but it’s just get better and better each time. It just sort of subtle ways so I recently started wearing Oticon More and I think they’ve sorted out the wind noise problem which was always a huge problem for me so just little things like that each time is a new iteration areas always improving so yeah definitely I think a huge, huge difference from five years ago

Geoff Cooling
I tend to, I tend to agree like its, so it’s almost like in the last kind of year or two hearing aids have almost meet, met at what we’d called Ronseal moment it does what it says on the tin. Haha, it’s a famous ad over here right, but you know it kind of really feels like you know here Knights appointed have met this Ronseal moments where most of the premium hearing aids for most of the manufacturers pretty much can be fit and if they’re fit properly, they will do exceptionally well for a large proportion of patients like that’s that’s how it feels to me, the days of you know, constant fire fighting in relation to patients in relation to fine tuning and you know overcoming problems and delivering solutions feel like they’re almost gone not, not gone all the way we are still complex cases there’s still some patients who have difficulties no matter what processing is an issue it feels like a large percentage of patients are almost fit well and forget. Now you know it’s not quite that simple but it feels like it’s moving towards that and even in my own, so I’ve been wearing hearing aids and I’ve pretty much solid for a couple of years now. Primarily really because of the Frank Lin evidence in relation to you know, processing issues you know, the start of brain cognitive decline and processing issues and that’s really kind of offload me into wearing hearing aids because I’ve acquired a moderate high frequency hearing loss. Most the day I can get away without wearing hearing aids if I want you know, but the end of the day I’m toward cranky, irritating – or at least that’s what she tells me. So by apparently by wearing my hearing aids for most of the day I’m less irritating. For them, but yeah, so even wave saw this or I’d seen this incremental improvement in relation to what manufacturers are offering and one of the things I think that – so things stand out for me in the development of hearing aids, so for instance, Phonak’s Marvel stands out, Okay, primarily because the connectivity alright Oticon’s Opn stands out for me, again, primarily because, you know, it felt for me that Oticon went from not knowing how directionality worked for some sort of black magic with directionality. That’s really how I felt to me, like, as a, as a wearer, and as a professional, understanding the underlying technology. And you know, Starkey’s jump towards expansion of the use case of hearing aids, you know, with the, with the kind of the ‘Healthable’ stroke hearable level features, all of those things really jumped out at me over the last couple years as, as evidence of this, you know, quite dramatic evolution of, of hearing aids into almost something else moving forward.

Amyn Amlani
Yeah, you know. Go ahead Steve

Steve Claridge
I was gonna say it, you know, I think that’s still gonna, there’s still gonna be those incremental improvements year on year. But I think, you know, when we go on to talk about, you know, disruption in the hearing aid industry and where things need to improve, I don’t think it’s a technology problem. I think there’s, well, you know, it’s gonna get better, but they’re already fantastic. I don’t think it’s a technology problem. It’s just a service problem. I think

Geoff Cooling
that’s interesting. Sorry, I think Steve, though, as well, they’ll read so for me, and you right, he got on really well, and you’re getting on exceptionally well with the with the Oticon More, right. But I think that we, we – me and you – have to be careful about not letting those, not letting that blind us to the fact that some people don’t, right, and as well as that. So I’m in we’re the Imelda… Imelda Marcos’s of hearing aids. Haha

Amyn Amlani
closets full of ’em huh?

Geoff Cooling
Will I wear the black ones today? Right? And that’s, that’s fine, right. But we, and, one of the things that we we are lucky enough to have available to us is the top level of technology. Whenever we’re testing stuff, whenever we’re wearing stuff, we’re always wearing the top level of technology, you know, because that’s what the manufacturer wants us to really understand and to review. And in fairness to the manufacturers they know that, you know our reviews are honest. And if we didn’t like it, we’d say so, I mean, it’s brave enough for them to, to hand over the devices as well, maybe if you consider it in that light, but but again, sorry, what I was saying was that, you know, me and Steve are quite lucky in that we have access to basically the best technology from the Best Traditional manufacturers out there. And there are people who don’t have that access, or on top of that as a as a professional, I see some with our technology who suffer quite body, you know, so my, my QuickSIN score is really low. I don’t know what Steve’s QuickSIN score is but I’d imagine it’s actually quite good. So our ability to process speech and noise is relatively good. So when we get support from top level technology, we do exceptionally well. but like, I still see some patients with QuickSIN scores of 15 and 20 even and you know, it’s a it’s it’s a it’s your stomach drops, because you know, that no matter how much they spend on the hearing aids, it’s, it’s not gonna deliver, you know what I mean? So,

