Working With a Hearing Health Professional
How to choose and partner with your hearing health provider
It’s time that the profession of audiology moves from being technology-centric to being patient-centric or patient needs-centric. Why? Because a person’s listening needs — along with his or her hearing loss, lifestyle and other factors — inform the selection of technology, not the other way around.Cynthia Compton-Conley, PhD.
Tips for creating a successful relationship with your hearing health provider
Choosing and working with a hearing health provider is one of the most important steps you take in managing your hearing loss. Most important is that you find a professional who will partner with you; who actively listens and makes you feel that you have a capable and understanding partner on the journey. We understand this can feel daunting; the guidance and resources below should help.
What’s the difference between an audiologist and a hearing aid specialist?
Audiologists and hearing aid specialists are both licensed to sell hearing aids in Washington State. Both are trained to test hearing and fit and adjust hearing aids.
Audiologists have a master’s or doctoral degree in audiology. They are trained to interpret test results from a medical perspective and to use advanced testing to determine the need for further medical treatment. They are certified by the American Speech Language Hearing Association (ASHA).
Hearing aid specialists are trained to recognize problems that require referral to an audiologist or medical doctor. They are are licensed by their state and can service hearing aids. In order to be certified, they must attend continuing education courses and successfully pass a national examination.
If you think you have mild to moderate hearing loss, starting with a hearing aid specialist may be sufficient; it can also be less expensive. If you have a more severe hearing loss or sudden hearing loss, it is important to see an audiologist to determine the cause and/or if additional testing and treatment is advised.
How to choose a hearing health provider
We highly recommended that you shop around for a hearing health provider. This is an important relationship that can mean the difference between simply living with or thriving with hearing loss. It’s helpful to have a check list of qualities and practices you want in a hearing health provider. Ask friends and/or your primary care provider for personal recommendations.
Qualities to look for in a hearing health professional
Does this person ask about more then my hearing loss; do they want to know about my lifestyle and interests, my family and friends? Are they interested in understanding how hearing loss is impacting my life? Are they empathic to my fears and concerns? Do I feel they are interested in my situation and care about helping me? Are they respectful of my time?
Answering yes to these questions indicates a patient-centric approach and sets you up for greater success managing your hearing loss. When your hearing health provider understands your listening needs, you can work together to determine which technologies can help you hear better at home, at work, and in different situations.
Does the person practice good communication strategies like looking at me when they speak? Are they actively listening when I answer their questions? Do they answer my questions in a way that I can understand? Am I comfortable speaking with them about my hearing loss, fears, and concerns?
Answering yes to these questions indicates you can talk openly and honestly with your hearing health provider and feel confident that your questions and needs are being addressed.
Problem solving skills
When I share a problem or concern, does this person dig deeper, asking more questions rather than making assumptions? Do they have experience addressing issues similar to mine? Are they engaged in figuring out the best solution for my needs? Can the call on colleagues or other resources if needed?
Because hearing loss is different for each person, an effective hearing health provider must be a good problem-solver. Answering yes to these questions bodes well for a long-term partnership that can address your hearing loss, even as it changes.
Thorough and patient
Is this person taking enough time to understand my hearing challenges? Are they considering every option to get to the best solution? Are they patient with all my questions?
It’s professional to be efficient, but a good hearing health professional will not speed through the hearing exam or attempt to get you out of the door with an insufficient treatment plan. A good provider understands that hearing loss is a journey and wants to help you find the best path forward.
Practice standards to look for in a hearing health professional
Ethical business practices:
- Current license or certification to practice in Washington State
- Offers multiple styles of hearing aids in with different features and by different manufacturers
- Will accept your insurance, if you have hearing coverage, and take responsibility for filing claims
- Provides a return policy for hearing aids beyond the 30 days required by Washington State law
- Testing includes measuring your ability to hear speech in noisy environments.
