4 ms·

I'm convinced that the real reason why hearing aids remain so expensive is because of the need to see an audiologist. In a day and age where Shenzhen makes hard

I'm convinced that the real reason why hearing aids remain so expensive is because of the need to see an audiologist. In a day and age where Shenzhen makes hardware iteration cheap for Chinese hardware companies, it makes very little sense for the hearing aids themselves to be so expensive. I'd love to hack on mine, but I lack the hardware setup that connects the hearing aids to a computer for programming, not to mention a copy of the Noah programming utility itself. Everything is completely closed - good luck finding an audiologist who's gone far enough into software programming and the open-source world to appreciate the benefits that FOSS brings. The UX shouldn't be so complicated - instead of the frequency-oriented UX that Noah presents to an audiologist userbase (which is well familiar with the underlying science and has an interest in working quickly and efficiently so as to proceed to their next patient appointment), have a more optician-inspired UX, which plays a sound or speech track and asks you questions like "does this track or this other track sound better to you?" and "does this sound too quiet or too loud?" over and over again until the end user "dials in" the right fit.

pkaye 8y ago
> I'm convinced that the real reason why hearing aids remain so expensive is because of the need to see an audiologist. That might change in 2020 in the US because some laws have been enacted that will allow some hearing aids (for mild hearing loss?) to be sold directly to the customer.
canada_dry 8y ago
> why hearing aids remain so expensive is because of the need to see an audiologist. A bit like the need to see an optometrist to get glasses. When I was in Beijing a few years ago I went to the glasses district (basically a few buildings all in the same area that are floor-upon-floor of eye glass shops)... I was able to get a thorough exam from the salesman, and had a custom made pair of glasses in a couple hours for under $50US.
- geomark 8y ago
  Is that a U.S. thing, having to see an optometrist? I did not need glasses when I lived in the U.S. But now living in a developing country my experience is similar to yours. Multiple eye glass shops in the shopping malls will check your eyes and cut lenses in a couple of hours. Cost depends mostly on how much you want to spend on frames - name brands are more expensive.
biggieshellz 8y ago
The problem is that patients don't always know what is supposed to sound right, especially if they've been going without hearing aids for years. If you take a person with a high-frequency loss and correct it to the normal range, they'll often complain that everything sounds sharp, or there are too many noises and it's hard to concentrate. Only after wearing them for a while does their brain learn to filter out the normal environmental sounds and adjust to the "new normal".
- solatic 8y ago
  Which is precisely why home self-programming is so important. It allows patients to go back and re-program as often as they feel necessary, and such additional tunings would not cost the patient the cost of additional audiologist visits. I guess the question is whether ignorance is bliss. If a patient self-sets a hearing aid to a level that the patient thinks is great, but isn't theoretically as great as it could be, is that actually a problem?
adisinom 8y ago
Self-programming is a viable option. In the past HA companies had a problem: audiologists weren't technical and didn't know how to program the increasingly sophisticated hearing aids. So the fitting software (1) automatically produces a reasonable fit and (2) at least the ones I've used have a section that asks questions and makes adjustments based on the answers. It's also worth noting that there isn't really a "correct prescription" but rather it's an art of arriving at settings based on the client's goals and feedback. The audiogram is a diagnostic tool but only a starting point for determining HA settings. From the HA dispenser's perspective, adjusting settings costs them time and therefore money after they've made the sale. From the client's perspective, you'd need to visit the audiologist for every adjustment. Self-programming avoids the problem. The programming hardware, software, and used hearing aids are all available on ebay. The prices are such that your average HN reader wouldn't have to worry too much about replacement costs if a HA breaks or goes missing. And the flexibility is great too. You may not need NOAH. For a Phonak hearing aid you only need the iCube II (programming device) and Phonak Target (programming software). The NOAH software is an optional place to store customer data which is useful in a clinic that sells hearing aids from different manufacturers.

pkaye 8y ago

> I'm convinced that the real reason why hearing aids remain so expensive is because of the need to see an audiologist. That might change in 2020 in the US because some laws have been enacted that will allow some hearing aids (for mild hearing loss?) to be sold directly to the customer.

canada_dry 8y ago

> why hearing aids remain so expensive is because of the need to see an audiologist. A bit like the need to see an optometrist to get glasses. When I was in Beijing a few years ago I went to the glasses district (basically a few buildings all in the same area that are floor-upon-floor of eye glass shops)... I was able to get a thorough exam from the salesman, and had a custom made pair of glasses in a couple hours for under $50US.

geomark 8y ago
Is that a U.S. thing, having to see an optometrist? I did not need glasses when I lived in the U.S. But now living in a developing country my experience is similar to yours. Multiple eye glass shops in the shopping malls will check your eyes and cut lenses in a couple of hours. Cost depends mostly on how much you want to spend on frames - name brands are more expensive.

biggieshellz 8y ago

The problem is that patients don't always know what is supposed to sound right, especially if they've been going without hearing aids for years. If you take a person with a high-frequency loss and correct it to the normal range, they'll often complain that everything sounds sharp, or there are too many noises and it's hard to concentrate. Only after wearing them for a while does their brain learn to filter out the normal environmental sounds and adjust to the "new normal".

solatic 8y ago
Which is precisely why home self-programming is so important. It allows patients to go back and re-program as often as they feel necessary, and such additional tunings would not cost the patient the cost of additional audiologist visits. I guess the question is whether ignorance is bliss. If a patient self-sets a hearing aid to a level that the patient thinks is great, but isn't theoretically as great as it could be, is that actually a problem?

adisinom 8y ago

Self-programming is a viable option. In the past HA companies had a problem: audiologists weren't technical and didn't know how to program the increasingly sophisticated hearing aids. So the fitting software (1) automatically produces a reasonable fit and (2) at least the ones I've used have a section that asks questions and makes adjustments based on the answers. It's also worth noting that there isn't really a "correct prescription" but rather it's an art of arriving at settings based on the client's goals and feedback. The audiogram is a diagnostic tool but only a starting point for determining HA settings. From the HA dispenser's perspective, adjusting settings costs them time and therefore money after they've made the sale. From the client's perspective, you'd need to visit the audiologist for every adjustment. Self-programming avoids the problem. The programming hardware, software, and used hearing aids are all available on ebay. The prices are such that your average HN reader wouldn't have to worry too much about replacement costs if a HA breaks or goes missing. And the flexibility is great too. You may not need NOAH. For a Phonak hearing aid you only need the iCube II (programming device) and Phonak Target (programming software). The NOAH software is an optional place to store customer data which is useful in a clinic that sells hearing aids from different manufacturers.