At Lafayette Hearing, we are all about finding the right solution to each person’s unique hearing problems. We have patients with milder hearing losses who sometimes opt to purchase an “over the counter” or OTC solution to treating their hearing loss. This can be cost-saving for patients in many ways, especially for people with milder degrees of hearing loss. I want to tell you about a patient I saw this past week—let’s call him Joe. This was a gentleman that I have seen several times over the past five years or so. He was coming back into our clinic for a new hearing evaluation, and he brought his wife with him.
The first time I saw Joe several years ago, I diagnosed him with a mild-to-moderate sloping high-frequency hearing loss. This means he has a lot of trouble hearing higher pitched sounds. This type of hearing loss is very common, and often causes people to need others to repeat things, especially if they are too far away. People with this kind of hearing loss will have trouble hearing in noise typically, and will need the TV to be significantly louder than other people will want it. Joe told me then that he was going to go the OTC route to treat his hearing loss, and I asked him to let me know if I could help him in any way down the road. He came back and had me recheck his hearing the following year or so. At that time, his hearing loss was stable. Joe told me he was very happy with how he was doing with his OTC devices, and that he really didn’t know why anyone would spend so much money on prescription hearing aids.
When I saw him last week, he and his wife both now were frustrated with how he had been doing with his devices over the past few months. His wife commented that, “Joe just looks at me like a deer in the headlights when I talk to him!” Joe said he felt like his devices didn’t make any difference for him when he wore them, and said that there were times were he felt like he heard better without them. Sometimes his wife would have to text him from upstairs to ask him to turn his TV down where he was because it was interfering with how well she could hear her TV , even when Joe was wearing his hearing aids.
Joe had been in touch with the lab that sold him his OTC devices. The lab had done all the troubleshooting they could with him, including replacing his receiver wires. His “domes” that sit in his ear canals were clean, and not blocked up by ear wax. He and his wife had done all the right troubleshooting steps to try to improve how he functioned with his devices, but things were not getting better for him. I fully expected his hearing loss to have progressed based on the kinds of things both Joe and his wife were saying. I was very surprised after the testing to see that his hearing loss had not progressed. Joe continued to have a mild to moderate hearing loss that was really about the same as when I first saw him.
We did some testing in the sound booth through our calibrated speakers with his hearing aids in his ears. We compared how he did with his hearing aids to how he did without his hearing aids. We discovered something quite surprising. Joe had significantly more trouble correctly recognizing speech in quiet and in noise with his hearing aids compared to how he did without them. He actually did better on my tests without his hearing aids, which is obviously not what anyone wants. For Joe, my recommendation was to get new hearing technology since he had already taken all the steps he could to get his existing devices working properly. He and his wife decided that he will try some prescription hearing aids now.
OTC devices serve a great purpose in our modern health-care world. They provide a less-costly option for people to self-treat their hearing loss, much like using “readers” to help you see small print as you get older. However, for many people, at some point, readers aren’t enough anymore, and you have to get yourself prescription glasses. This is one time when treating hearing loss has some analogies to treating changs in your vision. The OTC products are helpful, and can save you money, but only up to a point. Trying to treat your problem with an OTC solution isn’t always the best choice. Over time, the OTC solution just may not be enough. Both Joe and his wife could tell that these devices were no longer meeting his needs, and they had already done all they could with the OTC lab to ensure that his OTC units were working their best.
Prescription hearing aid technology has exponentially more research and development packed into the design of the chip and the algorithm for amplifying sound than an OTC device will ever have. Many prescription hearing aids have much better quality parts for both the microphones and speakers in them, and are designed with better protection against moisture and the shock of dropping the device. The computer chips in prescription hearing aids can make more decisions faster than the ones in OTC devices. Prescription hearing aids are designed to treat all levels of hearing loss, not just mild losses the way OTC devices are designed. Purchasing prescription hearing aids also gives patients access to professional hearing care. This care should always include both objective and subjective measurements of the hearing device function at regular intervals over time. Good care should also include measurements of patient satisfaction as well as objective measurements of sound in a calibrated test box and in the person’s ear canal. At our clinic, we are constantly testing how our patient’s devices perform with “test box measures” which take place in a calibrated testing chamber with precise acoustic measurements. We also perform “real ear measures” in the ear canal with the hearing aids, so we can know what kinds of acoustic effects someone’s ear canal has on the way sound travels through the ear. Finally, we can also do what I did with Joe and test someone with and without their devices.
This kind of care does not come with the purchase of an OTC device, ever. This is one of the reasons prescription hearing aids are more expensive than OTC devices. Better quality devices, and better quality care will always cost more. That investment in better hearing outcomes is well worth it if an OTC device is not able to meet your hearing needs.
An OTC device will typically not last more than 2-3 years. They are designed to be somewhat disposable, and do not include much professional care. Any care that comes with an OTC device will always be done “remotely, ” through a computer or smart phone. Prescription hearing aids typically last 4-6 years for patients, and sometimes longer, and providers can help in person or remotely. OTC devices have a place in hearing care, but patients sometimes need more than what an OTC product can do both from both a patient- care standpoint and from a device-function standpoint. Joe has “outgrown” what his OTC devices can do for him, and it’s time for a prescription hearing aid solution. I hope to post an update about Joe in the future, and we can compare how he does with his new, prescription hearing aids with how he performed with his OTC devices. Stay tuned!
-Dr. Susan Taulia, Audiologist
Lafayette Hearing Center
Lafayette, Indiana