A Hearing Loss & Late Deafened Blog

Audiologists are people too, who sometimes do not understand hearing loss…..

In Aging and hearing loss, audiogram, Audiologists, captions, Deafness, Hard of hearing culture, Hearing aids, Hearing Loss, Lip Reading, Relationships on December 10, 2010 at 6:13 pm

What is it about finding a good Audiologist? or should I say, Why is it difficult to find a good Audiologist? or maybe I should ask, what makes one say, ” I found a great Audiologist.”

I’ve been wearing a hearing aid now for about 16 years and have gone through Audiologists the way I go through antacids, quite a few.  Now don’t get me wrong, there are a few good ones out there.  However, I’ve encountered only 4 terrific Audiologists, two of whom cannot dispense hearing aids because they do not have the Doctorate, one who I really liked but had inconvenient hours was inconveniently located for me and the last one, is my current Audiologist.

What makes for a good Audiologist? Well, what I might consider a good Audiologist, you may not even think to consider.  Here’s MY list:

-Looks at me when they speak and if necessary, will type on their computer in large print what they are saying to me, especially, when my hearing aid (s) are not in my ears.  Only my most recent Audiologist provided this for me.  Was I surprised?  I wanted to jump out of my chair and do a song and dance.

-Explains the audiogram and your hearing loss or your child’s hearing loss.  I cannot tell you how many parents I encounter who have no idea what their child’s hearing loss is or what the audiogram is telling them.  Granted, the Audiologist may have explained it to the parent but they just did not understand. My current audiologist explained everything and reviewed everything before I left the office. 

 My Audiologist knows I’m in the field and initially, I felt somewhat silly listening to information I understood all too well.  However, I absolutely respect this man for doing this.

-If you’re in the market for a hearing aid, a good Audiologist should ask you what you expect to get out of a hearing aid? What situations you need hearing help in? Explain the different choices in aids that you have.  What each aid can give you or not give you?

-A good Audiologist will explain that the hearing aid will not provide you with 20/20 hearing.  That you will probably need to return several times for programming the aid. That you will need to keep a list of situations that the aid may not be working for you or cause noises to be  overstimulating.

-A good Audiologist will make sure you don’t leave without the next appointment when you buy an aid.  I have had several Audiologists sell me a hearing aid and tell me, to call and make an appointment if I have any problems…..NO>>>NO>>>NO…wrong! The good Audiologist will insist that you have to return within two weeks for possible tweeking or reprogramming and to review your overall experience.   Afterall, you do have a 45 to 60 day TRIAL PERIOD.  And that good Audiologist will want to help you acclimate and go through a successful trial period by coming to their office to guide you or counsel you if necessary.

-My Audiologist had notes sent to my home thanking me for my business and reminding me that if I have any questions to call. .  After I purchased my most recent aid, I visited my Audiologist approximately 5 times over a 6 month period.   When I recently called my Audiologist to cancel this last appointment because I felt all was going well, he informed me that his office will contact me in approximately 3 months to follow up on my progress.  Again, also reminded me that if I have any problems, to call.

It’s so important to find the right Audiologist to help you with your hearing needs. Someone who understands that when they ask you to take off your hearing aid, they know they cannot speak to you thinking you are hearing them as though you had the hearing aid in your ear.   JEESH! I think back to all the times I wanted to say to the Audiologist, or the intern, were you ever required to walk around with earplugs for a day? Don’t speak to me when I am not wearing my hearing aids jerk, unless you plan to write it all down for me.  It’s important to me that the Audiologist understand hearing loss.  Just because they are an Audiologist, doesn’t mean they understand what it’s like to walk around seeing peoples mouths move with no sound coming out.

What do you see as important in finding the right Audiologist? Do you have one now that you could honestly and proudly and comfortably recommend to a friend, if and when it would be needed.

Think about it.  You wouldn’t buy shoes from a person who keeps giving you the wrong size shoe to try on, or allow a car salesperson to talk you into buying a car you can’t afford, or seeing a Doctor that will not communicate properly in order for you to understand, so why would you see an Audiologist who doesn’t understand hearing loss?

