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Fitting hearing aids without real ear.

gandalf at infi.net gandalf at infi.net
Mon Nov 24 08:58:24 EST 1997

The person said, "we can always boast about our 5-6% return rates". This 
seemed to me to be an insult. We can also boast about our knowledge of poorly
designed research studies. In any case, your response is well said.
BTW, I not opposed to REM, just to the thoughtless use of it by those who want 
to vaunt their expertise over the patient. It happens in this area that 
a well known audiologist tells her patients that they are wrong when 
they complain about their hearing aids. It seems that her real ear unit 
informs her of the proper fit. Those folks come to me for resoulution of 
their difficulties. Maybe I'm a bit sensitive on the subject.

>>From: gandalf at infi.net
>>Date: Fri, Nov 21, 1997 18:10 EST
>>Message-id: <gandalf.1019.000C1326 at infi.net>
>>Your opinion is valuable, as are others. Denigrating me by assuming that I am
>>bragging about a low return rate is beneath my comment, so I will let it


>Excuse me but I must have missed something in the previous posts
>or somewhere else.  I'm quoting the entire post so you can clear it up for me. 
>Your original post is valid i.e. REM etc doesn't make you a qualified or
>compitent dispenser.  The point of the response seemed to me to be -- - even
>though we ( any practicioner) can claim a low return  rate the industry has a
>poor satisfaction rating based on Marketrak and others "ain't so hot".  

>The best avenue is a marrage of both worlds tech and compassion.
>Science and art are both needeed to help our patients.  The big problem is
>people using the Equipment to dictate to the patient and those that avoid tech
>to the subjective response only.  My personal experience has been to use the
>equipment to validate the patient's feelings about the sound quality.  I can't
>hear through their ears, but I can measure the change to "get my head out of
>that bucket" for improved subjective.   Neither approach is able to ignore the
>other if we reall want to do it right for the patient.

>Bob Siegel

>>I understand completely the ins and outs of real ear hearing aid fitting. It 
>>does not require a brain surgeon to do read a dial or to manipilate a 
>>frequency response. I assume you charge mightily fot the privilege of your 
>>customers getting this wonderful technology, plus it makes it seem that you 
>>are on the cutting edge of technology. You argue expertise, but what you 
>>say is money, money, money. Well, sir, I have renounced trying to boost my
>>at the expense of my patients. I am willing to go the extra mile, to try any 
>>formula which will aid them in their quest for better hearing. I have climbed
>>that mountain and have rejected it. For you to condemn me with your supposed 
>>superiority is laughable. I have thousands of patients who respect and seek  
>>out my advice, counsel and expertise. What you think is (in the words of Star
>>Trek Voyager's "7",)   irrelevant.
>>>It seems to me there should not be no argument over whether it is mandatory
>>>use real ear to succesfully fit hearing aids.
>>>If my memory serves me correctly, the latest Marketrak study revealed that
>>>64% of conventional hearing aid users are satisfied with their instruments. 
>>>This is not good.  We can always boast about our 5-6% return rates, but the
>>>bottom line is, more than 1/3 of our patients are not happy with their
>>>instruments.  This track record is not going to improve the present negative
>>>word of mouth about hearing aids.
>>>We owe it to our patients to conduct every possible outcome measure, whether
>>>be real ear, soundfield, subjective reports, and post-fitting questionaires
>>>(i.e., APHAB).  We also should be educating our patients about the superior
>>>technology afforded by programmable and digital hearing instruments. 
>>>We live in an era of wonderful hearing aid fitting technology.  I hope we
>>>past the days of simply asking our patients, "so how does that sound?"
>>>Steven D. Sederholm

>Robert B. Siegel M.S. CCC-A, BC-HIS
>Family Hearing Centers
>2001 Lincoln Dr W.   Suite E
>Marlton, NJ 08053-1531

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