How important is having my hearing aids fit in person versus buying over the internet?

It is extremely important to have hearing aids fit in person versus buying over the internet! Hearing aids are custom fit for your ear and for your hearing. When a hearing aid is purchased from the manufacturer, it comes as a blank computer chip. The person fitting the hearing aid takes into account the size and shape of your ear canal as well as the slope and degree of your hearing loss to fit the hearing aid to each ear. There are also verification measures that allow the person fitting the hearing aid to verify the output of the hearing aid is set appropriately for you when the amplified sound travels down your ear canal. In addition, it is very helpful to have someone show you how to correctly insert the hearing aids, clean the hearing aids, and troubleshoot them if something goes wrong while you are using them at home. 

This is an interesting question that will surely generate some passionate replies. This past weekend I was in Ohio and saw some wonderful commercials for the Cleveland Clinic advertising their approach to tele-medicine and how routine diagnostics and counseling can be completed in the comfort of your home. Today, medical care is evolving to fit the lifestyles of today's healthcare consumer. Cleveland Clinic doctors can even write prescriptions through a video chat!  Buying hearing hearing aids online can take many forms. You can simply click and buy everything from basic amplifiers to advanced conventional hearing aids from the major manufacturers and have them delivered to your home. While this may be convenient and can save people money, it's important to note that using hearing aids and experiencing success is usually dependent on coaching from a hearing professional during the initial adjustment (trial) period. For someone that chooses to purchase from an online provider, a key part of the purchase is to ask about remote coaching and counseling while you are adjusting to the devices. You'll want someone available by phone, email, and even video conference to answer your questions about cleaning, maintenance, batteries, and especially about setting realistic expectations for improved hearing. I've been fortunate to work with both Internet driven companies and have also had a close relationships with traditional medical/retail offices for many years. I've seen clients have exceptional experiences with both. 

Depending on the severity of your hearing loss, age, and type of hearing aid system being purchased, you may need the help of face-to-face professional service. You'll have to investigate both to see what is best for you. So, is one better than the other? It truly depends on you and your unique situation, and you should explore the advantages of both. That being said, be leery of anyone who says there is only one way to purchase hearing aids. Good luck!

Think of the hearing instruments as the building materials & the hearingcare professional as the builder. You could theoretically buy the hearing aids over the internet but you would still need the hearingcare professional to examine your ears, find out what your hearing priorities are, carry out a series of tests which may include audiometry including air & bone conduction testing & possibly masking, typanometry, QuickSin speech testing, demonstrations. Then the fitting which would include a feedback test, insitu audiometry/REM's. Then further follow ups, possibly impressions if domes were not suitable if you went the receiver in the canal route, conversations with your significant other(s). Checking data logging to see how they have been worn. Further QuickSin tests to measure the improvement & checking against your questions on your pre-test questionnaire to see if you feel there has been an improvement. Trying assistive devices to maximise the potential of the hearing aids. Possibly swapping to an alternative device.Whew! I've realised we do quite a lot! So yes you can buy them off the internet , but what are you going to do with them?

In today's world of instant gratification and online shopping, the purchase of hearing instruments may seem like an efficient means to improve hearing loss at a reduced cost. However, this simply is not so. The purchase is one thing but the fitting is the more important portion of this question.  There are two answers that must be understood... Buying of devices and self fitting them or buying devices with a service component included. Self fitting is just not a wise decision. By doing so, you've omitted the important 1st step ... the otological exam. This is where a trained professional examines the ear, the canal, and the ear drum.  Many pathologies are often found that require medical treatment before an aid should be considered. Ommision of this step would be foolish since your hearing loss could be secondary to far more serious maladies. The 2nd step is the audiological exam. Without a thorough and complete battery of tests, it is impossible to know what type of device is needed or the power and feature set that will best serve your individual loss. Thirdly, the fitting of the aid, although seemingly simple, is quite complex if done correctly. This is where proper programming, correct sizing and verification of proper output is critical. And finally the 4th part of a proper procedure is the counseling, the expectation and followup.  Rarely is an aid set correctly on the first attempt. The patient goes through an adaptation period that frequently requires multiple adjustments or tweaking of the instruments over time.  Elimination of any of these steps usually results in a poorly fit device and  subpar  results. 