Advertisements
  1. I’d like to add to what Pearl has said. Programming hearing aids or cochlear implants is both a science and an art. Good audiologists know the science and can do the programming. Great audiologists have a feel for the art of programming hearing devices. Audiologists with experience, intuition, and keenly attuned to the needs of their patients can develop their knowledge of the science into an art. And we all benefit.

  2. Great post. I wish everyone new to hearing loss and on their way to their first appointment with an audiologist could read this.

  3. Great post, Pearl!! I’m sorry to say I’ve never had an audiologist that I consider great. I know if I decide that cochlear implants are the way to go for me that I will not go ahead unless I make a love connection with an audiologist.

    Michele

  4. Shouldn’t audiologists be separate from dispensing hearing aids? That’s like a doctor dispensing prescriptions or a physical trainer selling exercise machines.

    Does this separation assure the consumer of a wider range of options and a more neutral judgment of which are the best? I think it does…let me know if I am wrong.

    • I couldn’t agree more! This also causes issue for me in that I have hearing aids that were given to me, and they need to be tuned to my hearing. I have had a hell of a time finding a decent audiologist that is willing to work on hearing aids that they didn’t get to sell to me themselves.

  5. Dianrez, you raise a very good question. Does the car salesman selling cars for Honda assure the consumer a wider range of options? Does the Opthomologist who sells eyeglasses offer you the best possible range of eyewear? and at the best possible price?

    Audiologists are not allowed to dispense hearing aids unless they have a Doctorate. Not sure why a Doctorate would make a difference? I do believe there are Audiologists who are neutral and who want to do the right thing.

    A good Audiologist is like a great car mechanic or a great computer programmer, or even a great scientist. The more educated we are, the more questions we can ask and the more options we have. If you know your options before you step foot into the Audiologist’s office, you won’t have to rely on the Audiologist.

    Like anything in life, you need to be an educated consumer before making any purchase.

  6. Dianrez made an excellent point!! I hope in the future buying hearing aids will be more like buying eyeglasses. I find the entire process extremely stressful and I’m an experienced hearing aid buyer. I can’t imagine how a new hearing aid buyer must feel with all the different options available. Good post!

  7. Dianrez and Kim, there are dispensers who sell hearing aids but they too can be dubious. There are a whole class of people like senior citizens who are not capable of going back and forth for programming. What to do? Programming our own aids? thats fine for those who are computer savvy but not for others. A regulation/law on the prices of aids? I’m not sure that will ever happen.

    However, lets agree that until something changes, we do need better education on buying hearing aids.

    -The first thing I would like to see is a price list available in the waiting room in every dispensing Audiologist’s office.
    -When you call an Audiologist’s office and ask, what hearing aids do you carry? it would be nice if the clerical staff would give you that information and not say, come in and we’ll discuss it. Since once you walk into that office, you are now going to be charged a fee for that visit to find out the Audiologist doesn’t carry anything buy Phonak and Oticon.

    Did you know that some Audiologist get their hearing booths and/or equipment from a major hearing aid manufacturer? And as a result, in exhange for the equipment they have to sell a certain amount of hearing aids by that company a month? This is the reason I prefer Hearing and Speech clinics or ENT clinics, because they do not rely on being owned.

    Again, I will stress. We have to educate ourselves. Every hearing aid manufacturer has an online site describing their hearing aids and the level of hearing loss each one can handle. I recently discovered that a hearing aid that was trying to be sold to me by a previous Audiologist, had no room to be programmed for the possibility if my hearing loss got worse over the next few years. Fortunately, I left that Audiologist but for other reasons.

  8. As a HOH person and co-owner of a private practice with my audiologist wife, Barb, I am empathetic to the schism between the HOH, deaf, and audiologists, as witnessed by discussions on many forums such as this. Aware of this nagging problem, we have opened a clinic that I hope addresses some of these problems and would like to hear your opinions. Here’s the program:

    Hearing aids are sold at actual cost, meaning the audiologist makes nothing on the sale of the instruments. This allows the audiologist to concentrate solely on finding the best one for you, eliminating the potential influence of profit margin being a factor.

