To procure hearing aids you have a choice of different types of providers available to you. There are big corporate type providers such as Spec Savers Audiology, Hearing Savers, Australian Hearing, National Hearing, Hearing Life & Audio Clinic in Australia. There are also independent providers who may be large multi-branched outlets or smaller Australian family owned practices like us; Harmony Hearing & Audiology. Let’s talk about them in this article.
Can offer good service including aftercare, although operate a bit like a production line. I worked for a large corporate company which has over 100 branches across Australia for several years. I have to say they were very good in terms of staff training and commitment to client care. However, we worked within the constraints that were set and our business was sales. Clinician performance was largely measured and rewarded based on numbers of monthly units of hearing aid sales.
Most corporate providers in Australia are owned by hearing aid manufacturers. This means they will sell you hearing aids from that manufacturer. For instance AudioClinc and Western Hearing Services are owned by the Oticon Brand (William & Demant in Denmark). This type of vertical integration is increasing within the industry with more and more manufacturers buying retail outlets so as to secure their supply chain. Corporate providers are built on this system where there is always some pressure on staff to sell one product line which is understandably how they survive.
This limits your choice as you are simply getting one brand. It doesn’t necessarily mean the brand or device you are prescribed won’t be suitable, it just means there is no real choice on offer. You are unlikely to be educated on the options from a range of leading manufacturers. I believe it’s best to make an educated decision on information derived from the least biased sources possible.
It would be fair to make clear a provider arrangement up front. In fact within the last year the Office of Hearing Services (OHS) that coordinates the Commonwealth Hearing Services Program passed legislature that made it mandatory to disclose to Voucher holders the preferred provider relationship. However, there is no regulation that this is disclosed to self funding clients.
In summary whilst the corporates try to ensure quality service and experience is on offer across their chains, it is sometimes not the case.
Rise of the Independents
Independent providers are Independent of any hearing aid manufacturer or corporate entity. They are usually smaller family run businesses and some may have several branches. They may also offer visiting sites for their services which can be located at health partners such as Medical centres or leasable offices.
Independents typically have access to all the hearing aid brands, however to be proficient they tend to focus on three to four leading brands. There may be a number of reasons they have a preference for several brands. This can include the commercial perspective of price, but also clinical considerations such as specialisation and positive client outcomes.
In running my own independent practice, I have chosen to mainly provide Oticon, Phonak, Signia (previously Siemens) and GN Resound as my primary suppliers. This is because they are able to supply me with everything I need to meet the needs of my clients. For example Phonak is renowned as a leader in power hearing aids and wireless accessories and I would always consider Phonak for my power user needs.
I would consider GN Resounds new Linx Quattro for musicians wanting excellent dynamic range for music enjoyment and preservation.
For socially active individuals that are often in dynamic and unpredictable communication environments, I would recommend the Oticon Opn with its Open Sound Navigator Lx platform that preserves the speech streams coming from multiple directions and attenuates background noise between speech sounds. This enables the user to easily switch attention when desired and reduces listening effort. If you are an Apple iPhone user this is an excellent choice as it also enables high definition Audio streaming through a 3.4GHz radio signal. Oticon Opn ‘twin link’ uses a separate broadband Bluetooth signal enabling outstanding binaural processing of sound between the instruments in real time. The hearing aids therefore operate as a wireless pair synchronising many of their modes of operation including the coordination of multi-band adaptive directional microphones.
For an android phone user, I would recommend the new Phonak Marvel for its quality audio streaming ability to any phone (whether Android or Apple iOS). Also for its improved natural sound quality for first time hearing aid users. I understand the science that there’s a necessity for narrow microphone directionality or “beamforming microphone” directionality when background noise escalates high enough to reduce bothersome background sound and enable the listener to hear the speaker they are facing. This is a terrific automated or manual option Phonak call Stereo Zoom that can help you comfortably follow conversation of people opposite you even in high noise environments. In its premium model the Marvel M90 or Belong B90 models it automatically activates as the “Speech in Loud Noise” Auto Sense mode only when it detects poor Signal (Speech) to Noise (Background noise) ratio’s that this listener would experience discomfort and listening difficulty. You can read the whitepaper about Phonak’s Stereo Zoom at the following link: https://www.phonakpro.com/content/dam/phonakpro/gc_hq/en/resources/evidence/field_studies/documents/fsn_phonak_stereozoom_adaptive_behaviour.pdf
For clients wanting completely invisible hearing aids (IIC), I would consider the Signia Silk for it’s comfortable instant fitting ability with its various sizes of interchangeable/disposable “click” sleeves and domes. It also has Signia’s latest chip platform offering great performance in noise and the ability to be adjusted using it Touch Control smart phone App. This uses ultra high frequency sound rather than Bluetooth to make the adjustments so it’s compatible with both android and iOS smart phones.
For the most discrete deep canal fitting custom hearing aids, you can’t go past the Starkey Sound Lens. Starkey was one of the first companies to specialise in making tiny invisible hearing aids (IIC) and they have it down to a fine art.
