#104

To me the question is whether an independent audiology practice is still a viable business model.

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#105

The time is coming quickly where the answer is no.

Many are already struggling mightily with all the pressure from insurance companies, 3rd party groups, and big box retailers.

When OTC becomes a reality, DTC isn’t far behind. That will spell the end for the small private practice Dispenser or audiologist.

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#106

All this talk about closing audiologist offices has me thinking about the people with profound or near profound hearing loss. The typical OTC hearing aids I doubt will fit these people.
Hopefully the system will continue to help those who still need it. This just might create the needed separation for government hearing aid support.

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#107

Same issues as mom and pop hardware stores etc. I would think the best strategy of any lower volume retailer is to stress their high service level. And yet apparently in the hearing aid biz only about half the clinics offer REM.

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#108

I think optometrists and pharmacists have experienced something similar too. There are still independent practitioners, but much less than there used to be. Discount chains have popped up in those fields though, but so far none of that seems to have occurred in audiology so Costco took advantage. Instead of discount chains in audiology, we seem to have the private label chains, which are certainly not discount in price.

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#109

Hardware stores are like a candy store to me. The Ace in my hometown is thriving. Their prices are in line, maybe a touch higher than the discount stores.

#110

Same here. I go out of my way to patronize a Home Hardware store. Their prices are mostly competitive, they stock things the big box stores can’t be bothered with, and the service is superb. Example - I recently took back a big box of pipe fittings I didn’t need. Some of them came from a big box store (from days when I didn’t have time to go out of my way). The Home Hardware store took them anyway as long as the UPC is something they stock. Contrast that with the tales of DIYers here, and even some folks who bought from a different clinic, who weren’t able to get any help from multiple clinics for any price.

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#111

That’s a good example of how different hardware stores are to a typical audiologist office. Hardware stores are thriving and audiologist offices are not.
The concept of DIY and the modern audiologist office in the future might have rates for all services to help people with aids. The idea is great service for a fair price.

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#112

Can you explain the acronym DTC?

#113

Direct to consumer…

I have heard, cannot confirm, that Sivantos is already working towards that, and it is a terrible idea.

#114

are you talking about selling hearing aids on line . Audicus does this now. They are Hansaton aids, I bought a set for my mother who has dementia and lives in long term care. I had her old hearing test, so I uploaded it for them to program the aids to her loss. I could no way take her to an office. I explained why the test was old, and that there was no way mom could even take a new hearing test. They were understanding, and helpful. Nor, did I want her going without decent quality hearing aids. Mom is 90, Her hearing loss is almost identical to mine, I have resound Quattro 9’s. When I tested her hearing aids in my ears, I found them quite acceptable. Hers cost $1200 , I think. So, I think there is a market for easier access to hearing aids, especially for folks who don’t want or need any bells and whistles. I use a ton of stuff mom does not need, ( multi mic, tv streaming, smart phone ap, different settings ) Mom cannot do any of this, I needed to aim for the middle, and give her something so we could communicate, and didn’t cost an arm and a leg as mom as no money either. Frankly there is a huge untapped market and we boomers aren’t getting younger.

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#115

Honestly i have read alredy many of this type of discussions and i have not seen much changes.
I agree that HA Manufactures need to make profit . I also agree that AUD also need to make Profit.
But in my Opinion Hardware Prices must be unbundled from the Services. I cant see the Point where in UK i have to pay 1000$ for one aid and in Switzerland from the same aid and Swiss manufacturer 2500 both without bundled services. Nearly nowhere on the web are HA prices transparent viewable you only get priceing when you contact them.

I would say that in booth cases the seller of the HA makes Profit the one which sell it for 1000$ and the other also who sell it for 2500$
I would like that When i need to purchase the HA i have trancparency world wide.

AUD Shops they may concentrate them self not on selling . They should fit that thing with specalized know how. They should publish theyr costs per hour for the work.
And wich HA brand the know best.
Actually when i bring my car in to Garage i pay the repair also Hour based. and of coarse the parts needed for replacement.
Why this is not Possible in this Industrie?