- Provides a thorough review and explanation of your test findings and options for treatment
- If necessary, can refer you for medical evaluation to determine the need for medical or surgical treatment
- Provides instruction and counseling on operating and caring for your hearing aids and how to adjust to wearing them
- Monitors the performance of your hearing aids with scheduled follow-up appointments
How to prepare for your hearing appointment
Everyone has had doctor a appointment where they forgot to ask the most important question or follow up on a key bit of information. But hearing loss makes this much more common because you have to concentrate so hard to understand what is being communicated. That’s why it’s incredibly helpful — for you and your hearing health provider — if you are proactive and prepared.
Tips to prepare for your hearing appointments:
- Check with your health insurance provider to determine your coverage.
- Have a significant other come with you to help track information and ask questions.
- Bring a written list with all of the topics and questions you want to cover. Include:
- Your symptoms and how long you’ve had them. If the hearing loss in one ear or both? Ask friends and family to help you make the list as they may have noticed changes that aren’t obvious to you.
- Key medical information, especially related to any ear problems. Include any chronic infections, injury to your ear or previous ear surgery. Also list medications, vitamins or supplements you take.
- Summarize your work history, including any jobs, even those in the distant past, that exposed you to high noise levels.
- Bring a list detailing your daily, weekly, and monthly activities; include work, school, and recreational and social habits.
- Call the office ahead of time and ask for hearing accommodations. Watch this video for information.
- For telehealth appointments, ask to connect early with a nurse or assistant to ensure your connection is working and captions have been turned on before the audiologist joins the call.
The Ida Institute has developed a set of Telecare Tools to help people with hearing loss prepare for their first and follow-up appointments. The online Telecare Tools help people with hearing loss to articulate their unique needs and circumstances. As a patient, the tools are designed to involve you in your own care, making you a partner with your hearing care professional.
All the tools, as well as videos and other information, can be accessed for free on the Ida Institute’s website.
The Ida Institute is a nonprofit organization based in Denmark working to advance a person-centered approach to hearing care.
Important questions to ask your hearing health professional
Asking questions during your appointment encourages two-way communication and gives you a solid foundation for understanding your hearing loss.
10 questions to ask during your hearing test appointment
Asking questions during your appointment will encourage two-way communication and will give you a solid foundation for understanding your hearing loss. The answers to the suggested questions below become your tools for living well with hearing loss.
- What type of hearing loss do I have?
- How much hearing loss do I have in each ear?
- Is my hearing loss permanent? Will it get worse?
- Is my type of hearing loss genetic?
- Will hearing aids help?
- Given my interests, what hearing aid features will I need?
- What is included in the cost of the hearing aids?
- What is your return policy?
- What other devices do I need? What about alerting devices?
- Will you send a report to my primary care physician with the test results?
What to expect at a hearing test
Hearing tests are relatively fast, easy and painless, and there is nothing you need to do to prepare. Your appointment should include the following elements:
The hearing health provider will start by reviewing your medical history and asking questions about your hearing health. Be sure to let them know about any ear pain or hearing loss symptoms you may be experiencing. Share information about where and how you are experiencing hearing loss. And let the doctor know if you can hear and are having trouble understanding what is being communicated.
Examination and testing
Examination: Your provider will examine your ears including your outer ear, ear canal and eardrum. Using an otoscope they will look inside your ear canal and check for irritation, infection, or obstructions like earwax build-up.
Hearing exam: The first hearing test happens in a soundproof booth with a pair of headphones. Your provider plays different tones and you identify in which ear you hear the sound.
Hearing in Noise Test (HINT): A complete examination also includes a HINT test which measures a person’s ability to hear speech in noisy environments. For this test, your provider presents phrases with keywords in both quiet and noisy environments and you repeat the sentences.
Hearing test results
Hearing test results are usually presented on a chart or graph known as an audiogram. Your provider will review your audiogram results with you and explain the cause, type, and the degree of hearing loss you are experiencing. An audiogram also displays comprehension results of spoken words in both quiet and in noise. Pure tone and speech comprehension information, as depicted on an audiogram, provide information needed for proper hearing aid fitting. The audiogram results can also indicate if you need further evaluation.
Discussion of hearing loss treatment options
Once the details of your hearing loss are determined, your provider will review your treatment options. It is very important to provide a complete picture of your lifestyle and how hearing loss affects your daily life. Because we take our hearing loss with us everywhere we go, it is not uncommon to need a combination of devices to help you live a full and engaged life with hearing loss.
