|
Home > Archive > Hearing loss support > June 2006 > Mail order hearing aids (was High-end hearing aids)
You are viewing an archived Text-only version of the thread.
To view this thread in it's original format and/or if you want to reply to
this thread please [click here]
| Author |
Mail order hearing aids (was High-end hearing aids)
|
|
|
| A potential problem with mail order hearing aids with local audiology
support is the quality of the overall result. There's a good reason why
the total price of the conventional solution is often three times the
cost of the aid. The audiologist typically pays $1k for a digital aid,
and charges $2.5k-3.3k for the total package - for $1.5k-2.3k margin.
The audiologist bill includes amortization of equipment, plus the cost
of facility, and payroll, and such expenses are real whether the aid
comes to the audiologist by mail or is carried in by the patient.
If the audiologist supporting a $1,500 mail order aid only charges $750
for services (testing, earmold, fitting, aftersale maintenance), that's
$750k margin. Does the mail order aidseller truly believe that the
audiologist provides the same level of service/support for half to a
third of the margin? Do you?
Will the patient receive the same diagnostic and fitting services in
both cases? Will the patient have the same aftersale service from the
aidmaker in both cases? Will the overall result be as satisfying (and is
there any possible way to know)? 15-18% of all aids wind up in a drawer.
Is there a way to determine whether that percentage is higher or lower
with mail order aids?
An audiologist with a cash flow problem, or perhaps someone just
starting out as a sole practitioner, might welcome the additional
revenue from walk-ins carrying aids purchased online - particularly if
it's treated as "incremental business" that doesn't have to absorb
overheads. I think the only way a seasoned and successful professional
would take responsibility for the overall result is to handle the
overall solution.
Ike
Not in the industry.
Medman wrote:
> I agree with Ike and take it one step further. Close examination of the
> chips between a "high end" manufacturer who sells hearing aids through
> audiologists, and reputable mailorder and/or the Internet sites that
> sell hearing aids, show little or no difference in features and
> functionality. The only difference is price. Specifically for ITE (In
> The Ear) digital hearing aids, you might pay between $1,000 at $3,000
> each at an audiologist, whereas from a website or mail order house, you
> might pay between $200 and $800 for a hearing aid with the same
> functionality. An audiologist does provide the additional services of
> "handholding", testing, and face-to-face consultation which you pay
> for, but if you are willing to give that up you can save a lot of money
> by going mailorder or through the web.
>
> And yes, I am in the business
> www.hearingcentral.com
>
| |
| erration@yahoo.com 2006-06-04, 9:08 am |
| It may well be the case that distorting the market and restricting
normal freedom of choice can be shown to have a positive result in some
instances. But that is not a basis for generating law that affects and
restricts all. If the result is indeed viewed as desirable by some, it
should be encouraged by appropriate means - not forced on all by
strategic laws that compromise individual rights and derail healthy
market forces.
A projected positive result is not a sufficient basis to deny
individuals their normal options and to close markets to all but the
proponents. If the anticipated result is considered important, it
should be encouraged by providing information, but never forced on
consumers by anyone much less by the efforts of those who stand to
gain. Too often those who know best are wrong and the greater wisdom of
the affected is wrongfully disengaged. This country prohibits
unacceptably intrusive laws of this kind.
Those who wish to buy services only from retailers can always choose to
do so without trying to force everyone to do likewise.
| |
|
| Interesting post.
Thanks Ike for a rational response.
"Ike" <binarydotike@gmail.com> wrote in message
news:OD49g.3043$VA3.901@newsfe13.lga...[vbcol=seagreen]
>A potential problem with mail order hearing aids with local audiology
>support is the quality of the overall result. There's a good reason why the
>total price of the conventional solution is often three times the cost of
>the aid. The audiologist typically pays $1k for a digital aid, and charges
>$2.5k-3.3k for the total package - for $1.5k-2.3k margin.
>
> The audiologist bill includes amortization of equipment, plus the cost of
> facility, and payroll, and such expenses are real whether the aid comes to
> the audiologist by mail or is carried in by the patient.
>
> If the audiologist supporting a $1,500 mail order aid only charges $750
> for services (testing, earmold, fitting, aftersale maintenance), that's
> $750k margin. Does the mail order aidseller truly believe that the
> audiologist provides the same level of service/support for half to a third
> of the margin? Do you?
>
> Will the patient receive the same diagnostic and fitting services in both
> cases? Will the patient have the same aftersale service from the aidmaker
> in both cases? Will the overall result be as satisfying (and is there any
> possible way to know)? 15-18% of all aids wind up in a drawer. Is there a
> way to determine whether that percentage is higher or lower with mail
> order aids?
