What a con, man

@dbanner07 said:

If you like Cosco and had a good experience that is great but it does NOT dismiss the evidence that Dr. Cliff and his fellow audiologist have presented.

He doesn’t present evidence, he presents anecdotes. I could do the same thing. Like I could say 95% of people who come to costco have never had REM preformed. I could say that 90% of those same people say something along the lines of “this is the most compressive test I’ve ever gotten and I went to an audiologist before this” - those two things would be true from what I’ve seen anecdotally, but that doesn’t make them facts or evidence.

Another anecdote he states again and again, including in this video, is that the KS10 was faulty because it’s a costco product, and he throws shit against the wall insinuating it’s because it was an inferior product and erroneously claims that the Phonak counterpart to the KS10 did not have the same issues. They did have the same exact issues. A simple search of this forum would show you that. And an even more extensive search of google would show you that Phonak released firmware updates to fix the exact issue the KS10 AND Phonak product were having. But Cliff doesn’t mention any of this; either because he’s ignorantly unaware and just throwing shit against the wall, or because he’s intentionally misleading his potential customers.

The Costco hearing aids are cheaper BECAUSE of the lack or near-lack of follow-up service. You want to entrust your healthcare to a big box store? Fine, get the cheap price and take a chance when something goes wrong. And believe me, something will always go wrong.

In truth, the instrument is only half of what you need when you’re looking for help for your hearing. You will ALWAYS need follow up care. Your hearing changes. Your hearing aids get feedback. Your ears get wax. Things go wrong and need fixing.

I rejected less-expensive hearing aids at my insurer (Kaiser Permanente network) because the audiology dept in my area (Washington DC) was chronically understaffed and I didn’t want to wait 6 weeks for an appointment if something was wrong with my hearing aids. That is a lousy standard of care. So I went out of network and bought them with an interest-free credit card, and paid for them over 21 months. But I knew after 20+ years of wearing hearing aids that being able to hear and communicate and function in the world was worth it. When I have a problem someone gets me into the office within a day. Sometimes same day.

Buy your luggage at Costco. Don’t buy your healthcare there.

So if I show you people who have went to the audiologist and weren’t happy then does that blow your theory of getting better care?

Come on. Plenty of people are happy with the aids and service they get at Costco.

Dr cliff. Is just trying to make more money. Period

I have had my Kirkland KS 10’s for a week short of 3 years. They have just been shipped to Phonak for service before warranty expires on May 16th. I cannot fault Costco at all. Also in most cases when contacting them regarding follow up care, I usually get seen the next day.

What I understand of Costco protocols is that they are heavily directed out of Ontario, which until recently has been entirely staffed by audiologists and managed overall by an audiologist with a strong interest in best practices. During my time as an audiologist, Costco has made REM mandatory, and later made documented probe depth checks mandatory, and later made it mandatory for documentation that REM is within 5 dB RMS or prescriptive targets or otherwise documented explanation for divergence from targets. These second two changes were in response to poor implementation of REM in the first place. That all said, it’s one thing to put protocols into place and another thing to regularly audit clinics and ensure that protocols are being followed and that clinicians have the appropriate education. Further, there’s some theoretical understanding behind what is happening with REM and why it’s important that isn’t always taught, which can impact a clinician’s ability to appropriately implement the practicalities of it. I have also absolutely seen clinicians who run REM and then return hearing aids to first fit. (I don’t really undrstand the logic behind this, but when I’ve asked they have suggested that REM is to prove that hearing aids can meet prescriptive targets, but then they don’t use them. ) I know that Costco is still working hard to actively implement good REM practices, which is another way of saying that there are still a lot of places where it isn’t being done properly.

But there are also piles of private clinics where is also isn’t being done properly, or at all.

In regards to the KS10 being ‘faulty’, there were absolutely updates for charger functionality. That said–this is rumor but I’ve heard it from both people inside Phonak and inside Costco–the returns of the KS10 in America were much higher than the returns of the Audeo AND of the KS10 in Canada. If it were a product issue, you’d expect it to be about even everywhere.

As ever, I would not hesitate to direct a loved one to Costco in Ontario. I’d hesitate in America.

Are there any places in USA that you would confidently recommend?

Here’s my Costco audiogram from the beginning of January:

Here is my Applied Hearing audiogram from last week:

Everything is about the same (±5dB) except the low frequencies. I doubt there is much assistance in those frequencies, so it didn’t strike me as an issue. I didn’t ask for top of the line aids. The audiologist told me that I should buy the most for what I was willing to spend. As far as the Oticons, she told me the price difference between the level 1 and 2 (I think. It might have been the lowest level) was only $200. For what they were charging, $200 is a rounding error.

When my Jabras were in for repair the second time I had a pair of Philips 9030 as loaners. I thought they weren’t amplifying the sound as much because they didn’t have the harsh high frequency sounds as the Jabras. The fitter said that many patients found them more ‘natural’ sounding. It turned out that the Philips were actually amplifying quite a bit more than the Jabras. I found intelligibility was better. I kept having to turn the Jabras down because the harsh sound was uncomfortable.

