Putting Audiologists out of business
Manufacturer’s of digital hearingaids supply audiologists with computer software that allows them to change an aid’s settings. The audiologist can add or remove preset programmes and adjust various sound levels.
I think it would be really useful if us hearing aid wearers could have our own version of the software so that we could make modifications to our aid’s settings ourselves. This would be particularly useful when new aids are being trialled as it’s likely that during this time a lot of tweaks are going to be made to try and get them just right. If we could make some of the tweaks ourselves it would save trips to the audiologist, useful if you don’t live close or if the audiologist is very busy and you have to wait a while to get your aid modified.
Because most of us aren’t trained audiologists, our software would have to be simplified from what the audiologist would use. And that’s fine because it would be enough to give people basic functions with which they can tweak their aid’s settings.
Here’s some of the things I think could be safely modified by a wearer using personal-software:
- Overall volume up / volume down
- Add / remove / edit programme
- Run or remove feedback dampener
- Specific-range volume up or down
Possibly the user could select boxes that indicate a problem they are having with a certain sound range – they could select options like, “I can’t hear deep male voices”, “I can’t hear the telephone” and so on. Once they’ve made selections, the software could up the volume to try and help the particular problem.
The software could ask the user to listen to tones and then adjust the aid accordingly – like a hearing test. The software could come supplied with a ‘buzzer’ that the wearer presses when the hear a sound. Your own personal hearing test! Obviously this wouldn’t be a controlled test and wouldn’t be conducted in a soundproof environment. But it may allow people to make some modifications themselves.
It would be very important for the software to be able to undo any of the changes that the user makes. The user needs to be able to undo anything they change that doesn’t sound right. It would also be good for the user to be able to revert to the audiologists default settings.
I think that if personal hearing aid modification software was designed that was easy to use and foolproof then many people would be able to safely use it without damaging their aids or their ears. Maybe we wouldn’t be putting the audiologists out of business just yet, but we’d certainly cut down on their workload.
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Starkey labs has a lot of disgruntled Vietnamese employees. Waving a few c-notes on their faces can get them sell you copies of the software.
Steve
I want access to the hardware and software to tweak and edit my programs as well. There are a preponderance of reasons why that would be desired! For myself- I would like to take my laptop, hardware connections to connect the hearing aid to the computer, and software into different environments like the park, backseat of a car, shop, bar, e.t.c.
I went ahead and called the phone line for the wholesale resound hardware and software department that the audiologists use. The person on the other line was helpful and told me they would sell me the equipment. They asked me if I was an audiologist and and I told them the truth- no.(Technically the equipment can only be sold to an audiologist but some persistence can get around this). It was quite expensive so I didn’t go forward with it at the time. I’m sure you could track down the numbers for Starkey and their equipment sale lines that the audiologists themselves use.
I think a proactive hard of hearing person like yourself would be able to make this happen.
My skepticisms: the fairly expensive equipment will become obsolete quite rapidly, the equipment will take some time to learn how to use and doesn’t look all that intuitive (but I’m sure we could figure it out eventually).
[...] previously wrote about how letting hearing aid wearers program their own aids would be good thing. To briefly recap: I think that giving us wearers a simplified version of the software that [...]
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Of the bullet points you listed above Steve, there are hearing aids available that do all of those things, with the exception of adding/removing programs, without needing software or a computer. It’s all done right on the device.
Dr. Tom,
Thanks for the response. Which device offers specific range volume changes and what kind of ranges can you specify? Is it a case of altering settings such as “deep tones”, “high tones” and so on?
I was envisaging a PC application that would display an audiogram – or some other representation – with which people could tweak specific ranges using the mouse for precision.
Also it would be fantastic if anyone could input their audiogram and have the aid automatically configure itself.
What you do not understand is that it’s not as simple as get software and making adjustments. If you want to be able to program a set of hearing aids be prepared to fork out some big bucks! You will have to purchase a programming box, cables and flex strips! That is unless you want to do it wireless. (Which will cost a lot more?) None the less you can look forward to spending no less than $1500 dollars to get started! Not to mention you better have the system requirements needed to operate the software. Be prepared to make a lot of mistakes because without a good understanding of compression, TKs, time constants you may find adjusting a hearing aid is not as simple as it looks! Anyway good luck!
