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Study explores benefits of a battery club to a private practice and its patients

Williams, Victoria A.; Danhauer, Jeffrey L.; Johnson, Carole E.

doi: 10.1097/01.HJ.0000327758.94344.10

Apart from offering a valued added service to patients and increasing a practice 's revenues from battery sales, the authors say that having a battery club also brings a practice the intangible benefits of increasing patient contacts.

Victoria A. Williams, BS, is a PhD/AuD student at the University of South Florida. Jeffrey L. Danhauer, PhD, an audiologist, is a Professor and Chair of the Department of Speech and Hearing Sciences, University of California Santa Barbara, and owner of Hearing Consultants of California, the private practice used in this study. Carole E. Johnson, PhD, AuD, is a Professor in the Department of Communication Disorders, Auburn University. Readers may contact Dr. Danhauer at or at Department of Speech and Hearing Sciences, University of California Santa Barbara; 1476 N. Fairview Ave., Goleta, CA 93117.

Patients need information about batteries and easy access to them from the day they purchase hearing aids throughout the life of the instruments. For example, hearing aid wearers need to know that removing the tab from a zinc-air battery initiates battery drain that cannot be stopped, that batteries should be stored in a cool, dry environment, and that a battery's life expectancy is 3 years or longer.

Battery clubs are a popular way for practices to help satisfy patients by reducing the costs of batteries while increasing convenience and providing them with information. Battery clubs are also seen as a way to build customer loyalty and stimulate extra business by encouraging patients to return for follow-up visits and services, including hearing aid cleaning and adjustment and the purchase of new instruments.

Recently, an evidence-based study concluded that hearing aids improve adults' health-related quality of life.1 However, even successful users often require appropriate and repeated counseling on the care and use of their hearing aids and batteries. MarkeTrak statistics have shown that hearing healthcare professionals dispense nearly 93% of all hearing instruments, yet they sell only about 49% of the batteries that hearing aid wearers buy.2 This represents a missed opportunity for improving patient care and increasing business.2

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The purpose of the study reported here was to determine if the combination of a private practice's marketing efforts (including a patient questionnaire) and a battery club directed to its existing database of hearing aid users could stimulate additional demand for products and services.

Hearing Consultants of California (HCC), the private practice in this study, has been a family-owned and operated audiology business for more than 25 years, and has offices in Santa Barbara and Lompoc. HCC started a battery club more than 15 years ago through which patients purchased 10 eight-packs of batteries in person or by mail. Although the club was originally successful, increased postage rates and mail problems after 9/11 made it more difficult to run and less profitable. Gross battery sales were only about $250 a month during the 2 years before the present marketing effort began.

HCC theorized that reminding patients about the club and its benefits (including an extra pack of batteries, cleaning, electroacoustic analysis of the hearing aids, and a hearing screening) could stimulate battery sales and other services. The practice developed a 19-item, one-page questionnaire to assess hearing aid users' opinions and knowledge of their current hearing aids and batteries and their satisfaction with them (see Appendix A).

The initial mailing went to a list of 1264 households with hearing aid users that was derived from HCC's database. It included a cover letter explaining the battery club, the questionnaire and instructions on filling it out, an order form, and a return envelope. A second battery club reminder and order form was sent to 1243 households about a year later and included a cover letter with the patient's address on the reverse side and an order form stapled around a return envelope.

These marketing efforts were conducted from June to August 2006 and May to July 2007. HCC recorded the demographics of new battery club members, battery sizes, and dates of purchase so that members could be reminded when it was time to re-order batteries. Participants were offered a chance to win lanterns donated by Rayovac, and those who purchased battery club memberships and/or returned the questionnaire received a chance to win a free battery club membership they could use themselves or give to someone one else.

HCC purchased all supplies, including batteries, envelopes, labels, stamps, and printer paper and cartridges. Volunteers contributed about 168 hours to preparing the two mailings.

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The initial mailing produced a 9.8% response rate for the questionnaires (273 were undelivered and 97 of the responses were usable). A summary of responses to each item appears in Appendix A.

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Patients' knowledge and use of hearing aids

The first seven items on the questionnaire provided information about the respondents' knowledge and use of their hearing aids. Unfortunately, question #1 (adopted from Solodar and colleagues3) was unusable because it failed to specify whether participants were to rate their hearing abilities with or without their hearing aids. The majority (78%) wore two hearing aids, and most (88%) were evenly split between behind-the-ear (BTE) and in-the-ear (ITE) devices.

Over 90% of respondents had worn hearing aids for more than a year. Many of the instruments were over 2 years old, which alerted HCC that it was time to inform those patients of new hearing solutions that might be appropriate for them. About 95% used their hearing aids regularly, 90% used digital circuitry, and 82% were either very or moderately satisfied with their hearing aids. The eight negative ratings reinforced the need to improve services for all patients.

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Knowledge and use of batteries

Items 8 to 19 focused on what participants knew about and how they used hearing aid batteries. Most used size 13 (39%), 312 (28%), or 10 (23%). Two did not know their battery sizes and failed to respond, which suggested that they needed additional training.

About 55% already purchased their batteries from HCC. The rest went to drug stores, Costco, or military bases, which showed there was a potential market for HCC to try to reach. About 43% paid more than $8.50 for an eight-pack of batteries, which is the price that HCC charges, even before Battery Club discounts.