#116

In the UK the core business has shifted a little. There’s still a big need in this area for fittings, but some people with the skills are probably going their own route. The complexity of fitting and pairing products is still a little above the skills of most 70-80 year olds.

We’re doing lots more wax control now as Dr surgeries are offloading this part of their service.

What bothers me a little is that there’s a bit of a treatment gap in terms of patient care in OTC fittings. There’s several referral to GPs due to secondary conditions letters going out from my main branch every week. Who covers this if the patient self-diagnoses and fits?

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#117

Yes i see that. And is also not a good route if patient self diagnose and fit.
The best way would be when patient know where they can get professional care, fitting equipement etc and go to specalized people who know how to do it.
Spezialized AUD would be well known thrugh the community or friends. If hardware and Skills get unbundled from Each other. Why i cant go to buy second hand HAs somwhere and let them Professional fit it?
Here in switzerland 1Hour in a Car repair shop cost me 140$-180$
A good AUD can ask also a good price for a good work. I think the black sheeps would die if the work they do is not good enough.

#118

That seems reasonable. However “my” Audiologist(s) have NOT pushed HAs at me. In 2012 I told my primary doc I was losing hearing, he took the 10-second peek in my ear and sent me to the Audiology Clinic (an impressive private practice). I got a very good exam, even referred to a head-scan for possible neuroma, then counseling (obvious advice). This year is clearly worse. The clinic’s new owner couldn’t see me for a month, did a fair test, but I had to say “I want an aid!” Took another month to get another hour to talk about that, and only general suggestions made. I just wrote two checks for “fitting” and “half down”, and we’ll see how fast that comes through.

Thanks. I knew they were high. Interesting that Rexton vs Phonak seem to post 75% vs 50% markups, so not even an industry agreement on the size of the vigorish.

Also interesting how 100-200-300-level devices can be VERY different list price but not so much different cost hammered-down. Of course some of the intangible cost of developing leading-edge algorithms has already been paid by wealthy or over-sold private buyers.

I pay $75/hour; but it is two guys in the woods of Maine and they are not good for anything fancy (mufflers and rust-repair, they are great). The big-sign shop on the highway probably is $100-$125/hour. It was in that range in suburban New Jersey 10 years ago, more now.

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#119

I kind of have to agree with the whole used car salesman metaphor. I let myself get talked into trialing a Livio which I alread know will not have the Bluetooth versatility of the Phonak Marvel. Hopefully he will not freak if or when I tell him after the trial I still want the Marvel. He claims the Livio provides better high frequencies and and something else, I wrote it down, can’t recall now.
I do plan to learn self programming once I have a hearing aid initially programmed with Real Ear, hopefully it is not too excessively complicated.

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#120

Hey Tom,
I have the Marvel M90-R and had REM done when I got them a year ago. I’m really quite satisfied with them. When I got them, being the tech that I am, I also found a copy of the Target software (I keep it up-to-date) and purchased the required Noahlink wireless. So far I’ve only used Target to do the Marvel 2.0 firmware update, turned WhistleBlock OFF for the Music Program and to look around at what my audiologist programs. She doesn’t like that I have the self programming software/hardware and cautions me not to mess with anything where I don’t know what I’m doing. :blush:

I’d love to see your audiogram. Would you consider entering it using the “MY AUDIOGRAM” menu item on the upper right? You can see mine by clicking on my Avatar (my face icon).

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#121

when I switched providers ( I have resound quattros ) I was told that the new provider had to enter my audiogram from scratch, in other words she could not “see” the settings. Is that true. Sounds like you bought the software and now can see everything that your audiologist did. My 2nd audiologist had to reprogram the aids from scratch, rather than just tweak.

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#122

I hadn’t really thought about the added value of being referred to your doctor and I’ve been referred, I’m due to get my head scanned. The same applies to having an eye test, they can spot things that need to be referred.

#123

That was probably just her preference. I recently reinstalled Windows on my PC, which required re-installing Target for my Marvels. When I connected to the aids for the first time after that, Target asked if I wanted to use the settings in the aids, or start a new session. Same thing happened with TrueFit and my wife’s Moxis.

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