Audiologist versus Hearing Instrument Specialist

So this image flashed across Twitter and LinkedIn, and got me wondering, what are your experiences with having your hearing care from the audiologists versus HIS? Have any of you been to both and experienced any differences? Let me know!

Oh, and if you don’t know what I’m talking about see the discussion on our site at audiologist vs hearing instrument specialist. Thanks!

1 Like

I’ve worked with a number of AuD and Master degree. I have worked with one HIS. I found all competent and giving an edge to one with a Masters.

I’ve interacted with clinics, ENT audiology, and Costco. The ENT and Costco were excellent. The clinic I saw as a profit center.

When I retired, I was bombarded by clinic ads. Talk about shoddy ads… They all seemed to have a next ## customer “deal”.

I’ve dealt with two hearing aid specialists and a total of 3 audiologists, but only 2 could fit hearing aids. I don’t know if it’s state specific or not, but in California, just being an audiologist does not give you the right to prescribe hearing aids–one needs some additional certification. Anybody know how much of audiologist’s training actually involves fitting hearing aids? Oh and in comparison. One hearing aid specialist stood out for being more thorough than anybody else, but she was not particularly knowledgable as she was relatively inexperienced. One audiologist definitely knocked Costco, but I was not impressed with his thoroughness.

Well…to this anonymous internet punter…I gotta say that many of those “criteria” are not particularly relevant to assessing and fitting HA’s.
Some of them are certainly relevant to medical issues surrounding hearing loss that would be beyond the scope of what a fitter would be used for. That fitter would say go seek medical attention. Fine. That was my first experience with a fitter.
So for me the nod to the Aud are Education. Sure. I didn’t know about the child thing. Maybe that’s a US thing.

But the fitter can assess the need (presumably objectively and not motivated by a sale) and then provide and fit the aid.

Beyond that is all medical. Sure.

The science stuff at the bottom is irrelevant to getting HA’s.

I have experienced recommemded HA by both - Audiologists and Hearing. Instruments providers.

In my opinion I need them both. The audiologist for the accuracy of the test and the HA provider for the extensive experience with HA instruments that applies to your specific needs for a HA.
My first set of HA back in 1998 was recommended by the Audiologist. After that experience I researched for other options - after a second HA test by another Audiologist 4 years later - With a copy of the latest test results I found the HA instrument specialist to be relatively less expensive for fitting my then current need
primarily since he had several options from HA makers that would meet at that time my HA need.
The Audiologist was limited to very few makers- not more than 2 or three , that would provide similar quality of correction instruments but at a bit higher price. I find this definition similar to new automobile car dealer who are “lock in” to represent only one car manufacturer products. while the Instrument specialist can shop any maker of HA - usually they have available more than three of the major brands of HA.
After my first set in 1998 I have depended on independent HA specialist for my HA needs.

'Cept if either are actually a company store.

I’ve seen one audiologist, two HISs and whoever it was who did the test at the ENT. The first HIS was the best at explaining things, and he was very thorough. The girl at the ENT was okay as well, but she shot through the test so much I’m not sure how accurate it was (she had both the air and bone conduction going at the same time instead of two separate tests and it was CONFUSING.) The last HIS and Audi were the worst. The audi forgot to test an ear… Forgot. To. Test. An. Ear. I was rushed in and out of the office so fast and it was going to be 5 appointments just to pick aids (one for the test, one to pick the aid, one to do the molds, another to see accessories, and finally the last where I actually order. Then three more appointments to get everything set up.

My suspicion is that, all things being roughly equal, the best fitters are the ones with the most experience (i.e. who fit the most HA’s of the brand you are interested in). One advantage of an online seller who does large volumes is that they get lots of experience with ALL of the brands they sell. Ditto the Costco folks who deal in a small number of high-volume HA’s.

1 Like

Someone can also be an audiologist with a Master’s degree. I saw one a few months ago. I do feel that an audiologist knows more about hearing than a hearing instrument specialist. I was referred because I was tested at Costco and they said my word recognition scores had plummeted, and that I should see an ENT. Of course, in our non health system I saw a nurse practitioner. But to stay on topic, I think an HIS can be very useful and knowledgeable about hearing aids, and most of the time they can do what is needed. When it comes to health, even the audiologist can’t do anything.

They all seem to knock Costco–it’s taking away their business!