    All services, including hearing tests, fitting, adjustment, batteries, earmolds, repairs, performance verification, education, follow-up, etc. are provided for a flat monthly fee, currently at $59 USD per month, with the exception of the first month due to the additional time required during the trial period. The fee continues throughout the hearing aid warranty period, and can be stopped anytime for whatever reason you wish. You will pay only for the services you have actually received.

    Your time spent with the audiologist is customized to your specific needs, rather than on the traditional calendar basis. Observations of how “things” are going by you, your family and friends, and the audiologist are all considered, and used to determine the frequency of your visits and reason(s) for the visit.

    The number of patients accepted is limited to insure the audiologist has time to make sure the service you receive is customized, and time slots are available for you in a very timely manner.

    That’s basically it, the nutshell version. Right now the customized schedule of education and service is being done in a seat-of-the-pants manner, similar to what we did with a small group of patients at our old clinic (it worked well). Now I am working on software that will make this task easier for you and the audiologist, and I’m hoping to include in the first version “real time” alerts about the sentiments your and your family are experiencing so the audiologist can better monitor your experience from afar so she can head off problems before they become troublesome. But getting from “That would be good.” to actually making it work well in the real world is more gnarly.

    Unquestionably, professionals in the hearing industry need to do a better job than we have been doing. We need to provide information in a better manner than we do now. We need to be more transparent about what you are getting, and how much it is actually costing you for what you get. While I make no claim the program above will solve all those problems, it believe it is a start in the right direction.

    What do you think?

    P.S. I didn’t include a link to our web site because I want this to be a frank discussion about the concept (and your suggested modifications) rather than becoming a plug for our new practice. For what it’s worth, after eight months of operation we have observed that people who have never seen an audiologist or considered hearing aids have been pleased with the program, especially after comparison to the alternatives. People who currently wear hearing aids appear to struggle much more to grasp, much less accept, this approach. Many come around, but certainly not all. Interesting, and at this point I’m still not sure exactly why some are balking. Not that this program is great for everybody, I know it’s not. But why, is the unanswered question that would be good to know.

  9. I’m not sure how this can make sense. First off, when the Audiologist is getting the aid from the manufacturer, the Audi is already paying a fee on top of the actual cost. The Manufacturer is the first person to make a profit of the Audi. The Audiologist then turns around and charges the patient another fee ontop of the amount the Audi paid for the aid. So how can you be charging the patient the actual cost of the aid?

    I am guessing the first month of visits is going to cost the patient more than $59 per month due to additional visits being made? What you are actually doing is overriding the warranty/trial period which is FREE and charging the patient. The $59 a month fee plus the first month of how much of a fee could land up costing just as much as the hearing aid would have cost. The Audi does not make a big profit, its the manufacturer who makes a big profit. Depending on the location of the Audi, for example, lets say Park Avenue in Manhattan, the profit could be larger.

  10. Charging a flat monthly fee is an interesting concept. I’m in favor of discussing new ways of paying for equipment and services. This one, though, seems like it can become really expensive. Over the warranty period, the consumer probably ends up paying the same as under the traditional business model, if not more.

  11. I haven’t bought hearing aids lately because I’ve moved on to a cochlear implant. However, I had a couple of criteria when I was deciding which CI clinic to use, and I think the same should apply to a person looking for a hearing aid. One was that the clinic carry more than a single brand of hearing device. I want an audiologist who can select from more than one manufacturer to find the best aid to fit my needs, rather than fitting me with brand X because that’s all they have. Second, I wanted a clinic where there was more than one qualified audiologist to do the CI mapping. And the same was true for my hearing aids. I don’t want to have a problem and be told the person is on vacation or out ill and won’t be back for a few weeks. The hardest thing to judge is the skill of the audiologist. Assuming the person has the professional credentials needed, the only way to judge his or her skill is to get to know them. There are several audiologists at my CI clinic capable of doing the mapping. As a patient, I have the ability to either request the same audiologist each time, or try a different one if I wish. That gives me a greater sense of confidence in the clinic.

