Having posted a number of times about Costco’s hearing aid program - I think I can add some greater objectivity based on numerous visits to different Costco dispensaries. Let me organize my most recent thoughts:
It is a truth that success is primarily dependent on the skill of the fitter, less so (I think much less) on the type/brand of hearing aid within each category (i.e., premium).
When all you have is a hammer, everything looks like a nail. This is a truth that applies (in my experience) particularly well to hearing aid dispensers (vs. audiologists) - but generalizing is dangerous. There are really talented dispensers, and not-so-talented audiologists. In general, and in my experience, Costco dispensers are more of the hammer-equipped variety (I will explain later in this post).
The great advantage of Costco is at the level of price and quality - but poorly fit hearing aids aren’t worth much.
Costco should have a better program of standardization among its dispensers, and should have regional audiologists to deal with more difficult fitting challenges.
Much of the anecdotal evidence about brand, fitting, success and so forth suffers from being highly subjective - and there is a big luck factor.
So, here are some facts (or at least I think they are facts) which correlate with the points numbered above. I have now had Kirkland Premium’s (Rexton Onyx more or less) fitted and re-fitted at three different Costco dispensaries. The greatest success has been with Tammy Neystel at the Ft. Worth Costco - primarily due to her superior knowledge of the Rexton fitting software, and her willingness to put the time into making things work. She is not a big fan of the Resound or Bernafon aids, contra to another dispenser in California who pushes Resound and dislikes the Kirkland product. This is point No. 2, above - it appears that the dispensers at Costco push the product that they know the best in terms of fitting software. At yet another California location, the dispenser was not comfortable adjusting my Kirklands - she did not really know the fitting software, and instead urged me to return the Kirklands and purchase Resound Forzas - which she believed to be a superior product - but, given her lack of knowledge with the Rexton software - I think the bias here was that she believed she could do a better job with the Resound fitting process.
This leads to more of the truths alleged above, and a counter-intuitive conclusion. Much has been made of the benefit of Costco dispensers not having a “dog in the fight” - in the sense that they are paid by the hour - and thus perceived to be neutral and not dependent on making a sale. This is true as far as it goes, but the other conclusion one can reach is that not having a dog in the fight (and being paid by the hour) means that the success of the dispenser is not highly correlated with (or dependent upon) user outcome or satisfaction. The motivation to cultivate lasting relationships and create user happiness is not tied to the paycheck of the dispenser in the Costco world. It is much more of a mass production mindset - and - to some extent - the job security of the dispenser is not proportionately linked to the outcome of the sale and fitting of hearing aids. Private audiologists can’t stay in business if they are not outcome driven. For the HA users who are adequately accommodated by standard fitting software, Costco’s program and structure is a good thing - most outcomes will probably be good, as long as the consumer understands the limitations of mass-marketing of hearing aids.
Out of this comes the seminal question for a would-be purchaser of Costco HA’S - the dispenser should be asked at the outset which fitting software he or she knows the best and is most comfortable with. That should guide the choice of hardware - not internet hyperbole or subjective comments. Keep in mind that most dispensers really don’t understand the science behind the software - or how to manipulate the software to go outside of the standardized, software-driven fitting process. So, go with the hardware that correlates with the fitting software best known by the dispenser. Forget the A vs. B issues in hardware and features - unless of course you have profound or abnormal hearing loss - in which case an audiologist is probably where you belong.
Point 4, above, is a big one. The variability I have encountered in dealing with several different Cosco dispensers leads me to believe that the dispensers in each region should be under the guidance and control of a competent audiologist - who would be available to promptly assists in less-than-cookie-cutter fitting situations. As the Costco HA program grows (and it is growing like crazy), so grows the need for quality control and outcome management. If I sound negative about Costco, I am not. I think Costco can do a better job - and there are plenty of us that seriously appreciate being able to purchase a pretty high level of technology at a fairer price.