Now, the second answer! There are reputable companies that sell hearing instruments online that add the all important service component. In this situation you are buying the correct products only after a trained and credentialed subcontracted professional has performed the steps outlined above. The relationship is such that the healthcare provider takes you as a new patient although your purchase is actually made online. There is typically a cost savings in the initial online purchase with professional service and followup on a local basis. This is an effective delivery model that meets the standards for quality care and customer satisfaction. This is a more "canned' approach with a preset number of followup appointments so expect a charge from the healthcare provider once those followup have been exceeded.   You may want to check on local providers and bundled services where you may pay a little more but get unlimited access to adjustments and counseling. It may be your least expensive option over the long term. 

The most commonly misunderstood variable to successful rehabilitation with hearing aid use is the belief that it is due only to the device.  Although the hearing aid is one critical component, it is imperative to work with a trained, licensed, and experienced professional who can perform accurate diagnostic hearing assessment, make an appropriate recommendation, properly fit hearing aids and provide critical follow up care for successful hearing aid use.  Being able to verify that the hearing aid is programmed appropriately and safely for best benefit is also critical and this cannot be done when something is purchased through the internet.  In addition, you may be at risk for voided warranties for devices that are unauthorized by manufacturer's who prohibit sale of their devices online.  I would be very skeptical of purchasing hearing aids online mostly because we've seen the problems after the fact for consumers who've sought our assistance.  In a similar way, I would think it would be unwise to purchase a cast for a broken bone online, purchasing a pacemaker online, or trying to buy a custom fit wedding dress without a seamstress/tailor.  

Hearing aid dispensers and audiologists are trained to find audiological red flags that might lead to other problems that require medical attention. Sometimes there are physical or conductive problems that require further investigation.

Counseling is another component that should not be overlooked. We show patients how to clean the aids, change batteries, place in the ear correctly, recounsel and explain to patient about expectations. 

If a patient purchases an incorrect over the counter amplification product it will not be a positive experience. If anything, it may sour the patient on getting the correct treatment for their loss

 Direct-to-consumer (DTC) hearing aid sales have been happening for as long as I can remember and there are outstanding business models available if you do your research. There are vast numbers of people who are happy with various online purchase options. Online purchase options can range from basic amplifiers for a few hundred dollars to some of the major brands for much more. Some local hearing professionals will provide additional programming and counseling for a service fee if you need it, but many online companies provide all the support you may need to have a successful experience.

Bottom line is that today's hearing aid technology has reached a point where you can be very satisfied with an online experience.  Given that online/DTC purchases disrupt the traditional way of doing things. All types of medical care and medical device sales are evolving right now and hearing aids are one of them. There are definitely reasons for working with a local hearing provider, and that may be the best option for you. Do your research. Visit with a local hearing professional and look at your options. Ask for a copy of your hearing test. Call some online stores and ask questions. You'll receive a trial period wherever you buy, so if you're not satisfied with any part of the purchase experience you'll be able to return the devices (get the details of the return policy). Just remember, every person does not need to purchase hearing aids from a traditional store/medical setting. As a healthcare consumer you have options.  ***Originally written by Steve Eagon, Audiologist

I would like to add that a good, reputable, company will have you speak with a licensed hearing professional to make sure you are good fit for a particular product. You should also expect support and everything you need to take charge of your own hearing healthcare needs.

The importance is that you see someone to have your hearing tested to make sure there is no issues before getting hearing instruments. With that being said buying anything on the internet is hard because nobody is there when things go wrong. Hearing is difficult to fix and seeing a specialist about your hearing allows us to make adjustments to your hearing instruments and addess difficult issues. Not everyone thinks that sounds are soft or loud and differs from one to another. That is why when being treated for hearing loss it takes time to get adjusted to what you are suppose to be hearing. The best answer is I want go on line to by my next set of glasses because they are prescribed to fit only my vision. I will go to the speacialist I have always gone to because I trust them and know if the prescription needs to be changed then she can handle that. The internet does not program, adjust and service hearing instruments. You are paying as much for the service as you are the product neither can go without the other. 

Jeffrey C. Cline

I get questions like this all the time.  Yes you can buy online, but odds of the settings/programming being perfect for you are extremely low.