Steve Claridge
so are you saying that’s fixable through technology then, do you think that it’s is going to improve so that that is, you know, workable

Geoff Cooling
I think as our understanding of how the brain walks in a in a, in a better way in relation to processes, right? And how hearing aids move down the route of artificial intelligence and how that’s applied to what the hearing aids are doing, I do think there will be improvement, as well as I think that improvements of battery, improvements in innovation within microphones, etc, etc, will allow for smaller, cheaper, ancillary devices that are easier to use and probably are more versatile than what’s available right now. And a combination of all of that should start to really ease into those into the people who have problems who have issues with speech in noise who have issues with that process. Yeah, like I said, we’re lucky. You know, we have a hearing loss good technology overcomes that hearing loss and our brains can handle the process of more or less, right? For people who who can’t, there’s still room for prior innovation and technology moving forward. But I think that that concept feeds into what Steve was talking about as well, because hurdles for people like me and Steve, you give us good technology. Okay. And we’ll just get on, we’ll get on really well. Okay. If it’s well fitted, we don’t necessarily need the ongoing input from the professional. And I think that’s one of the things that that I, myself and Steve have discussed on many occasions. Right. And I can understand it from Steve’s point of view, and I can understand it from my point of view as a consumer if I wasn’t involved in the profession, right? We don’t need five years of aftercare. All we need is decent technology that’s fitted well. And and we’ll probably just get on ya know what I mean? yeah, I think that’s one of the things that has driven that consumer awareness and that I was changing consumer wants or needs that we were discussing earlier, I think that the one size fits all approach to business model is has kind of, it’s just, it’s not really gonna work moving forward.

Amyn Amlani
Yeah, no, I agree. And so let me let me, I’m going to back up just a little bit based on a comment. So you and Steve are wearing premium products? Let me ask this question first. And then you’ll see where I go with this. Have you tried any of the lower tiered products within the same manufacturer? So instead of the level 9, for example, are you down at the level 1 or the 3? And can you tell the difference between the 1 and the 3 and the 7 and the 9s?

Steve Claridge
I’m not recently To be honest, no, no, I’ve been on sort of top level for a while. But in the past, I have done that. I think it’s quite, it’s quite an interesting thing. So the years back, I was looking to buy a new ITC, and I was in there and after hearing test, you know, a new a new Audi said, right, okay, well, you can have this one that’s, you know 3000, you can have this one, that’s 2000. And I said, I was sort of saying, Well, you know, what, where’s my? How much of my benefit Am I going to get from my 1000 pounds? And there wasn’t, he couldn’t really all he said was just go away and try and come up with that there was no, you couldn’t really quantify, you know, the benefits between like, say, a level 9 and level 5, wasn’t really a, so, you know, for me for making a decision how much money to lay on the table, there was no sort of clear guidance, really, other than go away for a month and try that, try the level nine and go away for another month and try to find and see, see if you think it’s worth worth a difference for now. Now I have a worn, lower tiers.

Geoff Cooling
So when the manufacturer send us off to me, it tends to be the trial version. Okay, say what’s the brief for as, as you’re probably aware, the trial versions now can be set to different technology. Right? So in the past, okay, what I’ve done is, I have set them to different levels of technology, okay, primarily to understand the sound quality, not necessarily the efficacy and differences. Okay, so, to answer your question. Recently, I haven’t, but in the past I have, okay. And what I found, what I’ve found is that my ability to process speech or noise seems to be pretty good. So even if I have, you know, a bare bones aids, that has automatic directionality, I get on relatively okay. And that’s one of the things that I kind of realized that a while ago and it’s one of the things that I kind of, whenever I’m doing a review, I remember to emphasize that when I’m reviewing the product, that actually I get on relatively well in speech noise with hearing aids. So But yeah, I mean, there is there is differences in technology we both know and how I tried. So my professional, what I tried to do is I base, the technology level that I might recommend on the overturning of her ability to process speech noise and occasionally then her speech discrimination. So those two we’ll say numbers helped me to better recommends the devices that might be suitable for them and again I don’t know how most other people work, it seems that it seems that in the UK maybe and in Ireland there’s a although it’s got better has changed for more dispensers who don’t really or they may understand the technology, but they find it difficult to quantify the real world benefits to the consumer and that’s something that actually we haven’t explored Steve thinking about, we havent explored that, maybe that’s something that we should explore in relation yeah no like because you know in fairness we’re usually talking about top of the range stuff we don’t make any bones about that or we don’t hide it in any way but yeah, maybe that’s something that we should explore

