The Better Audiologist?


Which is better? To go to an audiologist associated with an ENT or medical practice OR to go to an audiologist not associated with an ENT mor medical practice?



Initially I thought it was better going to a practice associated with an ENT, but now I don’t think it’s relevant. Perhaps it’s similar to asking if you should see a blue eyed or brown eyed audiologist. I’d try to find recommendations. There is some info on the site. You can do a search by the city you live in.


I think better things to assess are their independence from manufacturers and their standards of practice. Ask about real ear measurements. Ask about their qualifications and standards of practice that they follow. On top of that you need a little luck.


Except for large chains such as Costco & Sams Club, they are ALL dependent on the manufacturers of the aids they sell, much as car dealers are dependent on their vehicle manufacturer(s).


How is Costco any different? They might have more leverage on bulk pricing, but at the ground level there is far less autonomy over the types of product that they have on the shelf than an independent. They still buy all their product from the ‘big 5’ manufacturers.


They offer many different brands and their hearing staff are salaried. They also have a diversified product line and a large buying power to exert influence on the manufacturers. If Costco decided to drop Resound aids, the Costco business would not suffer much.

They are a large “warehouse club” business. muc like a huge department store with their hearing centre as one department.


I understand the model - however the fact that the market is an oligopoly means that they have to buy from one of the main suppliers on an agreed deal for (slightly) legacy- in this respect they aren’t any better than your local independent, except for price.

As for autonomy of product choice, are any of them selling Marvels, Quattros, Evokes or Opns ?


An independent here usually only sells from one or two manufacturers. A falling out with any one of them could kill their business. Costco does not have that issue. The user also has a large choice of professionals at no additional charge is one does not suit them well.

Due to their buying power, Costco tends to be lower priced too, sometimes half of the competition’s price.


Why and how would ‘falling out’ with a supplier occur? Why would it be damaging to one’s business? If you don’t like the offering from supplier X, you migrate more customers to supplier Y and so forth. They don’t control the income of the business and the reps just want to earn their bonuses, almost irrespective of what you do.

Don’t get me wrong, I’ve got nothing against the Costco model, we have the same issue with large cut price chains (Specsavers etc) undercutting the high street price. What I don’t recognise is the ethereal panacea that Costco seems to be represented as on here. It’s a profit making business like any other - they make WAY more than their advertised 10% on hearing aids - and you’ll get a broad variety of choice of (slightly) legacy product. You can argue that having more than one person dealing with your issues is prone to lead to lack of continuity and/or accountability too - so I’d say that was fairly moot.

It’s your money at the end of the day, so the decision where you spend it is up to you. On the local high street which contributes to your local economy or in the multinational company wherever they pay their taxes.


For my money, Costco at least has the equipment for Real Ear Measurement that the independents here do not have.
I am now hoping to find a branch that actually uses the equipment for that. The 2 I have tried do not. :frowning:

Saving money is just a bonus, especially when I have been driving 2 hours each way to visit.

I am sure you could do as well or better but the time & cot to visit make it not economical for me. :wink:


Although I’m a fan of Costco, I’ll be the first to admit that they’re far from perfect. Although they have done REM with me, it’s been pretty cursory. To me what you get by going to Costco without needing to do any research or seeking of recommendations is the assuity that nobody will try to sell you a pair of $6000+ hearing aids. I think it’s pretty clear if one is willing to spend the money and do research to find a good audiologist, one can have a better experience.

To me, at least in the US, it’s difficult to know if you’ve found a truly independent audiologist. There are so many manufacture sponsored businesses–Miracle Ear, Beltone, Audigy, etc.


Since I am located i a more rural area, finding competent professionals in many fields is a struggle.


In fairness that’s likely to be a problem wherever you go. Even the least partisan Audiologist with sufficient knowledge to make an informed brand decision is likely to have some ‘taint’ to their opinion.


Is that true though? I ask in all honesty…not challenging. Are there not hearing aid stores or chains that aren’t beholden to 1 manufacturer? I know there are stores/chains that are owned by manufacturers as per our hosts map…but are there not any that are on their own and simply get supply from whatever manufacturer as Um_bongo says?


They need to be set up as “dealers” that do not significantly compete with others nearby. There is usually some specialized equipment and/or restricted software needed for programming too.

Of course, Canada is likely a little different. I got my hearing aids after moving to the US from the Toronto area.


I enjoy a little shared opinion based on experience if shared that way, such as I really like the way Brand X handles, frequency lowering, feedback, wind noise, etc. I really tire of people who recite markting claims.


That’s inherently untrue here. There’s two independents in my home town and three main chains.

I’m not indebted to any one manufacturer. The other independent claims autonomy too. Boots hearing care are 50% owned by Sonova, I believe GN has a stake in Amplifon and Specsavers is run as separate franchises under their umbrella - they do deals with the big suppliers.

It’s unlike car dealerships as there’s no specific flag over the door, we as independents can move the offering around and diversify if we want.


Here Costco use audiologists, do real ear measurements and sell a variety of aids from many manufacturers. They are also not paid a commission on the sale of aids and do not advocate for HAs unless the patient meets certain criteria to indicate a need. Those are all good things. Their prices are very good also.

Many of the hearing aid/audiology clinics here are owned by one of the big six and do not offer independent advise. They may be cheaper for that brand of aid but they only offer one brand. They may or may not use audiologists to fit the aids and the profession is unregulated by government so there are no required standards. Each country does this differently so you need to understand the requirements in your country of purchase also.

In Australia most ENT owned clinics are chains with many ENT surgeons affiliated with each chain. They tend to have standards for practice because they were set up by the ENTs when they could not find reliable audiological services to send their patients for their testing. Some, however do use commissions as part of staff income so not all are the same.

Do some research on who owns the clinics you are considering and ask about who staffs them, whether they are paid commissions and what their qualifications are. Get to know the system in your country and you will be better able to judge where to look for hearing aids.


In the US Costco makes a point of stating their audiology people are salaried, not commissioned.


One more point I know on Costco, but apparently only in California. All fitters here are H.I.S., Hearing Instrument Specialists, none that I have found are Audiologist with an Audiology Ph.D. degree. None of the HIS fitters at my store know of true Au.D audiologists at other stores in the state.

In California both HIS and Audiology PH.D. are licensed by the state and the certifications are the same for all. No one can practice hearing aid fitting without State certification. Costco requires the HIS fitters here to perform REM and many tests, more than I got at any Audiologist clinic. Asking the fitters here, they state that all California stores have mandatory tests to perform, including REM.