Would you feel awkward wearing hearing aids?
About 20% of people have hearing loss. But only a third of them will actually wear hearing aids. Too many people just don’t want the stigma of hearing aids. (Or all those finicky wires!)
But what if they looked just like regular earbuds? Like for example Signia Actives. They look just like regular earbuds, and they adapt to different listening needs on the fly via an app. In this episode of TechFirst with John Koetsier, I chat with Dr. Tish Ramirez from Signia about these cool new earbuds.
Noisy room? There’s a setting for that. Music? No problem. Need to hear what’s in front or behind? Just change a setting. Need to hear what someone’s saying through a mask? There’s a mode for that, too. Need more volume? Less? Just turn a dial via the provided app.
Scroll down to see the full show, subscribe to the podcast, and get a full transcript of our conversation. Or, check out the story in my column on Forbes …
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Read: New AirPods … or hearing aids?
(This transcript has been edited for length and clarity.)
John Koetsier: Welcome! We are with Dr. Tish Ramirez, who is Signia’s VP of Professional Relations and Product Management . Thank you so much for being on the show.
Dr. Tish Ramirez: Absolutely, I’m excited to be here. Thank you for having me.
John Koetsier: Awesome. I am too. Talk to me about the Signia Active earbuds. What are they, how do they work?

Tish Ramirez, Vice President, Clinical Education and Professional Relations, WSAudiology
Dr. Tish Ramirez: Yeah, really exciting news is, you know, we are a hearing aid company — these are hearing aids that are disguised as earbuds.
As you know, many of us know that there’s a lot of stigma when it comes to hearing aids, but we also know that a lot of people need this assistance to help them hear in various environments. And people are wearing earbuds everywhere — you see them in the park, you see them in the grocery stores. You know, sometimes people want to be tuned out when they’re grocery shopping, they have their earbuds in, and these blend right in with the earbuds that are out there today.
John Koetsier: What I really like about them — and my mother is 85 and she has hearing aids as well. My dad passed away a year or two ago, but he had them as well and they had all these finicky little bits with them, right, there was a wire and a little piece that went around — this is just simple. Like put that in your ear … there you go. Right? Very, very easy. Very simple. I can imagine my mom being able to use it and not have to worry about it.
I’ve seen her try to fiddle with this and her fingers are not as deft or as nimble as they used to be anymore, and it seems simpler.
Dr. Tish Ramirez: You’re exactly right, John. So, I mean, it’s not only for the younger consumer out there, right? It’s for anybody who’s looking for the ease of use as well.
So like you said, from a dexterity standpoint, they’re easy to take in and out. And you can just pop them in the charger and the portable charger allows you to take them on-the-go. You can pop them in the purse; you can put them in a pocket; and we have Qi wireless charging available with the Actives as well.
John Koetsier: Cool. So I want to get into some of the technology and you’ve got some cool technology in there: directional hearing, hearing for different environments, other things like that which are really, really cool.
But let’s talk about you for a moment. You’re an audiologist. You’re wearing the product right now. Why is that?
Dr. Tish Ramirez: I do have hearing loss. I was born with hearing loss, it’s something that’s just genetic in my family. Nothing severe, but enough where I do struggle in particular environments. And I have an atypical hearing loss, it’s a low-frequency hearing loss.
So I struggle a little bit more with the lower frequency tones, not — you know, soft as well, but it’s the low frequency. So anybody that has maybe more of a base tone to their voice, I would struggle hearing them. And it’s exciting to be able to wear something that, you know, people ask me about them all the time when I go out into public.
John Koetsier: So what’s really interesting to hear about that is that I went through a tuning process with these, right? And the tuning process was via the app. It was really interesting — I’m going to ask you about that in a moment — but it can be tuned to exactly what you have issues with, correct?
Dr. Tish Ramirez: That is correct. So, one of the things to keep in mind: these are hearing aid devices, so they do require a hearing care professional to fit them appropriately. So if you do have hearing loss, you want to be sure that you look for a hearing care professional in your area and you can ask them about Signia Active. Say, you know, ‘This is something that I want. They look really cool, they’re the earbuds that I’ve been waiting for.’ But that’s exactly right, John. So it’s the hearing care professional that we need and we partner with so that they can program the hearing aids appropriately for your hearing loss and for your needs.