Amyn Amlani
And the reason that I brought it up is exactly where you’re going with this is – if the top end is really that good, and the bottom and is not that good, which is what we would expect because it’s a lower number, but now you have direct to consumer products like Bose and Nuheara and you have all these other items that are coming in that cost a lot less – okay now they don’t have the customer service and we’ll talk about customer service in just a minute that Steve brought up, but how then will the market look if these direct to consumer markets are just as good as these lower end products but maybe not as good as this top end product? What is that going to do for the market in the future? And if you’re going to make these comparisons it would be really interesting to find out what are the differences between these products if there are

Geoff Cooling
We did them so we’ve, I’ve tried Eargo in the past I tried the original Eargo then I gotta go with a year ago I think Neo and they were basically one program devices just you know three programs that suited three different kinds of average loss. So that was them more recently I’ve tried Nuheara and hear okay. I’ve tried the Alango Technologies Wear&Hear and both of those offers self-fit, self-fit and customization and both of those in different places because they’ve operated on several times delivered a relatively decent ability to hear. Again you know maybe I’m not the best subject because if I have even semi decent directional microphones showed me in a noisy environment I’m I get on relativity okay. And I did put a Nuheara and I did with the Wear&Hear now those devices are situational devices

right I have real problems with occlusion it drives me insane. I get all I don’t want to fight people and stuff.

So, so yeah, so the situation or the places at best right. However, like I’ve even tried that MDHearing, right, and you know they are basic hearing aids, you know, for the price of it. Sound quality was really, you know, wasn’t great, wasn’t fantastic by any means. It offered kind of older technology, directional mics, and they kind of did what they said on the tin.

Amyn Amlani
Welcome to This Week in Hearing. My name is Amyn Amlani and I have the privilege of serving as your host. For today’s webcast, I have the privilege of having discussions with two notable and well respected international colleagues as we consider hearing products, traditional and evolving changes in service delivery and consumer perception and experiences as they seek to improve their quality of life. Please welcome Geoff Cooling and Steve Claridge. They’re co founders of HearingAidKnow.com and Audiology Engine, they’re both writers and hearing care bloggers. So welcome, gentlemen. [Part 2]

Geoff Cooling
So, but the most recent one, I think that’s really as far as captured my imagination. Is the Lexie Hearing from hearX. That’s right. And that’s that that’s really, that really, it’s blown me away, right? Not necessarily because the hearing aid is made from Intricon. You know, it’s kind of a basic hearing aid, offers directionality, offers noise reduction is self fit. Yes, we are checked to fit on them. And the fit is okay. To the self fit app. But what really, I suppose blew me away about Lexie Hearing was delivery and the aftercare and the gamification of wearing their hearing aids. And that really struck me I thought to myself, I remember going through it and going through that experience and thinking to myself, like we don’t onboard new users, the way Lexie Hearing does, like we’ve, we’ve a lot to learn from Lexie Hearing in relation to onboarding new users in relation to the consumer experience in, in what you know what you’d call it an omni channel manner and that’s kind of what really blew me away about Lexie Hearing and but Lexie Hearing, and for me, isn’t necessarily about the product, right? The product as I said, bog standard. It’s okay. What really fascinates me is Lexie Hearing as a platform for moving forward because, in essence, Lexi in essence hearX have built a platform that would allow them to sell any hearing aid direct to consumer and deliver a consumer experience. That’s outstanding. And that’s what really fascinates me about Lexi Hearing

Amyn Amlani
Yeah. Steve, have you tried the Lexi devices?

Steve Claridge
I did. I mean, they sent me one. And I agree with that Geoff just said, I love the whole, you know, the box and the measurement piece of cardboard to go with the air to get the wire right. And the documentation was straightforward. The app was great, but I’ve got a severe loss now. So I was outside the fitting range. So I could I could look how the package you know how it works as a package, but I can actually test

Geoff Cooling
Poor Steve is always at the window looking in.

Steve Claridge
Yeah, I mean, there’s all these great OTC products and stuff coming out, but I’m just, you know, outside the fitting range of most of it really, I think we had a what you were saying asking before about the you know, where where the OTC which are as good as the lower level hearing aids? How that would play out, I think, you know, once if once people become more aware of what’s what’s on the market, and how they the differences between them, then then they’ll make those choices themselves? I think so. Yeah, I mean, if the lower level tech of say a phone app was the same as a, you know, an Eargo or something that somebody could just pick up off the shelf, you would have to think that people would choose the the off the shelf one over having to go and see a professional and, you know, spend time and multiple appoinments and all that kind of stuff. So yeah, I think just you know, more, more, more knowledge from the consumer will make them make the informed choice. Yeah,

