Once you have decided to get your hearing tested, it can be difficult to know where to go. The TV and newspapers can be full of advertisements offering “Free Hearing Tests” or “No Obligation Trials” for hearing aids. One way to protect yourself as a consumer is to be aware of who is offering these services. In the world of hearing healthcare, two types of providers exist: Hearing Instrument Dispensers and Audiologists. Knowing the difference can help you decide which type of provider to seek out.
A Brief History Lesson
To understand the difference, a short history lesson may be helpful. In the early 20th century, Cordia C. Bunch began to write articles on hearing testing, findings in abnormal ears, the impact of noise on hearing, etc, and in 1943, the first book about clinical audiometry (hearing testing) was published.1 Then as World War II closed, Captain Raymond Carhart began to publish guidelines about selecting hearing aids by comparing how individuals performed with different hearing aids and using their best performance to select the best device. His seminal book, Speech Audiometry, was published in 1946.1 As our soldiers returned home from World War II with noise induced hearing loss, Audiology was born.
While in its infancy, Audiologists were primarily testing hearing and had little to do with the selling of hearing aids. Once testing was completed, the patient would be sent to a hearing aid dealer to purchase a device. These Hearing Aid Dealers, also known as Hearing Instrument Specialists, have been selling hearing aids to the public since the early 20th century with the first “practical wearable electric” device being invented in 1902. Training for dealers was solely conducted by the manufacturers of the devices. 7 Around this time, there were few, audiologists who bucked the system and worked with “Hearing Aid Dealers” selling hearing aids – which was a violation of the Code of Ethics for the American Speech Language Hearing Association (ASHA) at the time.2 Through the 50’s and 60’s, these Dealers and Audiologists worked side by side in selling, but in the 1970’s as the Code of Ethics began to change and the FTC/FDA regulations evolved, the two professions diverged as Audiologists began to dispense hearing aids.3
With this history in mind, today the most profound difference between an Audiologist and Hearing Instrument Specialist (HIS) is education. An Audiologist graduating today will have completed an undergraduate degree in a related field of study, most commonly Communication Sciences and Disorders, and a graduate degree in Audiology. The graduate degree is a clinical doctorate known as an AuD (or Doctorate in Audiology). Graduate education in Audiology includes coursework in the physics of sound, anatomy (including the ear and brain as it relates to hearing and balance, assessment techniques in hearing, assessment of the balance system, hearing aids, cochlear implants, noise exposure, etc. Successful completion of practical skills and knowledge in direct patient care that is concluded with a year-long internship or residency under the direct supervision of a qualified Audiologist. In addition, to receive national certification with ASHA, an audiologist must pass a national examination.4
In Oklahoma, a license to fit and dispense hearing aids can be issued to anyone who is 18 years of age, of good moral character and has completed high school. They are required to complete a practical examination demonstrating competence.5 A hearing instrument specialist may apply for a national license, known as a National Board for Certification in Hearing Instrument Sciences (NBC-HIS), after they have worked full time in hearing aid dispensing for 2 years and have a valid state license.6
Another area of difference is the type of practice settings. While a Hearing Instrument Specialist is generally found in places primarily devoted to hearing aid sales, an Audiologist is qualified to work in many different locations. You will find Audiologists in medical settings such as ENT clinics or hospital outpatient facilities or even monitoring nerve function in brain and spinal surgeries. Audiologists work for Veteran’s Administration Hospitals evaluating hearing, determining if a veteran’s hearing loss is related to their military service, issuing hearing aids, etc. You might find an Audiologist supervising or performing your annual hearing testing or teaching you how to use your hearing protection if you work in a noisy environment. If you have a cochlear implant, it will be the Audiologist who ensures that the externally worn processor is working appropriately for the best outcomes possible. The Audiologist may even own their own hearing aid dispensing practice – choosing to primarily work with hearing aids.
In summary, when seeking hearing care, an Audiologist is well qualified to evaluate your hearing and hearing aid needs through their extensive education and practical training. The Audiologists at Oklahoma Hearing Center are dedicated to working with you to find the most customized and appropriate solution to your hearing problem. Call us today at 405-546-4280 to make an appointment.
- Jerger J. Ten highlights from the history of audiology. Hearing
- Staab, Wayne. https://hearinghealthmatters.org/waynesworld/2011/audiology-pioneers-in-hearing-aid-manufacturing-ii-richard-scott/. September 11, 2011.
- Staab, Wayne. https://hearinghealthmatters.org/waynesworld/2013/hearing-aid-dispensing-ix/. April 16, 2013.
- American Speech Language Hearing Association Website. https://www.asha.org/certification/. Downloaded November 9, 2020
- Oklahoma State Department of Health Website. https://oklahoma.gov/health/protective-health/consumer-health-service/hearing-aid-dealers-and-fitters-licensing-program/apply-for-a-hearing-aid-license.html. Downloaded November 9, 2020.
- National Board for Certification in Hearing Instrument Sciences Website. http://www.nbc-his.com/certification-process-landing/. Downloaded November 9, 2020
- Curran, J and Galster, J. The master hearing aid. Trends in Amplification. June 2013; 17(2): 108-134.
- Once you have decided to get your hearing tested, it can be difficult to know where to go. The TV and newspapers can be full of advertisements offering “Free Hearing Tests” or “No Obligation Trials” for hearing aids. One way to protect yourself as a consumer is to be aware of who is offering these services. In the world of hearing healthcare, two types of providers exist: Hearing Instrument Dispensers and Audiologists. Knowing the difference can help you decide which type of provider to seek out.