1. Feedback processor, you need a live ear for that.  Setting feedback limits requires for he person to be near the fitting module (computer and some sort of interface) so it can be run and analyzed.

2. Personal hearing - hearing is extremely personal.  Your perception of loudness, ear canal size and shape, and sound shaping must be done live in person (as above, it is set by a computer with the person in the room)  Also, some clinics use a verification method called REM Real Ear Measurement, essentially it is a way to test how the hearing aid is performing inside your ear.  Even if this is not run, it is essential to have the patient there so you can talk (because as you speak, you may notice sounds or frequencies you don't like or can be tweaked)

3 Warranty, this is tricky.  No manufacturer will honor a warranty unless purchased through accepted channels.  Some online companies are allowed to send you aids, but are REQUIRED to have them set by a licensed professional in person.  All other purchases outside this channel, the warranties typically are not honored.

You can save money by going through companies like TruHearing or Choice Hearing, but you only have 45 days to get the fitting right, and after that you pay for ALL visits... so what typically seems like a good deal, is actually about the same price you would have paid anyway.  

You can also ask about unbundling.  Most prices you get from a clinic include all followups for a period of time, you can often get a lower price if you ask for a price that doesn't include all that.  

This is a question that we field often as audiologists.  Having worked in a full-service ENT practice,  a full-time audiology-dispensing clinic and a mail-order hearing aid program, my answer will reflect all 3 experiences.  The biggest challenges that you may experience when buying over the internet are the on-going care that you and your hearing aids  may (or may not!)  need.

I write this as my last patient leaves from his walk-in appointment.  He is upset because we charge him for $25 for "cleaning" his hearing aids.  What we actually did is:  1.)  video-otoscopy to check his ears since he has had the aids for over a year (they are occluded with wax, worse on one ear than the other and too deep for removal in our clinic.  2)  Cleaned the aids and replaced the wax guards and domes because they were not in good shape.  3) Reprogrammed the right aid for more volume so he can hear better until he sees the ENT to have the ear wax removed.  4)  Did a feedback test on the right ear to reduce the feedback as a temporary measure until the ear is cleaned.  

You, as the patient, might be very tech-savvy and feel that you can pick out the best hearing aids by reading the manufacturer's specifications.  That is fine.  However, you need someone who can verify the fitting using speech-mapping, and check to see that you are getting the most out of the hearing aids in everyday life.  Those are very important steps  in the beginning.  The other issues become so much more important later on.  As one who worked in the remote delivery of hearing aids (aka mail order, aka over-the counter delivery) I can tell you that there are many problems not solved by emails and telephone.  There are some things that are taken for granted, such as seeing you and your hearing aids in person.  Buy on the internet if you wish, or need to, but be sure there is someone locally that can assist you. Expect to pay for their time, expertise and care.  They have to pay rent, licenses, business and malpractice insurance, electricity, staff, computers, printers, etc., (etc.:  I just paid $1100 for all the lightbulbs in my clinic to be replaced!) 

Be certain that the manufacturer's warranty is valid, as the hearing aids may have been replaced under loss and damage.  This would mean the manufacturer then owns the hearing aids, and if they are sent for repair without knowing that then they will be confiscated.  Unfortunately, fraud exists in this area.  

For more information, please see my LinkedIn articles:  

https://www.linkedin.com/pulse/rocket-science-noreen-gibbens

https://www.linkedin.com/pulse/i-can-get-hearing-aids-less-internet-noreen-gibbens

It is important to have hearing aids fit in person versus buying them on the internet. Hearing aids are custom for each persons needs. Most often you will have to have the hearing aids adjusted or serviced at sometime and if you buy them online you won't get the services needed in the future. Also, during the consultation you will get to see the different types of hearing aids and see what is going to be best for your hearing loss.

It depends on the severity of your hearing loss. If you have the incorrect ear tip you will either have lots of feedback (whistling) or may sound like you are in a tunnel. The ear tip needs to be matched to the prescription of the hearing aid. This can only be done in person. Most dispenser will charge you for an office visit especially if you purchased the HA elsewhere. Further , no one can adjust your hearing aid if they do not have a copy of your exam, so therefore be prepared to pay for an exam. Usually when you purchase a hearing aid from a reliable Audiologist/ Dispenser a service plan may be included in the price. Remember you get what you pay for.