Amyn Amlani
in what’s interesting is is the whole conversation about service because I think that’s, that’s, to me, that’s a really important piece. If, for example, and I have not seen the Lexie box, I don’t have one yet. I’m hoping maybe they’ll see this thing and send me a set. I don’t know. But, But, but at the end of the day, I think the customer service has a lot to do with whether or not someone adopts the product. And I will, I’m really convinced of that more and more as I’ve looked at this in this as research is starting to come out. And, you know, as you pointed out with the Lexie product, you don’t have a provider, they’re over your shoulder. They’re using, you know, customer service, they’re using the internet, they’re using all these other tools. You have these self fit devices. Have these other tools that are available to it in the market is now moving in that direction. And so the question now becomes providers are going to have to change, as Geoff pointed out, you know, the one trick pony that we’ve had for 50 years is no longer going to work. And they’re going to have to evolve into, I’ll use this term, it’s not a favorite of my patient centered care, which is nothing more than customer service, and improve that model. And so I’m really curious to hear your thoughts on what the provider can do to now start to compete with this gamification and these other things that these technology companies are starting to penetrate the market with,

Steve Claridge
Well I think, you know, I don’t think we’re going to get to the point where there’s no practices, there’s no professionals, you know, there’s always going to be the need for you guys, there’s always gonna be people that can’t self fit, aren’t so tech savvy, or just like, you know, like Geoff said, some people have got, it takes me longer just to get used to him. It’s the whole process and issues and whatever. So yeah, I mean, there’s always going to be a place for practices without a question. But for me, it’s just about options, really, I mean, at the moment, so yeah, you know, these OTC devices are starting to come out. But up until recently, an option really was to go in, see a professional and go through that whole process. And I think, yeah, people just don’t want to do that for various reasons, you know, the cost is one thing, but just, you know, it’s just you got to take time off work to go and visit. And you know, they host or medical angle to, it kind of puts people off because they don’t want to feel like they got a disability, and they got a problem that needs correcting. So there’s definitely a place for practices, it’s difficult to be honest, it’s difficult for me to see how you could compete with an OTC product that sits on a shelf in a box with a good enough onboarding app, and a self fit. That is pretty much but it’s never going to be as good as professional, you know, sat hearing tests, you know, REMs are always going to be difficult probably inside a box. But I mean, so with that box model, if somebody goes in the shop buys it and puts it in the say, this is quite good. I’m reasonably happy with it. But you know, this one, things just annoy me, way more, we hear the metal sink, it’s too loud or door slams too loud, or I can’t hear ladies voices, they got a little problem. So you know, tele audiology is becoming Should I think, be becoming much more of a bigger thing. And it’s, you know, the providers are given that option on the app, but from what I gather from where people are still not really getting picked up that much. So definitely, I think, you know, if I was a professional now, I think I will probably be advertising tele audiology and saying that, if you’ve got a problem with hearing aids, getting in touch with zoom, obviously, there’s going to be connectivity issues, but you know, providing that service so they can just, you know, contact you book you for an hour, you can fix their problem for him over the phone. So yeah, I think that could definitely be you know, people don’t necessarily have to come and see you. But they could just, you know, book you for an hour, however much your hourly rate is and you fix that specific problem for them that the software can’t fix. So yeah, I think I definitely see a future where there’s fewer practices, but there’s still going to be plenty out there. I think I don’t think it’s just going to destroy the industry, I think there’s going to be a lot fewer. But I think you know, the best the best practices will keep going and you know that people just kind of find the end at the moment and don’t do such a good job are probably not going to be in business much longer. From

