Dale Johnson: The conversation starts here on KFOR FM 103.3 1240 AM, Dr. Sandra Miller is here from Complete Hearing. And the reason I have a smile on my face is because just before we sat down to start the show, we went on to Amazon. Can I talk about this?
Dr. Miller: Absolutely.
Dale Johnson: I want to talk about this. I’ve asked Dr. Miller, I said, “Can you buy a hearing device on Amazon?” And she said, “Well I don’t know. Let’s just check.” So we are on Amazon right now and last week if by the way, go back to your-
Dr. Miller: Yes.
Dale Johnson: … Website and listen to last week’s conversation and Dr. Miller talks about the FDA approved hearing devices, which won’t be out until the middle of next year.
Dr. Miller: Right.
Dale Johnson: Fair to say. But yet on the Amazon page that I’m on right now, I see a pair of FDA approved personal sound device aids.
Dr. Miller: Right.
Dale Johnson: Amplifiers.
Dr. Miller: Amplifiers, oh my goodness. Do you as the consumer know the difference between an FDA approved sound amplifier and FDA approved sound hearing aid?
Dale Johnson: No.
Dr. Miller: Absolutely not.
Dale Johnson: I think of them as the same device.
Dr. Miller: The same thing. We do have sound amplifiers, we call them personal sound amplifiers and they’ve been on the market for a long time. You can go buy them on Amazon, over the counter currently and peoples are going to I think be very confused over well what does this other FDA thing that’s coming out with hearing aids, how is this going to be different? And what I would tell you is there’s a big difference between an amplifier and a hearing aid. Currently what’s happening legislatively, we’re getting groups of professionals together to make sure that what does this hearing aid do to be called a hearing aid? What is the frequency response? What is the limiter? How is it going to function? What is it appropriate for?
Dr. Miller: This is very different than an amplifier, but I think out to the general public, if you walked into Walgreens … If you go to online, do you know the difference between an amplifier and a hearing aid?
Dale Johnson: No.
Dr. Miller: Most people don’t.
Dale Johnson: No, I don’t.
Dr. Miller: The hard part is we had to make sure that we stay educated. So I’d love to talk today just about if you’re going to buy something online, Amazon is my favorite place to shop, so I love that we went there. Who can you trust? Who can you trust when you’re online to to purchase something? Because I think we should all ask ourselves that. Right?
Dale Johnson: Well I do not find … And I’m scrolling, I continue to scroll down, there’s just dozens and dozens and I don’t see hearing aid.
Dr. Miller: Yeah.
Dale Johnson: I see amplifier aid on all of them.
Dr. Miller: Right. So amplifier aid, hearing-
Dale Johnson: Just makes things louder.
Dr. Miller: It makes things louder. Yeah, it’s a flat response. It’s very basic, if you think about it’s good for quiet essentially is what I tell my patients. Well, they amplifiers are really good for quiet. They have no computer processing capabilities in them that are sophisticated enough. When you see four channel noise reduction in a hearing aid, that’s … Or excuse me, a hearing amplifier that’s $59.95 you just want to go, Hmm. I don’t know if that’s quite true.
Dale Johnson: I got a chuckle out of that one. Here’s a pair for $35.
Dr. Miller: Oh, even cheaper and I bet it gets 10 stars or something.
Dale Johnson: I bet it arrives broken. I can’t imagine it showing up.
Dr. Miller: Yes.
Dr. Miller: When you get online, what I want you to think about is if you decide you’re going to do something online, you have to educate yourself. Anytime I buy any product online, if I’m going to go try something online, what kind of support and communication am I getting back from that company? Are they responsive to my emails? Do they have on phone number I can call where I can contact somebody? If you have this kind of … Joe is selling hearing aids out of the back of his car or in his garage, you don’t know what you’re getting online. There’s no storefront to tell you where do I need to go. Support is the most important thing when it comes to buying something online. And then if you’re reading some claims, like I just told you in terms of, “Oh, we got 10 stars and we can fit 90% of hearing losses with this amplifier,” really show me the research because that’s probably a very big false claim.
Dr. Miller: If it’s too good to be true, it probably is. Remember you get what you pay for, so even when it comes to this generic amplifier, we’re looking on here on Amazon, do you think the $39.95 one is better? Or the $100 one, right?
Dale Johnson: I’m thinking the $100.
