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Who Should Take Care Of Your Ears?

December 7, 2016

 You are having ringing in your ears.  You ask for repetition and struggle to understand speech in noisy environments.  Maybe you know you have a history of hearing loss in your family so you want to be proactive about your hearing health.  In all of these cases you need a hearing test.  So where should you go to get your hearing tested and potentially treated?  You will have to choose between the Big Box stores, physicians, the giant multi-location private practices, small private practices, and even the internet.  So which option is the best?  This article will explain what your best and worst options are with key insights from Melissa Wikoff, director of audiology at Peachtree Hearing and expert in hearing health.

 

Internet

 

It goes without saying that the worst thing you can do for your hearing health is to self-diagnose and go straight to the internet for a cure.  While aided listening devices (not hearing aids) are widely available online, they are really nothing more than low-tech microphones.  “They simply make all sound louder and this typically won’t help a person who has hearing loss”, Dr. Wikoff explains.  “A hearing aid is far more sophisticated than that and is the only real option for treating hearing loss as far hearing devices go.”  Dr. Wikoff is an audiologist in Marietta, GA who has been treating patients for 10 years.  She goes on to explain that actual hearing aids cannot be purchased directly by consumers on the internet, so you can be assured that if you are buying something direct on the internet, it is probably junk.  Furthermore, by avoiding seeing a qualified professional you may be ignoring a larger health issue. 

 

Big Box Stores

 

Now let’s address the “big box” stores.  This is probably the next worst option you could turn to, however it has become increasingly popular.  “I shop at big box stores often for essentials like paper towels and soap.  I even use their butchers from time to time.  However, I would never consider entrusting my sense of hearing to them” remarks Dr. Wikoff.  “They simply aren’t qualified to treat or diagnose hearing loss or even offer medical advice.  The reason is because these big box stores use hearing aid dispensers and not audiologists.”  The major difference between the two is in the level of education they receive.  Let’s take Dr. Wikoff of Peachtree Hearings education as an example.  Dr. Wikoff completed a four year undergraduate degree at the University of Maryland.  This is pre-requisite to being accepted to a post graduate audiology program.  Dr. Wikoff then completed a four year audiology post graduate degree from Washington University in St. Louis.  This included research as well as a one-year residency.  Dr. Wikoff holds a doctorate in audiology, as all licensed audiologists do.  It suffices to say that audiologists are highly educated and trained in testing hearing and treating hearing loss.  

 

Now consider a hearing aid dispenser.  Each state has its own laws around becoming a dispenser, but they are all relatively similar.  The basic requirement is that you can pass a state administered exam.  Most dispensers take a weekend seminar or preparatory class to help them to pass the exam, but even that isn’t required.  In fact, anyone can sign up for the exam and try and pass.  If you pass, you are now a hearing aid dispenser.  Now if you ask me, that is very problematic.  You cannot take a single exam to become a dentist, nor can you pass a single test and prescribe glasses, or really any kind of medical treatment for that matter.  The reason we don’t allow that sort of low bar for medical practitioners in our society is because it is extremely irresponsible.  Professions that people rely on for their health require a certain foundation and education that is essential to giving good patient care.  Outside of the field of audiology I don’t know that there is another example like this.

 

So why is the hearing aid dispenser even allowed to exist?  There are probably two main reasons.  Firstly, the field of audiology is relatively new and unknown to many, in comparison to other medical fields.  Recent advances in science and technology though have pushed the field into the forefront of our society faster than it could be appropriately regulated by state and federal governments.  Secondly, the hearing aid manufacturers and Big Box Stores have routinely fought against any regulation that could cause them to sell less products.  Unfortunately, they don’t have what is best in mind for their consumers in my opinion.  It’s worth noting that the audiology field does lobby for responsible changes regarding hearing health, but you have to remember who they are up against.  Big corporations.  So for the time being the decision comes down to you about who you let handle your hearing health: a highly trained and certified doctor, or anyone who can pass a weekend exam.  The comparison is night and day. 

