With current legislation allowing over the counter hearing aids for the first time, there are a lot of questions and even misinformation regarding hearing devices and the providers offering the care. These new over-the-counter hearing aids are being designed for patients 18 and older who believe that they have a mild to moderate hearing loss (National Institute on Deafness and Other Communication Disorders (NIDCD), 2022). Herein lies an unexpected problem. Based upon my experience as a licensed audiologist, it is rare that a patient can correctly identify the severity or degree of their own hearing loss.

Interestingly, a patient with a hearing loss that fits this “mild to moderate” criteria is typically unaware that they even have a hearing loss. Patients with more severe hearing losses who are aware they have an issue, are not good candidates since they will not get enough benefit from the hearing devices offered over the counter.

The biggest selling point of the over-the-counter hearing devices is that you can get them without visiting a hearing healthcare professional or a licensed audiologist (NIDCD, 2022). In some cases, this means not even having a hearing test which is typically considered a person’s “hearing prescription”. Without a proper hearing test from an audiologist, there is the possibility the individual could get under or over fit, meaning the hearing aids may not provide any benefit or they have the potential to harm hearing by giving too much volume where it is not necessary. Over the counter hearing aids are being built to ensure hearing safety, so the most likely scenario is that a patient may be under fit and not perceive any benefit from the devices. By not perceiving any benefit from the over-the-counter hearing aids, a person could potentially be discouraged and actually not seek further treatment for their hearing loss.

The over-the-counter hearing aids also advertise the ability to adjust the hearing aids using smartphone applications (NIDCD, 2022). From experience in the profession, an individual who has experienced hearing loss for a long time may be very sensitive to the stimulation a hearing aid provides and will subsequently adjust the hearing aids to a volume that is not beneficial to hearing in many environments. The individual will be able turn the hearing aid down to what they perceive as “comfortable” but in reality, the hearing devices end up not providing the amplification necessary to hear better.

In spite of the perceived benefits of over-the-counter hearing aids, there is a significant benefit from seeing an audiologist. An audiologist can test hearing while also determining the degree of hearing loss. Additionally, auditory counseling can help explain the changes occurring in the brain when auditory stimulation is introduced - and why a proper increase in volume is beneficial for their communication needs. Now these concerns about this bill do not concern every patient with a hearing loss; however, most patients that have asked me personally about the bill and whether they can get over-the-counter hearing aids do not fit the criteria mentioned in the bill.

Therefore, I think there is still a need for hearing healthcare providers to be involved in the conversation about hearing aids and can best advise their patients about their hearing healthcare. With the concern over untreated hearing loss and the potential for cognitive decline, hearing loss is not something that should be considered lightly. It is strongly encouraged that patients have a candid conversation about their hearing losses with a hearing healthcare provider before beginning their hearing healthcare journey.