I recently participated in an article for The Hearing Journal — the conclusion of its three part series on Over-The-Counter (OTC) hearing devices. Part 1 included perspectives from hearing health professionals. Part 2 shared views from hearing industry leaders. The third part was from the consumer perspective — people with mild to moderate hearing loss. I am happy to share the article below.
Are people with perceived mild to moderate hearing loss ready for do-it-yourself care with over-the-counter (OTC) hearing aids? Even after the passage of the OTC Hearing Aid Act in 2017, debates on the safety, cost efficiency, and overall impact of OTC hearing devices continue across the hearing health care spectrum. In our June and July 2018 issues, we heard from audiologists and industry leaders, respectively. Not to be left out of the discussion are the voices of consumers—people suffering from the physical, emotional, and financial burdens of hearing loss.
Greg Bawden is a training and administrative battalion chief for a fire department in Duvall, WA. Before getting diagnosed with hearing loss, he used to be an emergency responder. He is a past president of the Hearing Loss Association of America (HLAA)—Washington State Chapter and a weekend adventure athlete. Shari Eberts is a hearing health advocate, writer, and founder of LivingWithHearingLoss.com, an online community for people with hearing loss. She has adult-onset genetic hearing loss. David G. Myers is a social psychologist at Hope College in Holland, MI. He recently completed a four-year term representing Americans with hearing loss on the National Institute on Deafness and Other Communication Disorders (NIDCD) advisory council. Myers advocates for hearing aid-compatible assistive listening via telecoils and hearing loops (hearingloop.org). Herbert Rogers is a U.S. Air Force veteran. He’s now the director of security at the Hearing and Speech Agency (HASA) in Baltimore, MD.
Do you feel an OTC hearing device would be as effective as one provided by an audiologist? How likely are you to purchase an OTC device to address your hearing issue?
Bawden: I have a moderate to severe hearing loss and work in complicated and even noisy hearing environments, including teaching classes, attending and running meetings, and using telephones and two-way radios. I do not think an OTC device would meet my needs, but OTC hearing devices may work well for someone with less complex hearing needs. I have many friends who admit they can’t hear as well as they used to but have not purchased hearing aids due to the cost. OTC hearing devices may be the perfect start for them.
Eberts: The best hearing solutions are usually a combination of traditional hearing aids and other devices, so I am very excited to see what OTC products will be available. I hope that the innovation and new ideas that OTC hearing devices bring to the marketplace will eventually filter back into hearing aids for all segments of the hearing loss population—even those with more severe degrees of loss. It is hard to predict, but I imagine that OTC hearing devices will be as effective or more effective than traditional hearing aids in certain listening situations and less so in others. I will likely try out several of the devices to see what benefit they can provide, returning those that don’t work well for me. At a minimum, I expect I will purchase an OTC hearing device to use as a back-up should my primary device become lost or damaged.
Myers: I understand the case for OTC devices made by the White House President’s Council of Advisors on Science and Technology (PCAST), the National Academies of Science, Engineering, and Medicine (NASEM), and the Hearing Loss Association of America (HLAA). Inexpensive hearing devices with FDA-regulated performance and labeling will affordably introduce hearing assistance to people with mild-to-moderate loss—people whose numbers are too vast (or sometimes too poor) to be served by the nation’s 18,000 audiologists. Competition among OTC devices will surely also spark innovation in hearing care technology. Moreover, the risks of harm are minimal.
Even so, there is no chance of my purchasing an OTC device. Consider the professional standard of care I have received from my audiologists. They have:
- repeatedly assessed my hearing in a sound chamber, including a speech-in-noise test,
- selected hearing technology suited to my needs,
- customized its output for my ears, and verified the settings using real-ear testing,
- given me controls over directionality and volume,
- counseled me on adapting to hearing loss, and
- introduced me to the wonders of hearing loops (in my TV room and the public facilities and worship places of my community) and Bluetooth (for phone connectivity)—which together double the functionality of my hearing aids by enabling them to serve as wireless speakers for TV, PA system, and phone output.