 

Here’s a story to help drive the point home.  John Doe comes into a big box store because his wife won’t stop complaining about his hearing.  The dispenser at the big box store tests John’s hearing, determines he has a hearing loss in his left ear, sells him hearing aids and sends him on his way.  Sadly, the reason for John’s hearing loss is not from noise exposure or age, but rather from an acoustic neuroma, a rare benign tumor growing on the balance and hearing nerves in his inner ear.  John’s tumor goes unnoticed for some time until it has grown and begun to cause him other issues like dizziness and ringing in the ears.  The untreated growth of this kind of tumor eventually threatens neurological function in John’s brain and eventually it could take his life.  

 

Now let’s rewind… John Doe decides to go to an audiologist instead of a big box store because he read this article!  The audiologist has the education to know that John’s hearing loss is atypical.  They also have all of the technology and equipment to diagnose an issue like this and then refer John to a neurologist who can immediately begin treatment.  I think you get the idea.  It’s important that you see qualified professionals when your health is at stake.  

 

I Buy My Glasses at a Big Box Store, Why Not My Hearing Aids?

 

Here is a logical deduction people make about glasses and hearing aids.  If you have problems with your vision, you might wear glasses.  If you have problems with your hearing, you might wear hearing aids.  Therefore, hearing aids are like glasses for your ears.  It makes sense in many ways, however there are some important differences as well that you should consider before deciding to buy your hearing aids at a big box store along with your glasses.  

 

When you get glasses or contacts they are created with a specific prescription.  That prescription is static and the glasses cannot be adjusted after they are created.  In fact, they don’t really need to be adjustable because we can so accurately prescribe glasses.  When you put them on for the first time you can tell right away whether they are right or not.  Hearing aids are different in this respect.  “While a trained audiologist can accurately plot your hearing loss on an audiogram, correcting it with a hearing aid is much less exact”, explains Dr. Wikoff.  “That is because hearing is much more perceptual than vision, and finding the right levels and configuration for your hearing aids can take time and may be a process.”  Most hearing aid wearers require a few initial adjustments to get them sounding just right.  Therefore, it is often recommended to take a phased approach with the settings on your hearing aids.  This allows your brain to more easily and gradually adjust to hearing again.  The wonderful part though is that with time the brain is extremely pliable and will usually completely adjust to your new hearing in a matter of months or less. Thus having a well-trained audiologist is very important to help guide you through the process.

 

So to sum it all up, when you buy glasses, you get glasses.  When you buy hearing aids, you get an audiologist.  Or at least if you buy them the right way!  With glasses you walk out the door and may never go back to the place you bought them.  You can take your prescription elsewhere the next time you need glasses and not really suffer any major consequences.  This is because continuity with a practitioner is not nearly as important with glasses as it is with hearing aids.  It’s so important for hearing aid wearers though to have an ongoing relationship with their audiologist.  The audiologist knows your health history and your hearing aids’ settings and will make sure that you continue to have success throughout the life of your hearing aids.  You simply can’t get that kind of continuity and long term care with a Big Box dispenser.

 

Lastly, hearing aids require much more long term care than glasses.  While glasses typically consist of just lenses and frames, hearing aids are far more complex.  They are basically like tiny computers that sit in your ear.  It’s also a common misconception that hearing aids just make everything louder.  These days they are actually far more sophisticated than that.  They have the ability to programmatically amplify only the frequencies and pitches that you need, adjust to different acoustic environments, help to lower background noise, and much more.  The capabilities are truly amazing.  But like any great piece of technology, they require long-term care. Hearing aids may require repairs, maintenance, reprogramming, and cleaning throughout their life.  This is just another reason why it’s so important to have a good continuous relationship with your audiologist.

 

I think I could go on and on about more reasons why you shouldn’t go trust a big box store for your hearing aids, but I think it suffices to say that you shouldn’t buy your hearing aids where you buy your toilet paper!