Alternatively, go and live in the States (at least some of the states) and get aids from a company called America Hears, and they will provide you with everything software and connection-wise that you need to program your own aids entirely. However, it does seem to be a very small % that ask for or even use this facility. It might be on its way though!!
@Nathaneil
I agree with you that audiology is difficult – it is unlikely that the average hearing aid wearer is going to know about compression, time constants and so on. And that’s my whole point. I would like to see a programmer that makes it easy for people to make their own adjustments.
When you use Microsoft Word you don’t need to know how vector-based fonts are rendered using bezier curves. When you read a PDF using Acrobat Reader you don’t need to know how the arbitrary PDF drawing space is trasformed into a two or three dimensional space. My point? Good software makes difficult things easy. It takes away the complexity so that a user can do the things they want to do without worrying about the technical stuff.
@Keith
Yeah, I’d love to try out America Hears’ service – it looks very interesting. I did contact them to see if they planned to move into Europe but didn’t get a response – think I’ll try emailing again.
Great idea, but my audiologist friend says it takes ongoing training to keep up with
the constant software upgrades. She says programming the computer with software and
necessary training costs audiologists over $ 20,000 from the manufacturer and
they’re not compatible from one brand to another. If prgramming is done improperly it
could void the hearing aid warranty.
While it sounds good, it could increase the audiologists workload and be frustrating
for everyone concerned. My guess is the manufacturer’s wouldn’t put the R&D into it
— unless one dominates like Microsoft did. But with microsoft if you crash it’s just
data that’s lost, not a multi-thousand dollar instrument!
I’m a year late in this discussion but has anyone considered why audiologists spend years in school to learn how to help people with hearing problems? Are we doing it because it’s easy? NO. Are we doing it to make tons of money? Not exactly. Even if there were a simple software program available for the technologically inclined patient, there are reasons why individuals with hearing loss NEED audiologists. We are highly skilled and highly trained to help people hear well. We do not only fit hearing aids but we also offer our patients an aural rehabilitation program and the opportunity for successful use of their hearing aids. In the case of fitting hearing aids, everyone needs their audiologist to help them not only become adjusted to their new hearing abilities but also to help them maintain their hearing aids and manipulate the fine parameters when their hearing changes over time. Let’s not forget to mention that it is possible to set the hearing aids too loud thus incurring further damage to one’s hearing system and this is the main reason, among many, that the FDA has not approved over the counter hearing aids/software. Additionally, people need counseling from a caring and skilled professional who will help them understand what to expect and who is not afraid to find a creative solution to their hearing problem. Audiologists do much more than just fit hearing aids. We work very hard to help our patients and I take offense to anyone who implies that my job is limited to merely pushing a few buttons!
I have had my America Hears FreedomAD Liberty Open Fit hearing aids for one week and found the ADRO software to do the programming not that complex, The new hearing aid technology does but use compression anymore so changing settings is more like using a graphic equalizer on your sound system.
Sure an education is needed by audiologists and that cost money but the $3400 savings over getting older technology used Beltone was important and America Hears audiologists seem well versed. They can also used the software to make changes for you if you perfer not to do it.
The software/hardward combo to program my aids is a $149 option that to me is worth the money.
Well I see some of the “Death and Destruction” Audiologists naysayers here are beating the ol’ drum again about how HA users are so dumb, ie: (how dumb are they you ask).. that a burlap sack of rocks has far superior intelligence to be able to make some basic adjustments on a set of BTE HA’s.
Let me give you a common situation that quite often happens with HA users, especially new ones. They get their new HA’s and the Audiologist programs in a basic set of information for lets say four channels. Now the new HA wearer is sent away with a followup appointment a week or two thereafter for a evaluation and any additional tuning.
At that time the new BTE wearer has adjustments done.. and is told to use the BTE’s for the next couple of weeks.. and if needed then he/she will have to have another adjustment or so. Now this is where the problem comes up. They go in a third time and after the adjustments and another two weeks of “testing?” it still isn’t quite right to their hearing situation or satisfaction. So what happens? In a lot of cases the new HA user now takes them off and throws them into the drawer.. never to be used again.