Dr. Miller: Right. The little more you spend … And you already know that as a person, if I spend a little more, it might be better, but remember to educate yourself and if they openly admit, if they’re honest about their claims, what I would say, if you buy something online and there may be a disclaimer that says, this device doesn’t work for everyone. Boy, there’s some honest communication right there. I would more trust that than I would, this is going to work for everyone and anything you do online when it comes to hearing, there has to be some assessment done.
Dr. Miller: Don’t just order something without them knowing nothing about you. The best assessment would be an overall intake form of where do you struggle and then they should ask for your audiogram. That would be the optimum way to go forward with this, if you’re going to do something online.
Dale Johnson: You tell me you can buy hearing devices at Costco.
Dr. Miller: You can buy hearing devices at Costco.
Dale Johnson: Didn’t know that.
Dr. Miller: Yeah, it’s very … I would tell you that Costco, believe it or not, is the largest purchaser of hearing aids in the industry. They can buy a lot of hearing aids and for that reason they can buy in lots of bulk and they can pass that savings on to you, which is a good thing.
Dale Johnson: So it’s a hearing aid and not an amplifier device?
Dr. Miller: It is a hearing aid. What I would tell you is really great about Costco, there’s many benefits to buying at Costco. It’s inexpensive, so you can buy the Kirkland Signature Brand for $1,600 which they say a premium hearing aid. That’s really reasonable if you think about it. And those hearing aids are made by good manufacturers, they do use manufacturers that we would dispense in our office as well. The other great thing is a lot of times they do have an audiologist on staff, which is a good thing to.
Dr. Miller: We want to make sure ultimately, no matter what we’re talking about in terms of if I do this, how do I make sure it’s right for me or is this best for me, is we follow something called best practices in our office. And that just means every hearing aid is maximized to the potential of you based on your audiogram as well as your ear canal shape. And we use something called real ear measures.
Dr. Miller: The manufacturer doesn’t always know what’s best for you. They know you have hearing loss and they can kind of guesstimate where would this gain should be. But until we make sure it’s meeting your specific ear needs, you’re not going to get the maximum potential from any device you buy regardless of what you spend, unless that’s completed. Now, good news. Costco does do this, but I was telling you earlier, anybody can do this if they have the equipment, but do they know what they’re doing? And it goes back to using a trusted professional who knows and is educated to use this equipment appropriately and to make sure, Oh well I ran that measurement. Well, did you know what to do with that measurement once you ran it? And did you correct where it needed to be corrected to optimize the hearing device for the patient? That’s ultimately the bottom line when you fit any device is let’s make sure it’s optimized to the maximum potential for the patient.
Dale Johnson: You impressed me early on, Dr. Miller when you said, “That as long as the device meets the need of the person, that’s fine-“
Dr. Miller: Right.
Dale Johnson: … “With you.” And if later on in their life that doesn’t meet their need and they come in to see you, you will still help them-
Dr. Miller: Absolutely.
Dale Johnson: … Despite the fact they didn’t buy their hearing device from you.
Dr. Miller: Right. I think what’s interesting about Costco … And I’m going to tell you just a few cons. Only one in five people who buy a hearing device initially from Costco will go back and buy again, 20 to 25%. to me that says a couple of things that says, was the device appropriate for you and was it fit appropriately? So did you get maximum benefit? Did you have a bad experience? We’re all about, I want to be treated well when I go someplace and I want to be cared for and I want to make sure when I do put out thousands of dollars for something, what was my experience like? So maybe the experience wasn’t great. Many people don’t know this, when you buy a hearing device from Costco, it could potentially be locked. And that word locked simply means when you walk out of Costco, you can’t go to another provider and have it adjusted.
Dale Johnson: I can’t walk into you and say, “Adjust it.”
Dr. Miller: Most of the time the answer is going to be no. And what happens is I have to figure out what manufacturer you’re wearing, call the manufacturer and ask for an unlock key, and sometimes they’ll give it to us and sometimes they won’t. Imagine you move away from where you bought your Costco hearing aid from and there’s no Costco and nobody can program your hearing aids. A locked hearing aid is not in your best interest because you can’t easily go get another additional service from someplace else without it being kind of a … We really strive to make sure we can treat the patient when they come in and sorry, you’re hearing is locked, this is going to take us a few extra steps to help you. But that hearing it does become locked.
Dr. Miller: The other thing is those hearing aids you purchase at Costco are less expensive for a reason, they’re de-featured. So they might say, “We sell Phonak, we sell ReSound, we sell Oticon,” and they do sell those hearing aids. But imagine that they’re de-featured, they’re not rechargeable, they don’t have maximum noise reduction, they don’t have a wind manager, things that people need. Those features are taken out. You are buying a less featured hearing aid when you buy a device from them.
