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The hearing aid delivery system: Does it provide good value?

Van Vliet, Dennis

doi: 10.1097/01.HJ.0000292590.67818.d7
Final Word

Dennis Van Vliet, MA, FAAA, is Division Manager, HEARx West, LLC. Correspondence to him at 17021 Yorba Linda Blvd., Yorba Linda, CA 92887; e-mail

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We were recently at a social event attended by a number of people with diverse backgrounds and resources. They work in many different environments, including sales, engineering, banking, business, and healthcare. They have their own individual tastes, but most of them appreciate and have opinions about wine.

What generated the most discussion? Not the highly rated $15 to $25 bottles of wine, but the $1.99 Cabernet from Trader Joe's Markets, an offbeat and popular retailer. It was not that the $1.99 wine was better than other choices, but it was quite acceptable and represented a very good value. Trader Joe's has reportedly sold a million cases of the wine, and demand is still high!

My lesson for the evening was that people, even people who can easily afford more, appreciate a good value, and get really excited about it. It wouldn't have worked if the wine hadn't been good enough to pass muster, but it was pretty good. As a result, the drinkers commented about it, discussed it at length, and went out to buy a case or two for themselves.

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A lesson learned is more valuable if we can generalize the principles to other areas. As I often do, I started thinking about hearing aids, and consumer behavior toward them. A delivery system for hearing aids has evolved that we believe offers good service and a range of appropriate technology.

We know that of the people who recognize that they have a hearing problem, only about 20% actually do something about it. It is unrealistic to believe that 100% of the self-recognized hearing-impaired population are true candidates for hearing aids, but certainly more than 20% are. Yet, as an industry, we have been unable to improve on these statistics, despite trying a variety of professional and marketing approaches.

What are the obstacles to reaching more people? While they differ from patient to patient, the most important ones include the stigma, cost, cosmetics, and (in)convenience of hearing aids. The perceived cost-to-value ratio is often a primary objection. We know that many hearing-impaired persons are able—and willing—to pay well for hearing aids, if they perceive the final result as a good value. Value does not necessarily equate to low price, but price is a piece of the equation. Further, there are real limits on what many people can pay, and our current pricing structure may make it impossible for many of them to participate as consumers.

We believe that the system we have created offers the services and products necessary to provide a partial solution for hearing loss. But many individuals either never participate in our system or opt out after trying. That raises some fundamental questions. Do we stay with the current system, assuming that any change will compromise the quality of what we offer? Or, do we reach out to those who do not perceive what we offer as a good value?

Staying with the status quo suggests that we are satisfied with the fact that our delivery system fails more individuals than it helps. Changing the system means that we may have to offer alternatives that do not live up to the standards that we have come to believe are necessary. This dilemma is nothing new to the industry, and alternative options in the form of disposable hearing aids, mail-order products, and assistive devices are offered. However, thus far, they do not seem to be satisfying very much of the unmet need.

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Alternative models to the current system may be difficult to implement for several reasons:

  • We believe that medical pathology needs to be ruled out for every hearing aid candidate. That typically requires a professional visit and some assessment. The professional visit may be seen as too costly or inconvenient, presenting an obstacle. Are we ready to compromise on the professional component?
  • We believe that a device with the minimum specifications necessary for acceptable performance cannot be sold for less than several hundred dollars. However, Songbird has proven that a hearing aid with good sound quality can be mass-produced to retail for far less. Are we ready to integrate a non-disposable product with similar electroacoustic characteristics that represents a good value into a service delivery model?
  • Change is difficult. We may believe that compromising on the current delivery model will create an unpleasant experience for the hearing aid candidate. Are we ready to look in the mirror and accept that what we believe in may not be the best solution for all patients, and that it is our responsibility to reach out with alternative solutions to broaden the impact of our service to the hearing-impaired community?

The final word? We offer good products and services, and we work hard to provide a positive experience for our clientele. Unfortunately, we are failing to reach a great many people who are in need. It is our responsibility to create alternatives that will be acceptable to more individuals.

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