Binaural users should use about one eight-pack a month or 12 a year. However, about 15% of respondents reported using more than 20 packs a year, which suggested that their hearing aids were malfunctioning or they were using them improperly and needed counseling. Outreach also seemed indicated for the 19% who said their batteries lasted more than 2 weeks, because batteries are unlikely to last that long if the hearing aids are actually being used.

Although about 83% of patients knew that batteries could be stored for 1 to 3 years or longer, about one in six incorrectly believed they could only be stored for less than a year, which might explain why some respondents did not wish to purchase batteries in bulk or through battery clubs.

The questionnaire showed that some patients (especially older persons living alone) preferred to purchase their batteries one pack at a time in person from the office perhaps for social contact. About 70% had never bought batteries in bulk or through battery clubs, 85% were satisfied with the way they currently bought batteries, and 12% said they sometimes ran out of batteries without spares, all suggesting that many of these patients could benefit from joining a battery club.

Although more than 90% of respondents reported no difficulty replacing their hearing aid batteries, the rest said they had problems at least sometimes or failed to answer, which suggested a need for further instruction on the subject. When asked how hearing aids could be improved, 92% said they could last longer or cost less. That helps explain why 67% said they would like to save money by buying batteries in bulk.

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Good for the patient and the practice

Enabling patients to purchase hearing aid batteries directly from their own trusted hearing healthcare professionals is a valuable added service because it saves them the time and trouble of making trips to other battery retailers. It also should ensure that the batteries they buy are fresh, as they come from a source that re-stocks frequently.4 Offering batteries also stimulates sales for the practice.2

Figure 1 shows HCC's gross battery sales before, during, and after this marketing effort. The first mailing resulted in 42 new battery club memberships, but once the offer ended sales quickly returned to their previous level. When the offer was re-introduced via the second mailing, sales again increased, reconfirming that participants like to save money on batteries. This is clear evidence that marketing the battery club worked.

Figure 1

Figure 1

Although it is impossible to determine how many additional hearing aid sales, repairs, and related services resulted from this program, HCC's staff reported re-establishing contact with several patients whom they had not seen in years.

The fact that about 82% of these respondents were satisfied with their current hearing aids suggests that they might help generate new referrals to HCC. Those who were less satisfied should be contacted for a consultation to address their concerns and a possible demonstration of new hearing aid technology.

The cost effectiveness of any marketing effort must be considered. In this case, tangible costs (i.e., postage, staff time, supplies, and batteries) would have been about $6276 if the volunteers had been paid $10 an hour. Net profit from increased battery club sales alone was $769; without the staff time included, it was about $2450.

Each practice must determine for itself whether the potential profits from less tangible items like new hearing aid sales and repairs generated from such efforts outweigh the costs. Certainly, there are other less expensive ways to conduct these efforts, and creative practices should be able to cut costs substantially, for example, by not using questionnaires or by including battery club information with newsletters or announcements about new services and products. Also, an office can stagger monthly mailings by targeting only a few last names based on letters of the alphabet, which would make it manageable for current staff to do as part of their ongoing duties during office down time and would even out the workload and level sales throughout the year.

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This marketing effort helped HCC clean up its database by updating mailing information and removing incorrect addresses and patients who had moved or died. That will cut the cost of contacting these patients in the future. Based on the cost of marketing this program, one can calculate how many battery club memberships must be sold to make it profitable. Again, this does not factor in the less tangible benefits resulting from such efforts or that costs can be cut considerably as mentioned above.

When patients purchase hearing aid batteries from outside sources, they represent lost opportunities for providers to make sales and increase contacts with their patients. Battery club members are less likely to run out of batteries and search for refills at retail outlets and other competitors.5 Thus, battery clubs are a proven business-builder, providing a means for constantly maintaining contact with a practice's best patients. Although practices that use battery clubs sell 20% more batteries than those that do not,2 only 62% of all dispensers—57% of hearing instrument specialists and 69% of audiologists—make battery clubs part of their overall marketing strategy.5

Clearly, if one is simply interested in surveying patients, sending a questionnaire to everyone in a practice's database is a waste of resources since more efficient sampling techniques are available. However, the equation is different when a practice wants to conduct a marketing effort to increase sales to all potential buyers. As this study shows, using both a questionnaire and a battery club as part of a marketing effort allowed HCC to stimulate battery sales and other services, educate patients about hearing aids and batteries, and help the practice focus on areas where patients needed more counseling.

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The authors acknowledge Rayovac, Inc., for providing the runner-up prizes for this study. Special appreciation is expressed to Kimberly J. Danhauer and Jeffrey Tatum (Tate) Danhauer from Hearing Consultants of California for their assistance with questionnaire design and administration, data analysis, and use of the data management system.

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1. Chisolm T, Johnson C, Danhauer J, et al.: A systematic review of health-related quality of life and hearing aids: Final report of the American Academy of Audiology Task Force on the Health-Related Quality of Life Benefits of Amplification in Adults. JAAA 2007; 18(2):151–183.
2. Strasser J, Begley T: Are your hearing “batteries not included”? Hear Rev 2002;9(2):32–33.
3. Solodar H, Williams K, Byrne D, et al.: Correlation between self-perception and hearing aid outcome. Poster presented at Audiology NOW! 2006, Minneapolis.
4. Campbell-Angah D: Audiologists must navigate a sea of complex dynamics to establish relationships and rapport with patients. Advance Audiol 2006;8(6):32–33.
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Appendix A. Tabulation of respondents' answers to the questionnaire.



5. Strom K: The HR 2000 dispenser survey. Hear Rev 2001;8(6):20–24.
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