  12. @Pearl: Sorry I caused confusion. When I said “actual cost” I meant that the amount you pay is exactly the same as the amount paid by the audiologist to the manufacturer to get the hearing aid to the audi’s office and placed on your ear. Not a dime more.

    How much the manufacturer makes on a sale is not published nor do they tell us. I have heard from insider friends figures that are roughly similar, but a bit higher, to estimates made on discussion boards like HearingAidForum and others. Missing from those figures are the other expenses paid by manufacturers for salaries, facilities, equipment, and the infamously pliable term research. What is certain, I have been told for years by factory reps that prices will come down once “x” happens, but “x” never seems to arrive and in 20+ years in this business I have never seen the cost of hearing aids to dispensers go down. I have, however seen the profits of the publicly held companies rise at a greater rate than unit sales alone would warrant, so draw your own conclusions. 😉

    The reason we chose the “hearing aid at cost” approach is this: My audiologist wife had began feeling as though she had betrayed her reason for becoming an audiologist. She wanted to help people hear better, not to become a hearing aid hawker. The traditional audiologist office style caused her to constantly think hearing aid sales because that is where 85%+ of a dispensing audiologist’s income comes from. If sales is how you put food on the plate, how much will you actually devote to service? The sad fact is traditional audiology offices count on you not taking them up on their service after the sale offer, because if even half who bought hearing aids actually did come in for the “promised” service on even a semi-regular schedule they would have neither the staff or time to fit everybody in. The service promise relies entirely on you being reactive (“It quit working”) rather than the audiologist being proactive in helping the “quit” not happen.

    To address this conflict, her new approach means 95%+ of her income comes from her being proactive on your behalf. This approach aligns her inner desire for having become an audiologist with the desires of those who come see her, and who value what she provides them. This approach is a complete shot in the dark, but Barb likes how it feels and is working for her patients, so we’ll see where this heads.

    Which brings up a point @Lorne mentions. I agree with you in principle, but remember expense is relative to the satisfaction you derive. Also, I have yet to find the patient who knows the actual cost of their hearing aid over a three to five year period – in large part due to the lack of pricing transparency that Pearl mentioned above. The hearing aid warranty does not cover everything, nor does the manufacturer reimburse the audi for their office time in refitting the hearing aid back onto your ear. Other expenses also crop up (replacing tubes, in the ear receivers, and a raft of other things that cost money). Complicating things further, some services are included for “free” (ha!) while others aren’t and some are occasionally given away. The short of it is, I looked at the records of quite a few patients at our old office before we sold it, to see what the actual out of pocket expense was in the traditional way of doing things (and we gave away much more than most offices). With the new hearing aid at cost and the monthly fee plan, you will be way ahead if you opt for a top of the line model, a fair amount ahead (but not a lot) if you choose a mid-line model, and you really should go elsewhere if you want a basic model.

    This is really getting way too long but I did want to answer your questions and comments, and hope you all will have more. Especially comments! I will make no bones about it. I don’t expect the program I mentioned above to be everybody’s cup of tea, and that’s the point. You deserve to have more choices than the industry has provided. Ours is but one. An alternative to the two tier system we have now of the economy route with sparse service like internet and wholesale club outlets (like Costco), or the (supposed) Cadillac plans found at ENT and dispensing offices. You deserve not only transparent pricing, but easier ways to compare your choices in an apples to apples manner.

    P.S. Just don’t ask me or my wife which hearing aid is best for you. Nobody knows that until one is hanging on your ear and they let you try it a while. And if Joe Dispenser says they “just know”, find a dispenser honest enough to admit they don’t but are really willing to go to the ends of the earth for you to find the best one for your needs.
    Insider advice, for free. 😉

  13. Glenn, I do think it’s fair for a client/patient to ask, for my type of hearing loss, which hearing aid would you recommend? Let’s face it, many elderly people prefer an in the ear aid due to “vanity” or other reasons. And most audiologists are more than happy to sell it to them, why? because it costs more but it may not be the best hearing aid for the individuals hearing loss.