>
> An audiologist with a cash flow problem, or perhaps someone just starting
> out as a sole practitioner, might welcome the additional revenue from
> walk-ins carrying aids purchased online - particularly if it's treated as
> "incremental business" that doesn't have to absorb overheads. I think the
> only way a seasoned and successful professional would take responsibility
> for the overall result is to handle the overall solution.
>
> Ike
> Not in the industry.
>
>
>
>
>
> Medman wrote:
| |
| ed121@mindspring.com 2006-06-04, 9:08 am |
|
I am surprised that no one mentioned two highly reliable sources of
hearing aids at prices getting close to what they would be if the
government restrictive regs were eliminated.
Those are Costco and the internet supplier, America Hears. Both are
highly reliable and stable organizations. America Hears is
technically highly competant.
The quality of the Costco licensed dispensers varys from excellent to
barely usable. Some stores have the good ones....and some have the
not so good ones. FYI, Ed
On Fri, 12 May 2006 11:39:34 -0700, Ike <binarydotike@gmail.com>
wrote:
[vbcol=seagreen]
>A potential problem with mail order hearing aids with local audiology
>support is the quality of the overall result. There's a good reason why
> the total price of the conventional solution is often three times the
>cost of the aid. The audiologist typically pays $1k for a digital aid,
>and charges $2.5k-3.3k for the total package - for $1.5k-2.3k margin.
>
>The audiologist bill includes amortization of equipment, plus the cost
>of facility, and payroll, and such expenses are real whether the aid
>comes to the audiologist by mail or is carried in by the patient.
>
>If the audiologist supporting a $1,500 mail order aid only charges $750
>for services (testing, earmold, fitting, aftersale maintenance), that's
>$750k margin. Does the mail order aidseller truly believe that the
>audiologist provides the same level of service/support for half to a
>third of the margin? Do you?
>
>Will the patient receive the same diagnostic and fitting services in
>both cases? Will the patient have the same aftersale service from the
>aidmaker in both cases? Will the overall result be as satisfying (and is
>there any possible way to know)? 15-18% of all aids wind up in a drawer.
>Is there a way to determine whether that percentage is higher or lower
>with mail order aids?
>
>An audiologist with a cash flow problem, or perhaps someone just
>starting out as a sole practitioner, might welcome the additional
>revenue from walk-ins carrying aids purchased online - particularly if
>it's treated as "incremental business" that doesn't have to absorb
>overheads. I think the only way a seasoned and successful professional
>would take responsibility for the overall result is to handle the
>overall solution.
>
>Ike
>Not in the industry.
>
>
>
>
>
>Medman wrote:
| |
|
| My position is that the hardware isn't nearly as important as the
service. I tried Costco once, and was terribly disappointed. I shouldn't
generalize based on one experience, but others voiced the same opinion
at ALDA - price is low but service is second class.
I don't know about America Hears, but if it's the conventional mail
order equation then my critique applies.
Bottom line - to me - is that the key issue is professional skill during
diagnostics, prescription, earmolding, fitting (possibly many visits) -
with the right of rejection and exchange, and other services that may or
may not be available from mail order suppliers and the local
audiologists that help them.
Ike
ed121@mindspring.com wrote:
> I am surprised that no one mentioned two highly reliable sources of
> hearing aids at prices getting close to what they would be if the
> government restrictive regs were eliminated.
>
> Those are Costco and the internet supplier, America Hears. Both are
> highly reliable and stable organizations. America Hears is
> technically highly competant.
>
> The quality of the Costco licensed dispensers varys from excellent to
> barely usable. Some stores have the good ones....and some have the
> not so good ones. FYI, Ed
| |
| Bruce Coryell 2006-06-04, 9:08 am |
| ed121@mindspring.com wrote:[vbcol=seagreen]
> I am surprised that no one mentioned two highly reliable sources of
> hearing aids at prices getting close to what they would be if the
> government restrictive regs were eliminated.
>
> Those are Costco and the internet supplier, America Hears. Both are
> highly reliable and stable organizations. America Hears is
> technically highly competant.
>
> The quality of the Costco licensed dispensers varys from excellent to
> barely usable. Some stores have the good ones....and some have the
> not so good ones. FYI, Ed
>
>
> On Fri, 12 May 2006 11:39:34 -0700, Ike <binarydotike@gmail.com>
> wrote:
>
>
You can go to independent dispensers and find excellent to barely
useable (I would say useless) ones there too...
| |
| ardway 2006-06-04, 9:08 am |
| I hope you sell a few to the 30 people who visit this site. It's not as
if there are a lot of people who read your blatant advertising here.
Ardway
ed121@mindspring.com wrote:
> I am surprised that no one mentioned two highly reliable sources of
> hearing aids at prices getting close to what they would be if the
> government restrictive regs were eliminated.
>
> Those are Costco and the internet supplier, America Hears. Both are
> highly reliable and stable organizations. America Hears is
> technically highly competant.