Voila! The hearing aids that, at first, I barely tolerated, I now love and couldn’t live without. What are the chances that I would enjoy these life-enhancing benefits without the support of my audiologists?
Rogers: I am cautiously optimistic about the possibility of less costly hearing devices, open access to innovation, and the opening of a broader conversation about hearing health. Of course, we don’t yet know much about how this process will really work or if these devices will be as effective as what is available through the current process.
As an advocate for affordable, accessible, and effective hearing health care, I know how important it is to address hearing health as early as possible. Because hearing loss is the most prevalent service-related disability, I think there is an opportunity to improve the lives of veterans as well.
How likely are you to visit an audiologist after experiencing issues with an OTC device?
Bawden: I work in looped environments. I regularly attend conferences and meetings where I use FM assistive listening equipment and an amplified neck loop. I require Bluetooth streamers or telecoils to use the telephone. I can’t see OTC hearing devices meeting these complex needs. For my last pair, fitting and adjusting required multiple visits with my audiologist.
Eberts: I am very likely to visit an audiologist after experiencing issues with an OTC device, as I already understand the benefits of an audiologist’s counseling and care. I hope that audiologists will choose to become familiar with the available OTC hearing aid offerings and provide their assistance to all people who need it, whether they are current or potential clients. As a hearing aid wearer, I understand that no device will ever be perfect and that fine-tuning and fitting will be required to optimize the experience for whatever device I choose. An audiologist would be my first choice when seeking out this help.
Myers: If I purchased an OTC device, I’d not likely have the chutzpah to ask an audiologist to service it (unless they advertised such service). That would seem a bit like going to my main street appliance store to assess different TVs, purchasing such online, then asking the local store for advice on its set-up and operation.
A more realistic possibility is that I might have experienced some benefit from an OTC device, yet wish for a better result—and for some of the cool connectivity experienced by my friends who have hearing aids with multiple settings, telecoils, and Bluetooth. Moreover, I might wish for the benefits of periodic hearing assessments and recalibration (and cleaning) of my hearing devices. And I might wish either to pay less up front (with future service not bundled) or with a bundled initial fee to feel free to return cost considerations intruding on my audiologist-patient relationship.
Rogers: From my own experience, I would consult with an audiologist, but I’m not sure that most consumers would be able to navigate that process easily. There is a real need for patient education at both the point of purchase and throughout the process.
What would make you select an audiologist’s expertise over purchasing an OTC device?
Bawden: I have used different audiologists for each of my three hearing aid purchases. The third audiologist is a keeper! She had the experience and knowledge to help me find solutions that involved more than just the proprietary Bluetooth connectivity accessories offered by the hearing aid manufacturer. She helped me find cell phones that worked with my telecoil, programmed my hearing aids to work in looped environments as well as with FM assistive listening devices (with powered neck loops), and she worked tirelessly to help get the correct hearing aid fit to avoid feedback.
Eberts: I hope that the two options are not mutually exclusive. In a world where OTC devices are available, I expect that I would continue to rely on my audiologist for annual hearing tests as well as ongoing counseling and support for whatever devices I choose to use. An audiologist’s experience with fitting and aural rehabilitation will always be important, irrespective of the device chosen. I imagine that OTC hearing aids will allow people the flexibility to use a variety of hearing devices, depending on the listening situation. Given the lower price tags, more experimentation will be possible, and hopefully better hearing outcomes for everyone involved.
Myers: The central reason for my electing audiological expertise is that hearing is extremely important. Our ears connect us to other people. Through the miracle of hearing, another person can convert thoughts into jostling air molecules that travel through space, striking my eardrum and ultimately triggering neural messages to my brain—enabling the wireless transmission of information from another’s brain to mine. How cool is that?
