Costco Objectivity

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:

  1. 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).

  2. 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).

  3. The great advantage of Costco is at the level of price and quality - but poorly fit hearing aids aren’t worth much.

  4. Costco should have a better program of standardization among its dispensers, and should have regional audiologists to deal with more difficult fitting challenges.

  5. 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.

1 Like

You sir…(or ma’am) deserve a standing ovation…

Excellent post.

I was tested at my local Costco earlier this week. The fitter seemed to run the test just fine. She was big on the Bernafons, said they see a lot of problems/issues with the Kirklands, and said the Resounds really had nothing great to offer. I do like the fact that they tell you the pricing on everything and that their prices are fair.

Tiler made an excellent point. Any premium or entry level hearing aid is only as good as the audiologist’s competence. I do not have a good experience with Costco fitters and simple adjustments like recruitment issues are too complex for many of them to handle. Many have an air of arrogance to cover their incopetence and the standard question seems to be “what do you really expect from this hearing aid”? What I expect is to hear as well as I can with my hearing loss after proper adjustment. There are two more Costco stores in my area to try. Positive part of Costco marketing is their price structure and returns. Big negative is their level of quality dispensers. Just my 2c.

Yes But…

you said…

"1. 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).

  1. 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).

  2. The great advantage of Costco is at the level of price and quality - but poorly fit hearing aids aren’t worth much.

  3. Costco should have a better program of standardization among its dispensers, and should have regional audiologists to deal with more difficult fitting challenges.

  4. Much of the anecdotal evidence about brand, fitting, success and so forth suffers from being highly subjective - and there is a big luck factor."

How are any of your well made points not applicable to private offices Aud/fitter? Every manufacturer has tech support for the fitter during an exam… including Costco aud/fitters.

YMMV

Costco is just like any audiologist office. There are good ones and there are bad ones and it’s up to you to find the good ones.

Hello folks, I’m newly registered with the forums and I have been lurking extensively recently prior to making the decision to go with Costco for the set of RIC instruments I am presently using. Tiler, thanks for your excellent analysis; it parallels my opinion although I don’t believe I could be as eloquent. I’m a textbook HF sensorineural hearing loss patient (30 years of jet engines) who was basically pushed to seek help when my wife and kids were tired of constantly repeating themselves and having to listen to the windows rattle from TV volume; the kicker was when I found myself entering conversation thinking I knew the topic only to find that when I added my two cents everyone would look at me with a look of “what are you talking about?”. After a visit to the ENT and exam by my audi I was fitted 8 years ago with an ITE model, allowing me to hear things I had been missing for years and improving overall quality of life. To make the long story short and to stay on topic, after going through the speech relearning process and dealing with the occlusion and, for lack of better description, having sounds drowned out by the sound of my chewing I decided to go for the new RIC upgrade. I consulted my audi, who recommended a pair of Phonak Audeo S instead of the Siemens Pure Carat 701 model I had in mind. He steered me toward the Phonak based on his apparently poor cutomer service history with Siemens. Cost: $3500 each, but he said he could maybe negotiate a total discount of $500 off that price. Needless to say I left thinking I would need to wait to save that kind of money - enough for a car where I come from. After finding this forum and discovering from these helpful folks that the Costco Kirkland brand was actually a variant of the Siemens Pure series, I paid a visit and and the experience has been nothing but positive. The store I use has an HIS and a fitter; they initially steered me toward the Resound Forza also, I think based on their experience with them, but the bundle price for the Kirkland Sig 4.0 was too good to pass up for a premium product so I took the plunge at less than a third of the cost offered by my audi for a similar premium instrument. When I came in for the fitting, the area Siemens rep was there also; luckily he had paid his normal call earlier that day and was asked to come back for my fitting. He was introducing a new (to Costco I guess) fitting instrument which mapped the ear canal volume and shape and input the data into the Connexx software to improve the initial fit and to reduce the number of follow up visits. The test consisted of small tubes inserted deep into my ears with the HAs inserted and then a series of tone and sounds injected looking for pressure response. I think the result was excellent; it has been 11/2 weeks since and the instruments improved greatly on my HF perception and overall response. My wife is telling me to turn up the TV now. The only questions I have for them so far involve power up default volumes and program options, but the perceived speech understanding improvement is noticeable. I bring this long winded speech to this topic to agree with Tiler, and to add that my experience may or may not have been as positive had I not already had the experience of initial fitting of my previous instruments, repeated fine tuning adjustments, learning the art of communicating to the hearing professional so they can make tweaks, and having realistic expectations. One note: the HIS told me she had been doing this for 14 years and had her own business before Costco until she found out that Costco sells to customers at the prices she paid for the same instruments. If you find the store with the right fitters, it’s gold. The jury’s still out on these folks, but I was impressed by a personal fitting by Siemens, chance or not. I probably would not recommend anyone going into Costco with hearing loss for their first HA experience although I know some will be financially pressed to do so.

planedoc

Steven, the fitters at my Costco told me that they had seen corrosion issues with the Kirklands (Rexton) from perspiration and other moisture. They actually gave me an additional drier with the purchase, telling me to use once a week. In my case I’m not worried since I am not a sweat hog and do not make cerumen, so I am pretty easy on hearing aids. Something to consider.

planedoc

Having lived the last 5.5 years with Siemens Active aids, I can tell you first had that these anyway (And I suspect any Siemens aid or made by them) suck moisture in like a super sponge. These “Actives” were even marketed toward people going to wear them to exercise, biking, work, and so on. The fitter at Costco confirmed that this is still an issue for their products. If you are having good luck with them-Great! Since I’ve had nothing but problems with mine during and after the 3 year warranty period, I won’t even consider them.

