Patient, client, or…?

Management of Clinical Cases

Valeria Serra
The Unexpected Visitor:
 You receive a host at your home.
 To start with, you were not informed about the time that this host would
arrive at your home and you did not have time to prepare anything.
 The host has brought a huge amount of luggage.
 This visitor is always interested in calling out the attention of everyone
and at all times.
 When the host laughs, the laughter is really loud. The host is sad if
everyone do not share the laughter.
 He or she uses everything that is at home and does not respect anything.
 The host “stole” your favourite seat when watching TV, even the channel
was the one that the host wanted.
 His or her food had to be special
 When the host wanted to sleep, everyone had to be in silence, but when
the rest wanted to sleep, he or she did not respect the rest nor their
sleep.
Would you receive again at home this visitor?

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The visitor is 6 months old and is your
grandchildren…
Then what?...Oh! Then you would
receive the visitor…

THE HEARING IMPAIRED is “the unexpected

visitor”. We don’t know what we will find…BUT
WE MUST SOLVE SUCCESSFULLY THE SITUATION.

We need to know how to LISTEN, NOT

PREJUDGE AND ANALISE THE PROBLEMS THAT
THE PATIENT DESCRIBES IN ORDER TO PROVIDE
THE “BEST POSSIBLE HELP”

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Is it the same selling shoes than selling
hearing aids?

…DO YOU TRY BOTH OF THEM?

YES! (SIMILARITY)

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 Is it the same selling shoes than
hearing aids?

As a general rule, it is the client who SELECTS (for different reasons that were previously mentioned:
colour, material, heel, aesthetics, etc.), TRIES and CHOOSES the shoes.

The salesperson can suggest some shoes sometimes, but usually intervenes to satisfy the “demands” of
the client. It would hardly occur that he or she proposes you to wear black shoes if you have come
looking for white shoes (that is, it would never be convenient, it would never be a logical explanation
that the salesperson would want to “convince” the client about choosing them).

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 Then?
HEARING IMPAIRED PATIENT HEARING IMPAIRED CLIENT

DIFFERENCES: in order to sell some shoes we will DEAL WITH A CLIENT, whereas in
order to sell hearing aids you will deal with a PATIENT AND A CLIENT AT THE SAME
TIME.

“This visitor” is PATIENT and CLIENT at the same time and the hearing aid specialist
will have to deal “both with one aspect and the other” having an ethical attitude.

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 Hearing aids

Examination Assessment
LISTEN TO THE PATIENT and OBSERVE THE RESULTS: knowing what the client is looking for and if it can
be offered. If it is not possible, make clear the reasons. Know how to ask in order to know the
expectations.
To sum up: YOU INDUCE THE CLIENT TO JOIN, IN ONE OR SEVERAL PROPOSALS (that the hearing aid
specialist has already “mentally” PRESELECTED, according to the individual situation of the patient).
“DEMAND” WITH “REAL NEEDS/POSSSIBILITIES OF AMPLIFICATION” (it usually occurs that the patient
concurs with a demand. Example: that it needs to be small, which is not always possible due to the
amplification needs of the patient). THE PATIENT IS ADVICED, THE REASONS ARE LOGICALLY EXPLAINED,
THE PATIENT TRIES THE HEARING AIDS AND FINALLY THE MODEL IS SELECTED.

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Closing of the sale:

While a sale is closed with the

payment of hearing aids, the
solution process of hearing
problems “is opened”, which is a
continuous work: reviews, solution
of complaints and problems,
cleaning, etc. The price of the
hearing aid includes the subsequent
attention that does not occur with
the shoes.

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We should treat at the clinic both of them
(patient and client simultaneously):
HEARING IMPAIRED PATIENT HEARING IMPAIRED CLIENT
KNOWLEDGE A deal is established where a person
(salesperson/hearing aid specialist)
PROFESSIONALISM
transfers or is obliged to transfer to
NATURAL AND SPONTANEOUS another person (client/hearing
BEHAVIOUR impaired) the property of the
determinate thing or a “solution”
Purpose: PATIENT’S LOYALTY, for
(service/aid), for a certain price and
the adequate professional condition.
performance and for the
adequate treatment that the Purpose: SALE of a product and/or
patient deserves. service.

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How to deal with a hearing impaired
patient:
It is essential to know the collective that, in the profesional practice, the hearing
aid specialist will work with. As a general rule we will deal with: POST-LINGUAL
HEARING IMPAIRED PATIENTS. It is a heterogeneous group that has experienced
what is to “hear” and has acquired language in a natural and spontaneous way.
They have priorised its COMMUNICATION for their hearing and language. They
need to know the DIFFERENT VARIABLES that affect the potential of the hearing
rehabilitation:
✓ Hearing situation.
✓ Age.
✓ Occupation.
✓ Manual dexterity.
✓ Visual situation.
✓ Attitude against to the hearing adaptation.
✓ Essential: MOTIVATION.

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Degrees of motivation:
Maryon Tate, defines in her book “Principles of hearing aid audiology” (1994) four types of attitude in
patients against hearing rehabilitation through the use of hearing aids:

· Type I: they do not require any type of previous “treatment”, the common thing in all cases is to know all
the problems and desires of the hearing impaired, explain the real possibilities of rehabilitation and
choosing the most suitable adaptation. The patient has a very positive attitude towards the hearing aid
and hearing rehabilitation.
· Type II: analising the causes that motivate the doubts about the adaptation and clarify them: bad
previous experience (which were the problems?), the doctor discourages the hearing aid, neighbours or
other patients have discouraged the patient. The attitude is essentially positive but there are some factors
that make it more difficult (example: a previous bad experience).
· Type III: potentiate positive attitudes, research and erase (to the extent possible) the negative aspects of
the patient’s attitude, gain their trust. Negative attitude but with cooperation elements.
· Type IV: knowing if the rejection is absolute, knowing and dismantling (if we are able to) the causes of
the rejection in order to know if the adaptation is actually possible. Absolute rejection to the hearing aid.

In all four types, according to Reiter (1990) “the success of hearing aid fitting requires 40% knowledge of
the audiogram and 60% knowledge of the patient and their lifestyle, which involves knowing how the
patient interprets their hearing problem”
To sum up: the aptitude and attitude of the profesional that intervenes is crucial.

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 Hearing impaired client
Professional attitude/aptitude is crucial: Mental attitude = leading the sale:

Dressed for success:

· CASUAL, behave in a natural and spontaneous way against the patient.
· CALM, because we know how to handle the situation, inform the patient, help them and offer the
service that they deserve.
· ELEGANT, confident, sure about our own technical knowledge and about achieving the objective of
the sale.

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To conclude…

If you are looking for

different results, you
have to try different
approaches. Albert Einstein

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