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Audiologists - Dispensers Consumers: What Do They REALLY
Think About Hearing Health
Eric Timm
Vice President, Marketing & National Sales
Phonak USA
Phonak U
August 2009
Course Objectives
• Describe how patients think about the category
and the process of becoming a hearing
instrument user
• Outline the differences between how audiologists
and hearing instrument specialists are motivated
and how they think about the industry
• Apply the insights from this study to how they
approach their own practice behavior
Study Profile
• Southeast
• Northeast
• Southwest
• West
• Midwest
Focus group discussions were held early 2009
Screening Criteria
• Consumers –- consumers were segmented into
‘Active Seeker’ and ‘User’ targets focus groups
• Dispensers -– licensed and practicing Hearing Aid
Dispensers
• Audiologists -- earned a Masters, AUD or PhD
advanced degree in audiology, and actively
dispensing hearing aids
A Few Words About Focus Groups…
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Qualitative research technique
Should not project to general population
Brings together 6-12 respondents
Relies more on group discussion than directed
questions
• Purpose:
– Provide overall category information
– Stimulate new ideas
– Generate hypotheses for quantitative testing
Study Objectives
– Gain a deeper level of insight and understanding of the
attitudes and behavior of hearing aid professionals,
uncovering the key triggers that drive Audiologist and
Dispenser interest
– Better understand customers’ and consumers’ tacit and
emotional beliefs about hearing aid brands/products,
including key factors that influence their attitudes and
behaviors
– Understand the consumer hearing aid decisionmaking process, specifically to determine what drives
them to a particular Audiologist or Dispenser, and
understand what information sources they evaluate in
selecting a particular brand or device
What are YOUR Hypotheses?
• Among Hearing Health Professionals:
– Brand Perceptions?
– Manufacturer Selection?
– Switching Behavior?
• Among Consumers:
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Buying motivations?
Channel selection?
Information sources?
Brand perceptions ?
Key Findings Summary
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‘Users’ and ‘Active Seekers’ have similar impressions of the frustration
of hearing loss; however, Users feel the emotions much more deeply than
Seekers
Consumers are not aware of the difference between Audiologists and
Dispensers, yet they appear to comprehend ENT (Ear-Nose-Throat)
physicians are the most closely linked to the medical community
Consumers use word-of-mouth and the internet as sources of
information to learn about hearing aids and brands, yet they turn to
their professional for advice regarding the specific brand and model
best-suited for their needs
Users are engaged with the category, yet have very little brand
awareness / understanding; Seekers have even less brand awareness
Although Professionals are very aware of different brand alternatives,
they perceive very little differentiation between the key players
Attention from a manufacturer’s representative appears to be the primary
reason why Professionals use a certain brand, and will switch to a new
brand
Consumer Detail
Consumers: Hearing Loss &
Purchase Motivation
• The physical symptoms of hearing loss are
different for everyone
• Other health issues often take precedence over
dealing with hearing loss
• ‘Users’ perceive hearing loss and its impact on
their life differently from ‘Seekers.’ Similar
themes include frustration, isolation,
embarrassment and fear
• Users “rely” on their hearing aids to help them
live “normal” lives
Consumers: Hearing Loss &
Purchase Motivation (II)
• To make up for not being able to hear appropriately,
Seekers engage in compensating behaviors that allow them
to function as normally as possible while dealing with their
hearing loss
• Denial, vanity and cost are the major factors that delay a
consumer from obtaining a hearing instrument
• Younger consumers still in the work force adopt hearing
assistance much sooner than retired consumers
• Childhood hearing loss was especially traumatic for those
who grew up 30-50 years ago
It’s personal
Consumers: Information
Sources & Channel Selection
• Consumers primarily use word-of-mouth as their means to
learn about hearing aids
• The internet plays an increasingly important role for
information gathering, and even channel selection
• While they may not use industry terminology, most
respondents recognize there are a variety of hearing aid
styles; yet they may not know the advantages and
drawbacks of each style
• Respondents, especially ‘Seekers,’ are largely unaware of
the difference between Audiologists and Dispensers
Consumers: Information
Sources & Channel Selection (II)
• Channel selection may be driven by severity of hearing
loss, as some consumers are forwarded from their ENT
(Ear, Nose & Throat specialist) to an Audiologist working
with the ENT
• As Users need to replace their hearing aids, they are much
more likely to consider alternate channels for subsequent
hearing aids to decrease the cost of the instrument
• Costco is an appealing provider of hearing aids
Consumers are looking for new
solutions
Consumers: Hearing Aid
Adoption, Usage & Satisfaction
• Historical experience with lower-quality hearing aids drives
impressions of current hearing instruments, and may delay
Seekers from obtaining hearing aids
• Aesthetics are a primary driver of hearing aid selection; in
fact, some may select an instrument for aesthetics,
regardless of performance
• Usage behavior differs based on severity of hearing loss, as
some respondents only have one instrument, or only use
them for watching television, whereas others depend on
their hearing aids all the time
• Satisfaction with hearing aids is mixed; some respondents
are overwhelmingly pleased with their instruments,
whereas others complain they do not meet their needs
Consumers: Hearing Aid
Adoption, Usage & Satisfaction (II)
• A few Users complained their hearing aids are
uncomfortable, whereas other Users professed they often
forget they are even wearing them
• There is little understanding that hearing aid performance is
linked to the quality of the fit
• Satisfaction appears to be linked to the frame of reference
or expectations respondents had for their instruments
before being fitted with a hearing aid
• Price is a major dissatisfier
• Seekers expect hearing aids to last “forever” whereas Users
have become accustomed to four to five year life spans
Fitters have a major impact on
consumer satisfaction
Consumers: Brand Perceptions
• There is very little awareness of hearing aid manufacturer
branding or advertising, although awareness of channel
advertising and promotion increases when consumers are in
the market for a hearing instrument.
