Staff Standpoint | March 2016 Hearing Review

Karl The March 2016 issue of The Hearing Review offers “rants” from five hearing industry experts (p 16). As I was helping guest-editor Marshall Chasin, AuD, with that feature article, I thought of three short rants of my own:

1) Skin-toned hearing aids. Maybe it is just me, but I’d like to know how many patients have been shocked out of even trying amplification because they were handed a “beautiful, small, discreet” skin-toned hearing aid. My initial (and silent!) reaction when, for the first time some 23 years ago, a skin-toned ITC was placed in my hand by the proud manufacturer was, “Oh my gosh! This is a replacement body part that came from someone’s ear!” Of course, I knew that wasn’t the case, but I was unprepared for the fleshy color. I felt like someone had just placed a tongue in my palm. Rarely do skin-tones accomplish the desired effect of making the prosthetic unobtrusive when sitting in your hand, on a table, or in an elegant box (picture a severed little-toe in that box).

Which brings me to another point: a hearing aid is not a prosthetic or replacement body part—and it certainly shouldn’t be positioned as one, especially in today’s high-tech world that is burgeoning with hearables and wearables. The hearing aid does not replace any part of the ear; it is a Class I (ie, relatively safe) medical device that amplifies sound and enhances the residual hearing a person still possesses. Ask the FDA: it defines a hearing aid as a medical device; conversely, it defines a cochlear implant as a prosthetic.

Certainly, I understand the desire of many patients to want a skin-toned BTE or ITE to blend in with their natural skin color. That’s reasonable and understandable. However, from a marketing perspective, I think the general population has the same initial reaction to a skin-toned hearing aid that I did (“Ewww!”). Want real proof? Place a skin-toned hearing aid in a kid’s hand, or the hand of  anyone else who has no preconception about what a hearing aid looks like, and watch their eyes.

My only point here: Don’t shock a potential first-time user with the idea of a prosthetic, because that is not how they perceive hearing aids or hearing loss—specifically their hearing loss. In their view, they’re not missing ear parts; they just need a little help with their hearing. It’s absolutely fine if they end up choosing the skin tone. As an industry, we are better off portraying hearing aids as part of the medical electronics family rather than the prosthetics family. For positive first impressions, use any color except skin tone.

2) The audiogram and its limitations for demonstrating hearing loss. I’m not going to go too far on this one, because Drs Chasin and Beck touch on this topic, as well. I’m a self-confessed science nerd and happily endured years of college physics, chemistry, and calculus. But, even with a science background, for my first couple months in the hearing care field, I still had difficulty divining the mysteries of the audiogram and recognizing what any given audiometric configuration represented.  Why? As James Jerger, PhD, pointed out in the April 2013 Hearing Review, although the history and evolution of the audiogram make sense, it’s still an upside-down graph. Not enough people are scientifically inclined to begin with, so trying to teach upside-down chart reading during a moment fraught with emotional turmoil for them (ie, Did I fail my hearing test?) is not a great counseling strategy. When they’re nodding their heads at you, mostly they’re just being polite and trying to hide their internal anguish at being shown they have a hearing loss.

3) Validate—for you, your staff, and your patients. This rant is blatantly ripped-off with apologies to Sergei Kochkin, PhD, who has extolled the merits of validation for over two decades. It seems you cannot eat a $10 meal at the local greasy spoon, get a $50 oil change, or check out of a $150 hotel room without being asked by the proprietor to answer these four questions: 1) Did you enjoy our services/offerings? 2) Would you come back? 3) Would you recommend us to a friend? and 4) What else could we have done to make your experience better? Yet, the majority of people who pay for a $3,000-$6,000 pair of hearing aids get no such survey. Validation, preferably using an established validation method, gives the customer an important say in the matter (maybe even a rant), and it gives you and your colleagues the feedback needed to recognize potential problems.

Okay, you heard my rants. What are yours?


To read the rants from five long-time hearing industry experts, see the “RANTS! Some Things We Would Change—If We Could” article in Hearing Review.