A Response to Geoffrey Cooling’s Recent Linkedin Post entitled “Are Professionals Over Medicalising Sensorneural Hearing Loss To Justify a Business Model”

Remaining a fan of Geoff Cooling’s never dull and often provocative posts, I’ll take the bait and formulate a response to his recent observational challenge.

First, let’s isolate the various bits of chum Geoff has thrown into the conversational waters.

The statement “overmedicalizing sensorineural hearing loss to justify a business model” is a rather clever demonstration of Geoff’s gift for verbal slight-of-hand (or in this case, “turn of phrase”).  By staging his challenge with this phrasing, the reader is pre-nudged to concede that sensorineural hearing loss must not actually be a health issue, but merely a target market –  and that the only way professional care can exploit this particular target market is by playing the “health care” card.

As I have said before, and I will say here again, hearing loss (including sensorineural hearing loss) is absolutely a health concern.  And, it is a health concern BEFORE it is a commodity purchasing issue. This should be overwhelmingly obvious to anyone who is aware of and acknowledges the many significant comorbidities associated with hearing loss.  This of course includes Geoff’s category of “age-related, genetically predicated or noise induced sensorineural hearing loss.”

Geoff is willing to concede that professional involvement is “crucial to the testing process, and that hearing loss can be indicative of far deeper and more nefarious issues”.  Agreed.  But, once sensorineural hearing loss has been found, Geoff asks “why should we (the hearing care professional) remain involved?   And, he asks this to suggest that there may be no real, defensible answer to the question.

Well, here’s my offering.

First, the human side.  We have all heard and read many times that it takes seven or more years once an individual has recognized that they have a hearing issue before they do anything about it. Some might argue that cost is the reason. I think that at least in part, the reason for this is grief.  For many, hearing loss is psychologically difficult to accept.  And, in a fashion similar to coming to grips with the loss of a loved one, coming to grips with accepting hearing loss can be a process.  And, like any form of grief, it is a process that can be helped, guided and eased with knowledgeable support.  The value of funeral directors is not defined by their showroom of coffins.  (If that were the case, coffins should be sold on-line direct to the consumer.)  Rather, their value is their knowledge in guiding loved ones through the process, and their empathy to both acknowledge and help carry some of the emotional load. This is what the best in hearing health care professionals I know do. And, they do it with a level of personal conviction that indeed often characterizes those who are drawn to this field.  This is a key reason why 95% of consumers who receive professional care are very satisfied with the care and treatment provided. This is a valid reason why the hearing care professional should remain involved.

Second, the science side. Fundamentally, treating hearing loss with amplification has one fundamental goal.  To restore audibility for sounds important for life.  Primarily, speech cues.  This is where simple sensorineural hearing loss is actually not so simple.  For example, internationally recognized hearing aid prescriptive target rules have built into their target rational accommodations for factors such as recruitment, cochlear distortion, binaural summation, prior hearing aid use and even the unique phonemic content of certain languages.  All dynamic issues that change as a function of degree and configuration of the hearing loss.  All of these are complexities that are not only fundamental considerations in effective sensorineural hearing loss treatment, but are clearly important considerations in maximizing the ability of amplifiers to deliver the most effective restoration of important sounds like speech cues for those with sensorineural hearing loss.  When amplifiers are not adjusted to deliver this sort of targeted performance, they become less capable of delivering effective treatment.  And, when the hearing health professional includes in their treatment process objective real-ear measurements to verify that such targeted performance is actually delivered to the patient’s eardrums (or that it will ultimately be delivered through professionally guided rehabilitative steps) then this too is a valid reason why the hearing care professional should remain involved.

Third, the business side.  Of all of the ways to deliver hearing health care to consumers, operating an independent brick-and-mortar hearing care business is without a doubt one of  the most expensive business models. And, in its historic billing and services form, sustaining this model has never been more challenged.  But, I would not dismiss professional care value simply because this particular business model is showing its age.  Rather, I would encourage smart practitioners to re-invent this model, including finding ways to incorporate OTC and DTC technologies, building services around such technologies and expanding the publics definition of hearing health care to include other important hearing considerations like prevention and balance.  What Jason Meyer suggested fits here.  Find where the patient’s needs are and build the process and solution to accommodate those needs.  This too is a valid reason why the hearing care professional WILL remain involved. 

Written by Dave Smriga, VP Corporate Communications, AUDNET Hearing Group