So, it’s finally time to do something about your hearing loss. You’re loved ones are tired of repeating themselves, and you’re tired of nodding blankly at misheard conversations around the dinner table. So, you jump online and try to achieve the daunting task of navigating the complex world of hearing aid brands and options. Which manufacturer is the best? Which level should I go for? Should I go behind the ear, or in the ear? Which model handles noise the most e ectively?
These are all natural and important questions to ask. But what if I told you that you were overlooking the most important factor when it comes to predicting success?! You might be surprised to learn that the single biggest predictor of success with hearing aids isn’t the brand, the technology level, or even how advanced the noise reduction features are – It’s your audiologist. Yes, the person sitting across from you matters more than the device itself! Let me explain why.
Hearing aids are not “plug-and-play”
Unlike a pair of reading glasses, hearing aids are highly sophisticated medical devices that must be precisely programmed for your ears, your hearing loss, and your brain. Two different people with identical hearing losses could walk out of di erent clinics with the exact same hearing aids yet have completely di erent experiences. One might cheerfully boast: “I can hear my grandchildren again. Restaurants are manageable. I feel like myself.” The other might complain: “Everything sounds sharp. Background noise is unbearable. They’re sitting in my drawer.”
The difference? Almost always the way the hearing aids were set-up, tuned, and calibrated.
Best practice is not optional — it’s essential
For decades now, research has consistently shown that when audiologists follow a series of strict, evidence-based fitting protocols, patient outcomes improve significantly. Yet many hearing aid users are unaware that these steps even exist, let alone that they should expect them.
One of the most critical of these is a process called Real Ear Measurement (REM). This involves placing a tiny microphone deep into your uniquely sized and shaped ear canal to ensure the hearing aid is providing the correct amount of amplification at each pitch to meet your hearing prescription. Without this critical, and often overlooked step, an audiologist is flying blind, and whatever investment you’re making into your hearing is certainly not being optimised.
Of the multitude of studies that have demonstrated the improvements in hearing outcomes when best practices are followed, one sticks with me most: In 2012, Dr. RonLeavitt and Dr. Carol Flexer discovered that old analogue hearing aids, when fit properly using REM, were able to outperform modern digital hearing aids (not programmed with REM) in background noise. Incredible! This demonstrates the point beautifully! The audiologist and the process they follow is more influential on your hearing success than the technology itself! Naturally, the best outcomes were achieved when the modern digital hearing aids were fit using REM – combining the best technology with the best practices.
What is the Alternative to REM and Best Practices?
The quick and dirty way to fit a hearing aid is something commonly referred to as First-Fit programming. That’s when an audiologist simply enters your hearing test results into the software and clicks a big shiny button that reads ‘First-Fit” (hence the name). The software then makes a series of simple assumptions in deciding how much volume to provide. Then, BINGO – you’re all done! What makes this whole process even worse is that the formulas used in First-Fit programming often optimise for initial acceptance and comfort, rather than audibility and effectiveness, thereby often resulting in gross under-amplification in key regions of your hearing. This process ignores the unique characteristics of your ear canal, and the drastic effect they can have on the degree and tone of amplification.
Why wouldn’t an audiologist/clinic follow best practices?
At Holistic Hearing, we are deeply committed to following best practices. However, despite the clear advantages of best practices, compliance in the industry is generally low, with some research indicating that a staggering 70-80% of professionals fail to routinely comply with best practice guidelines. So why might an audiologist or clinic not follow best practices?
- Following the correct processes takes time. REM alone can take up to 20 minutes (depending on the complexity of the hearing loss). For clinics that try to maximise the number of appointments they can squeeze into a day, that’s valuable time that adds up over the course of a week/month/year.
- The equipment required to carry out many of these processes is expensive, often costing tens of thousands of dollars. If the consumer is unaware of how a fitting should be done, a clinic may find that expense hard to justify.
- Performing processes like REM requires specialised skills and expertise. Performing REM without the requisite skills can actually make a hearing aid sound worse.
So what’s the Takeaway?
Purchasing a hearing aid is not like purchasing any other consumer good, like a sound system or TV. While it’s natural to agonise over which brand or style is best, please don’t overlook the importance of the professional guiding you through the complex process of rehabilitating your hearing. Remember that a portion of your investment is in the audiologist’s expertise, skills and time – all of which are among the most important predictors of your success. At Holistic Hearing, you can rest assured that best practice audiology underpins every appointment, helping you get the very best performance from your chosen hearing aids.
Good luck, and good hearing!
