I wanted to share my insight from a first-hand perspective as both a provider and hearing aid user as it relates to the Over the Counter Hearing Aid Act, HR 1652, which U.S. Rep. Marsha Blackburn is sponsoring.
In addition to my service as a Metro Nashville Council member, I am a doctor of audiology, licensed since 1978. I’ve practiced in medical offices, owned a full service private practice, and now provide consulting services to otologists, audiologists and hearing aid dispensers all over the country.
In a June 7 press release Blackburn said “This legislation is the first step to ensuring that millions of Americans can finally have access to affordable hearing aids,” and “Just as someone can correct minor sight loss by purchasing reading glasses from their local pharmacy, so too should they be able to correct minor hearing loss with an affordable and accessible hearing aid. This is a bipartisan, commonsense solution the people want and need.”
While I don’t disagree with entry-level instruments being made available to the hearing-impaired population, I do worry about the notion of someone being able to self-diagnose and purchase an instrument without benefit of comprehensive evaluation.
One cannot look in his or her own ears to determine if wax is a problem. Once removed, the problem is solved if his or her hearing is normal.
An audiologist is trained to identify medically or surgically treatable conditions that would preclude hearing aid use. Early identification in many cases can avert a life altering or threatening health condition. This is not a scare tactic. It’s real.
When the Songbird from Johnson & Johnson came out, I saw a patient who had previously received one of the devices and found it not to be working. Upon completing a comprehensive evaluation, I referred him for medical intervention. He had an acoustic tumor.
A reason for the proponents of the legislation is that without having to be medically evaluated and go through a licensed audiologist, new services could emerge for self-evaluation, just as online vision tests have for direct-to-consumer eyeglasses.
My personal experience offers me additional pause for concern relative to this approach. I experienced headaches for years and assumed that it was due to vision issues and tried readers thinking that my contact lenses needed a boost. I finally mentioned this to my doctor, who ordered a CT Scan, thinking that I had a sinus infection. Unfortunately, I had two schwannomas in the pterygoid process of the sphenoid sinus arising from the Vidian nerve and the Greater Palatine Nerve.
Today I have limited sensation in the right side of my face. But I am lucky as we caught them before they were inoperable.
Importantly under this proposal, no follow up audiologic service is included or required so that there will be no verification that the device provides appropriate service to the patient.
Best practices would dictate that the following be employed with any hearing aid fitting:
- Verification of hearing aid performance by measuring the specs on an analyzer.
- Programming with real ear measurements to the prescriptive fitting
- Providing a trial period
- Scheduling follow ups to make appropriate and necessary adjustments to better tailor the listening experience to the patient’s needs
- Follow up for long term maintenance and evaluating performance measures
Sheri Weiner, Au.D., is a doctor of Audiology and Metro Nashville Council member, District 22.
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