What Does It Take to Achieve Better Hearing?

When it comes to hearing loss and hearing solutions, the price of hearing aids has long been the center of attention for patients, clinicians, manufacturers, and retail corporations. The cost of hearing aids leads many patients to explore all the avenues of purchase available to them and search for the best price. On the surface, this type of search makes sense. In reality, patients should factor in services and outcomes when deciding on device models and purchase points. Better hearing can only be achieved by combining good technology with individualized fitting, verification, and monitoring. In recent years, research has linked hearing loss to early cognitive decline and a higher risk of developing dementia. Hearing loss is a health issue best treated sooner rather than later, with the goal of the best possible hearing outcomes for each individual patient.

Here are some key factors that may lead to a better understanding of hearing care:

• Hearing problems are not the same as visual problems. Your ears are only the entryway for sound. However, we hear with our brain. Sound travels from our ears to our brain through auditory pathways in our brainstem, and science does not yet fully know how those pathways work. We do know that perceiving sounds is not the same as understanding speech. An audiogram (a test of hearing sensitivity) is only one of different tests that need to be performed as part of a comprehensive hearing assessment. Using audiograms only as the basis for hearing aid selection is just wrong.  There is not a “hearing aid prescription” for an audiogram result. Therefore, consumers should know that hearing aids cannot be compared to lenses, and that understanding speech is a much more complex skill than vision. Buying hearing aids online is inherently problematic.
•  Louder is not better. Loudness does not equate to clarity. Poor amplification only makes sounds louder, not clearer. Complaints we often hear from patients are: I can’t follow the conversation; I hear people talking, but I don’t know what they are saying; and, I hear people well, but my spouse/business associate/friends mumble. When hearing aids make sounds louder but not clearer, patients continue to experience the same difficulties they had before getting hearing aids.  We do need to make sounds audible to the patient. However, the quality of the sound that the patient receives is the most important aspect.  Consequently, programming hearing aids is a crucial part of the process, and a patient must be present and work with an audiologist. We need to make sure that the hearing aid is performing as we think it should inside the patient’s ears. This is called verification, which requires placing a small microphone in the patient’s ear canal to test the sound coming out from the hearing aid. It involves diagnostic equipment and a clinician’s expertise to conduct these measurements. Verification helps ensure the patient receives the best signal possible, as this signal will travel up to the brain through a damaged pathway. The better the signal, the easier it will be for the brain to process the information received.
  
• Technology is only part of the solution. Hearing loss is a health problem, not a technology problem. Hearing loss should be properly diagnosed and treated in clinical settings by hearing care professionals. When it comes to hearing loss, there are only two professionals trained to deal with these problems: audiologists and ear, nose and throat (ENT) physicians. Doctors of Audiology concentrate on clinical aspects of hearing loss, such as the diagnosis (type and degree of hearing loss), the impact on communication (assessing how hearing loss affects speech understanding), and the possible solutions. Physicians concentrate on the medical aspect of hearing loss, such as treating ear infections, identifying malformations within the auditory system, identifying masses or tumors that need to be surgically removed, or deciding on other forms of medical/surgical treatments. When hearing symptoms are not properly identified, and proper testing is not conducted, many undesirable effects and complications may occur. Hearing care is health care.  

Patients who need hearing devices should ask themselves: do I want to buy a unit of technology or do I want better hearing? The answer to this question will determine where they receive services and the outcomes they might expect. In today’s market, consumers are constantly bombarded with advertisements that promote online hearing tests, concierge hearing services with hearing tests in your home or in your office, calibration of hearing aids without the patient present (based solely on the audiogram and then shipped to his/her home), and big-box retailers offering hearing devices at wholesale locations all over the country. Today more than ever, consumers need to be well informed about what drives costs down. Low prices are not necessarily for the benefit of the patient, although marketing might suggest that. Consumers need to understand the difference between:

• health care professionals vs. dispensers/technicians
• clinical diagnostic services (professional expertise using diagnostic equipment inside a sound booth setting) vs. convenience
• audiograms and hearing thresholds vs. a comprehensive assessment of their functional hearing
• basic calibration vs. proper fitting of devices verifying that hearing aids do what they are supposed to do inside the patients’ ear canal, and
• most importantly, the difference between hearing aids sales vs. hearing outcomes.

At Chicago Hearing Care, we see a variety of cases every day. Our patients fall in many different age groups, with different conditions and expectations. Oftentimes we see patients who have had a poor result from hearing devices in the past. Prior to coming to us, they might have received services in the comfort of their homes, either by being tested in their living room, or by ordering devices online. Sometimes they’ve purchased devices from a large chain or discount store. They come to us with concerns that they are hearing but not understanding. Perhaps they were encouraged to buy more expensive devices, having been told that better technology will solve their problems. Often, they purchased hearing aids with services packages that included the calibration of hearing aids, plus a couple of follow up appointments (more calibration). None of them received a comprehensive assessment of functional hearing (true listening performance), verification of the hearing aid calibration inside their ear canals, and performance assessment and monitoring after receiving hearing aids. In other words, these patients just bought hearing aids, but now they want better hearing.  They choose our services now because they know that better hearing requires expertise. Unfortunately, they learned this information the hard way.   

Our patients make the trip to Chicago Hearing Care the same way they make a trip to see other health providers. They receive a comprehensive hearing assessment. The audiogram is only one test of different tests we conduct. They spend a lot of time in the sound booth doing speech understanding tests with and without hearing aids, before programming, after programming, months after fitting for monitoring, etc. The recommendation of hearing devices comes after extensive testing where we determine if patients would benefit from hearing aids, or from implantable devices such cochlear implants and bone anchored hearing aids. Our patients know that we combine technology and professional expertise in everything that we do. As a result, our patients hear better. This means that they understand speech better, much better. Our prices are competitive when you consider the cost of the technology and all our services, and we have devices to fit different price ranges as well. Best of all, our services are based and driven by outcomes, not by price.

“The bitterness of poor quality remains long after the sweetness of low price has been forgotten.”

– Benjamin Franklin