Clinic updates

Why do some Americans not want to pay for Service?

For many years now I have been aware that many people do not want to pay for service. People will gladly pay for a product and especially a product that is deemed less expensive than other products in that same category. This post, however, is not about the product, it is about service.  

First and foremost, we are changing our service plans to accommodate the warranty time of the hearing aid. We are offering retro upgrades if you have purchased in the last three years, and your hearing aid is still under manufacturer warranty. The details are spelled on service packages online and in the clinic.

My intention for this post/blog is to share why we are changing the service packages to help accommodate a problem.

Reading about fees for service, PPOs, and paying for people’s time is interesting. On one hand, fees for service in health care insurance have changed because some doctors were doing unnecessary testing to get a better payout. So now the insurance fees are based on a “whole body” approach to what is acceptable for this illness or condition so to speak. I can’t speak too much on this topic other than I want to mention it and let you know I am not referring to this insurance fee for service.

Thus we are not talking about insurance payments since I am sharing the common disturbance of private pay for service.  

There are many services available for people to choose from.  For most services, you have to pay out of pocket to receive them. One such service is when you need to fix something. You call the service person and either make an appointment or they come to you and charge you for a service call. Then there are parts and labor on top of the service call. Do we like spending money on repairs or services? No, but we know we have to pay as it wouldn’t be right to not pay. If we all didn’t pay, who would help us with what we need?  I learned early on that there is no such thing as a free lunch.

What about a massage? If you want a massage, usually that is private pay. Perhaps you don’t get a massage because you don’t want to pay and that is fair. Many people do like massages and they have to pay for the service. Some insurance companies do not cover chiropractor care or even optometrist care.

If you need something and you receive the service, you pay. Audiology services, same thing. When you come see an audiologist it is private pay as health insurance doesn’t cover service as a benefit.

Since 2012, when I went into business for myself starting Chears Audiology, I had a “menu” type option and as I learned about the industry and people’s behaviors and what they wanted, I unbundled the product even more from the service. Do any of you remember my “menu” book at the front bar?

Anyway, I remember fondly a patient named Michael in 2015 ish. He and I had many a discussion on transparency and pricing. This was around the time that Time magazine revealed what doctors and hospitals were charging and when the insurance didn’t pay, people found out they were paying 10 dollars for an “aspirin”, or something so astronomical. Apparently, many people were filing for bankruptcy because of medical bills.  

Around that same time when I was hanging with Michael, I went to the dentist and they gave me a fluoride treatment. Later on, I found out that the horrible stuff they spread on my teeth cost 85 dollars which was not covered by insurance. I now know to say no to that treatment as I didn’t like it and well.. I have to say one of my best features are my teeth and they are in good shape (despite the fact that I love candy).

Now that I know darn well that when I get something outside of what insurance covers there will be a cost.  Going back to my audiology business, I know that since 2012 we have been discussing how Medicare does not cover hearing aids. And because Medicare does not cover hearing aids, many other insurances also do not cover hearing aids or the care that is associated with the hearing outcome.

I understand and know that there is no way people with moderate or greater hearing loss can get a hearing aid and expect the desired outcome without service. People think that just getting them put in their ears is all that is needed. Or is it?

I am here to tell you it isn’t! You don’t know the difference that we professionals understand. We went to school to think, analyze, treat, explain, counsel, and more to help people who need hearing and ear care services. There are so many aspects to fitting and counseling for better hearing. I can’t even count how many times I have seen someone who was fit by a retail “warehouse” device, or came in to see us for better hearing, as the retail “warehouse” device “never worked for them”. Some people do believe the retail warehouse device works for them, but how do they know? Have they consulted with a professional that will offer audiological services?  I guess what I am saying here is I believe our services are worthwhile, most of the time.  Ha

Over my years in private practice, I have offered a number of options for paying for service.

One method, for instance, is the bundled method. We have accounted for our service and don’t need to charge you as you come and go for help. This bundled method has some faults. First, it keeps the cost of hearing aids nice and high.  While some of you choose our 5-year service package with full bundled costs, most of you do not.   

