Why I Only Recommend PREMIUM Hearing Aid Technology Levels


In this video, I’m talking
about why I only recommend premium level hearing aid
technology, coming up. (funky music) Hi guys, Cliff Olson, Doctor of Audiology, and founder of Applied Hearing
Solutions in Anthem, Arizona. And on this channel, I cover a bunch of hearing related information to help make you a
better informed consumer. So if you’re into that, make sure you hit that subscribe button. And don’t forget to click the
bell to receive a notification every time I post a new video. If you’ve spent any time at
all researching hearing aids, you’ve probably identified
that different manufacturers have different levels of
hearing aid technology. The higher in technology,
the level that you go, the more features that
hearing aid will have. But they’ll also cost you more money. So let’s go over these
different hearing aid features and see why they justify
this additional expense. Number one is hearing
better in background noise. Hearing aid manufacturers
spend millions of dollars each year trying to reduce
the signal to noise ratio of their hearing aids by a few decibels. But this few decibel reduction
in signal to noise ratio can mean the difference between you hearing and
understanding a friend that you’re eating with at a restaurant, or not hearing them, and having to watch their
mouth the entire time that you’re eating. So the better technology
level that you have, the better you’ll hear
in background noise. Number two is better automatic
adjustment capabilities of the hearing aids. Premium level hearing aid technology does a better job of auto identifying whatever environment that you’re in, and actually putting your hearing aids into the best program settings for that particular environment. So if you’re the type of person who does not like to push a
push button to change programs, based on the environment that you’re in, premium level hearing aids
will help do that for you, and do it better than you
can do it on your own. Here’s an example of a
premium level hearing aid that has different program settings, depending on which
environment that you’re in. If you’re taking a car ride, the hearing aid automatically
puts you into the car program. If you’re in a restaurant, the hearing aid automatically identifies that
you’re in a noisy situation, and either puts you into a
speech and noise program, or speech and loud noise program. If you’re listening to music, the hearing aid will
put you into a program that is designed
specifically to leave music as natural as possible. If you want your hearing
aids to just flat out work without you having to worry
about making adjustments, depending on the
environment that you’re in, then premium level hearing
technology makes a lot of sense. And a third feature is
more adjustment handles. Premium level hearing aids have
more adjustment capability, so the hearing care professional
that you’re working with can customize them even better. Think of a piano keyboard. Now imagine a piano keyboard
with only five keys. If you restrict the amount
of keys on a keyboard down to five, your ability
to play quality music would be extremely restricted. Most premium level hearing aids have up to 20 adjustment handles than can be used to program a hearing aid at very narrow frequency ranges. While basic hearing aid models can have as little as
three adjustment handles, that only allow for broad adjustments in the low, middle and
high frequency ranges. Not having enough adjustment handles can result in over-amplifying some areas for your hearing lost prescription, while under-amplifying others. While having up to 20 adjustment handles will allow for almost an
exact prescription match throughout your entire hearing loss range. Now these are all great
reasons to recommend premium hearing aid technology, but the main reason that
I primarily recommend premium level technology verses
all other technology levels is because I do not wanna
leave any benefit on the table. If you end up going with the
lower levels of technology, you will be hearing better, but you’re always gonna
find yourself in situations that you’re gonna be
like could I hear better in this situation? And the answer is most definitely yes. Now naturally, I’m
expecting some of you to say of course you’re recommending only premium hearing aid technology. That is what costs more,
and you’re a greedy guy, and you’re trying to get as much money from your patients as possible. But the fact of the matter is is that I actually make less money dispensing premium level technology than I do any other level, and that’s because it costs
me more to get those devices from a manufacturer. And I’d rather eat some of the cost of those premium level devices so my patients can hear better. Now when you start to calculate out how much additional it
will cost you to go from a second tier device up
to a premium level device, you’re looking at anywhere
between $200 increase in cost for a single hearing aid,
up to $500 increase cost of a single hearing aid. And then when you look at for the lifespan of a hearing aid being
around 4.4 years, on average, and I would say that that’s a
pretty conservative estimate, I would say that you could
probably get substantially longer than that if you take really
good care of your devices, but let’s just take four
years, for instance. If you increase the
cost of your technology by 400 to $1000, you’re
only gonna be spending, really on average,
about 100 extra dollars, to 250 extra dollars per year, for both of your hearing aids. The way I see it is that
people primarily come to me in my clinic because they want to maximize their hearing potential
with their hearing devices. And so I can either try
to accomplish that task with a lower level piece
of hearing aid technology, which is like trying to
program that hearing aid with my hands tied behind my back. Or they can go with
premium level technology that lets me do whatever I need to do to maximize their hearing potential. So the natural question
is, do I ever fit someone with hearing aid technology that is not at the premium level, and the answer is of course, yes. If there is patients who come into me with existing technology, and they want me to fix the programming in those hearing aids, I’m absolutely happy to do that. And then there’s other
individuals who have residual hearing that is so bad that fitting them with
a premium level device doesn’t make any sense, ’cause they’re not even gonna perceive all the benefit from those devices. I typically think of these individuals as cochlear implant candidates, but for whatever reason, they either can’t or don’t want to go through surgery. Those are the individuals that I fit lower levels of technology on. Now all this being said, paying for premium level
hearing aid technology would be a waste of money if you don’t have best
practices performed on them during your hearing aid fitting, like real ear measurement. And let me show you
what I’m talking about. Here is a graph that shows performance in background noise with
a variety of high tech, premium level hearing aids, and an old analog hearing aid. The shorter the bars, the
better the user’s performance in a noisy situation. The long, black bars
indicate the performance of a modern, premium level hearing aid, when that hearing aid is programmed without using real ear measurement. The shorter gray bars
indicate the performance of the same hearing aids,
when they are programmed using real ear measurement. You can see that even an
old analog hearing aid performs better than a modern premium technology level hearing aid, when those hearing aids are not programmed using real ear measurement. I don’t care how advanced
the hearing aid is, it will not perform up
to its full capacity without real ear measurement
performed on them. Now this is just one example of why you need real ear
measurement performed on your hearing aids, during
your hearing aid fitting. Nearly every additional feature that you find in a
premium level hearing aid will be negatively impacted if you do not have real ear
measurement done on them. This basically means
that you’re gonna take whatever additional money that you spent on those premium level devices, and flush it right down the toilet. So if you wanna achieve whatever your max performance ability is, then premium level hearing aid
technology is the way to go. But this is only if best
practices are followed when fitting your hearing aids, and this includes real ear measurement. That’s it for this video. If you have any questions, leave them in the comment section below. If you like the video, please share it. If you wanna see other
videos just like this one, go ahead and hit that subscribe button. I’ll see ya next time. (happy music)

