Patient’s Problems with Hearing Aids Highlight The Importance of REMs

A recent case in our clinic highlighted a troubling trend in hearing healthcare that borders on professional negligence. A patient came to us after years of struggling with improperly fitted hearing aids purchased online, demonstrating why proper fitting procedures—especially Real Ear Measurement—are essential for successful hearing aid treatment.

This patient's experience illustrates a critical issue we see repeatedly: hearing aids dispensed without following established best practices, leaving patients with expensive devices that provide minimal benefit. At Applied Hearing Solutions, we believe this situation raises serious questions about professional responsibility and patient care standards.

The Case That Raised Red Flags

This individual had been working with an online hearing care provider for tinnitus treatment, receiving mail-order Phonak hearing aids that were programmed remotely. Despite wearing prescription-level devices, he reported getting more benefit from his Apple AirPods Pro—an over-the-counter device that shouldn't outperform professional hearing aids.

When he flew to Phoenix for evaluation at our clinic, we discovered the root of his frustration. Using Real Ear Measurement, we found his hearing aids were programmed so far from his hearing loss prescription that they were essentially useless. He was significantly under-amplified across his entire high-frequency hearing loss range, while being over-amplified at frequencies that didn't require additional sound.

The most telling discovery? His Apple AirPods Pro were actually programmed better than his expensive prescription hearing aids. This explained why he preferred the consumer devices over his professionally dispensed equipment.

Why Online Hearing Aid Dispensing Falls Short

When hearing aids are ordered online, providers rely entirely on manufacturer "first-fit" algorithms based on audiogram data. These initial settings represent educated guesses about amplification needs, but they're based on average ear canal measurements that rarely match individual patients.

The fundamental problem is that every person has unique ear canal size and shape characteristics that significantly affect how sound is delivered to the eardrum. Without physically measuring these individual differences through Real Ear Measurement, it's impossible to program hearing aids accurately.

We've never encountered a patient with "average" ear canal dimensions in our clinic. This means first-fit programming—the only option available for remote fittings—inevitably results in suboptimal performance for virtually every patient.

The Real Ear Measurement Solution

Real Ear Measurement allows us to precisely verify that hearing aids are delivering the correct amount of amplification at each frequency range. We place probe microphone tubes in your ear canals alongside your hearing aids, then measure the actual sound levels reaching your eardrums.

During this process, we compare your measured amplification against your specific hearing loss prescription. The goal is to match your prescriptive targets as closely as possible, ensuring you receive adequate amplification where needed without over-amplifying frequencies with normal hearing.

For our patient with the improperly fitted Phonak devices, we switched him to a different hearing aid brand better suited for high-frequency hearing loss and programmed the devices precisely to his prescription using Real Ear Measurement. The result was immediate and dramatic—his tinnitus disappeared completely when wearing the properly fitted hearing aids.

Our Applied360 Review and Refit Programs

When patients come to us with underperforming hearing aids, we often recommend our Applied360 Review consultation. This comprehensive evaluation determines whether existing devices are capable of treating your hearing loss effectively or if they simply need proper programming.

Many patients qualify for our Applied360 Refit program, which essentially starts from scratch with existing hearing aids. We verify proper physical fit, perform comprehensive Real Ear Measurement for all speech levels, and optimize every aspect of the programming over a structured three-week period.

This process can transform hearing aids that previously provided minimal benefit into devices that deliver exceptional performance. The key difference is following research-backed best practices rather than relying on manufacturer estimates or general comfort adjustments.

The Professional Responsibility Question

This case raises important questions about professional ethics in hearing healthcare. When providers choose to dispense hearing aids through methods they know cannot achieve optimal results, are they meeting their professional obligations to patients?

Research clearly demonstrates that proper hearing aid fitting requires in-person verification procedures. Real Ear Measurement is considered the gold standard for hearing aid programming, yet many providers skip this critical step—whether due to time constraints, cost considerations, or lack of proper equipment.

At Applied Hearing Solutions, we believe patients deserve better. Every hearing aid fitting includes Real Ear Measurement verification because we know it's the only way to ensure optimal performance. We also maintain the equipment and expertise needed to perform test box measures and validated outcome assessments.

The Cost of Cutting Corners

Patients who receive improperly fitted hearing aids often struggle for years with devices that could perform much better with proper programming. Some give up on hearing aid treatment entirely, assuming the technology simply doesn't work for them.

Others continue seeking solutions, spending additional money on new devices when their existing hearing aids could be optimized through proper fitting procedures. This cycle of frustration and expense could be avoided if initial fittings followed established best practices.

The most concerning aspect is the missed opportunity for hearing improvement. Our patient lived with inadequate hearing aid performance for years when proper fitting could have provided immediate benefit for both his hearing loss and tinnitus symptoms.

Why Best Practices Matter

Comprehensive audiologic best practices exist because research has proven they deliver superior outcomes. These procedures aren't optional conveniences—they're essential components of effective hearing aid treatment.

At Applied Hearing Solutions, we follow these practices with precision because we know shortcuts compromise patient outcomes. Our Applied360 programs incorporate Real Ear Measurement, test box measures, and validated outcome assessments to ensure every patient receives optimal care.

Finding Proper Hearing Care

If you're struggling with hearing aids that don't seem to help, the problem may not be the technology—it could be the fitting process. Our Applied360 Review can determine whether your devices are capable of better performance or if different technology would better serve your needs.

Don't settle for hearing aids that make sounds louder without improving clarity. Properly fitted devices should provide clear, comfortable hearing in various environments, not just increase volume.

Contact Applied Hearing Solutions at (602) 877-0000 to schedule your comprehensive hearing aid evaluation. We'll determine whether your current devices can be optimized through our Applied360 Refit program or if new technology fitted with proper best practices would better serve your hearing needs.