Geoff Cooling
my, from my perspective, I think that so I think there’s a couple of things. And I want to address a couple of things that Steve said. So, one is the medicalization of hearing loss. Okay, so Steve said there, you know, the whole medical model in relation to your go to clinic, blardy, blardy, blar and handicap or disability. Okay. And that’s one of one of the things that I’ve been thinking about quite lately is in relation to it. And I wrote an article about in relation to what we best describe as simple sensorineural hearing, which I feel is what I have. Okay, so I have simple sensorineural hearing loss. Yes, it’s highs…. at what Do I, is that a medical problem? Okay. Is that a medical problem? Do we need to go to a hospital setting or a clinical setting to have that dealt with – Should I have to go to a clinical setting to have that dealt with, right? And so from my perspective, the answer’s no, I don’t think that or I don’t think I have to for instance, I believe that it was a product ready if there’s a product available to me that I can you know, kind of like self program and get on with and are providing the support that I need. Why should my follow that model? Why should I not,or why should I be forced into a medical process, right, so that’s, that’s one of the things that I want to address in relation to what Steve has said, right – is simple sensorineural loss and medical problem? Okay. But it also brings me on to, you know, the question that you asked, right? How will we, as a profession, live in this in this new setting? Okay, I think there’s there’s possibly two options for us moving forward. The first option is it do as we’ve always done and die, as Steve has said, Okay, so there’ll be premium audiologists, premium independents, we know who they are already in the marketplace right now. And they’re doing exceptionally well, and will be all the others who aren’t really offering anything apart from great service. All right. Great service. Haha. Let’s not discuss that and we won’t dwell on that. So and I think that’s more ways, that’s one way we can go the other way possibly is okay, you said, How do we compete raise and I feel that actually offering those devices moving forward with those devices, like the Lexie Hearing device or, or a Nuheara device or anything else that comes out that’s aimed at that, basically, marketplace, we haven’t actually penetrate at all right? Providing those devices will allow us to become relevant to those, if we don’t provide also, if we try to ignore those, devices, and we pretend that they don’t exist, or we poopoo them or whatever, I think that we as a professional will lose our relevance to the people who use those and it goes beyond just to where we, you know, we’re focused on hearing the voices right naturally, okay. But there’s, there’s a whole customized audio world out there beginning, from headphones, to televisions to settings on your laptop to, it’s just endless. This idea of customized audio that’s been that’s been made available right now, the consumer right, and those consumers are going to evolve and mature with this idea of customized audio and in an in an easy and simplistic manner, more or less, right. And then, if we’re not relevant to those people, they won’t look to us as they realize that the customization of the audio that needs to be delivered, needs to take the next step towards, you know, proper hearing aids, or hearing care moving forward. And we’d have to, part, one of the things

that if we’re not relevant to consumers right now. We won’t be relevant to them in the future when they’re making ready to make a jump to, I suppose, even called predictable here in our traditional hearing care. And I think that’s really important for us to realize, I think if we do that, I don’t see the death knell for avoid or audio professional. I think if we don’t do that, I think that the audiology profession will an essence become a clinical professional thats focused on clinical needs. And very complex cases. In essence a hospital profession

Amyn Amlani
Yeah, Yeah, I agree with you and you had a wonderful blog this was a month or two ago that that kind of addresses a lot of these these issues that you’re talking about

Geoff Cooling
Yeah, I think that I think that for us as a profession because you know I’m in a unique position on the user on the professional reading for us as a as a profession we’ve got people within the profession are like “uh-huh, we’ve seen it all before” but you haven’t you haven’t seen this before. You know, you haven’t seen this kind of like meeting of customized audio and an ever burgeoning um marketplace of devices that are actually all right available to consumers in a, in a direct manner. So one of the things I did recently was with the Active Pro from Signia Okay, so I wanted to test the AI on the app right? So I fitted the signia Active Pro in my with my hearing loss, played with it for a week and then I cleared it. Set it to like a flat 40dB. Okay. Shoved her in my ear and used the Assistant to fine tune alright so ‘too bassy’ ‘not clear enough’ ‘too bassy not clear enough’, etc, etc. Alright and though the Assistant, I was kinda able to get the amplification within the ballpark of what I need when I checked it. Okay, so I didn’t write it up because that frightened the Jesus outta people – haha. But that’s what I was able to do. And that’s what I mean about you. You haven’t seen this technology before. You know, even the Bose stuff people laughed at the Bose stuff. And that’s fine. I understand that, you know, the Bose hearing aids are our basic hearing aids, not unsurprising about them, not necessarily hugely innovative about them. However, they’re Bose and consumers recognize that not only that, this is fascinate right. Bose has said, you know, your buy, you buy the receiver. Oh, by the way, you’ll probably have to replace the receiver once a year, and it’s chargeable. Many hearing aid manufacturers say that… haha

Like so, I mean, this this whole, like it’s it’s only held these non- traditional providers, are these non-traditional manufacturers have have kind of entered the marketplace and said, you provide receivers every few years because they filled them or wax. Are you mad? We’re not going to do that. Yeah. You know what I mean?