 

ENT’s

Seeing an Otolaryngologists, or ENT, for your hearing issues is probably the next best option.  Interestingly, most ENT’s actually spent very little time on the subject of hearing and audiology.  In some cases, they may have had nothing more than a seminar on it.  For this reason, some ENT’s employ an audiologist as part of their practice.  This is a newer development in their industry due to the increasing technology and advancements in hearing health.  However, for most ENT’s audiology is not a primary focus of their practice.  In fact, there is much more money in the other typical areas of otolaryngology like managing diseases of the mouth and throat, or sinus surgeries for example.  For that reason, audiology often sits on the back burner in a typical ENT practice.  What that means to you as a patient is less sophisticated equipment, fewer choices for treatment of hearing issues, and less face time with a practitioner.  It is very typical to see that an ENT will only schedule shorter appointments for audiology needs and less often than other kinds of appointments.  That is because they have to maximize their time on the most effective ways to make money.  That’s great for their practice, but not for you if you need hearing aids.  ENT’s also suffer from many of the same issues you would experience with other large medical practices, like difficulty scheduling, having to see different doctors based on availability and long wait times.  Ultimately this ties back to the fact that you need a dedicated audiologist who will spend as much time as needed with you throughout the life of your hearing aids.

 

Large Audiology Groups and Private Practices

 

This is probably the second to best option for you to explore if you are having issue with hearing.  Most large audiology practices will only employee fully educated, trained, and certified audiologists.  So you don’t typically need to worry about the level of education or experience with their practitioners.  They also typically have good equipment and can properly diagnose most issues.  However, there are several drawbacks to using a large private practice.

 

First of all, large private audiology practices suffer from many of the same issues that large ENT practices do.  They employ a large staff of audiologists, assistants, front office, marketing, billing, and so on.  This means that they have certain financial demands that have to be met as the practices have large financial footprints.  Wikoff remarks on her experience in the industry, “Often times the audiologists working in these practices have quotas to meet.  That means they have to sell a certain amount of hearing aids per month or quarter.  If they don’t push enough product then the practice doesn’t make enough money, people get fired and hired, so on and so forth.” The notion of sales quotas in a medical profession too itself pushes the boundaries of what is medically ethical.  “Personally, the idea makes me uncomfortable.  A patient should be able to be seen without fear that they will be prescribed an unnecessary or wrong treatment because an employee is being incentivized to do so.”

 

Secondly, large private audiology practices also typically cannot give you the time and continuity that you need as a hearing aid wearer.  Because of the emphasis on driving revenue in these practices, audiologists are typically booked all day with short set appointments.  This allows them to see the most patients possible in a workday and maximize their revenue.  I think of it like a hearing aid selling factory.  The more people who come in, the more they can sell.  Unfortunately, this means you as a patient won’t likely be able to get the face time you need and will have to schedule appointments far in advance like any other busy medical group.  Also, these large practices typically employ many different audiologists across different locations.  That means that when you make an appointment you may need go to different offices to see your audiologist, or you may need to see a different audiologist altogether.  In both cases the emphasis on patient care is compromised.  The fact of the matter is that you don’t want your health, hearing or otherwise to be treated by a company.  You want your health treated by an individual who knows you and is invested in your health, treatment, and success.

 

Small Audiology Practices

 

You’ve finally made it!  Small audiology practices, like Peachtree Hearing, are hands down the best option for someone who needs help with hearing health.  If you have the ability, don’t consider going anywhere else.  At a small audiology practice you will still see a qualified and competent practitioner and don’t have to worry about seeing a dispenser. They typically have all the equipment needed to properly diagnose and treat you in the one office as well.  They usually run with very low overhead since they don’t employ a large workforce and therefore there is not pressure to sell a particular type or amount of hearing aids.  Also, your audiologist at a small practice is typically more free to act as a medical practitioner rather than a salesperson.  This means they can spend as much time with you as needed.  They often welcome walk-in or last minute emergency appointments.  This is precisely the kind of care you need when you have an issue with your hearing aid and you have an important meeting that day or maybe you are going on vacation the next day.  It will also allow your audiologist to work more closely with you when you first get your hearing aids to make sure you have success with them.  If you ask me, when I got to my doctor I want them to know me, my history, and have a comfortable rapport with me.  I want to feel like I’m being treated like family even.  That the doctor will do for me the same they would for their own brother or father.  That is precisely the kind of care that you can only get at a small practice.  Dr. Wikoff explains, “At a small dedicated practice like Peachtree Hearing you can get the quality and quantity of care that you need to hear better!”.  Peachtree Hearing is located in Marietta, GA 30068.  For top notch care in the greater Atlanta area call Dr. Wikoff today! 

 

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