Also, the new Phonak Virto B titanium is a great option for durable, discrete and completely in the canal (CIC) hearing aids. Ear canal anatomy permitting they can also be made as an IIC as they claim, however I still don’t think they can make them quiet as small as Starkey and when I have ordered them for clients they invariably are delivered more as an IIC/CIC hybrid with an accompanying argument that ear canal anatomy didn’t permit a deeper fit. As with Phonak’s Receiver in the canal (RIC) hearing aids the CIC’s and IIC’s also possess the Auto Sense modes which automatically acoustically optimises the performance for the listening environment.
What Does it Matter To You?
Being totally independent empowers the Audiologist or Clinician with the freedom to make the best decisions for You. We take into consideration the merits (Pro’s and Con’s) of all the latest hearing aids from a range of leading manufacturers. We strive to match the best hearing aids available to your unique ears, hearing levels, lifestyle communication needs and budget.
Facilitating the Phase of Adaptation
You need to consider that hearing aids take longer to get used to the glasses. The Auditory system takes longer to adapt. It stems from our evolution that our sense of hearing has evolved to protect us from predators by stimulating the fight or flight response when we hear an unusual sound. Any novel or renewed auditory signals (especially environmental) can be perceived as threatening, really grab our attention and can trigger a significant emotional reaction. Even household sounds like fridge motors running, doors creaking or your own clothing rustling will at first seem very stark and attention grabbing. Over time your brain will habituate and de-tune its sensitivity to these sounds putting them back into subliminal hearing. We always afford time in our appointments to counsel our clients through the requirement to persevere through this challenging phase in the quest for better hearing.
There is a real phase of adaptation or acclimatisation as we call it. You may have been suffering from hearing loss for seven years or more before taking action. We don’t usually give the full prescription of amplification to start, especially for new users. We tend to increment up the amplification up over a series of months as you acclimatise monitoring your loudness discomfort levels.
Personal Care to Facilitate the Phase of Adaptation
As an independent provider we can provide more readily available support to facilitate this essential phase. Additional appointments both in person and remotely are scheduled into our care plan to facilitate the increase in amplification up to full prescription as you adapt.
The time frame for adaptation can vary significantly between unique individuals so we prefer to monitor this on a case by case basis. Corporations with their conveyor belt style approach to hearing aid fitting are more likely to set the Automated Adaptation manager within the hearing aid to increment up after a set time frame whether the user is ready or not. This takes the personalisation and human support element out of the process.
Avoid the “Fit & Go” Online Corporate Store
Some providers claim to be a “one stop shop” and advocate a “Fit n Go” style service (more like fit and forget about you!) They really don’t have your optimum best long term benefits at heart and are simply just after the quick easy sale. If you are after the cheapest quick fix, then perhaps more of an online hearing aid store is the type of company for you. Invariably such purchases produce less than optimum and temporary results.
The Intimate Family Practice Difference
As a more intimate family practice we are about building lifelong relationships with our clients and their significant others. We build into our care plans a series of progressive appointments to facilitate this adaptation process. This enables more accurate monitoring of client progress, device usage and affords extra training and troubleshooting opportunities to ensure the clients confidently obtain ongoing benefits and that their instruments remain on their ears rather than in their drawers.
As a progressive company, Harmony Hearing & Audiology is on the cutting edge of technology and methods of providing health. This includes the use of “Remote Care”. This is a form of eHealth where we provide a virtual appointment with the Audiologist who can remotely program and fine tune your hearing aids. This takes place with the Audiologist during a live video chat in real time in your communication environments. This has numerous benefits including truly optimising the hearing aids to your environments. Greatly improving accessibility and convenience which also saves time and money. We offer a combination of In Person& Remote Careservices to provide the best of both worlds. This is described on our home page at: http://126.96.36.199
A global hearing health care authority Geoffrey Cooling describes in his excellent The LittleBook of Hearing Aids“Sound is a personal sense” and “generally most people will need some fine tuning around their prescription to be happy with the sound of their hearing aids.” He describes how “we start investigating the settings for different situations and discuss how you are getting on generally. This doesn’t just happen in the first week or month, this takes time and effort both on your part and the part of the professional who is helping you.” He also describes the fact that “Independent professionals are usually local business people who rely on the word of mouth of their customers to succeed in business. The fact that if they don’t treat people right, they won’t eat, is a pretty big incentive. However, more often than not, they are genuinely caring and committed to offering the best service.”
I couldn’t have said it better myself.
You can acquire a copy of Geoff’s great book The Little Book of Hearing Aidsfrom his “Hearing Aid Know” website or on Amazon see:https://www.hearingaidknow.com/updated-little-book-of-hearing-aids-for-2018
It’s a fun read that to help make an informed choice when investing in hearing aids.
For more information or to make an appointment Free Call 1800 02 04 06
Or email: [email protected]
Andrew Mackendrick (Audiologist)
Harmony Hearing & Audiology