Steve Claridge
Thanks. So I was just gonna say, I think you know, what you said there about the basically the same thing with the AI and they’ve gotten you back to pretty much where you needed to be. I think that that’s the key, that’s the endgame for me, you know, what I want to see ultimately, is, you know, the latest from Widex, Phonak, Oticon, GN on a shelf – be it in a specialist here in a shop or, you know, Walgreens or whatever, with an app like that, which might not get you 100%, you know, professionally fitted as if you were if you were using REMs, but I honestly believe, you know, software’s got to the point where it can get you to something that’s easily good enough for people to be able to operate in everyday you know, to go about their lives hearing better which is ultimately what they want, you know, they’re not probably not interested in being perfectly fitted 100% You know, this is 98% right? It’s probably good enough and I think you know, that people could release apps now with that kind of onboarding helper technology to do that and and also you know, ultimately you know, the other big part of the puzzle is just the feedback so if somebody comes into your practice two week’s really happy with them, but I’ve got these five problems and you go you go to your programming software and change it you know, what do you think is better or worse you know, and you try and work through those problems so there’s no reason why the app couldn’t be have like a sort of, would you call it like a virtual assistant kind of thing that walks you through so there’s got to be you know, typical problems I can’t hear my daughter walk you know, the slamming the door slams to our there’s got to be saying the adequate say, is the door too loud? Yes. Okay. What does it sound right now? Well, that’s much better thanks. So the feedback loop is much quicker, so you don’t have to wait to go to the practice and get an appointment in two weeks time. The app goes is the door sound today? Yeah, try that. Oh, that’s much better. Nice one. So I do think we’re getting really close to the point where software can fix software can have all your knowledge in it, it can take all your years of Audiology experience package that into some smart software that answers those questions for a lot of people not everybody course you know it’s not going to work 100% across the board and make everyone redundant but I think there’s a huge customer base out there who aren’t coming into practices for whatever reasons, who would do really well with that kind of a great hearing aid buy a great hearing aid off the shelf, couple it with software thats smart to fit quite well and a way to go and then if they’re not happy, they’re booking, book you for an hour or two, so you can fix it for me it seems just like a perfect solution. But

Geoff Cooling
I think it’s interesting, you know what Steve says, Well, you know, solutions they’ve talked about, you know, the $300 problem, not the $3,000 problem. You know, I’ve talked about that quite a bit right. And I think that for all these devices, the Nuheara device, especially uh you know the Wear&Hear device to a certain extent, the Olive Pro device. These type of voices kind of like, are attractive to the people who feel they have a $300 problem or a $400 problem, right? You know, they don’t feel they have a three grand problem, and they don’t feel that they have a handicap disability race. But yet, we our profession, in essence forces them into that kind of a model, you know, it forces them into that ‘you have a disability’. You know, like, many of us are aware, we have disabilities – are eminently aware and our wives tells us, right? haha. Our hearing might not be what we feel is one of our disabilities, right? Right. So, I mean, there’s gonna be, for me, there’s gonna be like a middle ground, there’s got to be a way for us to appeal to those people, right, without, in essence, a part of this medical model right. And these type of devices, I think, kind of, like an ideal way to solve their problems, because they do have problems, right, they wouldn’t be looking for some sort of support in noisy situations if they didn’t have a problem, right? So, you know, to solve those problems, to be relevant to them, and also to help them through. Okay, that that moves on to perhaps traditional hearing, right? But, like, even now, if you think about it, I don’t think this is an outrageous statement. Right? In 10 years time, okay. There may not be what we recognize as a traditional hearing aid. You know, the technology and the innovation is moving so fast, but hearing devices are so, may not be recognizable in the future in, in relation to what they are now, and how we’re involved with them now, so. So yeah, like, it’s, there’s a whole lot going on, and there’s a whole lot for us in the profession to think about, I’m not not afraid of it, I enjoy it. And that’s what I mean about, I said earlier, this schizophrenia, you know as a consumer I’m like “uhh” haha But you know, it’s there. For me it’s wondrous, this this evolution of technology and particularly in relation to how to Widex is using it the and Steve was talking there about the you know the doorslamming you know, stuff like that. And in essence, Widex was probably one of the first companies to introduce that with their machine learning, Signia have expanded on that with their point of assistance, and most of the hearing manufacturers will introduce that and, you know, fine children, they will forward as we know us, it’s already reduced so much, because as we were saying earlier, the bulk of our technology here tonight really help the bulk of consumers, right? So if if the while you’re random, yes, you might have to do some customization after your random okay for their specific needs. And then you set them free in the world and you know, what, nine times out of 10 they’re, they’re happy right? So it feels like already able to find children that we will have to do as professionals as we do. Okay, if AI or machine learning will reduce that even more or actually be used for really impressed that are really cool for self this Okay, what’s our justification for being that moving forward if we’re all selling here so that’s that’s one of the things that you know, I’ve been thinking about because our justification moving forward will be the compact eight

