Purchasing Hearing Aids Online or through Magazines

Advanced Hearing Care—Improving your Quality of Life. Potomac Audiology: 240-477-1010

Purchasing Hearing Aids and other Amplification Devices

Online or through Magazines

  • Over-the-Counter Hearing Aids
  • Big Box Retailers
  • Personal Sound Amplification Products (PSAPs)
  • Over-the-Counter Hearing Aids, Big Box Retailers, and Personal Sound Amplification Products (PSAPs)

Access to hearing aids ‘over-the-counter’ (OTC), that is, available over the internet or through magazines and catalogues, has been around for decades.  Anyone who can set up an online ‘store front’ can sell hearing aids direct to the consumer.  Some see this as a more ‘cost-effective’ way to purchase hearing aids to treat hearing loss. There are dozens and dozens of website and magazine advertisements that flood our emails and mailboxes daily. Being able to sift through all the pricing hype and determine what is in the individual’s best interest can be taxing. There is a difference between ‘selling’ hearing aids as a retail item to fix a hearing problem and treating hearing loss as a medical condition with the prescription of hearing aids and other assistive devices as treatment for the condition. However, with easy access to all sorts of devices through the internet and print media, it is easy to get misled into thinking that a lower price is always a better option.

There is no question that an individual can determine if he or she is having a hearing problem. There are hearing screenings widely available online these days and one can attend health fairs to get information about hearing loss and individuals can ask their primary care provider about getting a hearing test. It’s not hard to find a way to get one’s hearing testing. We take over-the-counter medications for symptoms like headaches and muscle strains and stomach upset, etc., after we have decided that we can determine (for ourselves) what is needed to address the symptom and bring relief. Many current over-the-counter medications/treatments were once available only through prescription by a physician. Times change.  In terms of hearing assistive devices to treat hearing loss, there are many choices; the issue at hand is whether an OTC or PSAP is best for the individual with the hearing problem. To complicate issues further, big-box retailers have burst on the scene to provide hearing aids to the masses who come through their doors to purchase other items at (seemingly) significant discounts, so why not hearing aids?

Patients are told that hearing aids can cost them somewhere in the range of $1500-$4000 for each device and since many insurance companies do not cover any or all of the hearing aid costs, they will be responsible for the payment. Insurance companies do not cover all medical care for anything but treatment for hearing aids has been excluded for so long that it’s almost a surprise when someone finds they have coverage for hearing aids. Although untreated hearing loss has been linked to dementia and depression and falling and other medical conditions, insurance companies and many federal agencies are still considering hearing loss as a ‘benign’ condition; something that just happens to us with no consequences. That is wrong, hearing loss is a medical condition that needs to be addressed. How it is addressed is the issue.

Just like with vision problems, people will try the simplest solutions first, like using reading glasses that can be purchased at the local drug store or online to determine if this helps them to read or drive. If the reading glasses work, as they oftentimes do, at least for a period of time, then no further testing or treatment is deemed necessary. However, when the reading glasses no longer suffice to help improve the vision, the individual will start to seek out more advanced or personalized treatment.

PSAPs

The analogy to hearing loss is a good one. There is no doubt that if someone is having problems hearing and they purchase an over the counter product or PSAP, they may indeed get benefit from the device. However, since PSAPs are not regulated in the same way as hearing aids, one might be quite sold a

Photo 1

Photo 1: Real-Ear Measurement

device that makes sound louder but it doesn’t actually ‘fit’ the loss. In our practice, we have seen many of these devices that individuals have purchased and and we have tested the with real-ear measures. Generally speaking, the testing indicates that the devices sorely lack the necessary signal processing necessary to address the hearing loss. In photo #1, you can see that the solid green line does not match up with the dotted green line. The dotted green line is the target we aim for to ensure that average conversational loudness is heard by the patient. This device clearly is not providing the necessary loudness and since it is a PSAP, it has limited to no ability for us to ‘close the gap’.  Contrast this PSAP to the one in photo #2. This device actually does a pretty good job at meeting the target’s but again we were limited in how much we could program the device to the patient’s hearing loss.

Photo 2: Real-ear measures with a programmable PSAP purchased by a patient online.

Photo 2: Real-ear measures with a programmable PSAP purchased by a patient online.