Address your requirements specific to the four universal communication needs we all share:
- Face-to-face communications: share any difficulty you have hearing during one-to-one and groups conversations.
- Media: discuss your ability to hear media on all platforms: TV, radio, tablets, tablets, phones, movie theaters, etc.
- Telecommunications: Share any challenges you have communicating on the phone. This includes landline, mobile and teleconferences using phones and computer devices.
- Alerting Signals: discuss how alerting signals can help keep you aware and safe in your home. Learn more.
Armed with this information, you and your audiologist can make good decisions about which hearing aid features you need and which technologies can help you at home, at work, and in other situations.
Hearing aid features and use
Based on your hearing test results, listening needs, and your style preferences and budget, your provider will suggest hearing aids that best suit your needs.
Wireless features greatly enhance the usefulness of hearing aids. Bluetooth may be used to connect to cellphones, tablets, and TVs. Telecoils connect to assistive listening systems (ALS), hearing assistive devices and telephones. Ask your provider for demonstrations. Consumer advocates recommend you get both.
Types of Hearing Aids
There are several styles available, including behind-the-ear, custom in-the-ear, open fit, completely in the canal, and extended wear products. There are options and benefits for each style. Understanding your needs and preferences is important to selecting the best option because the features available can vary depending on the style of hearing aid.
Getting your hearing aid properly fitted
When fitting your hearing aids, your provider should use a Probe-Microphone Test (also called Real Ear Test) to ensure that the hearing aids are working properly and are meeting established fitting targets for audibility and comfort. This test is the only way to objectively verify the sound levels in your ears.
When your new hearing aids are ready, make sure your provider shows you:
- How to place the hearing aids correctly in or on your ears
- How to access different programs and how to pair your instrument to your smartphones, TV or iPad
- How to use the telecoil feature in a ‘real life’ setting
- How to install and/or charge batteries
- How to clean, store and care for your hearing aids
Your provider should also help you establish several hearing aid outcome goals; this gives you a way to confirm if your hearing aids are meeting your needs.
Testing your hearing aids and follow-up care
Testing your hearing aids
It can take several weeks to adjust to hearing aids. Not only are you getting used to the change in your hearing, but you also need to get used to the devices. It is very important to wear your hearing aids everyday and in many different situations to properly test their usefulness. Just remember that if you don’t wear your hearing aids, you will never get comfortable with them, and never reap the benefits of being able to hear better.
This is where you and your provider decide if your hearing aid outcome goals have been achieved and determine what else, if anything, needs to be done to improve your ability to hear in all the important situations of your life. Validation is done after you have used your hearing aids for several weeks and should still give you time to decide if you want to keep your hearing aids or return them for your money back minus any agreed-upon non-refundable fee.
Finally, your provider will discuss the next steps in your hearing care. Most people see their audiologists at least once a year after receiving hearing aids. It’s important to maintain regular visits so that your audiologist can check your hearing, adjust your hearing aids, and/or determine if you need additional care.
Remember your audiologist is your partner on your hearing loss journey — you want to keep them involved in your care.
Washington State Hearing Aid Consumer Protection Laws
Access to information
You have a legal right to receive information and advice from your hearing health care provider about current hearing assistive technologies – including telecoils and Bluetooth – that expand the usefulness of your personal hearing devices. As of 2019, the law requires your personal hearing device sales receipt to include an opportunity to confirm you received information about telecoils and Bluetooth features.
Returning hearing aids
In Washington State, you have 30 days from purchase to return your hearing aids for reasonable cause, provided you meet the provisions of Washington State law and your hearing aids are in their original condition. Ask your hearing health care provider about their return policy, which may give you additional protection. It is important to try the hearing devices in different environments within your return window.
For more information, read this excellent article by Cynthia Compton-Conley, published in HLAA’s Hearing Life magazine: “Best Practices in Hearing Enhancement: What Jack Discovered and What Every Consumer Should Know” (link downloads PDF)
Buying Hearing Aids in Washington State – What to Expect (link downloads PDF)