Hi All,
Ok so I’ve got a pair of the Phonak Paradise p90 hearing and purchased them from Spec Savers in the UK. I’m pleased with them “Sort of” however when they were set up I asked the Audiologist if they could do Real Ear Measurements “REM”. I was told that they were not needed and that the tests and set up process within the target software was better and the preferred set up recommended by Phonak.
Have anyone else experienced this or is the audiologist just cutting corners?
I think it depends where you live. Here in Edinburgh they will do a REM fit, but the equipment is shared amongst 6 or 7 branches. Boots do not REM fit either, only Target software.
Sounds like your fitter is lazy or does not have the REM equipment.
I have Phonak p70r aids. I tested them with the initial fit for a week or so and did a REM after that. The REM showed the need for some changes and made a huge difference!
I would insist on doing REM.
Jim
REM is the gold standard to check and set your HA. Your Audie is just wanting to save money & time by not doing and on the other hand probably doesn’t know how to it…
Hi Terry, If you are happy with your new aids, I think you got a good deal, 2x Phonak Paradise P90 for £2395+4 years warranty+ 4 years free batteries and free regular checkups. I was quoted £3800 at a nearby independent, although that did include REM fitting.
Hi Terry, Target 7.1 has its own form of Real Ear Measurement which is adjusted during the fitting, the fitter will run this once your audiogram has been uploaded to your aids, and once done Target adjusts accordingly to the acoustic parameters allowing for occluded or with mould vents, RIC domes or whatever receiver you are using, you will hear different pitches/noises in either ear, first one ear then the other, once calculated and after some fine adjustments and whatever extra programs you want installed, you are good to go. For instance, today I was fitted with a new set of Naida Paradise, left ear has no vent in the mould, right ear has a tiny vent, this was put into the calculations and Target adjusted accordingly. Cheers Kev 
The only way to truly tell if RIM is the correct fit for you is to do both fittings. From reading this forum you will hear two sides, each have their merits.
The never ending REM argument.
In-situ testing is IMHO more effective than REM … but for some reason many consumers seem to have latched on to the idea that REM usage is a sign of a good audi.
FWIW the UK NHS requires use of REM as part of their protocols. The audis have to use it for ‘political’ reasons … but many tell me that they then have to start again with hand tuning to make the aids actually work well.
Thanks for everyones comments they’ve been really helpful and a bit of an eye opener as to the opinions people have with regards to having REM or Not!
I now think having done a little research on the Phonak website it now clear to me that if I want the best from my aids Spec Savers should be doing the REM as set out on this page >>
https://www.phonakpro.com/com/en/resources/fitting-and-tests/overview-target.html
I have always had REM done with every aid I’ve had and have never had to return more than once or twice for minor adjustments. Spec Savers does state that they DO do REM on their website but I think this is just a marketing ploy to draw in customers and win sales.
From the Specsavers website ( The clinician will use a real ear measurement to ensure the hearing aids are set to the correct level based on your ear canal size and hearing loss).
Is that different to the feed back test? I haven’t reprogrammed my aids since v7. came out and I don’t recall a REM type test on the v6. software. Using B90’s.
As Hindlaugh90 pointed out Spec Savers do quote the REM but can’t be bothered to do it for some reason!
If they do not agree to do the REM for me then I’m a little stuck. I can either try to reprogram/adjust my own aids which might be an option, pay for the REM somewhere else to do it or get my money back. For now, I’m waiting for them to get back to me with a solution. I’ll keep you all posted 
Hi nsjmgm, the Real Ear Test is not REM (Real Ear Measurement), but I believe has to do with acoustic feedback management, my apologies for any confusion I may have caused… In the 30 odd years of using hearing aids here in the UK, I have yet to actually come across REM in either The NHS or indeed Privately… Cheers Kev.
Go back and insist on it. If they are stating that it’s part of their fitting process on their website, it’s part of the contract when you purchased the aids.