Hypothetical situation: I get a new set of BTE’s on a Monday. By Thursday I find several things that need to be done on my BTE’s. Are you as a Audiologists going to let me come in Friday, or open up your office Saturday to do what needs to be done on my HA’s. Let’s just say you do. Three or four days later are you as a Audiologists going to stay late past closing time Tuesday night to work on my HA’s because the sound/freq adjustments aren’t quite what I need? Are you as a Audiologists going to do this seven, nine, twelve times (if needed), until it’s finally gotten right.. if it’s gotten right at all? Of course NOT! After about the third or fourth time you’re going to tell me not to come back again (what you’re really going to say is “because of your type of hearing loss, this is as good as it’s going to get adjustment wise)… which will most likely result in non-use.
My thoughts are: “I don’t want to hear you tell me it’s going to be two weeks or more before you can see me to make those adjustments”. Sorry about that. I just paid $4,000 – $5,000 – $6,000 for the HA’s. The problem is: “There’s something wrong with them NOW.. so fix the problem NOW! NOT NEXT WEEK!” If I have a flat tire on my car and I call up AAA, my membership $$$$ has been paid to get it fixed NOW.. NOT NEXT WEEK!”
Now on the other hand, as Steve said in post #9.. “there’s NO reason why a HA user with ANY common sense wouldn’t be able to make a few of the simpler adjustments. You Audiologists can’t have it both ways. On the one hand you can’t say only Audiologists can do adjustments, but on the other hand complain about not making any money when a HA user comes in repeatedly looking to have minor adjustments wanted done.
Shi-Ku Chishiki ShiKu.Chishiki@Gmail.com
I wrote this to Stakeys:
I purchased my first Starkey a while ago serial number **********. Although I am sure that this hearing aid can fulfill my needs as it provides sufficient gain and has many amazing features but I am unable to exploit its potential.
Initially my audiologist put me on really loud settings which caused trauma to me…my speech understanding has declined to 48 % from 72% over two year period…I believe my audiologist is not competent with stakey software and for this reason I would like to take this control and manage micro manage my loss.
I found on the web that most hearing aid manufacturers have made their fitting software available online. Not so with Starkey and I find myself in unfortunate situation. I paid about $5600 for these aids what good are its features if I can’t use them? My audiologist is still putting me on analog algorithm and I would like to try digital to see aid’s true potential. I am aware it’s a hard thing to do to move from analog to digital fitting. My audiologist is really hard to get as she is serving three locations and when I get her it is for 30 minutes in office setting where I can’t possibly know what setting I am getting out with. I want to be able to switch back and forth with digital and analog programs until I fully adapt to digital. In my office I will use analog so I can function properly there and in home I will use digital to practice. I can’t get this much audiologist’s attention so I need to be able to program myself. Either please provide me a refund for my aid so I can buy a aid that I would be able to reprogram myself as I had spent nearly an year with them and still not satisfied with them or supply me software.
Here is my audio gram:
Side 250 500 1000 2000 3000 4000 6000 8000 Understanding
L 13-Dec-94 50 45 35 45 45 50 80 70
L 5-Jan-95 50 50 45 50 52.5 55 60 75
L 20-Apr-95 40 40 45 50 55 60 65 65
L 18-May-96 50 45 40 45 55 60 62.5 65 84% @ 45
L 8-Apr-99 55 55 60 60 65 70 70 70 72% @ 60
L 16-Oct-01 60 60 55 65 67.5 70 70 70 64% @ 80
L 9-Mar-04 75 65 65 60 67.5 75 80 85 48% @ 80
L 26-Oct-04 70 70 60 55 62.5 70 67.5 65 72% @60
L 13-Jan-05 55 55 60 65 70 75 75 55 80% @ 50
L 4-Jan-07 60 55 65 65 65 85 100 90 68% @ 80
L 11-Jun-07 55 60 70 65 65 70 90 85 40% @ 80 / 64% @ 90
L 18-Jan-08 60 60 65 65 70 75 85 90 40% @ 80
L 13-Aug-08 65 65 70 65 75 80 90 95 56% @ 85
L 10-Mar-09 62.5 60 72.5 72.5 77.5 100 95 68% @ 80
L 30-Jul-09 65 57.5 70 65 75 90 95 48% @ 80
Side 250 500 1000 2000 3000 4000 6000 8000 Understanding
R 13-Dec-94 45 35 35 45 50 55 70 60
R 5-Jan-95 30 40 35 45 45 65 60 55
R 20-Apr-95 30 30 40 40 50 70 70 75
R 18-May-96 45 45 45 50 60 60 65 70 80% @ 45
R 8-Apr-99 45 50 70 60 62.5 65 67.5 70 68% @ 55
R 16-Oct-01 50 50 65 55 60 65 72 .5 80 60% @ 80
R 9-Mar-04 50 50 65 60 60 60 95 85 76% @ 80
R 26-Oct-04 60 55 60 55 70 85 75 65 64% @ 60
R 13-Jan-05 50 60 65 60 80 75 100 85 60% @ 50
R 4-Jan-07 55 55 60 60 75 75 85 85 60% @ 80
R 11-Jun-07 55 60 65 65 65 70 75 80 36% @ 80 / 40% @ 90
R 18-Jan-08 70 65 70 65 75 80 90 90 52% @ 85
R 13-Aug-08 75 65 70 60 80 95 95 90 56% @ 85
R 10-Mar-09 75 65 72.5 65 70 80 40% @ 85
R 30-Jul-09 65 65 70 60 75 80 90 32% @ 80
As you can see my loss just keeps getting bigger and my understanding is dropping. I really need help which I am not getting from my audiologist.
Ali Akhtar aliakhtar@hotmail.com
Audiologists rank right up there with acupunture or psychics. Why do you think insurance doesnt cover the cost of hearing aids? Its because they are NOT MEDICAL DEVICES! Audiologists love to wear white lab coats and have “Dr.” in front of thier name. This makes a vast majority of people, especially newbies think they are in they medical proffession. THEY ARE NOT. This has very important implications on your life if you are hearing impaired.
Hopefully soon they will be out of business. I have specnt the last 38 years gettting ripped off and mislead by one audiologist after another after another. Spending tens of thousands of dollars for junk!
Its only now that we have millions of baby boomers losing thier hearing that any attention is being brought to the business and completely and utterly unfair and riduculous the whole business is set up. Look an an audiologists after salary on payscale.com or a similar site. They say they go to school for 8 years to become a “Dr.” yet they get paid less than an auto mechanic. Real MD’s make 5 times as much right out of school. What does this tell you?
You can safely ignore at least 75% or more of what they tell you, especially if it has to do with why you cant program you own hearing aids. The whole industry is similar to business to business, the hearing aid companies are thier boss, NOT YOU!
This does not mean audiologists arent nice people, go to church or or have bad intent or are out to make a buck etc. It means they are in a business that is fundamentally flawed.
We should absolutely have the ability to program our own hearing aids and have available to us every single setting an audiologist uses. After a weekend, I am pretty confident I will have learned enough on my own to know the basics of programming the aid. After a 4 weekends, I will probably know as much as the audiologist does.
I cannot believe how long this business has been allowed to continue on like it has. It only shows how little regard the public and lawmakers have for the hearing impaired.
Even now this is changing thank god and hopefully the business comes to and end in the next few years.
OH PLEASE! You CAN do it yourself. I have been programming my own hearing aids for a couple of years now. It is easy. HearSource.com sells hearing aids at reasonable prices and includes the hearing aid programming software, cables, USB programmer, etc. If you need help with an adjustment, they will do it for you remotely with any internet connected computer.
I have a theory. When audiologist grow up they want to be real doctors. My goodness. I was “playing” with a sound board for my high school band in the 60′s. Everything on that old sound board is what I need to adjust the sound output of my hearing aids.
It may be Halloween today but adjusting your own hearing aids isn’t scary. Even if the audiologists are saying BOOOOO.
