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AI, Audiologists and Providers

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I love this forum because I believe it is meant to help us all hear better. As for my take on . It’s just a tool. if you quote a reference from an AI result you find helpful provide the link to the actual source data (not the AI) so we know where the information came from and can make our judgement on the credibility. Some of what I find is helpful. As for audiologists and providers, over my19 years wearing hearing aides, like you I have had a variety of experiences. To me understanding that we are dealing with professionals that provide a service for us, but that also sell equipment and service to us is really important. Frankly I find that money gets in the way of getting the best service. When I have an appointment I am on their clock. I always walk in with a target list of what I want to work on with my provider. If I feel the programming is complex I assure that I have made contact with a senior audiologist with my manufacturer, in my case Phonak so half way through the hour the Phonak Audiologist remotes in to my providers screen and program manager. I then read my list to the on line audiologist. When I leave the office I WALKOUT FEELING THAT I got the best possible service that day before I then test and use the new adjustments in the real world. I find that If I do not actively manage my service the results are at a lower level. Advocating, in my opinion guarantees that my voice and best interests have been met without letting profit affect the games some providers play jacking up office visit costs. Ideally Dr’s, audiology professionals and those in healthcare could be more compassionate and patient centered, but they are in business to profit and live too. This is my take, it works for me. How about you? Oh, I assume I WILL GET MIXED COMMENTS. Those that see value in my process, others that will tell me i am off base, but that is what makes this forum great. Looking to hear your thoughts as I ponder a provider change :blush:

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@TonyF said:

so half way through the hour the Phonak Audiologist remotes in to my providers screen and program manager. I then read my list to the on line audiologist.

Ooof. If my patient wanted to do that I’d gently suggest they go elsewhere. The manufacturer audiologists are just regular audiologists, but ones who don’t spend their time fitting patients. They spend their time training audiologists on new software, hyping up their products, and supporting launch events. They DO know a lot about their own product’s software, but whether they have previous good experience fitting hearing aids is just a random as anywhere–I think the manufacturer job postings look for two years of clinical experience. If a patient wants their hearing aid fit by that person and not me, they can go anywhere and don’t need to sit on my waitlist for ages.

I suppose it’s a good strategy if you are booked to see someone who is weak at their job. And to be fair, from what I read on these forums there seem to be a lot of those people around.

Tony, since you have very clear expectations of what you’re seeking in the way of in-ear sound, I wonder if you might be happier going the -adjustment route. I tried it and found it was not for me. I just don’t have the expertise. But it works quite well for many here.

I agree that if your concern requires more understanding of some issue with the software, your approach might be useful, but you should have an audiologist you trust enough that they would be the one to identify that need and call the Phonak audiologist. My audi had done this, calling Oticon when I bought a new version that she was not as familiar with as yet.

@TonyF said:

If I feel the programming is complex I assure that I have made contact with a senior audiologist with my manufacturer

Do you ? If you don’t, what’s your basis for deciding whether the programming is complex?

Can you just call up Phonak and ask them to make somebody remote in to your appointment? I’ve never tried, but I’m surprised they’ll even talk to you. The audiologists, not the patients, are their customers. They usually won’t talk to patients, about anything, no matter how sympathetic the circumstances. They just tell them “Find a hearing care professional and have them call us about this.”

You are being very generous with that interpretation … I saw it as a nasty comment to you … it was a reply to you.

My poor choice of words was directed at my former provider, not toward anyone on this forum. People make mistakes, and others prefer to focus on that vs helping. I should have just used the word weak and moved on. Now the thoughtful part of the post is gone and I believe others gained information from the post. My intent was to help, my frustration caused me to be under stress for 8 weeks.

@TonyF said:

I should have just used the word weak and moved on. Now the thoughtful part of the post is gone

I think we’ve all been there.

And I wish it were easier to find great providers. I think audiology as a field is undervalued which hurts both the clinician and the patient. Other professionals do often seem to have an attitude about it, that will bleed into our own community of thought, that it is “just” fitting hearing aids. But when you fit a hearing aid you put your thumbprint on every single interaction that person has, every day. This isn’t a small thing. If there was a bit more focus on that, if clinicians could remember that in every moment of their day, maybe more care would be taken. I do think that the majority of providers (as people) do want to provide good care, although capacities may differ. But as in everything else, I think it can be hard to stay present like that throughout the routine of the day-to-day.

Self-advocacy is pretty critical in all healthcare, and also a hard skill to develop for some and worth talking about. In the current economic climate it will probably become more important, not less, because everyone is being squeezed and that friction between taking-the-time and making a living is higher. I’ve been trying to navigate through a couple of medical specialists lately and it’s like they don’t even review my file in advance of our appointment–I have to tell them the treatment protocol that THEY THEMSELVES had put me on, and it is hard to come into alignment in the two alloted minutes. The frustration is high.

