The Academy of Doctors of Audiology (ADA) urges consumers who suspect that they have hearing loss to seek treatment from a licensed audiologist or other hearing healthcare professional to ensure the proper diagnosis and treatment of hearing loss, and to identify potentially serious underlying medical conditions. Further, ADA reminds consumers that hearing aids are not always the recommended course of treatment for hearing loss.
"Even when hearing loss is detected through a comprehensive examination, hearing aids are not always a recommended course of treatment," said ADA President Eric Hagberg, AuD, "The purchase and use of a hearing aid without a proper examination, diagnosis and counseling is a recipe for poor treatment outcomes and increased risks."
Key risks of omitting an evaluation and treatment by a licensed audiologist or hearing healthcare professional include the missed diagnosis of a serious underlying health condition that requires medical intervention and subsequent hearing loss as a result of improper fitting and/or programming of hearing aids.
According to the ADA, there are many possible causes of hearing loss including:
- Aging - Hair cell loss from the nerve endings in the cochlea, stiffening of the cochlear structure, or loss of nerve endings on the acoustic nerve, may be age-related causes of diminished hearing.
- Blockages in the outer ear - Almost anything can block the ear canal and cause hearing loss. Common blockages include earwax, foreign bodies, swelling from allergies or infections, injuries, and birth defects.
- Ear infections - Generally, ear infections cause swelling in the middle ear, which in turn causes a build up of fluid behind the eardrum.
- Fistula - A fistula is an abnormal opening between the middle and inner ear that causes fluid to leak from the inner ear. Symptoms include dizziness, as well as hearing loss.
- Head injury - A head injury can damage nerves in the hearing centers of the brain.
- Medication - Some medications have been identified as ototoxic and can cause hearing loss.
- Meniere's Disease - Pressure in the inner ear may cause fluctuating hearing loss, tinnitus (ringing sensation), dizziness and nausea.
- Noise - The single most common cause of hearing loss is exposure to loud noise.
- Otosclerosis - This is a hereditary disease. New bone grows around one of the small bones that transmits sound from the outer ear to the inner ear. This new growth of bone disrupts sound transmission.
- Tumors - Tumors can be benign or malignant. Depending on where the tumor is located, the resulting hearing loss may be either conductive or sensorineural.
Many of these conditions cannot be treated with a hearing aid, and several require immediate medical intervention for treatment.
United Healthcare (UHC), the largest U.S. insurer by revenue, announced on Oct. 3, that it will provide subscribers and the general public with online hearing testing and allow the purchase/obtainment of hearing aids via the Internet through its subsidiary hi Health Innovations. This announcement came on the same day that UHC's parent company, United Health Group, introduced its 2012 Medicare Plans and began marketing to elderly subscribers. The announcement also ironically coincided with United Health Group's (United Health Foundation) announcement that it would provide a $50,000 grant to the National Council on Aging (NCOA) so that NCOA can "expand outreach efforts to seniors and aging services organizations, reminding them to work with health care professionals for appropriate (hearing) screening."
The announcement by United Healthcare to offer an online diagnostic, treatment and distribution model for hearing healthcare has prompted growing concerns within the health community.
"This undermines every good practice with regard to hearing healthcare as this diagnosis and delivery model is unsound, unsafe and unreliable," said Dr. Hagberg. "Without the proper diagnosis, counseling, hearing aid fitting and follow-up evaluations, successful treatment for hearing loss cannot be achieved."
On Oct. 12, 2011, the Better Hearing Institute released a press release warning consumers against "Do it Yourself Hearing Care." Read the full release here:
http://www.betterhearing.org/press/news/Internet_direct_mail_hearing_aids_pr10122011.cfm.
On Oct. 26, the Minnesota Department of Health released a statement stressing the importance of seeing a hearing health practitioner for hearing loss and advising that failure to do so "skirts state and federal legal protections and could result in harm." Read the full release here:
http://www.health.state.mn.us/news/pressrel/2011/hearing102611.html. United Healthcare, UnitedHealth Group, and hi Health Innovations are all based in Minnetonka, MN.
Also on Oct. 26, an attorney retained by the International Hearing Society (IHS) sent a letter to hi Health Innovations requesting that the company cease and desist selling hearing aids through its website. Read the full letter here:
http://ihsinfo.org/pdf/IHS_Letter_to_HealthInnovations.pdf.
On Oct. 31, ADA and the American Academy of Audiology (AAA) sent joint letters to Lisa Tseng, MD, Chief Executive Officer of hi Health Innovations, and Rhonda Medows, MD, Chief Medical Officer of United Health Group, expressing concerns and requesting additional information regarding the insurer's plans for an online hearing healthcare delivery system. Read the letters here:
Intricon Corporation, headquartered in Arden Hills, MN, has been contracted to manufacture the hearing aids sold by hi Health Innovations, whose parent company is UnitedHealth Group. This goes against the common practice within the hearing aid manufacturing community. In fact, most hearing aid manufacturers have made public statements that they will not allow their hearing aids to be sold online.
Hearing aids are medical devices regulated by the U.S. Food and Drug Administration (FDA) and must be recommended, sold and fit by qualified health professionals:
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?FR=801.420.
Further, all 50 states require licensure for the dispensing of hearing aids:
http://www.audiologist.org/resources/state-licensure.html.