John Koetsier: The interesting thing that I found is that there were different modes as well. There’s like the noisy room. There’s the room that reverberates, and just, you can control all that in your app. You can change what setting you’re in. You can change what mode you’re in. And I saw in the app as well, that you can select when — you know what, I want the bass to be loud, or I want the trouble to be louder. I haven’t seen that before.
Dr. Tish Ramirez: Yes, exactly. So this is exactly right. I’m not ignoring you, audience … I’m pulling out my Signia app. And yes, you have different adjustments in here.
One of the things that’s unique to Signia in these hearing aids is there’s something called ‘Face Mask Mode.’ We all know that face masks are not going away, right, anytime soon. I think that even with the vaccines out there, there will still be some public places that are going to require face masks. And I tell you, as a person with hearing loss myself, once these were more of a mandate, I really struggled — even with voices that I recognize, you know, I still had to lean in.
And this was one of the innovations that Signia made pretty quickly. This was launched just a few months after the pandemic to help you hear better with people that are wearing face masks.
John Koetsier: Is that—
Dr. Tish Ramirez: So again — yeah, go ahead.
John Koetsier: Is that two things going on? Is that one, there’s a bit of muffling of the noise, and is it also you’re getting fewer cues from the lips?
Dr. Tish Ramirez: Exactly. Bingo, John. And in addition to that, particularly at the beginning, right, you add that social distance to that as well. So now the sound has to travel further. It’s already been dampened by the mask, and then you lose the facial cues as you mentioned. And so it makes it really difficult.
So the cool thing is in the Signia app there’s a little person there that’s wearing a face mask. You just tap on that, and what that does is it helps pull those speech sounds. It enhances the speech sounds that are important to understand what somebody is saying. So just with one click, I can access that. I use it when I go into the grocery store. I use it when I pick up my child from school because there are some voices that I struggle with.
John Koetsier: Mm-hmm. So, as I mentioned to you earlier, my parents have had hearing aids and they’ve had to fiddle with wires. They’ve had these little fiddly bits, it’s really, really challenging for 85-year-old fingers to fiddle with the wires and bits. And you don’t have that in this little thing, which is great.
You also have had a scenario where they’ve had to go in, get fittings, get tested in an office scenario, and then come away with some $4,000 hearing aid. And I’m like, whoa, expensive and also a difficult process. You have a different way of setting it up in the app. Can you talk us through that?
[Update: I had a remote fitting for testing purposes. However, in order to get Signia Active, the average consumer would still need to go to a hearing care professional, get an official audiogram, and then be fitted for the device.]Dr. Tish Ramirez: Yeah. So there is an option for the hearing care professionals that we partner with to use something that we call Signia Telecare. And so this allows for remote fittings, remote adjustments, it’s basically that remote connection to your hearing care professional.
In addition to that, there is something in the app called the Signia Assistant. So this allows the wearer themselves to control and change the sounds in the hearing aids based off of the situation that they’re in that moment. So, you know, now it’s like having not only that relationship with your hearing care professional, but you now have kind of a hearing care professional in your pocket through the app, right, to give you that immediate adjustment that you might need in just one very specific situation.
John Koetsier: Cool. We talked earlier as well about this kind of merger almost, or this coming together of two separate worlds. You’ve got these earbuds and headphones that have been in the music and audio world, and you’ve got hearing aids and clinical aids for those who have hearing impairments. And there’s kind of been some merging of that. You see technology like Live Listen, where you can put your phone close to somebody who is talking and you can hear in via your AirPods or something like that. Was that part of the design inspiration behind what you did here?
Dr. Tish Ramirez: Yeah, of course. I mean, stigma is still a big reason why some people do not step into the door to see a hearing care professional, unfortunately, right? So, what we wanted to do is be able to offer something to those hearing care professionals so that they can help those patients — you that might be out there thinking, ‘Ugh, I don’t want something that looks like a hearing aid,’ right?
And again, the interesting thing is these are visible. People see these, but they’re cool and they look high tech.
You know, I’ve heard stories from some of our hearing care professionals where they have patients walk in their office — and you mentioned this, John, with your parents — they show them some hearing aids that have the wire. Those are what we call ‘receiver-in-the-canal, behind-the-ear hearing aids,’ and you know, quite frankly, they’re pretty discreet, especially for women, you can cover it with your hair and whatnot.
