Final Word | December 2015 Hearing Review

I’m using spare weekends to convert the old barn at my childhood home into a guest house. I’m capable of learning about or using previously acquired skills to take care of the various carpentry, plumbing, and electrical components necessary for the conversion. Some things, however, are just too complex for me to tackle. Heating and air conditioning fall into that category. Southern California is a moderate climate, with frosty winter mornings, and hot days in late summer, and early fall being the exceptions when heating or air conditioning are necessary for comfort. I researched quiet heat pump systems that don’t require extensive ducting. Installation is complex, requiring tools and technical skills I do not have. The local orange box home improvement center advertises them, but the installers are formula-driven and can’t get beyond the idea of a standard frame house retrofit. I took a friend’s recommendation and called a local heating, ventilation, and air conditioning (HVAC) contractor. The guy was great: knowledgeable and readily understood my needs. We agreed that he’d work up the specifications and send me a bid. When the bid came in, I was surprised at the cost. It was about 40% higher than I had expected.

Now I feel like a first time hearing aid buyer. There is a product-service combination that I need, but the bundled cost is more than I am willing/able to pay. If I were a statistic in the hearing aid market, the needed service and product is “unaffordable or inaccessible” to me. Maybe there should be hearings on Capitol Hill to address the terrible injustice of the fact that this system is beyond my reach. The truth is that it isn’t beyond my reach. I can afford it; I just do not see that the amount asked represents a good value for me. I’ve looked online and the components for the system are about half the total cost. I have no complaint with the provider; he comes highly recommended, but I think his labor bid might be too high. I know that two workers could install this in a day, and even if the provider throws in a service call or two under the warranty period, I still don’t see the value. Like a custom-fitted hearing aid candidate, I want this specific product, not some clumsy over-the-counter alternative system. I may search around and decide to pay the high price, and get the service and expertise that comes with it, or I might find a way to come closer to what I judge to be a good value. This is a good example of a free market system, and I expect that I will have a reasonable choice, even within the narrow criteria of acceptability I have chosen.

An important aspect of this story is the fact that the burden is on me to become educated about my options, find out what is needed, and find a vendor who offers good value. It isn’t that much different for people with hearing loss, but we may not have a free market for hearing improvement products that is as well defined as the one for HVAC systems.

Figure 1

Figure 1. Figure 1. MarkeTrak 9 found that about one-third of people with hearing loss go directly to a hearing care professional (HCP), about half converse with a medical doctor (eg, GP, ENT) about their hearing loss, and about one-fifth do not consult with any professional. Source: HIA.

In Figure 1, I interpret the data from MarkeTrak 9 (MT9) to reinforce the fact that consumers do not see a clear pathway to better hearing. They are confused about where to start. Should they do nothing, visit their primary care physician, an ENT physician, a hearing care provider, or a combination? The MT9 data show a scattered pattern of action among people with admitted hearing difficulty.

If we have a health problem, we visit a physician. If we need a service or consumer product, we do our research and make a selection. These consumer responses to a need are well defined. Unfortunately, it isn’t clear to hearing loss consumers who to consult for help, and how to think about hearing aids. Consumers see marketing for hearing aids that focuses on the technology. Hearing care professionals do market their services and fitting skills, but the message isn’t as compelling as technology—and consumers are left with a blurred sense of how to categorize a hearing aid, or where to go for hearing care.

The Final Word? We as an industry apparently haven’t been successful in communicating what to do about hearing loss, and how hearing aids fit into recommended treatment plans. Part of this is simply that the provider stakeholders each have a role, and tend to emphasize that role in marketing and practice descriptions. I’d favor a simple, objective step-by-step guide that offers choices, and puts consumers on a logical path toward getting the help they need that is accepted by all as the Standard of Care.

Will we get representatives of the stakeholders to agree on a universally acceptable logical path? If our goal is to do what is best for the consumer, we had better come to an agreement. Even if the marketplace evolves over the next few years to include more PSAPs and basic hearing aids as some are recommending, a consistent, universal message offering clear logical guidelines will be helpful for consumers.

Dennis Van Vliet, AuD

Dennis Van Vliet, AuD

Dennis Van Vliet, AuD, has been a prominent clinician, columnist, educator, and leader in the hearing healthcare field for nearly 40 years, and his professional experience includes working as an educational audiologist, a private-practice owner, and VP of audiology for a large dispensing network. He currently serves as the senior director of professional relations for Starkey Technologies, Eden Prairie, Minn.

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Original citation for this article: Van Vliet D. The Final Word: Leading Consumers to a Logical Solution. Hearing Review. 2015;22(12):50.?