I agree with the idea of programming your own hearing aids. Audiologist, even the best of them, cannot hear what you hear. They work off of what you tell them and try to match the fine tuning programming with that information. Plus you are in a lab setting, which isn’t what you are normally surrounded by on a daily basis and therefore the programming setup may or may not be useable in the real world.
I have been looking for and found much of what is needed to program my own hearing aids (GN Resound) and very much want to do the fine tuning myself. If I screw it up then it’s on me, so to speak. I have found the program software and shoes. But I’m not sure about the audio cables that attach to the computer, can a normal set of stereo cables that attach to the shoe and computer be used?
I can’t believe how incredibly ignorant this line of reasoning is. Couple of things I would like to comment on. Does your family doctor generraly have office hours on Sat or in the evening? In all but a few cases, no. Why? Because your doctor is not available at your beck and call. Your doctor probably has a family, needs some personal time, must take their child to the doctor, dentist, softball game etc. etc.If you have a real emergency you go to the Emergency room. No one ever died because they could not get their hearing programmed on Sunday morning.
Audiologists are probably making less than auto mechanics because there are so many hearing impaired people who think “all you have to do is turn it up!” Would you ever put something in your ear without first visualizing the ear canal? I wouldn’t. Would you put something in your ear that could potentially damage the hearing you have left, cause an infection, make you dizzy, promote ear pain give you headaches and last but not least, overlook a serious medical problem? Brain tumor comes to mind.
Someone compared using Microsoft word to software used for programming a digital signal processing component of the hearing device. Any idiot can learn how to type a letter using a software program. Once you learn about the anatomy and physiology of the auditory system, what sounds do to the inner ear, auditory nerve, brainstem and auditory cortex, how they might enhance hearing and understanding and clarity or make it worse, waveform difference of speech sound compared with unwanted noise, ( these are just a few things) then you can proceed to how to use the software. Lets not forget continuing education so you can learn about technology upgrades, how to apply them to you hearing aid ( Oh, what the heck, just turn it up!), how to troubleshoot the hearing aids heaven forbid the equipment you use to program them, when a repair is beyond your capability and has to be sent away,because remember when hearing aid is sent for repair KaChing!!!! Kinda like taking your car in and trusting your mechanic not to rip you off.
Hi Ted,
Thanks for the comment. I think you missed my point a little bit. I am not suggesting that audiology is simple or easy and I am not suggesting that people should be allowed to blow their ears off. What I am saying is this:
If people were given software to make adjustments to their aids after visiting an audiologist for fitting, they would be able to do things like alter volumes in specific pitches, turn off programmes, and stuff like that. If the software was easy to use and clear for them they would be able to do this safely.
The point about MS Word is that it’s a simple programme to use and, as you say, any idiot can use it. But do you know how to render bezier curves into a glyph to display a unicode point? Do you know how to scale and rasterize vector graphics? The hearing aid programmer should work on the same principle: make something that is hard into something that is easy for everyone to use.
Cheers,
Steve.
Hi Steve,
A software program is just that, a program. You have multiple choices which impact other areas. You may adjust one thing and that will alter everything thing. The HA software does not say “Are you sure you want to do that?” The programmers know how to manipulate the code, they give you the option to screw things up any way you want. Remember, they don’t know what you are trying to achieve. Individual hearing loss is just that.. individual. I have often heard audiologists comment that at instruction meetings when they can’t get the results they are looking for they are told by pushing to many buttons they have screwed up all the parameters. Time to go back to the beginning. I am afraid the folks who are not familiar ( and I am being nice here) with they way the ear, not the software works, will end up adding to the fodder that “hearing aids just don’t work” and put them in the top drawer. They wait another seven years with hearing loss before going to a professional.
Sensory hearing loss is caused by damage to the nerve receptors that send information the brain. The system is damaged. Hearing aids are prosthetic devices that when configured by trained profressionals who understand pyschoacoustics and the physiology ASSIST a person with a damaged system to hear better…not PERFECT (no one hears perfectly) but better.They are not a cure they are a prostheses. You have a damaged system and maybe you dont know what normal hearing is…food for thought. Spend all this energy focused on calling audiologists con-artists on finding the funding for stem cell research and other procedures that may eventually “cure” hearing loss. Hearing aids are not stereos are there similarities…yes there are but the fact of the matter is just because something sounds loud to you once may not require you to pull out a laptop and reprogram a hearing aid. If audiologists do such a bad job with years of training and state licensure are you really sure you would do a better job? There are lots of audiologists with hearing loss also and many of them are involved in research to make hearing aids better. It takes years of research to get all that technology into a tiny device you cant see in your ear. Unitron has hearing aids now that actually allow the user to make some general program changes on the fly….so don’t say that the options are not out there. However, audiologists perform an important service, are as much medical profressionals as optometrists and pharmacists (also Dr’s), and like everything else including you the regular person on the street are a constant work in progress.
Audis – You have made it very obvious how satisfied you are at achieving hearing tests, impressions, repairing aids, and ordering/making huge$$$ on HA sells, but you’re just as aggravated along with the rest of us with repeated adjustments (while you can’t even HEAR what we hear); so why not just save not only yours, but everyone elses headache and start providing us the programming kit. I witnessed the software (on screen) by Phonak how so simple the program is, amazing even a child can do this. The hearing aid technician showed me this and he’s not a licensed Audiologist – if he can do this, so can we!!!!!!! That’s all we’re asking for, so PLEASE!!!
OK all you folks who think you know so much about hearing, hearing aids and audiologists, do audiologists make less than auto mechanics or GREAT BIG BUCKS. Come on, you keep pointing to one extreme or the other, what is it and how do you know?
I agree that patients need some form of interactive component to their hearing aid experience that allows the audiologist to “see” what specific areas or listening situations in which the patient struggles to hear or needs further adjustments. The Unitron Yuu product (and now the newer Unitron Passport) allow the patient to use several settings in a remote control and then teach the hearing aid to “learn” what those user preferences are. When the patient changes settings and does not like the changes, for example, he can then go back to “home” and the settings reset to baseline. The audiologist can safely set the baseline as well as the patient’s parameters for self-adjustment so that they feel they have more control and influence on their personal listening preferences. Additionally, the audiologist can be relieved that the patient won’t inadvertantly overamplify (or in some cases underamplify) their hearing loss. Most patients are not aware of the deeper central auditory functions (simply put, what we do with what we hear or how we process and understand speech) that can be irreversibly harmed if proper amplification is not acheived. It is this later argument plus the risks of over amplification that prevents any manufacturer or audiologist from giving the general public complete control over a hearing aid fitting.
I want everyone to think about something briefly… At this time, anyone can go to Radioshack or any retailer and purchase an IPod, MP3, TV, radio, etcetera. Each individual has control over the volume settings in these instruments, yet, when studied, their preferences for loudness vary dramatically. Even more so, the general public routinely prefers to overamplify themselves (just roll down your window at a stop light and take a listen). There is no oversight on the output of these everyday things, yet OSHA heavily monitors and fines companies who do not install proper guidelines and precautions for noise conservation for employees.
If you were an audiologist and your main goal was to prevent hearing loss and then treat it when it occurs, would you trust the general public to understand how and to what degree to amplify their own hearing loss? The answer is “No.” We want to do no harm to our patients and also prevent them from doing harm to themselves.
Thank you,
I am just starting my search for an audiologist and hearing aid that would be best for me. I would be grateful for advice or web sites recommendations. Is there something like a Consumer Report comparison of types and brands of hearing aids? Do audiologists have special relationships with certain companies whose products they recommend exclusively?
I have hearing aid programming software
And what would happen if you programmed your aids too loud and did further damage to your hearing and then went to sue the manufacturer? This is one of the big reasons patients are not allowed to program their own hearing aids.
Hi Kristine,
I think that good programming software for consumer use would not allow you to turn the volume up to extreme levels. But of course there would be a danger that that over-amplification could happen.
Some adequate warnings in the software should be enough to deter people and I guess it’d come with a disclaimer to say it’s your own fault if you blow your ears off. Same as an iPod really.