Staff Standpoint | November 2014 Hearing Review
By Karl E. Strom, editor-in-chief
There have been a lot of dire and ominous warnings from a vast range of industry experts, many of whom I greatly respect, during the past year. To be sure, there is a lot of change in our industry, and one has to acknowledge as much. Big Box retail hearing aid sales are “coming of age,” and will doubtlessly continue to impact the industry and dispensing offices. Average sales prices (ASPs) have come under intense pressure, and Hearing Review survey figures suggest that ASPs have been flat or declining over the past 5 years. Finally, Internet hearing aid sales continue to grow while relatively unfettered (at least so far) from any real regulation by the Food and Drug Administration (FDA).
But is the sky falling? In my 20 years as editor of The Hearing Review, I’m not sure I’ve ever seen pessimism rise so high relative to independent dispensing. I don’t wish to sound like a Pollyanna. I do think there are serious issues to worry about, but we should also recognize that there have always been “big changes” looming on the horizon with the potential to negatively impact the hearing aid dispensing market and distribution power of traditional practices—and never did. Here are just three examples:
hi HealthInnovations, 2011. When United Healthcare announced that it had formed a new division, Hi healthInnovations, to distribute hearing aids, it caused great consternation and even an air of panic in the industry (for review, see the Hearing Review October 2011 interview with hi HealthInnovations CEO Lisa Tseng and May 2012 interview with Tseng and Noreen Gibbens, AuD). As a subdivision of an insurer that serves 10 million Medicare beneficiaries, the company initially marketed its products through its preferred providers and through a more controversial online gain prescription tool (see Dianne Van Tassell’s article in the January 2012 HR) which was eventually mothballed just prior to a cease-and-desist letter from the FDA. The company had not received appropriate 510(k) clearances for the online test, and this test has yet to reappear 2+ years later. However, hi HealthInnovations continues to market its products through its medical network and also online via more than 60 audiology offices across the United States. And, although it has experienced success in some areas, the company shows few signs of radically changing hearing aid distribution.
Disposable hearing aids, 2001. When Songbird came out with its disposable hearing aid in 2001, a number of experts felt that a subscription model—with no battery sales, lower replacement costs, constant free technology upgrades, a programming system with 7 easy configurations, etc—might drastically alter the dispensing landscape and give manufacturers more power over the distribution system. Songbird failed in the professional market because it could not overcome significant design problems (eg, one hearing aid configuration for both left and right ears resulted in user discomfort) and some inherently thornier distribution conundrums. But, even if Songbird had been successful, it now seems pretty clear that it would not have subverted the traditional dispensing system. In fact, we have a successful disposable hearing aid right now (Lyric), and more are planned for the future (eg, EarLens).
The transistor, 1951. One would have thought the advent of the transistor—a game-changing innovation first introduced by Raytheon in hearing aids in 1951—would have prompted dispensing professionals to dance in the streets. With its introduction, the transistor spelled doom for the unwieldy vacuum tube hearing aids and the advent of wearable devices—or at least hearing devices that literally didn’t burn you from the heat they gave off. But several articles and commentaries in Hearing Dealer (later renamed Hearing Instruments) at that time fretted over what the resulting lost battery sales would mean to dispensers. “The big question regarding transistors which has been on virtually every dealer’s mind is: ‘What effect will reduced battery sales have on my business?’” wrote editor Bob Edgell in the March 1953 Hearing Dealer. In fairness to Edgell (an editor who went on to become a major publishing industry mogul and even establish his own company which employed this editor during the late-80s), his answer to the “transistor/battery problem” was essentially: “Stop the naysaying!”
And I’d agree with him. The one thing all these threats—and opportunities—had in common was that the naysayers forgot that we’re in the healthcare business. When people need hearing help and become ready to purchase a hearing aid, most of them understand that it’s important to get it right. Yes, some people will buy the lowest-priced or easiest-to-obtain product no matter what. Let them; that’s their choice. However, what hearing care professionals cannot lose sight of is that you have a proven and comprehensive solution for an extremely detrimental and debilitating (if untreated) chronic health condition: hearing loss. And, as Curtis Alcock and Doug Beck noted in our April edition, our message must emphasize that better hearing equals better life, better opportunities, and better health and cognition. Discounting services isn’t the answer.
Most people, when confronted with the true gravity of hearing loss, will want a healthcare professional to help them solve the problem. We need to stick to our guns and position professional hearing care as the solution to a health issue that greatly influences general health, cognition, and quality of life—and then make darn sure consumers receive that comprehensive care.