Dr. Miller: And the other thing we find our patients do express concern about there’s a long wait time, I have a problem and I want to walk in to be serviced and nobody’s there to service me or well, I can come back when it’s going to be next week or in two weeks and you have a problem now what do I do now? There’s just some cons you want to think about. I tell my patients buy the device where you feel it’s within your budget and you feel like you’re going to get the experience you need. We want to give you the experience you deserve, so we would love to be able to make sure we maximize every potential in terms of if you buy a device, it needs to be fit to the maximum benefit that you can get. And that’s only going to happen if we do best practices.
Dale Johnson: How about over the counters? How does that compare to Costco?
Dr. Miller: That’s a really good question. Think about when you buy a hearing it at Costco, you are truly buying a hearing aid. Okay? That just means that it’s going to come from a manufacturer. It’s going to be programmed by somebody in terms of a professional way and fit to you in a professional manner. Hopefully they’re going to be going over how to take care of it, how to use it, and how does this apply to your whole entire … When you get home, what do I? When you buy something over the counter, I want you to think about, I’m going to get what I pay for here. I have to open it out of the box myself. I have to read the instructions to figure out how am I going to use this and when something goes wrong with it, who’s going to take care of it for me?
Dr. Miller: Am I going to be able to fix that on my own? Can I call the 800 number on the pamphlet that’s on the inside of that box and can they help me over the phone? You have to think about what kind of experience do you want to have with this. And again, like you said, we will see any hearing aid you’ve purchased. We will try to guide you along the way and help you because that’s the most important thing we can do for you, is if you’ve invested in something, we never want you to feel bad that you took that first step. Take the first step, but let us help you along the way.
Dale Johnson: Can you spend just a few moments in telling me more about the real ear measurements?
Dr. Miller: Yeah, absolutely. In audiology we have a measurement that’s called real ear measures. Imagine that your ear is different from everybody else’s and your ears are different from one side to the other. The ear canal is a long chamber, think about that. And it’s closed on one side, so it has an acoustic resonance is the word we use. And everybody’s ears are different lengths, different diameters, they’re different shaped. When you stick a hearing aid in a person’s ear, what’s coming through the hearing aid is different for everyone, because of the canal we’re putting it into. The computer may say, “Here, press this button and that will be the best fit for the patient.”
Dr. Miller: Oh my goodness, no. It’s based on an average ear canal size. They put it on a mannequin we call KEMAR and they measure this acoustic resonance in this KEMAR model and that’s what they base their best fit on. Well, how many people’s ears are shaped by KEMARs? Not very many. We would tell you when you come in, we put a microphone down inside, right next to the level of your eardrum and we put the hearing aid on top of that and we measure the acoustic resonance of what’s happening in your ear. We use speech, because that’s what you listen to every day. So we use soft speech and moderate speech and loud speech and we check the output of the hearing aid to make sure that when somebody is talking to you in different volume levels, is the hearing amplification appropriate?
Dr. Miller: And then when it gets too loud, what does the hearing device do with that sound? Does it cap it so it doesn’t harm your hearing? Those are the measurements we take and we take it across many dynamic frequencies. It’s not just low, mids and highs, it’s all the frequency ranges. And depending on what kind of hearing aids you get, I may have three buttons to push to help you or I may have 20 buttons to push to help you in terms of maximizing the potential of what your hearing device can do. When people say, “Well, Dr. Miller, you just want to sell me a premium hearing aid because you make the most money and they’re the most expensive.” Not true.
Dr. Miller: Imagine that that hearing device actually cost us more to acquire, to dispense to you. It’s actually, our profit margin on a premium hearing device is less than any of our other devices. We want you to have this, because it’s going to give you the maximum benefit and it gives us the maximum flexibility to meet your needs. When we do take that measurement of real ear measures, we can go into every one of those pitches. Instead of three, we can do 20 and imagine how much better that sounds when we can optimize it to the target you need.
Dale Johnson: So you have a piano with all the keys and not just three [crosstalk 00:12:10] keys.
Dr. Miller: Right. Yes.
Dale Johnson: Get the service you deserve at Complete Hearing. 4200 Pioneer Woods Drive in Southeast Lincoln in the neighborhood of 70th and Pioneers and go online to, that’s the best place to get started from the convenience of your home complete-hearing.com and every Saturday join us for The Conversation Starts Here.