selling hearing aids....

[abrens02]

I am looking into audiology as a possible career change (I work as a sign language interpreter currently). It wasn't until I started working in the schools with deaf kids who sign but also use a variety of hearing devices that I really became interested in audiology. It was so awesome to see the benefit the kids got from their ci's/hearing aids, and I wanted to learn so much more.

There are so many things about the profession that I think would love (CI's, vestibular work, working in a medical field) but am looking for some honest feedback about one aspect of the job that I really have a hangup about. I've done a couple observations and had discussions with the audiologists I observed, and something that really bothered me was the crazy high cost of a set of hearing aids. One audiologist told me that it only costs in the hundreds of dollars to actually make them, but the costs get inflated as you buy from the manufacturer and then in turn have to sell for a profit. She explained that the patient wasn't just paying for the aids but also for your services to program, fit, clean, repair, etc. That just seems crazy to ask someone to fork over thousands of dollars for a device that costs as much as an iPad (not telling them that), and feel okay with it because they will get your services. What if they move? What if they decide they don't like you as a provider and switch to a different office? Wouldn't it be more fair to the patient to lower the cost and then charge for these services as needed? I guess I just don't know if it's ethical to be a medical professional while also trying to sell something for a profit. Kind of like how no one trusts car salespeople- they're not just in it to help you, they ultimately want you to buy something so they can make money.

I also was put off by the audiologists' attitude towards their patients who either haven't bought a second aid for a binaural set, or have an older aid and aren't upgrading. It was like " well so and so hasn't gotten a second hearing aid no matter how many times I tell him" or "Mrs. Blah blah really needs a better hearing aid but she just won't upgrade". Do audiologists think people are made of money? Don't they realize the kind of investment it is to some people to drop 5k? I guess I'm torn between being really fascinated and interested in the field of audiology, but totally turned off by the idea of selling hearing aids.

How terrible do I sound? I really don't want to insult anyone's choice or profession. I mean, ultimately my dream job would be a hospital gig working with cochlear implant patients, but am I going to have to grin and bear the whole "hearing aid salesperson" thing during grad school clinicals, or as a recent grad trying to get some experience? Anything you guys have to say would be helpful. Thanks.

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[jblil]

Not sure if you saw this thread, but think long and hard before you jump in:
http://forums.studentdoctor.net/threads/this-is-my-story-cautionary-tale.1008835/

 

[TheEarDoc]

I am looking into audiology as a possible career change (I work as a sign language interpreter currently). It wasn't until I started working in the schools with deaf kids who sign but also use a variety of hearing devices that I really became interested in audiology. It was so awesome to see the benefit the kids got from their ci's/hearing aids, and I wanted to learn so much more.

There are so many things about the profession that I think would love (CI's, vestibular work, working in a medical field) but am looking for some honest feedback about one aspect of the job that I really have a hangup about. I've done a couple observations and had discussions with the audiologists I observed, and something that really bothered me was the crazy high cost of a set of hearing aids. One audiologist told me that it only costs in the hundreds of dollars to actually make them, but the costs get inflated as you buy from the manufacturer and then in turn have to sell for a profit. She explained that the patient wasn't just paying for the aids but also for your services to program, fit, clean, repair, etc. That just seems crazy to ask someone to fork over thousands of dollars for a device that costs as much as an iPad (not telling them that), and feel okay with it because they will get your services. What if they move? What if they decide they don't like you as a provider and switch to a different office? Wouldn't it be more fair to the patient to lower the cost and then charge for these services as needed? I guess I just don't know if it's ethical to be a medical professional while also trying to sell something for a profit. Kind of like how no one trusts car salespeople- they're not just in it to help you, they ultimately want you to buy something so they can make money.

I also was put off by the audiologists' attitude towards their patients who either haven't bought a second aid for a binaural set, or have an older aid and aren't upgrading. It was like " well so and so hasn't gotten a second hearing aid no matter how many times I tell him" or "Mrs. Blah blah really needs a better hearing aid but she just won't upgrade". Do audiologists think people are made of money? Don't they realize the kind of investment it is to some people to drop 5k? I guess I'm torn between being really fascinated and interested in the field of audiology, but totally turned off by the idea of selling hearing aids.

How terrible do I sound? I really don't want to insult anyone's choice or profession. I mean, ultimately my dream job would be a hospital gig working with cochlear implant patients, but am I going to have to grin and bear the whole "hearing aid salesperson" thing during grad school clinicals, or as a recent grad trying to get some experience? Anything you guys have to say would be helpful. Thanks.

Well the products actually cost usually close to $1,000 for a set from the manufacturer and that's only if you are a high volume seller which most folks aren't. When I worked private practice and I sold high end hearing aids they cost me around $2100 for the set. I sold them for around $5800, but all follow-ups were included for 3 years as well as batteries. So basically they got the hearing aid and my services on demand for the life of their hearing aid. As I told my patients you are paying more for my services than just the device. I always had a hearing aid fee and a dispensing fee so patients knew what the hearing instruments cost and what my services cost. I was always very transparent about it.

Hearing aids cost that much because of the R&D behind them. The hearing aids you see in the offices today started out as a backpack hearing aid about 5-10 years ago and it costs a lot of money to bring something through FDA level 2 trials (not as much as a drug does, but still it isn't cheap!).

If the patient switches to a different provider then they pay out of pocket. If you buy a car with lifetime free service and you move do you expect the new dealership to honor the old dealership's deal? No you wouldn't. Why do you think any audiologist would be any different? Selling hearing instruments is no different than selling any other durable medical equipment. The issue people have is they don't realize what DME costs because their insurance usually picks up most of the cost, but hey feel free to go buy a back brace, CPAP machine, etc. out of pocket and see how much it runs you when it costs pennies to manufacture and hearing aids have much more sophisticated parts and electronics.

Many audiologists get upset when patients don't buy two hearing aids because we are set up to hear with 2 ears. The research has proved this time and time and time again. So we see patients who want to buy a mid level monaural product for the same price they could get binaural economy digital hearing aids (that would do them much more benefit with their daily communication needs). Then the same patient comes in multiple times to our office with the same complaints of "I can't hear well in background noise, I can't hear out of my unaided ear and it feels plugged up or unnatural, etc." when they went against our medical advice. Try going to your doctor and being put on blood pressure meds or diabetes meds and then take half the dosage and then go in every single week and complain how your BP or glucose levels aren't controlled and how horrible you feel and how the medication is junk and doesn't work and see how long before that doctor shows you to the door and says find another doctor. I know many audiologists who decide to not to bill for multiple things and constantly try to find the best deal or best hearing aids for the money they can for their patients. I sent patients to BVR all the time or the lions club or other organizations when they needed help. I constantly tried to help them afford what they needed. I know people aren't made of money, but at the same time I'm not going to give away my services for free or deal with someone complaining about issues they are having just because they refused to listen to my advice the first time. That's where the "attitude" comes from.

There are plenty of audiology areas where you do not have to sell hearing aids. It's part of why I joined the VA system. I can just fit what is appropriate and do my counseling and help people. Cochlear implants are the same way since insurance usually pays for them.

And yes while in grad school you will be helping to sell hearing aids and expected to do so. It's just part of the job. And yes as a hospital audiologists unless you work with just cochlear implants (highly unlikely) then you will be selling hearing aids. The VA is about the only place where you can work as an audiologist and not have to sell anything.