Second, the bundled model lacks transparency, as you don’t really know what the cost is of the service you are getting from me, your audiologist. And the cost is so much higher than the cost at a retail warehouse.

Lastly, if you don’t need all the services, why should you pay for those bundled services?  We do not see many of you very much as you are happily hearing.  

Hence, many people like to itemize and pay as they go. It makes sense.  I appreciate this method and myself like this method unless I can get buy 4 massages and get one free. haha 

We also want to try (yes I said try) to have the most competitive pricing, therefore, we have unbundled the cost of our service from the product. This has worked pretty well over the years.  We can’t really compete with a retail warehouse as I don’t buy as many hearing aids in one year as they buy in one day. And maybe it would take me 10 years to buy as many hearing aids as the retail warehouse orders and fits in one day!  Think about it.  

So we still can’t compete in price of the hearing aid and we still need to be paid for our time. A problem for sure when we want to compete.  I fear it is only getting worse.  For instance, more and more people wait months to go to a retail warehouse for a hearing aid.  Instead one could come in within a week or two and see us.  Understanding that they will get better service, and experience and not wait months to get help.  

I just read a post in “Medium”, (a publication of shared spaces for stories written around a common theme or topic, usually by multiple authors) by a person who shares the same observation I am finding.

She shares in her publication that many, not all, people do not want to pay for her time, energy, expertise, service, and help and avoid paying by various tactics. She shares how she has lots of schooling and years of experience and is able to offer something that a novice can not do. She claims to be a professional. I too have lots of experience and years of schooling.  

This post also points out that she likes to help people and feels badly asking for money. She wants to accommodate. This woman writes how when she was younger, she gave away her time more freely.

Now in her older age, she feels empowered to stand up for herself. Not to mention she has bills to pay like you.   I completely relate.  As an entrepreneur, a clinician, and a businesswoman, I often wonder what people would do if their employers didn’t pay them.  How would they feel? Very disrespected.  Right? Would they quit, scream, sue, demand, or picket?  Well as a business owner, we can’t do any of that other than ask you, those who need our service to rightly pay your bill.  

Coming back around to why I decided to write this post. For most of our patients,  you are respectful of our time and service cost and stop at the front desk and ask how much you owe us. Some of you are even in a service package and still respect us and want to pay us for our time. We thank you for that.  And we also thank those of you who send us deli sandwiches from a famous deli in NY, bring us chocolate, oranges, syrup, flowers, and other such yummies.

I am talking to the people who don’t stop and offer or I feel they are trying to find some tactic to get away from paying. People who stop by without an appointment, hurry and leave before asking if there is a charge.  Are these people hoping to not pay or do they just not understand etiquette for small business?  I hope it is the latter. 

Recently Malia and I had a long conversation with one of “our people” patients about the issues we are facing charging service fees, for our time essentially.

Because more people are not respecting the idea of paying for service or are complaining about a fee for our time, with comments like, “My friends don’t get charged when they go to a retail “warehouse”… how are you going to compete”? Malia said, “We just can’t compete.” We can’t.  

Many of you probably do not think twice about this topic and that is why I am pointing it out. I like when people are educated and then do the right thing respecting one’s time.   

If you are out of your service plan or want our professional advice, please know that we do charge for this type of service. Customer service is different. I am talking about hearing health care services. I thank you for asking what you owe. Perhaps you won’t owe anything, but it doesn’t hurt to ask.

To make life better for you, and easier for us, we have decided to extend to you, those who purchased a 2-year service plan to 3 years! Since the hearing aids are in warranty for 3 years, our service will also cover that time.  The packages will go up in price to accommodate more time. Going forward, therefore, there will be a 3-year plan.  After that, you know the drill.  

For those of you who purchased the one-year plan, we are offering the opportunity to purchase the 3-year service package for ¼ of the price of the new 3-year plan.

The other package is the 45-day trial package. If you do this package, please be aware that there will be service fees every time you come in for service after this 45-day period. Our prices are posted on our website, at the front desk and you can always ask before you come in.

If you don’t want to pay us, then please don’t come in. It is that simple.  We will miss you but we are here to help those who appreciate our time and efforts. 

Thank you for listening and reading.