>
> The quality of the Costco licensed dispensers varys from excellent to
> barely usable. Some stores have the good ones....and some have the
> not so good ones. FYI, Ed
>
>
| |
| erration@yahoo.com 2006-06-04, 9:08 am |
| "I don't know about America Hears, but if it's the conventional mail
order equation then my critique applies."
Not very conventional. This is my understanding:
You are familiar with Hearphone. AH stuff has the same basic DSP
configured for 16 band, 4 channel operation. They also ship you a
programmer (that takes the place of a HiPro) and programming software
(very detailed). They set it up per your data and impressions and ship
it to you. Then you get to fine-tune it yourself or you hook it up to
the Internet and they program it from the factory for you (or both). 60
day no-charge return.
IMO this arrangement by itself doesn't guarantee a good result. A bad
company doing this would be just as bad as a bad dispenser. AH has a
good rep so far but somebody else could do the same thing very badly.
The self programming option may be good insurance for some but not for
others. If they perform I hope they will succeed. If others have a
better idea and better performance, I hope they will prevail.
There is no sense in trying to cast the market this way or that way.
You are bound to be wrong initially or eventually. Like normal markets
they should be left free to develop to the user's preferences.
| |
|
| I'll be impressed IF the UPS driver has an audiology degree.
Snide comments aside, there are the issues of a professional's check for
potential pathology, initial audiometry, getting the earmold right,
vent, and the quality of fitting.
Ike
erration@yahoo.com wrote:
> "I don't know about America Hears, but if it's the conventional mail
> order equation then my critique applies."
>
> Not very conventional. This is my understanding:
>
> You are familiar with Hearphone. AH stuff has the same basic DSP
> configured for 16 band, 4 channel operation. They also ship you a
> programmer (that takes the place of a HiPro) and programming software
> (very detailed). They set it up per your data and impressions and ship
> it to you. Then you get to fine-tune it yourself or you hook it up to
> the Internet and they program it from the factory for you (or both). 60
> day no-charge return.
>
> IMO this arrangement by itself doesn't guarantee a good result. A bad
> company doing this would be just as bad as a bad dispenser. AH has a
> good rep so far but somebody else could do the same thing very badly.
> The self programming option may be good insurance for some but not for
> others. If they perform I hope they will succeed. If others have a
> better idea and better performance, I hope they will prevail.
>
> There is no sense in trying to cast the market this way or that way.
> You are bound to be wrong initially or eventually. Like normal markets
> they should be left free to develop to the user's preferences.
>
| |
| erration@yahoo.com 2006-06-04, 9:08 am |
| "Snide comments aside, there are the issues of a professional's check
for
potential pathology, initial audiometry, getting the earmold right,
vent, and the quality of fitting."
It would be interesting to get your opinions (+/-) on those issues
should you decide to investigate how they are actually handled.
| |
|
| erration@yahoo.com wrote:
> "Snide comments aside, there are the issues of a professional's check
> for
> potential pathology, initial audiometry, getting the earmold right,
> vent, and the quality of fitting."
>
> It would be interesting to get your opinions (+/-) on those issues
> should you decide to investigate how they are actually handled.
I'm pretty comfortable with my existing relationship: an audiologist
with decades of experience, ENTs that respect her, the best hardware,
great staff, professorship at a local U, and I can do the fitting myself
using her computer and HiPro box. It just doesn't get better than that,
so I'm unlikely to ever find out how America Hears. That doesn't mean AH
is bad, but it means I won't know one way or the other.
Ike
| |
| Wayne Boatwright 2006-06-04, 9:08 am |
| On Sun 14 May 2006 09:34:18p, Thus Spake Zarathustra, or was it Ike?
> erration@yahoo.com wrote:
>
>
> I'm pretty comfortable with my existing relationship: an audiologist
> with decades of experience, ENTs that respect her, the best hardware,
> great staff, professorship at a local U, and I can do the fitting myself
> using her computer and HiPro box. It just doesn't get better than that,
> so I'm unlikely to ever find out how America Hears. That doesn't mean AH
> is bad, but it means I won't know one way or the other.
Few people have the luxury of programming their own aids. I'd rather take
my chances on selecting my own hardware because only *I* know how I want to
hear. I've never had an audiologist adjust my aids to my satisfaction, and
that includes the head of Cleveland Clinic's Otolaryngology department.
The only professional assistance I require is someone who knows how to take
a decent deep impression for molds.
--
Wayne Boatwright @¿@¬
_____________________
| |
| Ignacio 2006-06-04, 9:08 am |
| I agree with you
I have two digital Siemens Phoenix 313 (299$/unit in ebay)... easy to
adjust with trimmers, two years warranty.