34 comments

Looks like there is a thousand dollar difference between entry level and premium level technology. I totally agree with you. But in our neighborhood money is not plentiful. Folks are still only making $12 a hour in a professional setting. Always look forward to your Vids.

Dr Robyn Cox has done extensive research that concludes most users cant tell the difference.

https://journals.lww.com/ear-hearing/Abstract/2016/07000/Impact_of_Hearing_Aid_Technology_on_Outcomes_in.15.aspx

Other peer reviewed research concludes that more than eight channels redundant unless specific targeting for serious condition merit greater precision.

Will purchase Phonak M50 Rs to save $1600.

How can you tell for sure, if your hearing aid professional is using real ear measurements? They say they do, but always add a qualifier, such as, I’m not going to set them all the way because it would overwhelm the brain!

Thank you for your time and vids. They are very helpful in this bewildering and costly market. Last week you recommended EARGO and today you recommend going top shelf in selection. I like the conveniences of EARGO but wonder if I am short selling myself. My loss is in the higher freqs. Was the EARGO vid based on budget restraints? Also, is there any other way to identify a provider with good practices besides Yelp or Google? Thank you again.

Cliff, what are your thoughts on the research completed by Cox, et.al. in regards to this conversation. I think you need to proceed cautiously when your recommendations are based on manufacturers claims.

Here is a bit of the Cox research: "Conclusion: Modern hearing aids from major manufacturers are remarkably sophisticated devices which can yield substantially improved speech understanding and quality of life for older adults with uncomplicated, adult-onset, mild to moderate, sensorineural hearing loss. However, it cannot be assumed that more technologically sophisticated premium devices will provide greater benefits in daily life than less sophisticated basic devices. The combined laboratory and real-world outcomes in our research are consistent with the conclusion that when hearing aids are programmed, fit and fine-tuned using best-practice protocols, wearers similar to our participants will obtain essentially equivalent improvement in speech understanding and quality of life whether they use basic-level or premium-level feature technology. Because basic-level technology is less costly, benefit per unit cost would be higher for these devices. Therefore, it would be expected that patients will find them to have higher value than premium-level hearing aids. However, it is important for practitioners to keep in mind that the knowledge and skills required to program, fit, and fine-tune modern hearing aids are highly specialized. Professional services that follow best-practice protocols are time-consuming, but they are essential to securing an optimal outcome for each patient, no matter which feature level is recommended."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224118/

Also, research has shown, when dealing with gradually sloping hearing loss (such as the majority of our patients that more programming handles does not equal better fit. Can't find the source at the moment but in the early days of digital (Kuk with Widex if I'm remembering correctly) showed great benefit when going from 1 channel to 2. Some increased from 2 to 3 and then from 3 to 4 but little improvement in benefit above 4 channels. So, for example, if comparing a 12 channel instrument to a 20 channel instrument, in most cases you can get the exact same real ear results. Of course when your dealing with unusual hearing loss configurations, more channels may be justified.

Just my .02. Keep up the good work. Your videos are incredibly valuable!

Mr. Olson do you have / know anything about Lucid hearing aids? Sams club sell in my area North Carolina. Thanks for what you do for us.

