Ever Felt Like You Were Ripped Off?

Happens all the time, you say? Uh-huh.

Don’t misquote me.

I did NOT say ‘all the time’.

Mobile phones break, watches break, hearing aids break.

For example, I looked at my watch the other day … but more closely than usual, as it seemed a bit dirty. The gold plating is coming off … time for a new watch!

Now if I had taken the watch for a clean to a watchmakers shop, and they then cleaned the aid and pointed out the failed plating, I might be tempted to blame THEM for damaging the gold plating.

“You wrecked my watch with your cleaning potions. They must have acid in. Or you brushed too hard. I want a new replacement!”

The watchmaker can’t win: either he (unfairly) has to pay for a replacement … or he has a raging customer who bad mouths him.

Whatever happens, I very much doubt that watchmakers, or hearing aid dispensers deliberately damage goods in for repair just to make a sale.

One of the things that that bothers me about the hearing aid business is the attempt to present the dispensing and fitting of aids as if it were part of the medical profession. There is no comparison between a MD and a doctor of audiology and an even greater disparity is between a MD and a licensed Dispenser, who in some states only needs a high school education plus 6 months on the job training.

The fact is that the audiologists and dispensers are in the retail business and provide services to facilitate the sale of merchandise…i.e.: hearing aids.

But just because these guys and gals are retailers doesn’t mean they are unethical. There are good ethical retailers and some retailers not so good or ethical.

And a smart retailer knows that to build a clientel and be financialy sucessful, you must please your customers. Ed

One of the things that that bothers me about the hearing aid business is the attempt to present the dispensing and fitting of aids as if it were part of the medical profession

In the UK I would be taken to court by the regulatory authorities if I called my office a ‘clinic’ or even if I started wearing a white coat!

We are NOT allowed in any way to act like doctors.

English: I have seen hearing aid offices with fancy diploma’s on the wall. White coats and the holier than thou attitude. And the receptionist referred to the man as the Doctor. ( he did have a doctorate of audiology)… USA of course. Worked well I guess with the predominately old folks.

Such a charade makes the job of selling the higher priced aids much easier, I imagine. Ed

wow were you in tucson Arizona when you saw the hearing aid office with fancy diploma’s on the wall. White coats and the holier than thou attitude. And the receptionist referred to the man as the Doctor. ???

that is exactly how one of the places where I have been reffered to by my healthcare insurance company to get hearing aids…

The doctor will see you now John, lol the receptionist always tells me . all of the fitters, opps I mean doctors wear white coats here. The other thing i like is when they say "I’m a doctor how dare you question my programming of your hearing aid. I know better then you what you need to hear… the people at phonak will also back me up 100 Percent . do you want me to call them right now…

While a degree of any kind is no excuse to act like a tool (which is how these audis sound) - it is a valid point that a fair number of audis actually do NOT fit hearing aids.

They work in an entirely different facet of the Audiology field. These facets include: evaluating and treating balance disorders, auditory processing disorders, auditory rehabilitation. And MANY work for hospitals that dispense hearing aids (such as childrens hospitals) in which the audi does not benefit whatsoever from fitting the hearing aids, it’s simply our job. And many audis (not all) that fit hearing aids in ENT clinics are simply salaried health care professionals, whether they fit you with an aid or not, someone else in benefitting (the practice), not the audi.

True - some audis work out of a retail business model, but not all ;).

dr. amy
(feel free to criticize, it doesnt take my degree away from me)

this is true… I would agree with Amy

john: do you use a baha? how is it working for you? please post your review

Midline products? Such as analog hearing aids? Fugeddaboutit. Phonak has phased them out–the only kind you can GET now is a much more expensive digital aid–and never mind if the old analog aid sounds clearer and makes for better speech recognition. I have sev-prof loss in both ears, and would buy higher-gain version of my present programmable analog aids (Phonak Sonofortes) in a flash if I could. But they don’t make 'em. US automakers used to practice what is called “planned obsolescence,” by making each year’s car design strikingly different, and deliberately not building cars that would last that long. So that there was always a reason–increased part failures, rusting, a design that looks exponentially older every year–to buy a new, not a used, car. Or, think of our drug manufacturers, who lobby to delay the generic version of any of their products as long as possible–and come up with new products that while new, have in more than once instance not been appreciably more effective. Now, back to hearing aids: is piling on more expensive, new features and technology (“feature creep”) that don’t necessarily improve the patient’s hearing, while REMOVING from manufacture instruments that lack the new features but work fine, a fair way to treat consumers whose handicap makes them a captive audience?? It’s outrageous, plain and simple. Phonak, at least, is rolling in profits. That’s why they make those fancy cases that can be discarded if you don’t buy the aids, and that’s how they produce all the professional video testimonials that are posted (for free!) at YouTube. If you ask me, it’s a scam of emperor’s-new-clothes proportions.

The hearing aid industry sure can be a rip off. As the audiologist have pretty much taken over the hearing aid industry they have selected the most expensive and least efficient business model to pattern themselves after. The medical office model. High overhead and low volume. It’s a sweet gig if you can get by with it.

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Can you tell me why they cost soooo much?:confused:

Sorry, but that’s a total load of cynical ill-informed hogwash.

Simple low-cost high-power digital aids DO exist.
They can be programmed to act 100% like your old analogue aids. (There is NOTHING magic or special about analogue technology - it can be precisely emulated by a digital processor)

So … you CAN buy what you want … probably at a fair price.

The truth is that The Good Old Days were never actually that great, so there is little point in pining for outdated analogue technology.

However the aids won’t be free … they have to be fitted, which costs time and effort.

As for Phonak’s profits … would you rather they failed? Those profits paid for super 21st century products such as the Audeo YES IX.

