Why do hearing specialist make more money on average than AuD?

Discussion in 'Audiology [ Au.D ]' started by hillscor, Mar 15, 2012.

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  1. hillscor


    Mar 15, 2012
    I have been accepted into an Audiology program for the Fall 2012. However, I have been offered a paid apprenticeship with a hearing healthcare practice to become a licensed Hearing Specialist. In doing my research, I discovered that Hearing Specialists earn more on average, in many cases, much more that AuD's. How do I justify another 4 years in school when I could be practicing the same hearing healthcare within a few months, successfully helping patients resolve the same problems, and making more money?
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  3. BabyBleusMommy

    BabyBleusMommy 2+ Year Member

    Aug 12, 2007
    From what I know (and have experienced) hearing aid dispensers are all about the retail aspect of hearing healthcare... you can only test people with the intent to sell hearing aids, which to me would be very depressing. I enjoy being able to help people at my externship... this even includes people that aren't ready for a hearing aid.

    I know that not all dispensers are the same, but I have seen a handful of my elderly patients this year get taken advantage of by dispensers.

    As far as dispensers making more money, that may be true overall but if you are a great audiologist and willing to relocate to the right job I think you can make just as much money!
  4. EitherWise


    Sep 19, 2011
    Babybleus definitely hit on some of the key points - dispensers operate on the premise to sell hearing aids. This is not necessarily bad or a wrong thing but it can of course be taken in a direction that is not looking out for the patient. But I think it is unfair to assume, and then whose fault is it when the assumption becomes a self-fulfilling prophesy.

    The last time I tried to address a similar question I came off sounding pedantic so I do not want that to happen again. I will begin with addressing the salary disparity between a dispenser and an audiologist. Take this with a grain of salt because I am a recently graduated audiologist and do not have a comprehensive view of the field of hearing healthcare. I spent 90% of my program in university and hospital clinics, with 1 clinical rotation in a private practice. I have recently gone the route of pursuing private practice and with that have come face-to-face with the idea of dispensers. I have found myself bouncing back and forth between seeing them as colleagues or workmate and as competition.

    As mentioned before already, dispensers draw their income from the retail aspect of hearing aids. One of the biggest distinctions I found when you look up what is in the scope of practice for a dispensers/hearing instrument specialist (HIS)/audioprosthologist is that their testing is limited to "determining if a patient can be helped by hearing aids". The testing they perform is not diagnostic in nature like an audiologist. However, this distinction is not particularly revenue generating – just look at reimbursement rates for any of the diagnostic testing we do. The revenue generated from an hour of testing is nowhere near the amount of revenue that is made in selling a pair of hearing aids in that same hour.

    So you may be asking yourself why would I want to go into something that takes more work and time preparing but may not see a significant return on investment? That answer is going to be personal to you and I cannot answer that. I did not consider becoming a dispenser because I pretty much jumped straight into becoming an audiologist before doing my research like you are. But I don't regret it because with the Au.D. comes a lot more flexibility and control over my future. I am not knocking dispensers because they can serve the right population very well. They can work with audiologists in the field of hearing healthcare, by taking care of patients that do not need the clinical expertise and counseling that comes with the Au.D. If you want to work with the pediatric population you will need to get an Au.D.

    Coming out of my Au.D. program, it was implied that if you are just looking to make money then you are in it for the wrong reasons. But this view is very naïve because money doesn't just grow on trees and patients don't just pay you because you have the title of doctor. It is pretty basic that one should be compensated according to the type and level of work but I don't feel like this is happening. There are a lot of people that can be blamed but at the end of the day it is up to us audiologists to speak up and fight for what is rightfully ours. Sadly, most audiologists end up getting caught up in the bureaucracy of hospitals and universities.
  5. DrumHead

    DrumHead 10 Sir Tim Penny 10+ Year Member

    Mar 28, 2001
    WA, USA
    This is a great question and it can be addressed with the following two points:
    1. Scope of practice
    2. Opportunity

    HIS dispense hearing aids almost absolutely. Audiologists can dispense, but they also do MANY other things. It's like asking why the pastry chef makes more desserts than an executive chef. The pastry chef is great at making desserts, but the executive chef can do that and more.

    Don't get me wrong, hearing instrument specialists can be very knowledgeable and can serve their patients well, but dispensing hearing aids are their focus, and selling hearing aids is where the majority of the revenue is earned in hearing healthcare, whether you're an HIS or an AuD.

    An audiologist, on the other hand, can work in many other important positions that pay less or involve no sales or commission-based payment structure such as in public school, industrial audiology, ENT offices doing just diagnostics, manufacturing as customer support, balance testing, electro-physiology testing, an many other choices that do not generate as much revenue as pure dispensing.

    As an audiologist, you will always have plenty of opportunity to move in different directions professionally without having to go back to school. HIS will basically be relegated to doing one function: dispensing hearing aids.

    It is up to you to decide what you want to do and how much control you want over your career. If it's just about making money, then maybe the HIS is best for you. If you want to be able to help your patients using a wider variety of solutions AND make money, the AuD may be more inline with what you want.

    I say, take the HIS position and see how you like it. Make your decisions based on your experience and continue to ask questions. But I wouldn't recommend pulling your acceptance until you've had time to scope it out a little more.

    Hope that helps!
  6. DrAudio


    Aug 27, 2010
    Bay Area, CA
    OP, become a HIS and work for a year or 6 months or whatever. If you like the field, get your degree. If you don't - move on. Best suggestion anyone can make to you. I wish someone would have given me that advice a decade ago when I started my Au.D. - I would have changed directions.

    That's not to say that audiology can't be awesome, it just doesn't agree with my personality. But if I met a woman named Hearing Science Research I'd marry her even if she didn't drink whiskey. :love:

  7. hillscor


    Mar 15, 2012
    Thank you all for the input. Alot to consider. I don't want to make a costly mistake. The AuD will undoubtably provide more opportunities to work and help more hearing impaired people than the typical adult senior citizen presbycusis related patients. However, I cannot deny that I am having trouble justifying the opportunity cost, time investment, tuition cost, and living expense of 4 more years of school. At the end of the day, won't the majority of my practice really be devoted to aural rehabilitation through prescriptive hearing aids? After all, this aging population of prospective patients are mainly just seeking to hear better......I don't know if being up front with them that I am in the business of selling hearing aids to correct their problem isn't more transparent. I don't think that good patient care and making a fair living are mutually exclusive. Whew......this is not going to be an easy decision.
  8. quiteaud

    quiteaud 2+ Year Member

    Aug 31, 2011
    I'm glad I'm doing the Au.D. because I have an interest in vestib and CI, but if all I wanted to do was fit hearing aids, I would totally become a hearing instrument specialist. I really can't justify going through the Au.D. to do hearing aids alone.

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