• Unaided brand awareness among ‘Seekers’ is extremely
low, with only a few respondents recalling Siemens, Beltone
and Miracle Ear
• Users’ are generally only aware of the brand of hearing aid
they have worn.
• Users’ initial Brand selection is almost primarily driven by
the recommendation of their fitting Professional
• Users’ subsequent Brand choice is influenced by their
experience and satisfaction with a particular brand, yet
professional recommendation can trump this preference.
Branding is virtually nonexistent
in this industry
Professional Detail
Professionals: Channel Review
• Most Dispensers and Audiologists appear to be truly
motivated by the desire to help people and the technology
of hearing diagnostics and instruments
• Dispensers entered the business from a myriad of paths,
from entering the family business to answering a classified
advertisement titled, “Closers wanted”
• Many Audiologists “ended up” in the hearing side of the
business as a result of disliking the speech portion of
‘Speech & Hearing’ university coursework
• Audiologists are predisposed to think of themselves as
more educated regarding hearing and hearing loss than
Dispensers, but a few recognize Dispensers may have more
practical instrument knowledge and experience than
Audiologists
Professionals: Channel Review (II)
• Although members of each community recognize there are
“good and bad” representatives of each other’s field,
tension nevertheless exists between Audiologist and
Dispenser communities
• Interestingly, Dispensers were more likely to refer to their
clients as “customers” whereas Audiologists were more
likely to refer to their clients as “patients”
• Overall, professionals are dissatisfied with industry
statistics that only 15-25% of those with significant hearing
loss have hearing instruments
Shared motivations, different
paths
Professionals: Marketing & Sales
Approach
• Audiologists and Dispensers have difficulty differentiating
themselves from each other
• Audiologists in a “medical model” operate differently from
Audiologists in private practice who appear to think more
like Dispensers
• Audiologists may qualify their patient’s financial condition
when recommending an instrument, whereas Dispensers
are more likely to let customers decide from a variety of
instruments
• Dispensers are much more likely to attempt to get their
customers in for check-ups every three months to assess
their current instrument fit, but also to build the
relationship with their customer
Professionals: Marketing & Sales
Approach (II)
• Word-of-mouth referrals are perceived as the most effective
marketing tool
• Several professionals also feel mining their database for
direct mail is an effective marketing tool, yet they have
mixed success with print advertising
• Manufacturer co-op dollars are viewed as a significant
opportunity to promote their business, and can impact the
way a professional uses and promotes a manufacturer’s
product line
• Marketing effectiveness tracking is largely limited to gut
feel, and asking patients to check a ‘how did you hear
about us’ box
Marketing sophistication varies
greatly, depending on type and
size of practice
Professionals: Information Sources
• Professionals use a myriad of sources to reach their
required number of CEUs, such as manufacturer and
industry seminars, and online coursework
• One-on-one manufacturer rep. training is viewed as the
most effective way for professionals to learn about hearing
aids
• Industry journals are also important sources of on-going
information regarding the hearing and hearing aid industry,
• Professionals also use manufacturer websites for product
portfolio information
• Professionals desire a better, more comprehensive, brandneutral website to which they can direct consumers for
information
Personal training is best
Professionals: Brand Switching
Behavior
• Professionals select (and de-select)
manufacturers based on a variety of product and
program elements, and will largely remain with
their preferred manufacturer until they fall short
on one or more of the following:
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Track Record For Successful Patient Fits
Product Innovation
Software
Support Services
Representative Attention
Flexibility of Terms/Conditions
Professionals: Brand Switching
Behavior (II)
• Consistent, positive representative attention
appears to be the most effective way to drive
brand switching among professionals.
• Nickel and dime charges for accessories can be
annoying
• Wholesale prices roughly 10-20% above or below
market averages for similar equipment can also
drive brand switching
Good products are important,
but service trumps product
Confirmed Beliefs
• Consumers are dependant on fitters and still have limited
brand awareness
• Key solution needs continue to be TV, phone and hearing in
noise
• No 20/20 hearing restorative solution yet
• Fitters have limited exposure to brands outside their
immediate experience and dispenser attitudes are often
formed on aging perceptions
• Fitters have high hurdle to switch…high risk associated with
change
• Critical differences between audiologists and HISs
New/Surprises
• We have internet savvy consumers with a high level of
frustration with current informational resources
• Advertising/promotional activity is most effective when
consumer is ready…timing is everything
• Price resistance among consumers, driven by value
dissatisfaction and competing consumer health priorities
• Costco shoppers emerged as “smart buyers” within group
discussions
• Most consumers (except super users) wait until catastrophic
failure to replace HIs
Discussion Points
• Given the unique circumstances of each individual’s hearing
loss, how do you elicit this information?
• If denial, stigma and cost are major barriers…what are your
suggestions to overcome?
• How might audiologists and dispensers more effectively
differentiate themselves?
• What should drive manufacturer selection…product or
service?