I’ve been reading a lot lately about the new over-the-counter (OTC) hearing aids. They will soon be available for sale to “people 18 and older with mild to moderate hearing loss.” As a long-time hearing aids user, I couldn’t help but wonder if it’s wise to sell them online or at big box stores. Hearing instruments are considered a medical device that require a prescription, just like eyeglasses. I did some research and found there are sound reasons (no pun intended) to think twice before heading to Target or Walmart for better hearing.
The idea of OTC hearing instruments came about in 2017 when Sen. Elizabeth Warren, D-Mass, and Sen. Chuck Grassley, R-Iowa, introduced the bipartisan OTC Hearing Aid Act. Their goal was to make hearing aids “more accessible and affordable for consumers.” The law passed in 2017, but there was a lapse in action because of COVID. Last year the FDA established a new category of hearing aids that will be sold online and over the counter. The FDA is currently setting guidelines for would-be retailers.
I know the senators had good intentions when they proposed the idea. However, based on my research, I have a few questions. First: How do you know if your hearing loss is “mild to moderate?” While you may believe you have only a moderate hearing loss, it could actually be much worse. Only a qualified hearing healthcare provider, performing a hearing test in a controlled environment (sound booth), can determine the exact extent of someone’s hearing loss. There are questionnaires online that ask what you can and can’t hear, however those results are totally subjective. At best, they only give a glimpse into the severity of your hearing loss. It’s not an accurate evaluation.
My next question: How do you know your hearing loss is not caused by wax build up, a foreign object in your ear, or an infection? Hearing aids will not take care of those problems, and, in fact, they will only get worse. A very serious condition that causes hearing loss is an acoustic neuroma, a benign, slow-growing tumor that eventually presses on the hearing nerves in the inner ear. Without surgical treatment, it can be deadly. Only a qualified professional can determine why you have a hearing loss.
Like fingerprints, every one’s ears are different, from the shape and angle of the ear canals to the specific type and degree of hearing loss. A complete analysis and understanding of a person’s hearing is essential. That includes a painless, non-invasive test known as Real Ear Measurement (REM). It is considered the gold standard in prescribing hearing aids. It ensures the hearing instruments are programmed to an individual’s specific needs at every hearing level, and that sound is as natural as possible in every environment. Retailers will not have the equipment or the expertise to perform a REM.
Did you know that improperly fitted hearing aids can do more harm than good? If, for example, they are set louder than necessary to compensate for your specific hearing loss, the sound level can damage your hearing. Sustained loud noise, like excessively loud live music at a concert or loud music heard through ear buds, is the most common cause of hearing loss. Even if you give the retailer your audiogram, there’s no substitute for an experienced audiologist working with you in person to program the aids to your exact needs.
Here’s another question: How do you know what style of hearing instrument is best for you? Hearing aids are not “one size fits all.” The type of hearing loss and the anatomy of the ear canal determine the style. Let me explain. The part of the hearing aid that goes into the ear is either an earmold or a dome. Earmolds are just that, a mold of your ear that are custom made. Domes come in standard sizes, like shoes. An audiologist fits you with the right size. Dome-style aids are usually used for people with high-frequency hearing loss (like a child’s voice), and earmolds are used for people who have loss across all frequencies or at low frequencies. However, the audiologist takes other things into account: A person with vision loss, lack of dexterity or debilitating arthritis, for example, would be fit with an earmold, rather than a tiny dome-style hearing instrument that would be hard for them to maneuver.
As for cost, there are several inexpensive options. Many practices offer a pair of FDA-approved, digital hearing aids for a total $1,000 or less. Most have no-interest payment plans, and you can even lease hearing aids, just like you would a car. The cost usually includes at least one check-up and a starter kit of batteries and wax guards. Perhaps most importantly, the audiologist is available to answer questions and help with any problems you are having. That is priceless.
Cost seemed to be one of the main reason the legislation was passed in the first place. Again, I did my homework. In 2021 Americans spent $73 billion (that’s billion with a b) purchasing smartphones. A total of 300 million people in this country use smartphones and spend an average of $138 a month on apps alone. Which is more important? Paying to see a qualified professional to properly fit your hearing aids, or buying the latest smartphone?
Here’s my final question: If you can’t hear, what good is that $1,000 phone?