This fitter told me that most fitters have favorites that they like to recommend. His was Philips. The original guy’s favorite was Jabra (according to the second fitter). Most everyone here agrees that not all aids are suitable for everyone. Maybe Philips are better for me. I don’t know.

On a side note, the second set of Jabras that went back for service were probably not faulty. My issues were a really bad job of programming and short battery life, most likely caused by really bad programming. I can’t imagine why they were programmed so badly since they were only supposed to copy the programming from the original aids before they were sent in.

Jabra (or Resound or whoever). Doesn’t analyze and repair the aids. They just toss them and re-assign the serial numbers to a new set. It’s probably cheaper in the long run and makes everyone feel better that they’re getting a brand new set of replacements.

For those of us who are more nuts and bolts, it’s not quite so satisfying. I have no idea what went wrong with them or why. It can make one wonder if sending them in for repair on a regular basis will become a new activity.

Since I have invested in a couple of TV Streamer+ units that I cannot return, I have a vested interest in keeping the Jabras. I have a couple of months left before the return window closes. I plan to pester the fitters (a lot) before I give up on the Jabras.

I have had pretty good luck over the years with Costco. In the locations where I got the aids, it was usually the same guy that did the fittings and adjustments. Here in the east valley of Phoneix, there are 4 Costcos within a 25 minute drive. They are all busy, with multiple test booths at each location. Getting an appointment is usually pretty easy, within a few days, at most. So far, I’ve used 2 fitters at one location and one at another. On Tuesday, I’ll be visiting a third location. I haven’t found the fitter yet that makes me feel like, “This is the guy!”.

The quest continues.

@neroth8 said:

The Costco hearing aids are cheaper BECAUSE of the lack or near-lack of follow-up service.

That has not been my experience at all. Costco has given me wax filters and cleaning without cost for years after the warranty expired. They’ve been quick to respond in emergencies, even when I’m traveling far from home. They like to wait 2 years between hearing tests but did one for me after a year. I’ve received suggestions for more free services from Costco staff (sending HAs in for checkup before warranty was up, new fitting specs, etc.).

True, my current go-to person sold me an extra set of molds, but she spent at least an hour with me explaining the benefits, doing the fitting, answering questions, so I got the service and the molds for $80, and the molds really improve my ability to hear what people say - and ReSound got a portion of that $80.

Bottom line, as far as I can see, Costco has gone above and beyond my expectation for service.

It was extremely gratifying to be able to get new receivers 1,000 miles away from my home Costco when the receivers failed at the start of a visit with my elderly parents…

I don’t know what Costco’s goals are, but I’m pretty sure it’s based in part on closing sales with a much higher percentage of customers than private clinics do. Economies of scale may be a bigger factor, but I’m pretty sure that higher volume on lower mark-up can offer more cash coming in than lower volume and higher markup.

It’s funny that buying luggage at Costco was mentioned. My father sold luggage from 1939 into the '80s (with time out for WW II). His business took a big hit when old local textile mills were reborn as outlets. He kept up his service, changed what he bought and how he bought it, and did pretty well.

Audis see Costco’s failures. Costco sees audis’ failures. One size rarely fits all. But there are multiple business models that can provide a good income. I wouldn’t try to beat Costco on price and standardized service, but selling aids that Costco doesn’t sell and having the skill to service people Costco can’t service can work, as can being a traditional audi (if there is such a thing) an hour or 2 (or more) from the closest Costco.

Jabras aren’t knockoff Resounds. They are rebranded Resounds and are equivalent as far as I know. I’ll let others comment on this.

When I had my hearing test at Costco, I wore head phones. When I had my hearing test at Applied Hearing, there were tubes inserted into foam pieces and the whole assembly was inserted into my ears. Would that explain the difference? Why do you say that one is more accurate? How would you know?

@mrschwarz said:

Would that explain the difference?

It’s not the transducers per se, it’s probably the placement of the transducers. I’m actually surprised it wasn’t the other way around because it’s common to get a low frequency leak with inserts which will cause that weird low-frequency roll-off that you’re seeing on the costco audiogram. Do you wear glasses?

@mrschwarz said:

Why do you say that one is more accurate? How would you know?

Just experience. And, I suppose, education; theoretical understanding supports practical understanding.

It’s not foolproof . That guy sounds like a real piece of work.

If nothing else, the pandemic has given us a good demonstration of ‘educated’ medical youtubers who don’t know their. . . well, best not.

Neville!

Surprisingly, when I had Costco test my hearing, I had glasses on. Just last week, a couple of days before the Applied Hearing test, I had cataract surgery and I am no longer wearing glasses. Is that a clue?

Did they have you remove them for the test?

Why would you remove the glasses? I’ve never had an Audi ask me to in 20 years

DaveL