You hit the nail squarely Neville. I have experienced that friction with various health care professionals, not the two audiologists I have seen as it happens, but with others. Usually the compensation for services is not established by the provider or receiver but by third parties whether the government, insurance companies or other brokering agents. I have seen pressure increase in the past twenty years.

@portage said:

Usually the compensation for services is not established by the provider or receiver but by third parties whether the government, insurance companies or other brokering agents.

Yes. I’m happy to be in a private practice where the owner is also a working clinical audiologist. I’m seeing reports from other clinicans that they are lately having their clinical time compressed. We have 90 minutes for an initial assessment and hearing aid discussions. When I started we had 60 minutes, but our employer boosted it to promote good clinical care–additional testing allowances and further time to comprehensively answer patient concerns/questions. 60 minutes is doable, but often tight (time always includes associated paperwork/ordering/preprogramming). I’ve seen clinicians saying that their upper management is pushing them towards 45 minutes. My boss would never do that because she knows how long it takes. Someone who is not themselves a clinician does not know.

Appointment time, of course, being directly correlated with clinic (and so patient) costs.

Edit: Looping back to Tony mentioning going in with a printed list. Lists are good. Lists help to prioritize time and support patient/provider alignment.

Thank you.

Neville, I totally appreciate your perspective on providers and the state of things. The day I had my recent adjustments the provider who also agreed two days earlier to re invite / contact the same Sr audiologist at Phonak to our meeting who had helped us so much basically told me when I walked into his office after a 45 minute drive that his window was short. he did not contact Phonak as promised. My error as previously I had arranged the Phonak meetings myself with the US VP of Audiology. I trusted him once!

Three weeks prior he also said, the analyses and adjustments we do until you are fitted correctly are at no charge. I think that goodwill was because he ordered the wrong receivers for my molds and they needed to be rebuilt which cost us another 7 weeks of time. So when I told him I was still getting a tambourine in my right ear with higher pitched sound he said, you know you paid half price for your Phonak’s and should be paying me office fees by now. Was I suppose to feel guilty that he committed to do what he said, then bailed out and told me he was done letting me leave with fatigue and stress? I am lucky to have insurance to get my discount, but in 31 years of commercial and medicare insurance with my carrier I have spent over $475,000 on premiums and copays, and my carrier like most others is now into the health equipment business and they do quite well at it. FYI, I also sent my provider three new patients. Everyone is motivated by different things. It took me 8 months to find a preventive cardiologist to agree to treat me with a trial drug under the 21st century Cures act. He is johns Hopkins, world class and amazingly compassionate, and just goes the extra step on everything we do. It took 4 calls a day four days a week four 8 months to find him. So for me, understanding that every person see’s what they do, or a client patients differently. I believe in the need to advocate, or I might have been dead. As for my provider I will be on the phone tomorrow trying to qualify a few candidates to replace him that really know-how to program the manual spheric speech program and the 2.0 FW in total. In addition I am looking for a provider that is more interested in helping me vs. just taking my money. I try and practice what I seek. I bust my rear for my clients because it’s what i believe in.

@TonyF said:

So when I told him I was still getting a tambourine in my right ear with higher pitched sound he said, you know you paid half price for your Phonak’s and should be paying me office fees by now. Was I suppose to feel guilty that he committed to do what he said, then bailed out and told me he was done letting me leave with fatigue and stress?

No, with just that to go on, that sounds to me like an expression of frustration about a combination of a patient taking up more time than expected and also not knowing how to fix their problem, which is not on you and should not be put on you. The “our window is short”, in the absence of you arriving late, sounds like he was having a shit day. But again, that’s not on you. I also know that American providers are being mistreated by insurance middle men right now, but it also seems like it’s their choice to work with them or just see private pay patients? I may not totally understand the complexities of that one, but still not on you. So I hope your just for a new provider is fruitful.

Thank you again. Getting theses device setup and optimized as best as possible is not simple, but its nearing 4 months. Looking forward to finding a good provider and not having to think about it any more is a primary goal. I hope everyone on this site gets what they need as thoughtfully and fast as possible. Being able to hear well is a gift. Cheers Tony

Impressed with the amount of information provided here; not knowing what most are referring to. However being told you pay half price for them is rude. Why sell junk then? With my audio guy it is mostly a miss. And yes, I am paying for visits for awhile now. The shell malfunctioned after a year, warranty on it done. $285 for a new one. No. I’ll get the buds. Thought it was poor Phonak, but think it is the audiologist sales vs. Fittings. And then there is the 3 year warranty when they should last for 5. Most expensive I bought but am thinking twice about putting money out for brands again. Fed up. BTW, 5th set I own, worst I have ever had and think just maybe its the tech’s lack of knowledge past basic training.

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