My mother—who lived before today’s digital technology and cochlear implants—journeyed from sound to the utter silence of her last dozen years. And what a sad, impoverished later life that was—cut off from others (except through scribbled notes on a magic pad) and unable to hear her favorite television and radio programs.
We humans are made for relationship. We have what today’s social psychologists call a deep “need to belong,” for which hearing (for those not natively Deaf and fluent in Sign) is central to the sharing of emotions and ideas and happenings.
The bottom line: Hearing is important enough that the $6,000 I pay my audiologist every five years or so for the latest and best technology—and for the freedom to enjoy her bundled services—provides vastly more life benefits than the same amount of money invested by middle class people in a fancier or newer car or a slightly bigger house. And that is also why, without exception, I have advised each of the dozens of people seeking my advice over the last few years to make an appointment with a professional audiologist. Hearing matters.
Rogers: I would always consult an audiologist before making any purchase decision that could affect my ability to hear, even if I were to purchase a device over the counter. I think that an audiologist’s expertise in providing me with a baseline evaluation and a consultation or recommendation would be my first step in the process—no matter what hearing aid I ultimately purchased.
In short, I’d most likely select an audiologist’s advice and potentially purchase an OTC device for my own mild hearing loss. For a moderate or severe hearing loss, I can’t imagine that OTC devices will be enough, so the expertise of an audiologist will be critical to those consumers.
Readers, what do you think about the upcoming OTC hearing devices?
This article was originally published in The Hearing Journal. Reproduced here with their permission.
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19 thoughts on “Over-The-Counter Hearing Aids — What Does the Potential Consumer Think?”
I tried an OTC hearing device several years ago when I’d misplaced my hearing aid. I only used it for watching tv (I found my hearing aid soon after), but it worked surprisingly well for how inexpensive it was.
Thanks for sharing your experience. Technically, the device you tried was not an OTC hearing aid since they have yet to be introduced, but you probably tried a PSAP, some of which are likely to be similar to the new OTC category. I am glad you found something that worked for you.
I were bilateral hearing aids and have a profound loss. I find the cost of hearing aids exorbitant. The very least inexpensive pair I can find are $3,000 needless to say I can’t afford a backup pair. This is for the very basic no special programming I hope the OTC hearing aids are at a reasonable cost for the general public.
Thanks for sharing your thoughts.
Like David Myers’ mom, my mother spent the last 15 years of her life, in total silence. Most people didn’t have the patience to use a scribble pad with her, so she lived every day of her life, not being able to communicate much about anything to anyone. In the last year of her life, she spent much of it, dying from cancer, in and out of the hospital, hooked up to machines, unable to eat or drink…unable to communicate with people about her basic needs. Watching her suffer and knowing that she could not communicate with family, or doctors, or nurse, broke my heart. She died in 1989.
During that time, I couldn’t even really help her, because I was not educated…not yet a speech pathologist, with training in Audiologist. It would be another 5 years before I started on my journey…all the while, realizing how much I could’ve helped her, if I only had the knowledge that I eventually gained.
Then, within another 7 years, I started losing my hearing…finally getting hearing aids, in 2012. These hearing aids and my interactions with my audiologist, have been life-altering…changing my life, for the better (though not perfect) and have helped me survive, until I recently had to retire, because the hearing loss (even with amplification) became too difficult …I could no longer perform my duties, teaching and being a therapist.
My hearing acuity has declined, over the past 6-7 years….rendering me less able to cope with communication, professionally and personally.
Fast forward to 2018…I just found out about the BOSE Hearphones…watched a Youtube video, during which a new user (she just purchased this device a few months ago…she has what I’m guessing, is “moderate hearing loss”…she really wasn’t clear about the degree of hearing loss; although, it seemed to be significant enough, that she has used hearing aids, for several years and could not function, without them).
You can find the Youtube video, under the name, “Dana Ross”. The actual speaker is Dana’s friend, Anne Jones.