Steve Claridge
i think i think the industry I don’t see the you know, it’s it’s a it’s a medical industry up till now but I think we don’t really see it that way at all. I think you know, hearing aids are electronic consumer what devices like an iPad laptop, I bought me a few weeks back and so I think I don’t see why we can’t service those like say, you know, if my car has a problem my car I might be able to fix myself. Not particularly good, but yeah, mechanics but I might be able to fix it so I could try and fix it. If I don’t. I can hire somebody pay him for a couple of hours. You know, they quoted me Oh, yeah, that looks like it’s a three hour job. Okay, thanks. And I take it in and get it done. I don’t, I don’t buy into a whole, you know, £5000 pound three year relationship with the guy and garage I just want to fix my car. And I kind of just see hearing aids in the same way. I mean, I understand this whole, you know, there’s a lot of problems with, you know, people being able to get used to hearing aids, of course there is, but I don’t see why we have to stick with that existing model of the big payment upfront and the whole relationship kind of thing, cause some people want that. But it doesn’t have to be the only way. I don’t think, you know, if I’m, if I’ve got a problem, just fix it for Yeah. I see. I see that. I don’t need any more than that.

Geoff Cooling
I think that’s, I mean, is that one of the things that we haven’t delivered as a profession? Right, in essence, you know, we sat with Steve talked about this just recently about multitude. In essence, Steve is paying, okay, a lot of money to support somebody else’s hearing care journey. Okay, because Steve is accessing that hearing care journey. Steve. Steve is a one and done fit almost. Okay, so Okay, it’s not that easy, right? But Steve is almost the one and done, fit. And he might turn up, there were three times over a five year period for possibly some fine tuning, but probably some service needs, right? So why is Steve paying three and a half grand for a set of top of the range hearing aids or four grand for set of to of the range hearing aids right, when he’s by no means use four grand’s worth of services and in essence, right the reason is that is he’s actually supporting somebody else’s journey?

Amyn Amlani
Yeah, yeah. And in the States, that’s one of the things that we’re trying to do is move to an itemized a model. The problem is, is that, you know, for the, for the, for the provider, in a bundled model, they get all their money upfront, and then they don’t have to worry about that the person comes in like a Steve. And if you do it, where it’s itemized, it’s, it’s more of a marathon, you’re getting smaller chunks, and you have to, you know, you have to continue their customer service. And so there’s a lot of resistance towards that. So as you guys have so eloquently pointed out, the providers are going to have to change because the market is changing, the product is changing, and the patients are changing. And if they don’t, you know, the cream is gonna rise to the top, and those people are going to be in the marketplace, and those that are beneath it, well, you know, sorry, but maybe there’s another calling for you. And then the patients at the end of the day, as we all pointed out, they’re going to penetrate the market more – like we’ve never seen. And the hope is, is that they’re able to take care of their own hearing needs in a way that fulfills the issues that they’re facing. And as their hearing problems progress, they can maybe move up to the provider, and the provider then can potentially help them. So very unique place that we’re in at this point in time.

Geoff Cooling
Yeah, no, you know, completely agree and, and what you said so first of allwhat you said, relation to itemize was, like, as you were saying that I was thinking, you know, some people are a little bit, you know, I’m sorry, to my.. now I’m thinking, is that because they might have to actually do some work? Is that where it is? You better cut that bit out – hahah. What.. Sorry, What I was thinking was right, that, you know, what you said about this, you know, consumers will start again to look after their own solutions for their problems with this complete, you know, this wider concept of customized audio, I call it augmented audio right, just for want of an easy term. And this whole concept of augmented audio and how that fits into, you know, a burgeoning awareness of hearing loss and, and getting solutions to different situational problems. And then how that may evolve to, you know, a hearing loss that may need to be dealt with it, by a professional right, and it’s like is exactly what I said earlier on. If we’re not relevant at the customized audio stroke, augmented audio for situational solutions. How will we be relevant when it comes to you know what these problems are starting to exceed what these devices can offer. And that’s where I go back to Lexie Hearing. Okay? So let’s see here. So in the future, Lexi hearing offers the £700 quid setup here Next, okay, they really offer a £300 set of situational devices, okay. And then maybe they offer a $2,000 set of real hearing aids, and then Lexie Hearing brings their consumers exceptionally well, through a journey from device level, to the device level in that beautiful omni channel manner, with real gamification of wearing the devices, okay? If they do that, right, and a sell Phonak upper range hearing aids, or they sell ReSound upper range hearing aids, or they sell Starkey, top of the range hearing aids or whatever. Okay. And they do that, well, how will we be relevant to their customers. We won’t be we won’t have any relevance to their consumers.