Doc Audio - thank you - high praise coming from you. I’ve read a lot of your very informative posts with great advice freely given.

Jupiter - I hadn’t considered the application of the points listed to private audiologist / dispenser offices - except to the extent that I think I prefer the person selling and fitting my aids to have a dog in the fight, and, do keep in mind, that Costco cares less if you return your aids - probably not so with a small business owner. Success in outcomes is much more tied to the success of the seller in the private world. As to the other points, I am guessing that there are more similarities than differences, and I do think that private audi’s probably have their preferred devices and software for each category and type of hearing loss based on their historical successes and failures. I neglected to state that I started with an absolutely wonderful female audi who is tied to Audigy - but has extensive experience in fitting hearing aids by virtue of having worked for the VA for a number of years. Being a rank virgin in the HA world, I could not wrap my head around purchasing $7,500 worth of rebranded Oticon hearing aids - certainly not without becoming more informed about the whole HA world. For nearly three months I have done a “full immersion” learning process - including all of the Costco visits mentioned above, and lots of reading. Based on all I have learned and written here, I am heading back to my audi to try a pair of Phonak Audeo S Smart aids. We’ll see - I am not turning loose of my Kirklands unless and until I see (hear) a quantum difference. My fitting issue is that my right ear appears to be better in the 4-8k range than my audiogram indicates - and no Costco fitter has succeeded in getting rid of the tinny, harsh sounds I hear at times with different female and some male speakers. My audi did succeed in resolving that issue with the Audigy premium aids.

Planedoc - I hope you are not flying a v-tail Bonanza (aka, the "Doctor’s Coffin) LOL. No Costco I visited offered the services of being fit by a trained company rep. I suspect that you were darned lucky! I was not aware of the “real-time” fitting of the aids - and would like to see how that would work for me. The randomness of your experience and success is pretty supportive evidence for a couple of the points I made about quality control and the need for Costco to have a highly trained regional audiologist who knows and understands the importance of the services you received and is equipped and available to provide such services when needed. I suspect Costco will not go there - their business model probably wouldn’t allow for it, but one can hope.

Finally, one of the things that really bothers me in the whole “automated” fitting process, is that a robot can push the button marked “too harsh,” or, “sounds mechanical.” I want the person pushing those buttons to know and be able to explain in detail what is happening when those buttons are being pushed - is it a compression adjustment? Frequency changes? If so, which frequencies and why? I want the fitter to tell me if it would be better to live with the harsh sounds for a while to see if my brain will adjust - not just give me a quick fix that, in the end, might not be the best thing for me. In general, audiology seems to be as much art as science, and hearing aid dispensing seems to be more tilted toward computer-driven solutions with not enough artistic competence. I do not mean to offend anyone with that comment - I am sure there are great hearing-aid dispensers out there, and equally sure that some audiologists are not artists. Finding the really good ones of either stripe is the hard part.

Is the return key on your keyboard busted? :stuck_out_tongue:

Seriously, long posts like this need to be broken into shorter paragraphs to greatly improve readability.

my fitter, hawaii, agrees. he avoids rexton now

StevenC56: thanks for the feedback; rest assured i am closely evaluating these instruments and looking for anything that would lead to issues down the road - the advantage of the Costco 90 day returns.

jay_man2: there’s that return key! I told you I was a newbie; I also talk that way sometimes :slight_smile: Let me know how I do with this post.

Tiler - I inspect and repair corporate jets; Bonanzas are doctor and lawyer killers :slight_smile: I agree that i was lucky to have the Siemens guy there and the fitting tool used was apparently newer technology; I am easily impressed by shiny things with colored lights. So far I see a noticeable improvement in word/speech recognition, e.g., fewer instances of a lag between hearing the word/phrase and actually comprehending - I’m sure you all know what I mean. My audi also recommended Audeo S for a cost of $7000 and that’s where I defaulted into my research mode.

Now if I could only get rid of these darned crickets! :slight_smile:

Planedoc

I can understand the moisture issues in Hawaii; I haven’t been through a south Texas summer yet either, so I’m still monitoring. Thanks for the feedback.

I do have to mention that I went in to Costco for an adjustment the other day and the HIS was busy with another client, so the dispenser worked with me. He actually pulled up the Connexx application and looked through the “wizard” for my symptoms. I called timeout and waited for the HIS and she listened to my description and and made adjustments - successfully so far - using her experience and knowledge. This is what I referred to in an earlier post as having the advantage of working with an audi when i first was fitted with HAs and learnign a little about the process. A first time user at Costco may not recognize the difference.

Planedoc

What does HIS stand for? How many hearing aid employees are there at your Costco? At mine there is one person who does the fitting, etc., but he is not an audiologist and the second answers the phone, handles orders, etc. And they are open 3 days a week, but I have heard there are plans to add a fourth day.

HIS is a hearing instrument specialist.