Audiologists, Ear Nose & Throat Doctors, and Hearing Aid Fitters

There are several different types of businesses that provide hearing aids, and this can be confusing to the consumer.  The sources of hearing aids range from Doctors of Audiology, to Ear-Nose-and-Throat Doctors, to hearing aid dealers and franchise stores, and even big-box retail stores and internet sellers.

An audiologist is a licensed health professional with a Bachelor’s degree and a Master’s or Doctorate degree.  The audiologist is the highest-trained individual in the diagnosis, testing, evaluation, and rehabilitation of non-medical hearing loss (that is, hearing loss that is not associated with disease).  To be licensed as an audiologist in the state of Pennsylvania, a person must hold a Master’s or Doctorate in Audiology from an accredited university, complete 375 hours of practicum, complete a one-year supervised internship, and pass an examination.  In most states (Pennsylvania included), no one can legally use the term “audiologist” unless he or she holds an Audiology License.

In recent years, the Doctor of Audiology (Au.D.) degree has become the basis for the practice of audiology.  The Master’s Degree in Audiology is no longer offered, but licensed audiologists with the Master’s degree may continue to practice (“grandfathered”).  Many audiologists who began their career with the Master’s degree, have gone forward to earn the additional Doctor of Audiology degree.

Some audiologists are self-employed in private practice.  Others work as employees of hospitals, larger ENT (medical) practices, or in schools or other institutions.

In order to maintain an ongoing license in the state of Pennsylvania, an Audiologist must complete a minimum of 10 hours of continuing education each year.

Audiologists do not perform surgery, and do not prescribe medications (prescription drugs).  They may recommend over-the-counter medications.

Hearing Aid Fitter
In Pennsylvania, anyone who has registered as a “Hearing Aid Fitter” (dealer) with the state may legally sell hearing aids.  No college degree is required, however some Fitters take a correspondence course in hearing aids offered by the International Hearing Society.  In order to register as a Hearing Aid Fitter in Pennsylvania, the person must work as an apprentice under an existing Fitter, and take a written test administered by the state consisting of 160 true/false and multiple choice questions.  There is no practical examination (i.e. no observed test of the person performing a diagnostic test, taking an earmold impression, or counseling a patient).

There are many names used by Hearing Aid Fitters in Pennsylvania, such as:

  • Hearing Instrument Specialist (HIS)
  • Hearing Aid Specialist
  • Certified Hearing Aid Specialist
  • Board Certified Hearing Instrument Specialist (NBC-HIS)
  • Audioprosthologist
  • Hearing Aid Dispenser

None of these terms have a legal definition in the Pennsylvania state code.  They are all slightly different names for the Hearing Aid Fitter.  The term “audioprosthologist” is particularly confusing, and should not be mistaken for an Audiologist.

Hearing Aid Fitters are commonly employed by independent hearing aid dealers, franchise hearing aid stores, and general-merchandise retail stores.  A hearing aid dealership (store) does not need to be owned by a licensed Hearing Aid Fitter, it only needs to employ a licensed Fitter.  Franchise stores pay a franchise fee to the franchise company, and may only dispense that brand of hearing aids.  They often advertise “special events” with a “nationally-known hearing expert”, which is usually another Hearing Aid Fitter from the franchise company headquarters – who may not be available when the patient needs follow-up care.

Ear-Nose-and-Throat Doctors
The formal term for an ear-nose-and-throat doctor is “otolaryngologist”.  Many people abbreviate the specialty and refer to them as an “ENT”.  An otolaryngologist holds a medical doctoral degree (MD or DO) from an accredited university, and has completed a multi-year residency in surgical procedures. Otolaryngology (also sometimes called otorhinolaryngology) is the branch of medicine and surgery that specializes in the diagnosis and treatment of disease and other disorders of the head and neck.

There are many specialties within the field of otolaryngology, including the treatment of allergies, sinus conditions, treating inflammation and infection, diseases of the larynx (voice box), cancers of the head and neck, pediatrics, infections of tonsils and adenoids,  facial reconstructive and plastic surgery, etc.  ENT doctors also can prescribe medications (prescription drugs).

Many otolaryngologists employ an Audiologist to perform diagnostic tests of the ear, for both hearing assessment and for the diagnosis of certain diseases and conditions.  In some ENT offices, the audiologist will also perform hearing aid evaluations and dispense hearing aids, along with their other duties.

When you are seen by an independent Audiologist, if there is any indication of disease (inflammation, infection, drainage, bleeding, perforated eardrum) you will be referred to the appropriate medical doctor (usually an ENT) for treatment of those conditions, before beginning the process of hearing rehabilitation.

Retail stores
In recent years there has been a trend of retail establishments selling hearing aids, as an additional product.  Some discount department stores and “big-box” stores have identified an opportunity for increasing their profits through the sale of hearing aids.  Even one outdoor-product retailer has offered hearing aids, alongside such items as shotguns and fishing reels.  By law, they must employ a registered Hearing Aid Fitter.  However, in Pennsylvania, the only piece of equipment required is a basic audiometer.  Most of these stores lack a sound-proof booth, tympanometer, otoacoustic emissions device, and other testing equipment typically found in an Audiology practice.  Most sell only one brand of hearing aid, which may not be the most appropriate type for your particular type of hearing loss and needs.

Successful hearing aid fitting
You are probably acquainted with at least one person who has hearing loss, was “sold” a pair of hearing aids, and has been disappointed in the results.  The truth is, the primary factor in the success of your hearing aid fitting is the skill and experience of the provider.  There is no “silver bullet” technology that is the answer to all hearing problems.  An independent, licensed Audiologist is the most qualified professional to diagnose and evaluate your hearing, and to recommend and provide a comprehensive solution to your hearing needs.