    I totally respect you and your wife’s efforts to come up with another option for people seeking out hearing aids. However, I can truly see how expensive the service you are offering can get. I know that I am more than capable of buying an aid for $100 more than the audiologist pays the manufacturer (depending on the audiologist I go to). It’s just a matter of the individual being savvy enough to surf the web for the real prices. I am also in the field and have access to the book of manufacturers prices and know what it costs an Audiologist to buy that aid. Naturally, there are those audiologists who are owned by the manufacturers and must sell X number of aids a month due to the manufacturer having supplied most of the equipment in the Audi’s office.

    I no longer feel that it’s the audiologist that is making the huge profit but rather the manufacturer who is getting the top cut.

  14. This is very intersting Pearl. I’m now in the process of getting new aids. My aid will be paid for by Voc Rehab so I don’t have to deal with costs. My audiologist is a PHd and works out of a hospital. Thus far, I see that she has several brands in her office and would be willing to try any brand I request. I am glad that Alan pointed out that there should be more than one audiologist in the event one is on vacation or ill. I don’t know if that is the case at this facility and I will ask when I see her in two weeks. Also, I didn’t know that in the ear aids are more costly. She has left the choice up to me about in the ear or behind the ear. I used to wear a CIC which is no longer viable as my loss has become more severe. I have only seen her for an audiogram and I was with her for two hours. As you have pointed out, it’s really critical to be an educated consumer not only about aids but about the audiologists themselves. Ger referrals from satisfied people.

  15. Estelle,
    Since Voc Rehab is paying, you’re in a much better position. Just remember to make sure you have sufficient time for the trial period. 45-60 days is pretty much the norm although I know Costco gives 90 days. Make sure you won’t be responsible for any restocking fee should u decide to give back the aid during the trial period and try something else. The restocking fee is really a fee that goes to the audiologist for the time spent with them during the trial period.

    Also, any Audi that dispenses hearing aids must have what’s called an AuD. which is a Doctorate in Audiology. This does not mean they went to Medical school..lol. It’s almost deceiving. Anyway, good luck with the hearing aid and don’t sign anything until you’ve read all the fine print.
    Pearl

  16. @Pearl: Yes, it is reasonable for people to ask what aid an audiologist would recommend. The main point to remember is no audiologist knows with certainty whether a hearing aid will work for you prior to trying it, so don’t become discouraged if the first attempt turns out less than stellar. Just find an audiologist who encourages you, and will not give up trying before you do!

    Housekeeping note: An audiologist cannot dispense hearing aids by virtue of having an audiology degree (M.S, M.A., AuD or PhD). Like anyone else who wants to dispense hearing aids, audiologists have to pass a state administered exam to be licensed to dispense hearing aids. Last I looked (two years ago), three states didn’t require licensing (meaning an audiologist, bank teller, or a neighbor can sell hearing aids). Forty seven required licensing. Generally speaking, an audiologist has to get two licenses. One to practice audiology in a state (which is usually a formality) and a second to dispense hearing aids in that state. Weird, isn’t it? A small number of states were considering laws to waive the requirement of audiologists taking the audiology section of the test, but I don’t know what happened to those proposals, if anything.

    Your mention of hearing aid expense (and the processes of buying them) begs a follow-up question. What are an audiologists’ services worth? Let’s float some figures. Audiologists who are employees typically make between $40-75K per year. Practice-owner/manager audiologists typically make $60-95K per year. Does that sound fair for the services they provide? Now, think about the price you pay for a pair of hearing aids. Do the numbers still sound fair?

    Now consider the non-audiology degreed, state licensed hearing aid dispenser. Their annual wages (earnings) are pretty much identical. Is that fair?

    I know this example is a gross oversimplification, but it raises the question, “How much profit is fair when professionals help people with a medical condition?” Your answer directly effects the price of hearing aids, and also asks a significant ethical question that both sides need to consider. And discuss. How do you find the balance between education, service, price and expectation?

    On a different tack, I’m going to chide you gently for one comment: “…..can truly see how expensive the service you are offering can get. I know that I am more than capable of buying an aid for $100 more than the audiologist pays the manufacturer…”

    Define expensive. Fortunately, there are now many channels for buying hearing aids (for the sake of our discussion, charitable and government efforts will not be included). Internet sales fall into three categories. 1. Buy the aid(s), find someone local to fit and service them. 2. Buy the aids and program them yourself. 3. Buy the aids and get a specified amount of visits and time with an “approved” local dispenser.

