First-time patients need special consideration

Danielle Campbell-Angah is a former editor of an audiology magazine and currently works as a freelance writer for CareCredit. Correspondence can be addressed to HR at [email protected] or to Danielle Campbell-Angah at .

As numbers of first-time patients increase, learn how to put them at ease with communication and helpful services.

Although it is gratifying and lucrative for your business to keep old patients coming back, you certainly can’t forget about the patients who are coming to your practice for the first time to get hearing aids. These people may know that they have a hearing problem, but not know how that problem gets remedied.

They may not be prepared for the lengthy discussions about their hearing needs or the dialogue that’s necessary to ensure their hearing aids have been fit properly. They may not be aware of the rehabilitation strategies they must use to get the most out of their hearing aids, thinking they will have the perfect hearing of their youth, at the flip of a switch. They also may not be entirely comfortable with covering the entire cost of hearing aids out of pocket in one large payment, despite being convinced by the hearing professional that the technology will alter their lives for the better.

With all these doubts and knowledge gaps, the dispensing professional must be sensitive to each individual patient, demystify the process, and offer any services, including financing plans and aural rehabilitation strategies, that will make it easier to deal with purchasing and using the hearing aids.

When your conversations with patients are executed properly, not only will they understand the value of hearing aids and purchase them from you, but they are likely to return to your practice and tell others to come to you to regain optimum hearing.

Nowadays, More First-Timers

It is important to consider first-time hearing aid users because, as the 2006 Hearing Review Dispenser Survey1 reported, 51% of new clients were first-time users of hearing aids—the highest level in 14 years. Clearly, people are getting the message that hearing aids work, but many still don’t understand what is involved with getting to the point where hearing aids can help them to hear in a noisy restaurant or over the phone. This is where you, the hearing professional, come in.

Although many patients are concerned about how the hearing aids will look, they are “usually very skeptical about the whole process and the results,” according to Heather Shenk, AuD, audiologist for Advanced Tech Hearing Aid Centers, in Lancaster, Pa. “Some are skeptical of me and whether I will come through for them, based on experiences they may have heard about in the past.

“Sometimes I feel a little pressure, because I am walking with a person through this journey,” Shenk continues. “If the experience is negative, the person may not return for a second try for some time, if ever. I believe I have quite a bit of responsibility to the patient, and I don’t want to let them down.” Dispensing professionals who realize the delicate nature of handling the hearing needs of a first-time patient are the ones who are going to be most successful at giving an improved quality of life to these patients.

The good thing about new patients coming through the door is that “this person is finally getting help for a problem that has plagued them for an average of 7 years!” says Shenk. “I think some people are somewhat fragile at this stage because they have been the objects of jokes by family members for hearing something other than what was said or have been facing the emotional issues that develop when one spouse has a hearing problem. I’m happy that people have finally overcome whatever negative stereotypes they may have heard about hearing instruments and are on the road to being ready for the help they have needed for so long.”

Starting the Dialogue

Because so many emotions surround the pursuit of better hearing, recognize the internal struggles patients have had about waning hearing ability and what to do about it, as well as the “interventions” that patients may have endured at the insistence of a spouse or longtime friend; praise the patient for being proactive about remedying the challenges brought about by having a hearing loss. Your encouragement will help with their decision to give hearing aids a try.

The next thing you will need to do is encourage open conversation with the patient. At Shenk’s office, first-time patients are scheduled as soon as possible, and are given longer appointment times for the initial consultation. Knowing many patients are skeptical of hearing care professionals and the process to improve hearing, she focuses on drawing out the various concerns patients have about the process and the technology “so they can be addressed adequately during the patient interview and throughout the initial consultation.”

You should keep the conversation focused on what the patient wants and expects, as this is the biggest challenge, Shenk says. Most helpful to your process will be to ask open-ended questions, rather than questions that solicit a yes or no response, because you will get more detail from the patient. For example, if a patient recalls a time when he was embarrassed by a misunderstanding over the phone, ask the patient how that experience made him feel and how he handled subsequent phone conversations, rather than asking, “Did you feel nervous about talking on the phone after that?”