I paid $499 for Bose Hearphones a week ago. I have significant "cookie bite" hearing impairment.  I now have speech recognition superior to my $3,800 BTE hearing aids that I got about 4 years ago. I've noticed that the noise dampening feature of my hearing aids is superior for the mall and restaurants, but I also experience speech dampening and the dampening effect does not really very help with speech recognition.  They always sound artificial or tinny, like an old 1960s portable transistor radio and in order to understand speech, they are set quite loud.  The Hearphones, while not perfect, have much better fidelity and give a more natural sound at a much lower volume.  I can hear conversation in  a restaurant or at the mall with greater comfort,  clarity and more comfort. They are an order of magnitude better when listening to music! Obviously people can see you are wearing the Hearphones, but I'm turning 70 next month and don't mind if people know that I'm hearing impaired. In one of your other videos you tipped me off to the Bose devices. For me, the Bose Hearphones are great.  Thank you.

I'm 99% deaf, so I have what you recommend low level technology hearing aids. Surprisingly I can watch TV, use a phone and have conversations with very little problems. Background noise is a problem, and will remain one even with other devices.

I would like to make an analogy for premium vs. low cost technology with regard to hearing aids. Since technology is how you get your optimum fit of a hearing aid, I would like to compare them to computers since I sold computers for 4 years part time at an old CompUSA. Essentially, we had what I call the 1 year, 3 year and 5 year computer. The 1 year computer cost $1,000, The 3 year computer cost $3000 and the 5 year cost $4500. How does this relate to hearing aids? Essentially you are paying for technology and this is how a hearing aid is programmed. If you want maximum performance you have to pay the maximum performance price. The next consideration is financing. If you have to pay for it over time you want it to last technologically speaking at least until you pay it off before you have to go back for a new hearing aid. I would rather go through the financing process 1 time for a 3 year life hearing aid than go through financing 3 times for 3 1 year life hearing aids. I am not a expert at hearing aids so I would say if you have better experience than this for your hearing aid purchase please let me know. Based on my technology experience, I would bet this is the same for hearing aids since they are basically special purpose computers. The last thing is that if you buy a premium level hearing aid you will, at the very least, have a thoroughbred race horse level hearing aid for the 1st year, a medium level horse the second year and an everyday work horse the third year. If you go with the 1 year computer plan you will have three everyday work horses for three years. The time frame you get for a hearing aid may be different than my analogy of computers compared to horses but you get the idea. Pay the piper now or pay the piper later and if you pay now you hear better too. Now which would you rather do? I do not know Doctor Cliff but I appreciate his advice from where I am in Nashville TN. I do not sell hearing aids and have no interest in hearing aid companies. This is just one person's opinion. I hope this helps someone making an evaluation of hearing aids. Sorry to be so long winded but I type fast so I can be.

What about for a person with one aid? I had noticed that the premium level offers some special advantages with aid-to-aid communication to help with 3D sound, something a person with one aid can't use, of course. Is premium still the best course of action for one aid?

Idea for the next video: Double blind study.
You fit 4 aids (basic, standard, advanced, premium) to Joe Shmoe. One of your audiologists will randomly label the aids, A B C D. You give the aids back to Joe. Joe attempts to identify which tech level is in each aid. Your audiologist then discloses the identities of aids A-D to you and joe. Record reactions.

i know this will be a random question, but i would like to know if the Phonak remote app is accessible with the iPhone voiceover feature and the only way for me to find out is to see if you have any co-workers who would be willing to turn on voiceover and pair it to the phonak remote app and observe what voiceover reads and if i can adjust volume by flicking one finger up or down. i really would appreciate this. I want to know if this app is accessible for me to use as a blind user.

You should get Lively to sponsor you next. I’d love to get an inside look at their process and how they use video chat.

Have you considered doing a video on frequency lowering, which a lot of premium hearing aids offer? I could be wrong, that many lower performance HA also have this feature, but I find it a very interesting topic! 🙂

Should I be concerned that my audiologist would not tell me the brand of premium HA she was recommending for $6700?

​@UCpikvbsbLd6tMcuN7AEJ-1A could you do a video discussing client hearing aid candidacy (configuration & severity v. perceived benefit), and why some clients who are coming from old technology will try new premium technology and claim no difference between the two?

Quick question. My Audiologist is quoting a $3,000 price difference for a pair of Odicon hearing aids with basic technology vs premium. Your video sounded like I should expect much closer price. what’s up?

What do you think about the study done by Robyn Cox et al showing no appreciable difference between Premium and basic technology in double blind studies? Impact of Hearing Aid Technology on Outcomes in Daily Life I

The Patients’ Perspective

Cox, Robyn M.; Johnson, Jani A.; Xu, Jingjing

Ear and Hearing: July/August 2016 – Volume 37 – Issue 4 – p e224–e237

doi: 10.1097/AUD.000000000000027

If only insurance companies understood this. I'm lucky to get something covered, but definitely notice the differences. I just cannot afford the difference in cost, so now what?

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