How do you counsel patients regarding purchasing decisions relating to custom versus instant-fit versus disposable hearing instruments?
Assuming the consumer does not have an unlimited amount of money to spend on hearing aids, the counseling for consumers to choose between custom and instant-fit is fairly straight forward. The consumer merely has to decide on allocating their funds between signal processing and/or device housing.
In almost all cases, the signal processing available in instant-fit hearing aids can be obtained in a factory-customized housing, but at a greater cost for the customized version. If the consumer has an ear canal that is fairly normal in size and shape, the instant-fit hearing aid will be fine and the consumer can spend the money saved on customization to obtain better signal processing. If the consumer has a very small or abnormally-shaped canal that will not accept the instant-fit aid, then they must spend the money for the factory-customized shell, with the signal processing a secondary consideration.
Some instant-fit hearing aids have a disposable component. In the case of the two devices with disposable ear tips, the HCP must insure that the consumer has the visual and manual dexterity to attach and detach the ear tip. The consumer should be counseled that the disposable ear tips are designed to collect cerumen, thereby preventing the cerumen from entering the hearing aid. The ear tips should be replaced per the manufacturer's recommended wear schedule.
As for completely disposable hearing aids, consumers can be counseled about the product's short-term vs. long-term financial trade-off. On a short-term basis, disposable, hearing aids cost considerably less than non-disposable instant-fit hearing aids or factory-customized aids. However, long-term use of, and payment for, disposable hearing aids may not be cost effective for the consumer.
References for further reading:
''Instant-fit hearing aids'' by Robert Sweetow & Victor Bray in Advances in Speech-Language Pathologists and Audiologists, January 8, 2001.
''An analysis of entry-level, disposable, instant-fit, and implantable hearing aids'' by Robert Sweetow in The Hearing Journal, February, 2001.
''Description and rationale of a digital, instant-fit hearing aid'' by Victor Bray, Merritt Johns & Robert Ghent in The Hearing Journal, April, 2001.
Victor Bray is the Vice President of Auditory Research for SONIC innovations™, a Salt Lake City company founded to design, manufacture, and market a new generation of superior-performing DSP hearing aids. He was instrumental in the research and development of the nine-channel NATURA™, CONFORMA™, and ALTAIR™ hearing aids and the EXPRESSfit™ fitting system for NOAH and for PalmPilot.
Dr. Bray has degrees in Biochemistry, Audiology, and Speech & Hearing Science. He is a third-generation hearing aid dispenser, having obtained direct retail experience while managing a Beltone office for his family's hearing aid business. He has extensive clinical experience in diagnostics, hearing aid dispensing, and cochlear implant rehabilitation. He lectures internationally on the clinical application of advanced technologies to improve hearing aid performance and increase consumer satisfaction.
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