The reason why the independent location price was so much higher is due to the discount structure that Sonova run for large accounts, which puts the squeeze on the independent. The wholesale price of the P90 is pretty close to what you paid as the final price.
Some fitting systems perform a version of REM using the mic and receiver of the hearing aids.
It’s ok, but there’s an inherent weakness in trying to measure the output of a device using the device itself.
A proper REM uses a separate slim tubed mic that is passed down the side of the Hearing Aid dome or mould. My preferred calculation is Real Ear Aided Response (or the total amount of oomph in the bottom of your canal) measured against the ‘SpeechMap’ of known speech interpolated against your actual Hearing level.
This effectively provides an absolute ratio of output between the quietest sound you perceive and a loudness ceiling for every frequency. The input signal should be speech; not recorded, but live speech over a few sentences from the Audiologist. Hence the coined term ‘Live Speech Mapping’. After each ‘round’ of fitting the Audiologist should compare the output on the screen with the ‘speech map’ target and make adjustments to the hearing aids.
Done properly, it’s a very useful tool to refine fittings.
1.Is it the magic bullet that everyone claims? Possibly.
2.Does it make your fitting hit a target? Absolutely.
3.Will the client ‘like’ the prescribed sound in all cases? Perhaps 50:50.
4.Will this measurement/adjustment override some of the ‘comfort’ features that a manufacturer includes in the fitting SW? Yes, you may need to wind the fitting back for acceptance.
5.If you insist on fitting to this target and ignore your client’s response to the fitting, are they more likely to bounce the sale in the short term? Possibly, especially if you seem to be overly prescriptive in terms of their needs.
6. Are commissioned/targeted employees likely to use it early in the sales process in the light of #5? Probably less likely than not.
7. Does the kit require a higher level of training, confidence, expenditure and understanding. Yes; (I was slated on the FB forum for saying handwritten audiograms were a sign that you shouldn’t be using that provider; it’s pretty much a dead cert that people not using computerised audiology systems won’t be using a REM system)
So, as you can see, there’s a bit more to it than saying people are lazy. Especially in an industry/this site where the main driver appears to be price.
Thank you Um_bongo, for your professional insight is always welcome 
I have a lot of empathy for Audiologist like yourself trying to compete in a one-sided market which is extremely favourable to the “Big Hearing Aid Outlets” and very detrimental to the independents like yourself! In an ideal world there should be room for all, but unfortunately folks will hunt out the best price available that meets the depth of their pockets, and they quite rightly want to get the best aids they can get for a price they can afford, the price of this economics (Pre Covid) is quite clearly seen on any high street in the UK, 'tis mostly only the “Big Fish” whom survive and even the large high street retailers are suffering due to booming internet sales… In truth and I have said this before, I would gladly pay more for my aids if I felt the service received merited going to an excellent independent like yourself, the question I would have to ask myself, does that merit me paying double or more for the exact same set of aids??? I am most fortunate to have a fully qualified Audiologist at Boots Hearing Care whom will go that extra mile to meet my hearing needs, nothing is too much trouble and her best asset is that she cares deeply about my hearing requirements, and she is an excellent Audiologist. Unfortunately we live in, a money orientated world, and as such “The Buck” is the bottom line… Take care, cheers Kev.
I bought mine from Boots in England. They did REM. One branch did not have the equipment but when I said I wanted REM they sent me to a branch that did. It did make a difference.
Good to know, did they also do a word recognition test? I was in a branch of Boots last month, when I enquired about REM, they told me they do not do it. No consistency, but as I understand Boots and Specsavers are franchised businesses, so I think it depends on the franchise holder or owner, as to whether they REM fit or not.
Yes, they also did a word recognition test. I was not aware that Boots was a franchise. When I insisted on a REM test as a condition of the sale they handed me over to a branch where they. had the equipment. In my case, it was in another town but not further away. The audiologist there has been very good and has spent a lot of time helping me with HA issues.
