Asserting Our Value: Time to Make the Invisible Visible

Think about the last time you took a flight. Consider all the choices that went into making your decision about the flight you would take—the cost of checking a bag, the departure and arrival times, whether there was a connection and how long it was, the likelihood of getting your desired seat, and more. Frequent flyer programs, in-flight entertainment options, even the convenience of the terminal, may have influenced your decision. It’s likely that what is arguably the most valuable service an airline can provide—a safe arrival—didn’t even make your list. Why? At this stage in air travel’s history, we assume it is a given that the airline will deliver you at your destination with virtually no risk of devastating injury. As passengers, we don’t see the work of the air traffic controllers whose communication ensures we don’t collide mid-air with another plane. By the time we board the plane, the work of the engineers who ensured the plane was flight-worthy is a distant memory. We are so certain these steps will be taken, we don’t give it a second thought. Thus, when asked to list what we value most in selecting our flight, safety likely never comes to mind. DETERMINANT ATTRIBUTES One key principle of business is that “it has to be visible to be valuable.” Customers cannot value that which they cannot see or understand, and they do not value that which they assume to be equivalent. Determinant attributes are the factors that are considered by a consumer when deciding which products to use or what service to employ once they have decided that they need a particular product or service. For most consumers, the decision to purchase is determined by taking all available information, eliminating Factors Assumed to be Equal + Factors Not Well-Understood from consideration and using remaining information (determinant attributes) to differentiate between options. When no factors remain, the surrogate factor upon which a decision is made is usually brand recognition. In the case of the airline industry, travelers assume the experience of the pilot, the likelihood of arriving at the destination, and the probability of doing so safely is equivalent among carriers. They likely don’t understand the complexity of the flight plan, the superiority of connecting airports, or the quality of materials used to build the plane. What they do have visibility to is how good of an experience they have, how much they pay, and how efficiently they arrive, which is why these factors tend to top the list of what makes their decision instead of factors that are arguably more important to ensuring they land in one piece at their destination. In the current post-OTC hearing aid regulation environment, many articles and presentations have touted the importance of hearing health care providers, ensuring that patients are aware of the value of our services. But demonstrating our value is not as simple as telling consumers we’re valuable; it’s actually a tricky proposition because we need to make hearing health professionals’ services and expertise determinant attributes. THE CONSUMER PERSPECTIVE Assuming a consumer has decided that it’s important to take action to improve their hearing (which in itself is no guarantee – see my August 2021 Editorial: https://bit.ly/3XsLIKC), the list of most consumers’ determinant attributes is short. Take all the available information you have about why involving a hearing health care provider is valuable. As a hearing health professional, your list likely includes factors such as the complexity of nonlinear hearing, processing, and cognition; the importance of incorporating best practices like verifying a device fitting to ensure optimal amplification; and the long-term consequences of under-fit hearing loss. But recall that consumers exclude from their differentiation equation anything they don’t understand, which probably eliminates most of any good hearing professional’s list. Similarly, consumers eliminate anything they perceive to be equivalent, which in the case of prescription and OTC hearing aids may include factors such as aesthetic appeal and the ability to improve hearing and perhaps even different types of hearing health professionals. In the end, the factors that ultimately drive their decision are likely factors like price, experience (theirs or that of a friend/family member), and convenience. In the absence of even these slim variables, brand recognition—like that of big-box or wellness stores or consumer electronic products—may tip the scales. OUR ADDED VALUE Because most of these factors are directly related to the device itself, services and expertise are effectively devalued from a consumer perspective. Thus, the imperative for hearing health professionals is making the invisible visible to the consumer so it is taken into consideration when deciding what is valuable to them. Practices like free hearing tests preceding a device fitting make the value of the comprehensive diagnostic invisible. Failing to include speech-in-noise assessment, patient-reported outcome measures (subjective questionnaires), and discussing non-amplification options (implants or assistive-listening devices) all make the value of services and expertise that can’t be obtained outside of a hearing health provider’s office imperceptible. Not recommending aural rehabilitation or plans that exclude that care from coverage erase the perception of value of ongoing care in the eyes of consumers. Talking about hearing devices instead of hearing health eliminates important variables from consideration. As hearing health professionals, we know that these services and expertise are valuable to the individuals we serve. But value is in the eye (or in this case ear) of the beholder. If we want consumers to consider our services and expertise as determinant attributes when making important decisions about how to manage their hearing health, they must be visible to be perceived as valuable.