John Koetsier: Especially people with hair [laughing].
Dr. Tish Ramirez: Yeah, exactly. Exactly, John. There was not a stab at you at all. [laughter]
John Koetsier: It’s all good.
Dr. Tish Ramirez: So even with those types of devices, they can be somewhat discreet, but you show them something like this and they’re like, ‘No, that’s what I’ve been waiting for, something that looks more high-tech. I don’t care if people see that, but I care if people see something hanging behind my ears.’ So that’s definitely some of that inspiration, John, is how do we help those patients that need the help in these situations — because they do have hearing loss — but combat the stigma? And the Signia Active is the hearing aid that can do that.
John Koetsier: You probably know this better than I do, but I can’t tell you how important that is, because I went through that with my parents where they did not want to get a hearing aid. I mean, none of us want to acknowledge the signs that we are getting older [laughter] and things are happening, right? And that’s not easy to go through. And it’s hard for us to admit it to ourselves.
And then having to get a hearing aid, especially a traditional looking hearing aid, is challenging.
But we would see with my mom or with my dad, they would participate less in social situations. They’d be there, but not be in the conversation, right? And that was a big step back kinda socially. That was a big, big step back just in terms of their place in the family. And you could see the effects of that, some sort of isolation, right, and some challenges there.
And I really think a product like this, I mean, can help with that. I think that’s an important thing.
Dr. Tish Ramirez: Absolutely.
There have been, you know, studies that link dementia, depression, with untreated hearing loss.
And it is unfortunate because often these are our loved ones and, as you mentioned, they become isolated, just because they do not want somebody to see that they have this hearing loss, right? But yet, you know, it’s something that could help them and help them engage. So yeah, combating that stigma is so important for those that are looking for something that will help them hear better in any situation.
One thing that we really looked at with the Signia Active hearing aids is, you know, there’s a couple of different types of patients out there. So there’s the folks out there like me that have pretty significant hearing loss, enough where I do have to wear my hearing aids full time to gain that benefit. There are also some of you that might be out there that experience some difficulty only in certain situations. So maybe it’s when you have friends and family over for a social gathering and they’re wearing the face masks, etc.
So, we have a price these, you know, we have a couple of different price options for somebody like me that needs them everyday, but also the occasional use of hearing aids where I really do just want to pop them in when I’m in that restaurant. I can engage the directional microphones to really focus on the person in front of me, or I just want to pop them in at night when I’m streaming TV. So there’s a StreamLine TV that you can talk to your hearing care professionals about, and it streams the TV
directly to the hearing aids as well.
John Koetsier: Nice. Nice. We saw that with my mom that one-on-one it was fine. In larger social contexts, multiple conversations, music in the background — more challenging, right, more difficult.
You mentioned price points. What does somebody expect to pay for something like this?
Dr. Tish Ramirez: Yeah. You know, price always comes up, right? And this is something that we can’t just put a magic number on — I wish I could — because we do partner with our hearing care professionals, and the hearing care professionals are the ones that set the price based off of what the prices are in the region, based off of the services they offer, you know, they may offer extended warranties or unlimited visits for a couple of years. So this is where you really have to have that conversation with your hearing care professional to talk about pricing, because it’s based off of the experience they’re providing for you as a professional, that’s tied to the cost. [crosstalk] Say that again?
John Koetsier: Do you have a range?
Dr. Tish Ramirez: You know, a pair of hearing aids, it depends on the level of technology as well. So, they can range anywhere from $3000 to $7000, maybe even more, just depending on those services, in terms of the service packages that are offered by hearing care professionals.
John Koetsier: Wow. Wow. Okay, excellent.
Dr. Tish Ramirez: Yeah, and the level of technology as well.
John Koetsier: Mm-hmm. Excellent. Anything that we missed?
Dr. Tish Ramirez: No. I mean, if you want any more information about these hearing aids, you can visit our website at signiausa.com. We do have a specific section for the Signia Active hearing aids. You can learn a little bit more about this specific technology.
John Koetsier: Very cool. Thank you so much, Dr. Tish. Appreciate your time.
Dr. Tish Ramirez: Yeah. Thank you, John.
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