Note: You CAN still buy analogue aids: try Tondi in Estonia, that centre of technological excellence.

OK, can you suggest an alternative which allows a dispenser to pay his/her mortgage?

I would LOVE to dump my office and all the problems associated with rent, taxes etc so I am pacing up and down awaiting your suggestions.

Briefly: it’s due to a combination of:

  • strict legal environments
  • very low chip production runs leading to high hardware costs
  • high manufacturer development costs
  • the need to pay for professional support

To English Dispenser: Thanks for your response to my post complaining about planned obsolescence. I don’t wish Phonak went down the tubes, just that they didn’t discontinue fine products that work so well for so many, so quickly–especially when the new products that replace them cost so much more, without providing appreciably superior aided hearing.

I don’t believe there was any mention of “good old days” in my post, so I’ll assume you’re talking to someone else on that one, and rest assured, I understand that fitting takes time and money, thank you. I wouldn’t buy a hearing aid without an audiologist’s evaluation and advice. But I still don’t appreciate having to pay lots more for a digital aid, just to have it programmed so that it’s virtually linear. The bluetooth and fm capability is very convenient, but other than that, for me it’s been a wash.

Finally, allow me a genuine, non-cynical question: are audiologists typically paid commissions from HA manufacturers on aids that they sell? I haven’t asked my audiologist, because I don’t want to sound suspicious (and I’m relatively happy with his advice), but what’s the general practice?

Finally, allow me a genuine, non-cynical question: are audiologists typically paid commissions from HA manufacturers on aids that they sell? I haven’t asked my audiologist, because I don’t want to sound suspicious (and I’m relatively happy with his advice), but what’s the general practice?

Hmmm…allow me to shed some light without stepping on any toes.

There are several different situations in which audis and dispensers operate, so it does depend on who you see. I cant speak for dispensers, because i have never operated in a private hearing aid practice, but its safe to assume that they pay for the hearing aids (as any professional does) and then marks up the price to reflect costs they incur for fitting and servicing the aids. This cost can include many things such as payroll, office rent, equipment, etc… just like ANY business!

I work in an ENT practice and the process is the same. The difference is that the Audiologists here are salaried employees and so prices and mark ups are set by the practice owners. Since the practice is funded by their money, the profit goes to them.

When commissions are paid by some practices, it is derived from the cushion of profit. Our owners receive no commission from the hearing aid manufacturer. It is illegal in the US for hearing aid manufacturers to offer us “perks” to sell their aids, and our license would be revoked by the state board in which we practice in if we were caught accepting any gifts. That doesn’t mean that some manufacturers dont offer better prices than others…

Like I said, I can only speak for my experience. But something to remember is that what we do is, in fact, a business. Practice owners cannot sell the hearing aids for a price which doesn’t cover their costs or allow them to make themselves a salary - ANY business is this way, including any medical or health related office. How much the owner decides to mark up the aids is up to them, which is why you see prices vary so much.

Feel free to commence with the stone throwing. :wink:

dr. amy

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No stone throwing from me dr Amy :)… I think you’ve articulated things wonderfully!

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After reading some of the postings, I had to sign up and share my experience with this industry from a Canadian market perspective.

In recent years manufacturers in Canada have been purchasing retail offices, and positions within some of the larger chain groups plus offering discounts (or “Points”) to volume dealers. This is obviously a very gray area and not a beneficial setup for the end user as it limits the choices being offered to the patient, even if the dispenser/audiologist is only an employee, there is obviously going to be pressure to recommend certain brands only.
To add to this for the general public knowledge, 2 companies have a large percentage of the market through their ownership of hearing aid companies and equipment suppliers: William Demant Holdings owns 3 hearing aid companies (Oticon, Bernafon, Phonic Ear) Equipment suppliers Interacoustics,and Grason Stadler. GN Resound Group owns hearing aid manufacturers Beltone, Resound and Interton and equipment supplier Otometrics.

Forgot William Demant also owns Maico Diagnostics and Tremetrics, Otometrics has purchased several companies (Danplex, ICS Medical and a couple of German companies) which they have blended into their organization.

Sept 23 2010 Update
William Demant now owns Grason Stadler as of a few months ago, so the last of Clinical Audiometers made in the USA is now only a distribution company as all assembly is in Denmark and the components manufactured in the far East. I heard that Demant/Oticon have purchased Sonic Innovations, http://investing.businessweek.com/research/stocks/news/news.asp?ticker=OTIX:US so the pool is getting shallower for choice, prices will only go up from here. No wonder the economies of North America are such a state with the selling off of good high tech companies to off shore interests.

Just one of the many reason why i dont think it’s a good idea for manufacturers to be buying offices in the field. It limits options for audis and patients. No matter what a professional tells you, NO manufacturer is the best at EVERY aspect of hearing aids. Thats why patients need options to choose from and professionals need options from which to fit.

dr. amy

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Thought I would add the following in a new reply to bring it TTT.

This industry is becoming very concentrated in the hands of a few and prices and choices are going to go in different directions. Oticons aggressive purchase of existing offices is also shifting the balance to one manufacturers dominance, giving the hearing care professionals less choice of product in the future.

It will almost certainly be a cartel with William Demant at the head. Sad that good North American Icon companies are being off shored, and used for their good name only.

Sept 23 2010 Update
William Demant now owns Grason Stadler as of a few months ago, so the last of Clinical Audiometers made in the USA is now only a distribution company as all assembly is in Denmark and the components manufactured in the far East. I heard that Demant/Oticon have purchased Sonic Innovations, http://investing.businessweek.com/re…ticker=OTIX:US so the pool is getting shallower for choice, prices will only go up from here. No wonder the economies of North America are such a state with the selling off of good high tech companies to off shore interests.