    Then there are also hospital clinics, ENT offices, big box retailers, corporate-owned chain offices, manufacturer-owned chain offices (through a subsidiary), and private practice offices of many sizes – from a single part-time office to multiple full-time offices. Are there more types I haven’t included here?

    Quite a selection and a range of price points. A huge range of service efforts, too. What do you value most? Second most? Third? To each, expensive is a private definition of what you value. For someone who buys on the internet and works with a local audiologist (on a fee for service plan, or annual contract with “x” visits included?) our offering is indeed expensive. For someone who usually buys top-end or mid level hearing aids from a private or corporate owned practice, this plan is a bargain – without even considering the interest earned (and not lost) because you don’t have to sell stocks or empty a bank or retirement acccount to pay for everything up front. It depends on what you value most. Expense is relative – what you consider from a dollar perspective, how you value the intangibles, and the mix you are most happy with.

    What this industry really needs is for a few smart hearing aid wearing people to compile a list of the most common “features” people look for. Not an average, but the wide range of considerations that people like you can select as most important, and a list is then produced of three or four local outlets that most closely match your desires.

    But keep the design of this system out of the hands of us professionals. We’ll screw it up. 😉

    • P.S. Forgot to add a side note: Audiologist wife recently saw two new people. One person bought a set of hearing aids for $1200 three years ago. Nice aids, a freaking great deal. He hated them, was luke warm toward the dispenser he bought them from.

      The other paid $12,000 for a pair four years ago. (Yep, 12K! Did you just fall off your chair the same as I did when I heard that?). She’s absolutely thrilled with her audiologist and the way her hearing aids have performed. Wishes she didn’t have to move due to medical problems and being near to family. Would go back to audiologist in a heartbeat.

      Go figure. Uh, which deal was best, again?

  17. There’s another dispenser model that one might consider: a nonprofit agency dispensing hearing aids at cost plus a set amount for supplies and employing audiologists for the ongoing service on a salary basis. The Canadian Hearing Society uses this model in its Ontario branch offices and has become a major distributor of aids since beginning this program about 20 years ago. I’d check around to see who else follows a similar model in your area.

    • People like to say that hearing aids are too expensive. Simply compare them to other every day expenses and you will come to realize they are a great value. Let’s say you pay $100.00 per month for your cellphone or cable service as many of us do without batting an eye. Take 100.00/mo times 5 yrs of use. (the FDA life expectancy of a hearing aid) equals $6,000. I would say the hearing aid offers more to your livelihood than the tv or cell phone. If you have your hearing aid longer than you are ahead of the game. It is all perspective.

  18. I have yet to find an audiologist that I could even consider mediocre. Been to at least 6 or 7 (I’ve lost count, honestly) in several different cities up and down California. They talk with their back turned to me, don’t explain a thing, shrug their shoulders when I mention that I have severe nonstop tinnitus in both ears that really messes with how the tests work for me, never once have scheduled a follow up appointment, and roll their eyes at me when I ask if they know of any financial assistance programs out there. When a set of hearing aids sold to me didn’t work as well as my previous ones, no one would listen to me, and they insisted that there was nothing out there better for my type of hearing loss. I was talked down to until I accepted giving those hearing aids a longer chance. When those hearing aids broke down 3 days after the warranty expired, they showed me the door while I was in tears. I am extremely jaded by these experiences, at least as far as audiologists are concerned. The last audiologist office I went to, they HAD A DOOR BUZZER TO GET IN! This was in Beverly Hills on a very loud major street. Who thinks up these things?!! I would struggle to get in for several minutes sometimes, once had an elderly couple with better hearing than me help me to get in. I’m getting all keyed up just remembering these experiences.

  19. I am truly thankful to the owner of this web page who has shared this fantastic paragraph at here.

  20. I like what you said about them looking at you when they speak. Not only is it easier without a hearing aid to understand them, but it’s more professional. Thanks for posting!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: