32 LOUISVILLE MEDICINE
A SECOND OPINION
This space is for our physician members to speak their minds freely on both medical or non-medical issues of the day and respond to the opinions of others . The GLMS Editorial Board reserves the right to choose what will be published . Please note that the views expressed in A Second Opinion or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine .
As of Oct . 17 , the FDA has – finally – approved the sale of some hearing aids as OTC devices . Traditional Medicare has never covered hearing aids at all . Although Medicare Advantage plans have covered some costs , most Medicare users have borne the brunt . On average , they have paid 79 % of the costs , per Paula Span in the Oct . 10 New York Times ( NYT ). 1 Per my previous patients , hearing aids could range up to $ 8,000 – and still not be worn daily , for various reasons .
From the FDA ’ s news release : “ Today ’ s action follows President Biden ’ s July Executive Order on Promoting Competition in the American Economy , which called for the FDA to take steps to allow hearing aids to be sold over the counter . This effort also builds on the Biden-Harris Administration ’ s goal of expanding access to high-quality health care and lowering medical care costs for the American public .” 2
“ Hearing loss has a profound impact on daily communication , social interaction and the overall health and quality of life for millions of Americans ,” said Acting FDA Commissioner , Janet Woodcock , MD . Those with severe loss and everyone under 18 will still need prescription-only devices . The proposed rule will regulate the maximum volume output , control of frequencies and the insertion depth of the device , distortion control and other factors .
You can test your hearing on free apps ( SonicCloud and Mimi Hearing Test ), but both recommend using a device that connects to AirPods or a microphone ( although holding the phone very close to
Say What ?
by MARY BARRY , MD your ear works , sort of , according to online commentators ). Many younger people have undiscovered hearing loss from noise pollution in their youth ( top-volume headphone use for gaming and music ), chronic sinus and allergy problems with recurrent ear infections , smoking , excessive drinking , viral miseries and the like . Those of us who are older have senescent loss to some degree , although I can still hear a cookie package being opened at a hundred paces ( particularly if chocolate chip ).
I immediately worried about fraud in sales ( never overestimate the education or discernment of your average American ) and also about what people expect from such devices . Crystal clear separation of sounds in a loud environment is never going to happen . Better pickup of ordinary conversation in a calmer place is quite likely to happen , however , and that is where people spend more time , unless they work on a loud factory floor or in an echoing warehouse . What my patients who wore official hearing aids told me is that in general , they no longer irritated their spouses by missing half the meaning , and they could turn the TV volume down : both things that contributed to communal harmony .
The apps above administer a “ pure hearing tone test ” that generates a “ hearing number ,” reflecting how loud speech must be before you hear it well . 3 This hearing number can range from 0 to 100 decibels - the higher the number , the worse your hearing loss . A trained audiologist of course can use a variety of techniques more sophisticated than an app to define your hearing number , and tailor a hearing aid prescription more exactly . Even so , people generally need several follow-up appointments to get really good at using and adjusting their own devices in various settings . Using an expert to help you with your hearing should be the gold standard if you have