I first went to a place that sells hearing aids. I asked if they thought hearing aids would help my problem. Seeing that selling hearing aids was their business, of course they said yes. The young woman who administered the hearing test did, I thought, a very professional job. She told me they had some excellent aids on sale and could fit me with a pair for $2750. I made sure I could return them for full credit before I wrote the check. She fitted them that day. They were more of an aggravation than a help. I went back for adjustment. The adjustment didn’t really improve things. I went back gain near the end of the trial period and told her that the aids simply did not help my hearing. She took them back, without argument, and told me my refund would arrive in a couple of weeks. She seemed to know what she was talking about, was friendly without being flirtatious, and seemed to really care about doing a good job. A year went by and I decided to try to buy some aids off eBay and self program. First, I needed an audiogram, so I made an appointment with the audiologist at an ENT I had visited before. I had to see the ENT first, even though I stated up front that I was there only for the audiogram. The audiologist did the audiogram and then sat me down to discuss the results. She was very up front about my hearing loss and told me that I likely would not recover enough hearing even with aids to hear well. When I asked about frequency lowering, she told me that she had mixed results with it and that older folks usually didn’t benefit. We never discussed what brands of aids she dispensed, though she displayed my audiogram using Siemens software. I had to pay for the audiogram, but there was no resistance to giving me a printed copy. In my experience, which is probably different to most, both seem to provide the same services by different means with different philosophies. The audiologist working for the ENT could instantly get advice and testing for medical issues. At a price, of course. I didn’t ask the fitter at the hearing aid store for a written copy of my audiogram because she ended up doing it for free, since I didn’t actually buy aids from her. I figured she considered the test results as belonging to the store, not me. The only thing that didn’t ring true from the hearing aid store employee was that she told me that the aids I trialled could not be resold. I didn’t really believe that. At most, they could re case them, or probably just give them a good cleaning. Another hearing aid store actually sells used aids on their website.

I thought the same thing about returned/new aids but she was correct. They go back to the manufacturer. Just what they do with them, I don’t know.

In the US, there is a law that copies of all tests must be given to the person when asked for. I even got a CD of an MRI to send to a doctor friend for his review.

You don’t need an advanced degree to do ear wax removal.
Once an “expert” has determined what you need in the way of HA, an HIS is fully capable of doing the mechanics of fitting the HA and doing the programming.
Anyone can do “clinical research” on any subject - mainly takes someone whose main field is “statistics”.

Question -  Out of the $5K paid for a pair of HA - how much does the mfr. get?  How much does an "audiologist" get?   How much would a HIS get?
Once an MD or an audiologist determines the patient has no medical problems - why pay for an audiologist to simply fit and program HA?   Why not simply pay for an HIS  who is probably paid a lot less per hour?

This might be a duplicate post. Still having trouble using this new forum. (Have no trouble with the other 6-10 forums I frequent)

Out of the $5K spent for pair of HA—
How much does the mfr. get?
How much does an “audiologist” get? How much would a HIS get?
Once an MD or an audiologist determines the patient has no medical problems - why pay for an audiologist to simply fit and program HA? Why not simply pay for an HIS who is probably paid a lot less per hour?

You duplicated some of your text by using some spaces before the text.
And I think I might have a theory as to why.
How’s this for an idea…maybe it has to do with old school text presentation and/or typing wherein indenting the beginning of a paragraph is the proper style.
But here in this forum editor it works as an internal function to make the text scroll. Maybe Abram can turn off that function…I don’t know. Because as you found it happens on occasion.

Just a thought.

Edit: I’ve found out the internal function that gets triggered when someone indents their text. It’s for displaying code like javascript or something. It’s called preformatted text. I think there’s a way for Discourse to turn it off but I can’t find it now. But then maybe some people here like to display their mad programming skills with formatted blocks of code. :slight_smile:

Markdown, BBCode, and HTML are automatically rendered by this forum software… That’s why the preview pane is so useful. BBCode and HTML are pretty hard to use unintentionally, but Markdown has a few triggers that can happen naturally in text, like adding leading spaces before text etc … There aren’t that many markdown triggers that would happen unintentionally, so I don’t think it’s a huge deal… Check it out here Markdown Cheatsheet · adam-p/markdown-here Wiki · GitHub

I have been to both and have had good and not as good experiences with both. The best was a HIS who also wore HA’s and was far and away the best at programming my HA’s. She also set up a restaurant program that is absolutely fantastic at eliminating background noise and letting me hear only those at my table and perhaps the table next to me. When I told her she hit it out of the park with the restaurant program, her answer to me was when I have no patients all I do is experiment to find out what does and doesn’t work in setting up various kinds of programs.

Sounds as though your HIS is sitting on a pot of gold! What are your HAs? How severe is your loss? I don’t remember ever hearing of anybody with severe hearing loss hearing “fantastic in a restaurant!”

LRA

The HA’s with the fantastic restaurant program are an old pair of Resound Vivids with std tubes and full molds that I got at Costco a number of years ago. My low frequencies are very good up to 1k and then it drops to 30 and 40 dB at 1500, 45 and 50 dB at 2k and then it is severe to profound from 3000k to 8k. My Oticon HA’s are nowhere near as good in a restaurant, even when they are in their restaurant program or speech in noise program. Unfortunately, Robin has moved to a Costco closer to her home, so if I want to go to her I now have to drive about 30 to 40 minutes to see her.

I am profoundly deaf and wear Phonak HAs and hear very well in noisy environments. My Dad has always said I hear better in noisy environments then hearing people.