Immittance  testing was conducted, but the results are not reviewed with this case. The findings were consistent with cochlear site of lesion.

The patient’s hearing aids were found to be functioning properly, and were 3-4 years old.  They are digital hearing aids purchased from a hearing aid dispenser.

The audiologist advised the patient that the hearing aids could be “retuned” for her current hearing loss, and adjusted so that the volume control no longer caused the hearing aid to change in loudness: it would always be on at the preset intensity.  Because she had purchased the hearing aids at a local hearing aid dispenser’s facility and not at the audiologist’s office, the audiologist asked the patient if she wanted to return to the original office or is she would like to have the hearing aids tuned at this audiologist’s office. The audiologist volunteered to do the service without charge.  (The audiologist’s marketing strategy is to provide this type of courtesy service at no charge, believing that it increases the likelihood of the patient purchasing the next set of hearing aids at this office.)

The audiologist cautioned that the hearing aids would not function as well as brand new hearing aids, and gave an estimate of the cost of a pair of “top end” hearing aids of the same style.  The patient indicated that she wanted her current pair of hearing aids adjusted, which the audiologist did.   The audiologist spent a total of one hour with the patient over two visits adjusting the hearing aids.

The patient found that she liked not having to use the volume control wheels, but did not like that with this model, she now had to open the battery doors to turn off the hearing aid.  She reported that she was still having difficulty hearing at dinner and would start budgeting for a new set of hearing aids so that when the current ones next need major repair, she can just replace them.

Hearing aid sales are a profitable part of any audiologist’s practice, and with insurance companies providing limited reimbursement for hearing testing, audiologists need to carefully consider sources of income.  One option is to charge the patient for each office visit, such as those to adjust the hearing aid that was not purchased at this audiologist’s office.

• What are your thoughts on charging per visit as is done in most medical professions versus working to keep the patient happy in the hope that she will purchase the next set of hearing aids from this audiologist?