You’re experiencing trouble hearing: On average it’s taken you seven years to act on it, sometimes asking your family doctor (who is often clueless), sometimes going to an ENT, and sometimes responding to a TV ad or direct mail piece to see a hearing aid dealer or audiologist. Here are two barely-ethical Dirty Tricks they use to get you to buy their often-overpriced wares — And how you can combat them.
Dirty Trick #1: White Coat Marketing by the ENT:
You finally act, get your hearing tested, either at a standalone audiologist or hearing aid dispenser, or at an ENT’s office. You’re escorted either into the Dr’s office or treatment room for the “examination,” where he comes in with his white coat. He first looks at the audiogram, then he looks in your ears (and occasionally your nose & mouth), then he looks at the audiogram again, and then he delivers the sales pitch: “see my audiologist down the hall for your hearing aids,” sometimes even walking you down the hallway where you’ll part with thousands of dollars more than you would spend elsewhere.
Dirty Trick #1A: White Coat Marketing to the Scared Mother by the pediatric ENT:
You’re a scared parent of an infant or child newly diagnosed with hearing loss, and the pediatric ENT is telling you Junior needs hearing aids as soon as possible, and to see his audiologist at once, where you’ll quickly “find a way” to part with four, five, even six thousand dollars for low-to-middle grade (usually Phonak, sometimes Oticon) hearing aids, often signing usurious Care Charge or other patient financing agreements or asking Grandma for money. For the smiling Evil Audiologist — especially ones at “Children’s Hospital of [insert ‘City Name’ here]” or “[insert ‘Big Donor Name’ here] Children’s Hospital” — it’s like taking candy from a baby.
The way to combat this Evil AuD Dirty Trick is to ask the ENT for a prescription for the hearing aids — which ethically he must write — and once you have that, shop around. One thing Evil Audiologists are being forced to do is unbundle their services, and you can leverage this, buying the hearing aids elsewhere and have them programmed for about $200 by any audiologist — Just make sure she uses real ear measurement to get an accurate fit.
[This brings us to Costco: They sell “locked down” Bernafon, Rexton (Siemens) and ReSound hearing aids one generation behind, and you are forced to return to a Costco that sells hearing aids for any reprogramming. However, the $1299 Phonak Brio hearing aids are the same aids as the current expensive Audeo & Bolero aids; and once purchased can be programmed by any pediatric audiologist with Target 3.3, which every hearing aid professional has loaded (or if they have an earlier Target version tell them to run the updater from the Tools menu). The problem is that Costco will not fit hearing aids to people under 18 (even though they do a good job by using real ear measurement on every fitting), so you may need to ask the store manager if you can buy the aids in the package without being fit so you can take them to your audiologist for the earmolds & fitting.]
Dirty Trick #2: The Phony “Research Study” Discount:
This trick is used by ethically-challenged “professionals” to close a sale when the consumer is negotiating for a better price: Typically after some back-and-forth the Evil Audiologist will say “let me check if there’s a research study you can participate in;” and then he goes into the other room for a few minutes and prints out a phony “research study contract” with your name filled in. He then comes back in and says “Good news! There’s a research study you can participate in that will give you a $1000 discount” as he puts the contract in front of you to sign. But when you look closely at the contract, you’ll see no research institution or other entity named, and you’ll also see words to the effect of “in return for this valuable renumeration we are asking you to complete the study, and if you do not, you will pay $400 in fees if you return the hearing aids” — Meaning you’re now on the hook for $400 in fees if the Evil AuD fucks up your fitting. First off, all hearing aid manufacturers give generous 60 to 90 day free return privileges to their dealers, so you should never have to pay any more than the nominal cost of the earmolds if you return the aids. If you’re offered one of these phony “research study” contracts, simply cross off the exorbitant dispensing fee; and if they don’t agree, get up & walk out — You don’t want to deal with them.
[This is not to condemn all research studies: One small audiology chain in Salem, Oregon that has a boutique practice of specializing in single-sided deafness uses internal studies every couple of years to determine the best CROS hearing aid for first-time and long-time users. He can be an asshole ginger to his colleagues, but he’s NOT an Evil AuD.]
You walk into your drop-dead gorgeous audiologist’s office and she’s so hot, you pop a boner, ready to plink down $7000 for any new hearing aids she hangs on your ears. However, you need to disconnect her beauty from her brains, and we at The Evil Audiologist are here to assist you.
For starters, look at her diploma on the wall: How do you know that she was actually trained at a real school, and not some mail-order diploma mill… Or worse? We’ll give you our first hint here in the lede: If the school on the sheepskin says Lamar, Missouri State, Texas Tech, Gallaudet or Louisiana Tech, then Run Like Hell!
Fortunately, the people over at US News & World Report rank the various Au.D. clinical doctorate programs out of the 73 in the U.S.; and from our dealings with their alumni, these 3 pages of rankings are surprisingly accurate, especially the bottom-of-the-barrel programs on page 3. In addition, ASHA/CAA accreditation status can tell a story, with the Auburn program having been on probation and the Missouri State program actually — and deservedly — unaccredited.
When you look at the listings, they are somewhat skewed, as part of the ranking methodology is numbers of papers published by their faculty dinosaurs — That is what pushed Vanderbilt’s program to the very top of the pile. Vandy’s an excellent school, and their CI program & clinic are outstanding, but it’s certainly not any better than the others in the Top 8, such as Northwestern, UNC-Chapel Hill, Ohio State, or UT-Dallas. Basically, if the school on your audie’s sheepskin is on the first page, there’s a high probability she’s reasonably competent.
Published papers by faculty can also move a truly rotten audiology school to ratings mediocrity: Several experienced audies who supervise interns have told us that Gallaudet’s Au.D. students have the weakest clinical skills of any they have hired, as fluency in ASL is not a clinical skill — But we bet they masturbate really good! 😀
So-called “transitional AuD” (tAuD) programs are highly variable: These were online programs in which master’s level audiologists enrolled to plump up their credentials after all of the masters’ level programs were decertified (accreditation history here). Some, like University of Florida, are somewhat good; while puppy mills like Pennsylvania College of Optometry (Salus) and AT Still are dubious. In any event, if you see sheepskins for both an older masters & newer doctorate of audiology, you can get a pretty good reading based on where she earned her master’s.
In our next article, we’ll expose the sorry state of pediatric audiology with actual case histories, but to give you a preview — and with only a couple of notable exceptions♥ — the audiology & CI programs at “Children’s Hospital of [insert city here]” and “[insert Big Donor Name here] Children’s Hospital” are universally rotten to the core.
♥ The notable exceptions that have outstanding pediatric audiology programs are Comer Children’s Hospital in Chicago, and All Children’s in St. Pete~
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