Before reading the lead article by Kochkin et al in this edition of HR, a few things should be made clear. First and foremost, hearing aids work, they work well, and the vast majority of people who purchase them and receive professional hearing care services are satisfied. MarkeTrak VIII data—based on the very same data presented in this month’s lead article—indicate a 78.6% customer satisfaction rate (defined as “somewhat satisfied” or better) with hearing aids less than 4 years old. Second, this satisfaction rate has been moving upward (5.5 percentage points since 2004), while the percentage of hearing aids in the drawer has fallen to 7.5%—a 10% decrease since 2004.

However, what the data do suggest is that quality control at the point of dispensing has not kept pace with the industry’s rapid technological improvements. The study correlates the responses from a survey of about 2,000 hearing aid users with the typical hearing aid dispensing armamentarium to show that comprehensive protocols have a major positive impact on hearing aid brand loyalty, utility of hearing aids, positive word-of-mouth advertising, satisfaction with benefit achieved, reduction of hearing handicap, hearing aid use, and reduction of hearing aids in the drawer.

More specifically, the study finds that patients who have the highest success rates and become hearing care advocates (eg, recommend hearing aids and services to peers, etc) are those who have visited dispensing offices that:

  1. Ensure proper fit and comfort of the hearing aid (eg, make quality impressions/earmolds and perform hearing aid programming that utilizes the full residual hearing area);
  2. Achieve good sound quality (eg, use a hearing aid analyzer to check hearing aid function);
  3. Keep return visits to a minimum (eg, 3 or fewer per year)
  4. Have positive dispenser attributes (eg, professional, caring, helpful, etc)
  5. Have positive office/practice attributes (eg, clean, professional, updated decor, etc)
  6. Verify the hearing aid fitting using real-ear measurement (REM on all patients)
  7. Use a subjective benefit measurement (eg, COSI, APHAB, SAC/SOAC, etc)
  8. Use loudness discomfort measurement (ie, define UCLs and the residual hearing area)
  9. Use objective benefit measurement (eg, word recognition, HINT, QuickSIN, etc)

Other notable protocol items found to have a significant positive impact include: the administration of a customer satisfaction survey (eg, post-fitting validation); distribution of a self-help book; 1 to 2 hours of counseling time in the first month; and hearing testing being conducted in a sound booth (see Tables 3a-b in the lead article). Further, these protocol items appear to be additive; the more of them the dispensing office does, the better chance for patient/dispenser success (see Figures 6 and 7, also from the lead article).

The idea that a comprehensive protocol yields significantly higher levels of success with hearing instruments certainly isn’t new or shocking. The Hearing Industries Association’s “Consumer Journey” research and other papers have hinted at the same. My guess is that, when most dispensing professionals look at the above list, they’ll say to themselves, “I do that; I do that; I do that…” But, judging from HR‘s dispenser surveys, the items that probably stand out for many are the routine use of a hearing aid analyzer, REM, and objective and subjective benefit measures. My hope is that, should these items be absent from your dispensing protocol, this study will get you to reassess their value.

There is a lot more research to be done on this topic, and I suspect the data presented here will generate some heated debate. However, in my view, that debate is key to lifting the hearing care field to even higher levels of customer satisfaction and better, more consistent patient outcomes.

Karl Strom