I sent a secret shopper to Costco Hearing Services. Here's what happened.

Costco is recognized for providing high-quality hearing aids at low prices to its members, but how are its hearing health services? In this article, I'd like to concentrate on the level of service provided by Costco Hearing Centers to their members.

Last year, I scheduled an appointment for my assistant, who suffers from mild to severe hearing loss, at a local Costco Hearing Center so that we could assess Costco's dispensing model and the quality of care provided. I then had my assistant write a 10-page report detailing her entire experience. This required several trips to the local Costco.

Disclaimers

Before we get to her experience, a few caveats:

I am an audiologist who owns a hearing aid practice in the Phoenix area. Costco is, therefore, technically a competitor of mine.

When I uploaded this piece as a video last year, I received a lot of criticism. Please understand that I am not trying to upset anyone. I make every effort to be as objective as possible in my films. Still, I am well aware that there is some potential bias whenever I provide my opinion on a particular hearing aid or a firm that could be considered a rival.

With these disclaimers out of the way, let's talk about the following aspects of my assistant's Costco hearing center experience:

1. Testing
2. Hearing aid selection
3. Hearing aid fitting
   
4. Follow up visits

Testing

It was easy to schedule my assistant's test. Within a week, we had her in the Costco Hearing Center. For first hearing tests and device selection, Costco offers 45-minute visits.

The practitioner at this location was a hearing instrument specialist, not an audiologist. The critical difference is that an audiologist receives formal schooling that a hearing instrument expert does not receive in most circumstances. I have nothing against hearing instrument specialists. They have the potential to be amazing if they know what they're doing when it comes to hearing aid testing and fitting. According to my assistant, this particular provider had a warm personality, which is fantastic news.

After examining my assistant's case history, they discussed their previous experience with hearing aids but not nearly enough time was spent determining the environments where my assistant is struggling the most with her hearing loss.

Not only that, she mistook earwax for a perforation of the eardrum. She failed to do speech and noise testing, which is required by best practices. And she ended up testing my assistant's hearing improperly, which resulted in an inaccurate referral to an ENT for medical clearance and an incorrect prescription for setting up and programming a set of hearing aids.

Hearing aid selection

Costco is well-known for having a large assortment of hearing aids. A hearing care specialist should carefully pick and recommend the most appropriate equipment to a patient based on their specific goals and needs.

This is not what happened in this meeting. My assistant claims that the provider just inquired about which hearing aid she thought she wanted (A Kirkland Signature 10.0). And the entire process of making a recommendation took less than 30 seconds.

It was a nice touch that the provider asked for my assistant's input. It's ridiculous, however, that the hearing provider didn't even question why she thought the Kirkland Signature brand of hearing aid was the most appropriate, especially given that the vast majority of people with hearing loss have no idea what they're looking for in a hearing aid.

It's probably unfair because this Costco provider only had 45 minutes to complete everything from the case history to the hearing aid choosing process. In my office, this process takes at least 2 hours.

Hearing aid fitting

This provider did Real Ear Measurements when fitting hearing aids, which is critical for a hearing aid fitting. However, they did not run any diagnostic test box measures to confirm the hearing aids were mechanically sound before fitting them.

She also failed to do a feedback management test, which is crucial for determining the correct dome for my helper. The hearing aids were then not programmed to the correct prescriptive targets because the hearing test had been done incorrectly, resulting in faulty prescriptive targets.

Furthermore, they didn't start any validation outcome measures, which will make evaluating my assistant's subjective performance with these hearing aids at the end of the fitting period very difficult.

Follow-up visits

After the initial fitting, my assistant's first follow-up meeting was her best session with her Costco provider. The provider addressed my assistant's worries about background noise and her voice. And the provider made changes to the devices that appear to have resolved the difficulties.

Things started to go downhill after the second follow-up visit.

Some of the changes made during the first follow-up visit were beneficial. Still, they also introduced some new issues, such as static artifacts and warbling perception of high-pitched sounds in noisy surroundings. This shows a hearing aid's excessive usage of digital features. The provider employed even more digital features to compensate for the tweaks she made during the initial appointment, but this just seemed to exacerbate the problem. Using one of those diagnostic test boxes would have shown you what a hearing aid's corresponding input noise is.

When these tweaks and modifications failed, the provider contacted Phonak for assistance with the actual programming of the devices. Unfortunately, all of Phonak's programming change recommendations were only applied to the calm program, not the noise programs that my assistant was using.

Final thoughts

Takeaway #1: Good hearing treatment is more than good hearing aids. Costco sells good hearing aids, but even the best hearing aids are only helpful if the right one is chosen and calibrated correctly.

Takeaway #2: Real ear measurement is not the only best practice to observe. If you're unfamiliar with best practices, they're a detailed set of procedures that must be followed to enhance hearing aid function. You run the risk of missing out on many benefits if you don't devote the time required to accomplish thorough best practices.

Takeaway #3: When treating hearing loss, knowing what you're doing and why you're doing it is critical. There's a considerable difference between someone who fits hearing aids for a living and treats hearing loss professionally. Hearing loss treatment is complex and significantly impacts our patients' quality of life, so the stakes are pretty high.

Takeaway #4: This is just one Costco experience. Your experience may be much better, significantly worse, or precisely the same. It all depends on whatever service provider you choose.

It takes time to treat hearing loss. And you have to eliminate a lot of services to bring the cost of treatment down to where Costco has it right now. This makes providing complete best-practice care almost impossible.

However, if you cannot afford to visit a private clinic for complete best-practice care, you must seek treatment elsewhere. And I'd rather you go to Costco than buy devices online because at least Costco can give you in-person services. But, no matter how much money you save, you should never settle for anything less than an outstanding hearing aid experience, whether you go to Costco or elsewhere.