Audiologists: As Hearing Aid Competition Stiffens, Show How Your Services Add Value

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Hearing aid consumers have an ever larger pool of hearing aid providers to choose from, with Internet dispensers, discount networks and Big Box retailers offering lower-cost options.

Patients may choose these options voluntarily to save money or because their insurers limit them to such options—but, given that such options rarely involve audiologists, the result is often improper, poorly fitted devices and unsatisfied clients, said audiologist Harvey Abrams, director of audiology research at Starkey Hearing Technologies, at a session on health reform and audiology at ASHA’s 2013 Annual Convention.

This is far from news to audiologists, who of course know that their health care training is necessary for proper selection and fitting of hearing aids. But the value-added of an audiologist’s services is often unrealized by consumers. Thus, said Abrams, as distribution channels expand, the key is to demonstrate that the audiologist channel is the quality channel because it’s centered on the patient and focused on positive outcomes. To differentiate their services and ensure that they meet these standards, Abrams recommended that audiologists:

  • Develop a comprehensive treatment plan that lays out strategies for patients to follow.
  • Administer a patient-focused income measure such as the Client Oriented Scale of Improvement to determine what the patient considers his or her most important treatment needs.
  • Use meaningful tests such as speech-in-noise assessments
  • Establish patient-specific treatment goals based on what the patient wants to achieve, using goals that are specific, measurable, attainable, relevant and timely, or SMART. Identify with the patient what he or she would define as success: For example, being able to carry on a conversation with a spouse in a relatively noisy restaurant.
  • Select hearing aid features on the basis of treatment goals.
  • Verify the hearing aid parameters with probe microphone instrumentation (real-ear verification measures): an objective, evidence-based way to fit hearing aids. Treat but verify.
  • Validate the hearing aid fitting. The definition of treatment success is how well patient goals are met.
  • Prescribe hearing assistive technology, such as FM systems, infrared systems and induction loop systems.
  • Provide post-hearing-aid-fitting aural rehabilitation services in the form of auditory training and/or group aural rehabilitation. Don’t just hand the patient a DVD!
  • Itemize your fees. Building them into the cost of the hearing aids just diminishes your value as a professional because they’re not then seen as payment for professional services, said Abrams. “If you commoditize your services, your patients will shop around, possibly online or at places like Costco,” he explained.


Bridget Murray Law
is managing editor of The ASHA Leader.

Harvey Abrams, PhD, CCC-A, is the director of audiology research at Starkey Hearing Technologies in Eden Prairie, Minn. He has served in various clinical, research and administrative capacities with the VA and DoD. He is an affiliate of ASHA Special Interest Group 7 (Aural Rehabilitation and Its Instrumentation).