Hearing Health and Technology -- Workshop, Project No. P171200 #00032

Submission Number:
Nicole Payne
Initiative Name:
Hearing Health and Technology -- Workshop, Project No. P171200
As an audiologist, I see denial of problem, cosmetic concerns and lackluster physician referrals for treatment of hearing loss as the true reasoning for delayed action or inaction. Equating hearing devices to glasses is a poor analogy. We wouldn't treat macular dengeneration or glaucoma with glasses alone. Hearing loss is a disruption of the sense organ and/or neural transmission. Glasses restore vision. Hearing devices continue to work with a damaged system. Hearing devices are also only one aspect to treating a more global problem. Hearing devices with the addition of a comprehensive hearing evaluation & aural rehabilitation set up an environment at work, home and in the community in which the patient may succeed. I am fortunate to work in an environment in which we are able to offer options to ensure the care is collaborative. Patients may choose to purchase the hearing devices with initial programming services and/or a bundled service plan that includes audiological services for the extent of the devices 2-3 year warranty. Without service & professional instruction, most patients will not be successful with hearing devices. First, they need to be programmed with a prescription (real ear measurements, or verification) that is measured by placing a microphone in the ear with the device to ensure that at different input levels for sound the hearing device performs to ensure soft sounds are audible, conversational sounds are comfortable, loud sounds are tolerable and the maximum output of the device does not result in additional damage to the hearing pathway. Without verifying the output of each device in the ear, no one can be certain the hearing device is loud or soft enough for the anatomy of the patient's ear canal nor his/her hearing thresholds across the frequency (pitch) range. Especially with a high output or no restriction on maximum output, an over-the-counter device has the potential to damage the pathway in which it is supposed to be enhancing. Secondly, most of my patients initially struggle to properly place the devices in the ear and then maintain/change the different components of the device. Since mail order, online and personal sound amplifiers are easily available, I have seen numerous patients in my office that were under fit (reciving little gain from their device), over fit (receiving too much gain) or simply wearing a device that does not couple/fit well in the ear. This is doing a disservice to patient & his/her hearing healthcare. Finally, hearing loss just like any other disorder deserves to be treated within a healthcare model. Patients deserve options & exceptional service. As providers in our office, we have adapted to ensure our patients have choices & feel comfortable collaborating in their hearing healthcare treatment. The hearing device is however one piece of the treatment approach. The ears are simply the gateway to hearing and overall brain health. We must treat the whole person and neglecting this part ensures unrealistic expectations for the patient. I commend you on shedding awareness on the importance of hearing healthcare. I will support proposed legislation related to OTC hearing aids for mild hearing loss only, given that the following provisions are included in the legislation: 1. establish limited gain & output thresholds for OTC (mild hearing loss does not require a large range for gain or output; therefore, devices should be strictly regulated as stated); 2. ensure that OTC are available for ADULTS only; 3. establish a means for collecting information on consumer safety & other potential complaints; 4. require audiologic diagnostic evaluation; & 5. require labels with warning signs to seek treatment from an otolaryngologist for common medical conditions. If cost is driving factor for creating a "basic" class of hearing devices, then instead efforts would be better served ensuring more insurance coverage for patients & direct access to audiologists. Thank you for your time.