It also will be helpful to explain what different tests will tell you about the patients’ hearing, so they will be more understanding and accepting of a finding of hearing loss. Patients who have a clear understanding of the hearing problem will be more committed to fixing it.

Communicating Value

Though educating patients on the nature of their hearing loss will help them to better understand the situation, you also will need to communicate the value of hearing aids. Shenk makes a point of informing patients that hearing aids are “the key to better quality of life, better relationships, and less fatigue when communicating,” for example. Because your conversation is slowly progressing to a discussion of appropriate hearing aids and their costs, it is crucial to ensure that patients are informed of the many benefits of amplification to establish their value.

Speaking of the cost of hearing aids, you will likely find many patients have concerns about spending several thousand dollars at one time to pay for amplification, whether they voice this concern or not. Because of this, you should offer a payment plan, informing every first-time patient of its availability. Making assumptions about who can and cannot pay for hearing aids leads to lost sales. Patients who aren’t informed of your hearing plan may opt to walk out of your office without hearing aids, and then you will have the daunting challenge of getting these patients back into your office and attempting to convince them a second time to try hearing aids. A study suggests that fewer than 5% of those who leave tested but not sold on hearing aids return to be fitted. That means that once they’re gone, they’re gone.2

If you don’t have a third-party financing plan in place for hearing aid purchases, consider this: A 2006 survey conducted by Inquire Market Research revealed that, if there is no financing plan available, patients prefer to rely on many undesirable strategies to be able to obtain the hearing aids — from asking the professional to bill them monthly (32% of respondents) to deciding to purchase a lower-cost option that won’t necessarily give them the same benefits (24%) or even delaying care (20%).2

On the other hand, patients going to practices where payment plans were available felt that the practice was looking out for their best interest (50% of respondents), and it was easy to focus on optimal care rather than cost (50%), and they left the practice feeling they had received a good value (51%).2 The study shows that offering a patient financing plan can take the worry out of paying for hearing aids and make patients feel more at ease with the process of diagnosing and treating hearing loss. Both actions are things that help hearing professionals to get more patients fitted with amplification.

Aural Rehabilitation

As dispensing professionals know, the process does not end with the fitting and purchase of hearing aids. Patients need to be armed with strategies that will help them to be successful with using their hearing aids.

To help her patients with this, Dr Shenk stresses several facts during hearing aid delivery:

Lower volume level setting. First, “the hearing aids are not turned up as loud as they should be so they can adapt to hearing some sounds first, then more and more as we increase the settings over time.” Shenk does this to lessen the likelihood of patients returning to the office in a week to complain that their hearing aids don’t work.

More noticeable environmental sounds. “They will notice a larger difference with environmental sounds first, in addition to hearing voices better.” For example, a flushing toilet, the rattle of silverware, creaky floorboards, even the sound of moving around in a nylon jacket, will be different. Assure patients that “the more they hear the sounds, the less ‘weird’ the sounds will be,” until they get to the point where their attention will no longer be drawn to these sounds.

Acclimatization. “Hearing aids aren’t like glasses, and the patient won’t start hearing everything right away. … While the ears respond to sounds right away, it takes the brain a little more time to become accustomed to interpreting all these ‘new’ sounds.” Let patients know that there is a “rehabilitation time” that they will go through. Additionally, ensure that family members also understand the need for rehabilitation time by offering communication strategies that they can use with the patient.

Though it can be challenging, the patient and significant others alike need this information from you. “If they understand what the hearing aids will and will not do, there is a much better chance of them being satisfied with hearing aids performance, and the patient will be more satisfied as well,” says Shenk.


  1. Strom K. HR 2006 dispenser survey. Hearing Review. 2006;13(6):16-39.
  2. Inquire Market Research. Purchase behavior among hearing loss patients: results of a study with 200 patients requiring a hearing device. Santa Ana, Calif: Inquire Market Research; 2006.