How to cut down on returns while improving customer satisfaction

Returns for credit in a practice can be significantly reduced by setting proper expectations, having the patient “take ownership” of their hearing loss, providing viable financing options, and giving the patient the best fit and counseling possible for their successful hearing rehabilitation.

There are several reasons returns happen, some of which you can’t control. We’ve all had patients so resistant to wearing hearing aids that, even when the hearing aids work perfectly, they still end up in a drawer or back in your practice.

But often returns are caused by the way we communicate and interact with patients. At my practice, we have less than a 1% return rate because I have found that, with the right communication skills, we can prevent a large portion of returns—and at the same time, create happier patients.

Gyl Kasewurm, AuD, is the owner of Professional Hearing Services, a private practice located in St Joseph, Mich. Dr Kasewurm has been in private practice for more than 25 years, and her office, which employs 12 full-time staff members, has been profiled several times for its singular approach to patient care and the patient journey. She wrote this article in cooperation with CareCredit.

Help Patients Have the Right Expectations

The number-one reason patients return hearing aids is because the hearing aids do not do what the patient expected them to do. Their expectations were not met. Unfortunately, this is often caused by not spending enough time counseling patients and making sure their expectations are appropriate.

Many patients believe that improving their hearing health is as easy as buying a hearing aid, which is simply not true. We’ve found that, just because the hearing aid fits, it doesn’t mean the patient understands how and what they’ll be hearing. Regaining hearing health is a process in which the patient’s brain needs to relearn how to hear again and process sounds and noise. And this does not happen overnight.

In many audiology practices, we get distracted by busyness. There is always so much to get done and so many interruptions that sometimes we focus on mechanics instead of patient perceptions. We ask situational questions like “How long have you had hearing loss?” or “What kind of work do you do?”

Instead, we need to begin by testing so we can illustrate the handicap and show the patient that they indeed have hearing loss. The patient must “buy-in” and own their medical condition.

After you have established the medical condition, you need to uncover the real problem. Hearing loss is not the problem. The problem the patient is seeking to solve is how the hearing loss is impacting their life.

To uncover the problem, you can conduct a needs assessment. Maybe start by asking, “Mrs Jones, we’ve discovered together that you do have hearing loss. Now may I ask you some questions so I can better understand what YOU would like a hearing aid to do for you?” The conversation that follows will help you uncover which hearing situations are most important to the patient and their emotion related to the situation.

Then, and only then, you can illustrate the benefit to the patient and set the right expectations. “Mrs Jones, it sounds like being able to interact with your grandchildren is what’s important to you. When you can’t hear them, you say it makes you sad. Although a hearing aid will not be able to give you perfect hearing in every situation, if I can help you understand your grandchildren 90% of the time, is that what you’re looking for from me? Would that make you happy?” Now you have set expectations based on the patient’s needs and helped them own the solution.

Offer Patients the Right Guarantee

Many practices offer a trial period or tell patients they can “try out” their hearing aids for 30 days. Unfortunately, this language sets the foundation for returns.

The words “just give it a try” imply that there is a real possibility that the patient will not have success with the hearing aids, which may confirm the patient’s own belief that they don’t “need” hearing aids or hearing aids won’t work for them. So when patients eagerly accept a “trial period,” more often than not, they are not sold on having a hearing aid or convinced the hearing aid will improve their life. They just want to appease their significant other, be able to say, “Yeah, I tried it,” and feel confident they’ll be getting their money back.

With a trial period, the patient has not invested emotionally or financially, which means they are not committed to the process of hearing better. And if they are not committed, the hearing aids are coming back. They really have no incentive to try to make the hearing aids work.

Instead of promoting a trial period—which also encourages patients to think your time and effort isn’t worth anything—offer a satisfaction guarantee that details the process that needs to take place before a patient can return their hearing aid. This allows you to have that conversation with the patient about the time and effort it will take to become used to hearing aids and hearing again.

You should also charge for your time and expertise, refunding just the cost of the hearing instruments if a return does happen.

Help Patients Get the Right Hearing Aid

The cost of hearing aids can surprise patients, especially if their hearing loss and the problem they are seeking to solve require a more expensive instrument. When patients are not prepared for the cost, it’s human nature for them to ask, “Is there anything less expensive that will work?” As hearing care professionals, we know what hearing aid is best and know that, if the patient compromises, there is an increased likelihood that they will not be as happy with the device. When a patient asks for less expensive options, do three things:

  1. Remind the patient of the problem they are seeking to solve: “Mrs Jones, you told me that you would be happy if the hearing aids I recommend can help you hear your grandchildren 90% of the time.”
  2. Reassure the patient that your recommendation is in their best interests: “Mrs Jones, this hearing aid will do that for you and will make you the happiest.”
  3. Respond with another solution that will enable them to choose the right hearing aid: “Mrs Jones, many of our patients find they can get the hearing aid that is right for them if they can pay for it over time with monthly payments. If this would make you more comfortable, we do offer a program called CareCredit. Do you have a CareCredit healthcare credit card?”

If the patient has convinced herself that she can “make do” with a lower-cost hearing aid, you can make recommendations, but will need to readjust her expectations. “Mrs Jones, this hearing instrument costs less than the one I recommend. I want to make sure you understand that it will not work as well and that you may not be able to hear your grandchildren 90% of the time. Instead, you can expect…”

Make Sure Patients Are Fit Right

And finally, preventing returns can be as simple as making sure the hearing aid is fit properly. The July 2009 Consumer Reports survey found almost one-third of all hearing aids are poorly fit.

The solution is simple. You must do the outcome measures to ensure the patient is indeed fit properly. It’s important not to skip this basic step. Spend time educating your patients on how to put in and remove their hearing aids.

Of course, if a patient owns their hearing loss, has the right expectations, and understands the process of improving their hearing health, but is still unhappy or uncomfortable with their hearing instruments and wants to return them, you should promptly refund their money (less your consultation fee). This was covered in last month’s HR article; it’s the right thing to do and may keep the door open with that patient, allowing you to help them find a hearing solution in the future.


Correspondence can be addressed to HR or Dr Kasewurm at:

Citation for this article:

Kasewurm G. Only YOU Can Prevent Hearing Aid Returns Hearing Review. 2012;19(05):38-43.