Santa Barbara Audiology: working from home

I woke up this morning remembering something learned in the school of hard knocks: Work smart. Not just hard.

So here are the “smart” ideas that will keep everyone safe and hopefully keep me from going out of business. It turns out I can work from home in a lot of cases. Here’s how:

1) If get a buy a hearing aid or if you have a current hearing aid, I can program it remotely. The setup takes maybe half an hour. Remote programming is not ideal because it’s only so effective without “real ear” measurements, so I’ll eventually everyone will have to follow up in the office.

2) I can troubleshoot and help you do basic repairs remotely too, either via Skype or the manufacturer’s remote programming software. If you need help with Skype, I can walk you through it over the phone.

3) Manufacturer repairs can be sent from and to your home. Manufacturers are now willing to send repairs directly to patients for free. You can give me repairs through the mail slot or I can mail the repair form, box, and label to you to send it in yourself. Sometimes I have to reprogram a repair first though. In that case, you’ll have to pick it up at the office or pay for me to FedEx/UPS it to you.

4) And finally, I can mail batteries, domes, wax guards, tubing etc

These days it feels like what my grandmother went through in her lifetime – the flu epidemic, the dust bowl, the depression… only it’s happening all at once. We have to stick together (6 feet apart).

Life in Santa Barbara with Covid 19

We’re still open during this crisis. But there are a few changes though. Carol and the pups are staying home for now. I’m answering the phone as I can. I’m seeing only one patient in the office at a time and I’m encouraging everyone to make an appointment rather than just drop by. I’m wearing a mask and gloves, although I’m not sick, and I’m cleaning everything throughout the day. There are so many people who come here who are in the highest risk group and I’m doing all I can.

A woman was walking by and decided to ask about the chair. She said amiably, “Is this your chair? Is it just siting here all lonely?” I told her that I had put the chair outside for anyone who feels safer sitting in the sunshine when there’s another patient in the office. It’s also for people in the long line at Trader Joe’s if they get tired. Sunshine and a nice view of the mountains. What could be healthier, eh? She really liked the idea and told me enthusiastically that I had to post it.

Please stay well and safe everyone. Practice patience and kindness.

Over the Counter Hearing Aids

NPR covered over-the-counter hearing aids back in 2017. Since then, politicians have passed legislation that provides access to these new amplifiers. NPR, like the politicians, dismissed the audiology profession without talking to an unbiased expert in the field – not a doctor and not someone who sells hearing aids. Ruth Bentler at University of Iowa would have been a good choice. Todd Rickets at Vanterbilt would have been another.

The only way I’ve thought of to concisely explain what audiologists do is to compare them to orthodontists. You might ask why a bunch of wires cost $6,000. They’re just wires. It’s because they don’t help much if you don’t have an expert, with 6-8 years of education, custom fit them and fine tune them over time. Audiologists require at least 8 years of education.

I’m glad these amplifiers are out there, but they’re only appropriate for a limited group of people. I tell patients to try it out, but keep your receipt. I guess you could compare them to something like Invisalign knockoffs that you get on Amazon or at the drug store. They’ll work for a few people with slightly crooked teeth.

One last thing. The NPR podcast inferred that you have to spend $5000 on a pair of hearing aids. The $5000 ones can have a lot of benefits, but the quality of the fitting is at least as important as which hearing aid you get.

What really needs to happen is for legislators to come up with policies that help enforce competence and ethics. There are problems with both of those in this field. How you legislate something like that, I don’t know. That’s their expertise.

Costco Hearing Aids

I’ve gotten a lot of questions lately about the difference between me and Costco and why Costco’s hearing aids are so much less expensive.

Well, partly it’s because they buy a limited number of models from a limited number of manufacturers. So they buy in bulk. I can get any hearing aid from any manufacturer (except a couple of proprietary companies). I like that because they don’t all make the right hearing aid for everyone. I spend a lot more time keeping up with technology than they do, but it’s worth it. Here are some examples of hearing aids and why I might choose them.

Some people won’t wear hearing aids because they think it makes them look old. So, I can choose Phonak Titanium or Signia Styletto. Some work in an environment with lots of people and noise. So I have Oticon OPN S. Some people need rechargeable batteries. So I have a lot of options, but usually I think ReSound Quatro. I have people with deafness on one side and might try a CROS hearing aid. I’ve been trying Signia Nx for that lately. I have people with profound hearing loss and I’ll usually choose Oticon Exceed. Some people need to answer their Android phone, hands free, so I get Phonak Marvel. Starkey Livio Ai has fall detection, heart rate monitoring, and language translation. Widex Evoke has a great tinnitus masker.

I can also change manufacturers for things like earmolds. I’ve switched between companies like Westone, Starkey, ReSound, Oticon, Emtec, and Microsonic because quality can vary over time. They also have their own specialty. Microsonic is excellent at children’s earmolds and Westone is great at musician’s monitors.

Also, I’m an audiologist. They are usually hearing aid dispensers. While I’ve met dispensers that are stellar and audiologists that aren’t, audiologists have an advantage of graduate school education. The focus is different. Audiologists are trained to think of treating hearing loss, and that includes more than hearing aids. Sometimes it doesn’t include a hearing aid at all. A liberal education teaches more than how to do something. They teach why. So when you get unexpected results, you have half a chance of figuring out the why and how to fix it.

A few random things that come to mind: I take insurance and I work for free in Starkey’s Hear Now program. Costco’s ReSound hearing aids are locked – meaning only Costco can program or fine tune them. And, finally, I hope you enjoy this video, because it circles back to my first example of patients who think hearing aids make them look old.

Which Hearing Aid is the Best?

I get asked this question a lot. I see Consumer Report testing and audiologist Youtube videos that rank the hearing aid manufacturers. My answer is, For who? The best hearing aid manufacturer depends on who it’s for. There’s a problem with ranking manufacturers because it’s not a toaster we’re talking about here. I will say that there are a lot of excellent manufacturers that I work with. There is a lot of competition between them. They all have a specialty they focus on from year to year. They generally come out with something significantly improved every 5 years or so.

Call me if you’re wondering which manufacturer would be best for you and why. I’m big on education. 905-881-2620

Here’s a little homework though:
1) Read Consumer Reports’ buying guide .
2) Check out the major manufacturers listed below.

Signia (Siemens)

Mail Order Hearing Aids: Eargo

Patients sometimes ask me about Eargo mail order hearing aids. As with anything, there are pros and cons. I couldn’t put it any better or more thoroughly than an audiologist from Arizona, “Doctor Cliff”. Check out this video summary. I tell my patients to go ahead and try it. Just keep your receipt and know that, just like with real hearing aids, the law requires that you be given a 45 day trial period.