Big Box Retailers

Contrast these PSAP magnifiers to hearing aids that were purchased at a big-box retailer. The hearing aids purchased at big box retailers are good, state of the art devices that are truly hearing aids, i.e., they meet the FDA’s regulation for sale as hearing aids.  However, again, it all about how the device is fit to the individual to meet the needs of their hearing loss. In photo #3, we

Photo 3: Real-ear measures with actual hearing aid purchased at a big-box retailer (before we adjusted the aid using real-ear testing).

Photo 3: Real-ear measures with actual hearing aid purchased at a big-box retailer (before we adjusted the aid using real-ear testing).

tested the hearing aid a patient purchased at a big-box retail store and found that the target gain was not close at all to the necessary loudness. The patient complained that the aids were just not working; she was not hearing as good as she had hoped. After just a few minutes programming of the aid, the result is clear in Photo #4.

Photo 4: Real-ear testing with big-box retailer hearing aid after programming for a few minutes.

Photo 4: Real-ear testing with big-box retailer hearing aid after programming for a few minutes.

We were able to meet the target for soft, average and loud sounds and the patient finally heard what she should hear–adequate loudness as measured through the devices as they were intended to work.

When Real-Ear Testing is NOT Completed

At Potomac Audiology, our main goals are to assess your hearing status and understand your hearing abilities and problems then work with you to improve those problems. There are many ways to accomplish this from simple education about how to improve your everyday listening environments to hearing aids and other assistive listening devices.  When we prescribe hearing aids for you, we ensure the aids are fit appropriately using real-ear testing that measures what the aids are doing in your ear canal; we determine the output of the device ‘in situ’ or ‘in position’ because that is where you will wear the aids!  Lest you think we are only concerned with people who sell hearing aids over the internet and through print media or even at big box retailers, we have indeed had patients come to our practice because they are frustrated with their new aids not working well and after just a few minutes with the patient making the real-ear measures, we find (in many cases) that the aids are just fine, the fitting however was not done appropriately because real-ear testing was not done. To illustrate, in Photo #5 you will see a screen shot of a

Photo 5: Hearing aid prescribed at a well-known medical center before real-ear testing is done to set the aid appropriately.

Photo 5: Hearing aid prescribed at a well-known medical center before real-ear testing is done to set the aid appropriately.

real ear test with a ‘state of the art’ hearing aid that a patient brought in for testing after she moved to the area. She had obtained the aids at a well-known medical center and just assumed because of the facility’s reputation, she was getting the best care. Turns out the aids were not fit using real-ear testing. The aids were simply pulled out of the box and set to the manufacturer’s ‘first fit’ which means the prescription was based on the audiologic evaluation alone; this is never good enough as the ear canal and eardrum will always have an effect on the overall fitting that leads to the gain and output profile necessary to meet the patient’s hearing loss needs. After just a few minutes of programming the hearing aids and making some adjustments (luckily we had access to the programming software needed for

Photo 6: Hearing aid obtained at a well-known medical center after real-ear testing was completed and aid was programmed appropriately.

Photo 6: Hearing aid obtained at a well-known medical center after real-ear testing was completed and aid was programmed appropriately.

these specific aids) we were able to fit the aids for each ear for soft, average and loud input sounds (Photo #6). The patient was so pleased; she had no idea that real-ear testing was required to effectively fit the aids but she was glad we did it and she is now hearing effectively with her hearing aids.

Bottom Line

Although some individuals will do fine with hearing devices they obtain online and some will hear better (compared to having hearing loss!) even with PSAPs and OTC devices, these are just simple solutions to a more complex problem than most people realize. Hearing loss is not a benign condition and it should not be commoditized with a ‘retail’ solution for the vast majority of patients.

Go ahead–ask plenty of questions of your medical providers; ask them how to help you get to better hearing. Generally speaking, seeing an audiologist who will perform a comprehensive hearing and communication assessment and who will help you determine the most effective treatment plan and who will measure the hearing aids and other devices using state of the art, gold standard medical practice (including real-ear measures to verify the functionality of the hearing aids) is the best pathway to better hearing and overall better health.

Call Us for a Consultation  

If you have hearing aids that you purchased somewhere else, we will charge you for our services and time but we will do everything in our power to get those devices working for you. If you’ve purchased PSAPs online or through print media, we will do the same thing – we will help you get to the best hearing you can because we know it makes a difference when you ears and your brain get the sounds they need.