One thing that annoys me with ‘how do you hear me now approach’ is that they think we want to spend unlimited time in their quiet offices.
I have yet to see someone who follows best practices summarised by dr cliff and insists on using manufacturers audiometry as only equipment. You can’t follow best practices with HA alone!
If you have the equipment, use it!
If you don’t have, don’t tell us how it isn’t important /useful.
I don’t have time nor energy to ever again spend months to get something usable.
Rem gives me that with one setup.
And THEN I go out, take notes and complaints and start personalised fitting process.
@jlgreer1 sorry to hear that someone thought that only rem is the solution I mean, in quiet it works, for other situations other HA features had to be setup for you as well. Like amount of noise cancelling, directionality and so on.
I mean first thing after fit my fitter took paper tissue and rubbed it behind my ears to check those sounds.
Also, I strongly believe wrs (and quicksin) should be done before fitting to see what’s possible, and definitely use them as proper verification that we customers can hear and give feedback what we can or cannot hear. Immediately.
We shouldn’t be sent out of the office after first fit if our wrs with HAs and 65db isn’t in the ballpark of our best wrs without aids. Yes, in quiet. That’s first step. If you have time, you do wrs in white noise and see what you’ve got. Improve.
Having HAs themselves helps, but it isn’t necessary. What is a must is having huge empathy! Without ego issues that they know what works for us And willingness to learn and acquire the equipment that can help you help your patient.
Unfortunately sellers don’t have it, and they don’t invest in equipment because that doesn’t bring profit but cost.
So yeah, I’d say checking if someone follows best practices also checks someone’s empathy and desire to really help you.
My DIY is basically saving myself some trips (and time for my fitter as well), by tweaking those features, or deciding what I want each button to do. Gains per frequency are still in ballpark of my first successful REM fit (I had to have 2 utterly different, and after that we do one as a test each time when I change aids, and omg, I really tested them, m70, m90, 2x m90 rechargeable, 2x m90 13t, 2x p90 13t, now 2x p90rt are left )
But yes, I had to understand a lot and learn a lot how sound works, how tech works.
What I like in my fitter is that when he doesn’t know something he says it. It was rare, but happened (when we were discussing theory and trying to figure out how it exactly works).
Oh and I’m math - comp sci engineer and I’m curious, so I just dig to find out so many whys. In short, I know how to google, read and understand and ask tons of questions. I don’t think those skills are something special.
What I do see is that many sellers have 0 desire in those skills and results.
One more thing, to test wrs without aids, you use those headphones for tonal audiogram.
To do rem and test wrs with HAs you use calibrated speakers at the exact position.
[b] So if you have rem equipment and audiogram, you have equipment for everything useful. Use it.
If your only equipment is HA audiogram, you have zero.
We want to understand speech, we don’t care about pure tones. Test us with speech! [/b]
And don’t come here saying how it’s the same or even worse saying how audiogram alone is enough no matter which device does it.
Come here to learn from us and gain ability to help your patients properly.)
Unlike many people who come in person, we here did invest our time in learning something about it.
Manufacturers also encourage using REM verification, I personally heard on some courses on audiology.com
And we know that rem verification works only for those formulas.
So yeah, that’s my proof that point of manufacturer formulas is to reduce returns because many fitters have no clue what they’re doing and manufacturers try to compensate for incompetence.