In Spain (Europe) the audi sells the same HA for 1800$ (1500Euro)
In less than two weeks I managed to achieve a good fitting, better than
previous siemens and phonak analogs from the same audi (i tried several
audies)
Whit a little knowledge, it's possible adjust the HA yourself
I left the audiologist only for molds..
bye
(sorry for my English)
"Wayne Boatwright" <wayneboatwright_at_gmail.com> escribió en el mensaje
news:Xns97C3DF9FBE2CFwayneboatwrightatgma@217.22.228.19...
> On Sun 14 May 2006 09:34:18p, Thus Spake Zarathustra, or was it Ike?
>
>
> Few people have the luxury of programming their own aids. I'd rather take
> my chances on selecting my own hardware because only *I* know how I want
> to
> hear. I've never had an audiologist adjust my aids to my satisfaction,
> and
> that includes the head of Cleveland Clinic's Otolaryngology department.
> The only professional assistance I require is someone who knows how to
> take
> a decent deep impression for molds.
>
> --
> Wayne Boatwright @¿@¬
> _____________________
| |
| Wayne Boatwright 2006-06-04, 9:08 am |
| On Mon 15 May 2006 10:30:33a, Thus Spake Zarathustra, or was it Ignacio?
> I agree with you
>
> I have two digital Siemens Phoenix 313 (299$/unit in ebay)... easy to
> adjust with trimmers, two years warranty.
>
> In Spain (Europe) the audi sells the same HA for 1800$ (1500Euro)
>
> In less than two weeks I managed to achieve a good fitting, better than
> previous siemens and phonak analogs from the same audi (i tried several
> audies)
>
> Whit a little knowledge, it's possible adjust the HA yourself
>
> I left the audiologist only for molds..
>
> bye
>
> (sorry for my English)
Your English is fine. Thanks for your comments.
[vbcol=seagreen]
> "Wayne Boatwright" <wayneboatwright_at_gmail.com> escribió en el mensaje
> news:Xns97C3DF9FBE2CFwayneboatwrightatgma@217.22.228.19...
--
Wayne Boatwright
_____________________________________________________________
"How can a nation be great if it's bread taste like Kleenex?"
Julia Child
| |
| ed121@mindspring.com 2006-06-04, 9:08 am |
| Ardway ole buddy. I thought I established with you that I am not
connected in any way with any company in the hearing aid business. I
simply feel that it helpful to explain that there are alternate
sources for hearing aids beside the Audiologists. Every hoh person
should recognize that generally speaking Audiologists are not always
technologically up to date or always competant and they are certainly
not inexpensive.
I certainly would not recommend that anyone that is disfunctional in
any way or suffering from severe and/or rapid hearing loss do anything
other than consult an ENT or professional Audiologist pronto. Ed
On Sun, 14 May 2006 19:29:12 -0400, ardway <elbow@medblock.edu> wrote:
[vbcol=seagreen]
>I hope you sell a few to the 30 people who visit this site. It's not as
>if there are a lot of people who read your blatant advertising here.
>
>Ardway
>
>ed121@mindspring.com wrote:
| |
|
| ed121@mindspring.com wrote:
>The quality of the Costco licensed dispensers varys from excellent to
>barely usable.
As does the quality of audiologists.
--
I've had a perfectly wonderful evening. But this wasn't it.
....Groucho Marx
| |
|
| Ike <binarydotike@gmail.com> wrote:
>My position is that the hardware isn't nearly as important as the
>service. I tried Costco once, and was terribly disappointed. I shouldn't
>generalize based on one experience, but others voiced the same opinion
>at ALDA - price is low but service is second class.
I've been to several audies. In practical terms, the dispenser at my
local Costco is every bit as capable as any of them. YMMV, of course.
--
I've had a perfectly wonderful evening. But this wasn't it.
....Groucho Marx
| |
|
| I also value the services that a good audiologists can provide.
That said I wouldn't buy an instrument I couldn't program. I have a
HiPro, cable and software for several instruments and find it
indispensible.
I don't have America Hears products but I am very impressed with the
reaction of dozens of users who have posted about their experience with
them. I did look into them. They use licensed audiologists together
with technicians, who are all located at the factory and who are linked
to the customer (and his programmer) through the Internet. The software
that links them was contributed to by some MIT people who wanted to
help the effort. It's not an unsophisticated process.
In their process, your local audiologist generally does what you would
expect including tests and impressions.
Abstracts of discussions at Phonak university meetings have mentioned
that similar "remote programming" processes are being explored. For
many, there would be a lot of time and traveling saved by methods of
this kind and multiple very short "visits" would also also be made
practical. Reportedly, some AH customers end up not self-programming at
all. Remote programming seems to have real potential.
Like most things I think a mix of options to choose from (conventional
and otherwise) is a good idea.
Look for some introductions from major suppliers along these lines
before too long. For example, the availability of factory experts
backstopping your fitter by remote participation would be good
insurance and (I think) would appeal to many.
|
| |
|
|