Steve Claridge
I think your your expertise will still be relevant to you know, I was saying before, yeah, just you Geoff, just you. Only person left. No, but I mean, you know, that years of expertise is always going to be needed. Not always, but there’s going to be some people that, you know, go for that sound bit. And like you said, with the Signia, it’s good, but they might, might not be perfect. So there’s always going to be that the use for that knowledge and the expertise, but I just think it gets used in a different way. Yeah, tele audiology by the hour, whatever, you just need to sell your expertise in a different way, rather than getting people in for a whole, you know, five year, big uh big money outlay. I usually when we need you.

Geoff Cooling
Yeah, I think that is probably one of the most frightening things to the profession. You know, the, the idea of having the offer metered hourly services, I think that’s actually one of the most frightening things to the profession. And it’s because many people within the profession aren’t necessarily businessman, and they really don’t understand how to work out an hourly rate, and what that rate may be. And I think that’s one of the fears that kind of drives that intransigence for a change. And one thing I’d say to fashion we fellow colleagues, is that up to now, innovation and technology within hearing aids, okay, by hearing aid manufacturers, as an essence, conspired to protect our profession. Okay. And I don’t mean, that was a deep conspiracy or anything like that, I mean, that the innovation and technology just really drove our profession as the providers. Okay. Moving forward from this point, and, and that’s a lie. It’s not from this point – it’s from two years. Moving forward from this point, innovation and technology within both internally, within hearing aid industry, and externally, within consumer audio products right, will ensure that our profession is no longer protected, as providers, and I think that’s what’s really important for our profession to understand implicitly, so that we can decide how we will remain relevant to consumer, changing consumer, and how we will, I suppose secure our place moving forward. And I think, and this is like, with that split is schizophrenia that we’re exceptionally important within the consumer journey. Okay. I think up to now now we haven’t necessarily been consumer focused right, or patient, focus or patient centered or whatever changes you want to speak, you want to call it, okay. But I do think that we deliver benefits to the consumer when we’re doing our job, property and well. I do believe that we are important to the future of consumers who need hearing care who need assistance with hearing loss, who needs who need all of those things, right. But I think that we don’t understand how things are changing. And if we don’t move to meet those changing wants and needs, I think, in essence for our profession is gonna commit suicide. And that’s my worry, because, as I said, I do believe our profession is important, but for us to remain important and for us to remain relevant, we actually need to change, we need to address all those issues. So it

what we’re gonna do,

Amyn Amlani
yeah, yeah. Good advice, Steve. Any any last words of advice for providers?

Steve Claridge
I was gonna say, I don’t know if that was your question directly. But I think the other important thing we didn’t talk about was the whole stigma around hearing loss. So I mean, I know you, you kind of mentioned it earlier. But I think that’s something else that needs addressing. And I think when we continue to be a medical professional in a medical environment with medical devices, I think we’re not helping that stigma, people are still worried about how they’re perceived, which was really strange to me, because, you know, so I was in London last night, and on the tubes on the underground, you know, practically every other person had some white earbuds in their ears, listen to music or big, you know, massive headphone cans up and so people have no problem wearing things in their ears. That’s not the issue. It’s just the whole perception of what a hearing aid is and what that means for you. So yeah, I think that’s definitely a big hurdle that I think OTC and, you know, non medical type products will will help that. But yeah, I think for me, personally, I think professionals could be less, less medicalized and more sort of, you know, just just just another purchase, like, like a laptop, or an iPhone. I think that would that would help people be easier to just to come in. I think, I think you’ll get more people and if they didn’t, if the very if they felt like they were just purchasing an electronic device with your expertise as well.

Amyn Amlani
Yeah, yeah. Well, guys, you guys have been on for for some time now. And we’re gonna have to do this again. But next time I’m going to get HHTM to buy me a plane ticket. I’m going to fly out to where you guys and we could do this in a pub. And we’ll just record this thing until we’re done. How’s that?

Geoff Cooling
Yeah.

Amyn Amlani
In anything that is going to get us into trouble. We’ll just have to edit out so no one else can see. Yeah. Yeah. Well, I guys, I really appreciate your time. And I’m telling you, it’s been it’s been an honor and a pleasure. I think the viewership is going to get a lot out of this. And like I said, you know, in a year’s time, I think we need to revisit this because you guys have laid down some, some pretty interesting comments. And it’ll be interesting to see whether or not they come true. And if they do, you know, Geoff is going to become my clairvoyant, you know, and I’m going to start asking him about model numbers and all these other kinds of things so that I can retire before I’m 60.

Geoff Cooling
… But I have a five year store. Haha

Amyn Amlani
It’s been great.