So, Anne described the amazing features of this device..there are multidirectional microphones, that are built into the earbuds. These microphones help the user to hear speech in noise, so much more effectively, than her hearing aids. One simply needs to turn his/her head and s/he is able to hear a specific person’s voice/speech, more clearly. The Hearphones are described as most suitable for people with “mild-moderate hearing loss”. But, Anne stated that she has been so happy with the device, that she stopped wearing her hearing aids!
There are many tweak/adjustments, that one can make, directly on the device and/or via a smartphone app.
The device is also reviewed, on Youtube, by Dr. Cliff Olson, audiologist, in Arizona. Cliff has posted many educational Youtube videos, as well as reviews of products. His reviews seem to be objective …it doesn’t seem as if he’s pushing one device over another. He liked the Hearphones, but he did mention that an audiologist could more efficiently tweak the settings, by using real ear measurements (always the best approach…scientific and clinically more objective).
So, I very much want to try the BOSE Hearphones. I have expensive hearing aids, with a bluetooth streamer and microphone. The microphone helps a little, but it’s horrible to use in a noisy restaurant (which is what Anne Jones mentioned in her youtube video).
So…these are my two cents. I really agree with David Myers, in terms of wanting the biggest bang for my buck and in terms of the great relationship I have with my audiologist. An audiologist is really the ONLY professional who is capable of adjusting hearing aids. The reason that hearing aids are so expensive, is because of the time that the audiologist needs to spend, adjusting and re-calibrating hearing aids, over time.
Buying cheap hearing aids, is just too big a risk and as David mentioned, “hearing matters”. The expense of $6,000 or so, every few years, is worth it, because, it means “survival”. Being able to effectively communicate with others, is very important, in terms of quality of life.
On the other hand, if a Bose Hearphones device, can help me to have more pleasant conversations, in noisy rooms, then I want to try it…maybe I can use this device for noisy environments..it could serve as a backup, at the very least. I’m very intrigued and will report more, when I can get my hands on the Bose device.
Wishing us all success, no matter which device(s) we choose..
Thanks for sharing your thoughts on the subject. I think a combination of devices will be the way of the future. Here is hoping we all find what works best for us.
You can watch this video about the BOSE HEARPHONES…I’m intrigued …I want to try the device.
I watched this video, as well as a user review (Anne Jones) on Youtube….She described, in detail, how the device works and how it has helped her to the degree that she has been using the BOSE device, rather than her own hearing aids.
Wondering what others think about this device?
Have you tried it?
I have friends who like the device a lot but battery life is a problem. They use it primarily for meetings. Thanks for sharing the link.
The OTC Hearing Aid Act passed in 2017. What is the hold-up? I know we have OTC ‘hearables’ (e.g. the Bose Hearphones, BeHear, and iQBuds) and that we are ‘hearing’ rave reviews from the users. But many are ready to move on. Why have we not seen OTC hearing aids yet? What/ who is the hold up?
The FDA is still working on setting the standards. Hopefully there will be progress on this front soon.
And apparently they’ve been doing this for 3 years? I wonder if (like with affordable Rx) the industry lobbyists and our elected representatives have it stalled? Is there any way we get a progress report and an ETA from the FDA?
The sponsoring senators recently asked for an update. I have not yet seen a reply. Hoping there will be one soon. https://www.hearingreview.com/inside-hearing/chuck-grassley-and-elizabeth-warren-request-update-on-otc-hearing-aid-act
Hopefully the FDA will have the decency to answer their questions.
I am very suspicious of OTC hearing aids. Y need to have one calibrated to your hearing, not one size fits all. you get what you pay for. my hearing is very important and a top spending priority. I just wish they worked like glasses and we could put them on and hear, Even the cochlear implant , while it makes things better is not as good as it,s cracked up to be. strangely, those TV ears really work.
OTC hearing aids are not for everyone, but I am hopeful they will be a good alternative for some. Other technologies and non-technical skills like communication best practices are also important. Thank you for sharing your perspective.