by Terry Mactaggart, President and CEO, Summus Hearing Inc.
Terry Mactaggart
I’ve always been puzzled, indeed frustrated, about why family doctors are not engaged with hearing health.
Integrating hearing health into primary care is urgent because the global burden of hearing loss is already immense and accelerating. Over 1.5 billion people live with some degree of hearing impairment today, and that number is projected to rise sharply as populations age and noise exposure continues unabated. For the United States and Canada, the number hovers around 70 million. Without early identification, many patients miss the window for interventions that can slow or even reverse downstream complications.
Untreated hearing loss carries irreversible consequences for brain and mental health. It’s been linked to accelerated cognitive decline, increased dementia risk, higher rates of depression and social isolation, and a greater likelihood of falls and related injuries. The longer screening and referrals are delayed, the harder it becomes to restore effective communication and preserve cognitive resilience.
Global health authorities are sounding the alarm. The World Health Organization’s World Report on Hearing explicitly calls for “urgent and evidence-based policy action” to embed hearing care within broader health systems—emphasizing that delays will only inflate societal and healthcare costs while widening disparities in access to care.
By acting now, family physicians can intercept a looming public health crisis, improve quality of life for aging patients, and curb spiraling long-term expenses.
Many domestic studies validate these conclusions. So, while the need is obvious, why aren’t primary care physicians buying in? At least four reasons come to mind…
- Time constraints during visits – Family physicians often face time constraints during visits, prioritizing acute complaints over preventive or ancillary services like hearing screening, leading to inconsistent referrals to hearing health care.
- Lack of awareness and training – Many primary care providers report limited training and low awareness about adult hearing loss identification and management, which undermines their confidence to initiate discussions or perform basic hearing assessments.
- Some still distrust audiology—stemming from perceptions that audiologists, (and, certainly, hearing instrument specialists) primarily sell hearing aids. This opinion discourages physicians from making timely referrals, compounded by unclear or cumbersome referral pathways.
- Technology is not in synch – Electronic medical records (EMRs) and clinical decision support systems frequently lack embedded algorithms or fields for adult hearing health, so screening prompts and streamlined referral tools are absent from routine workflows.
Our direct experience suggests that with a short briefing, most family doctors acknowledge the hearing health problem, recognize that establishing a baseline for most of their patients is important and, with new tools and changes to the practice regimen, would be prepared to provide the service.
Primary care practices need clear signals, however, — from payers, professional bodies, and clinic leadership—that hearing health maintenance is as essential as blood pressure or diabetes screening. Right now, up to 85 percent of older adults never hear a word about hearing from their family physician, even when they raise concerns. Changing that starts with embedding hearing care into the very fabric of how primary care is delivered.
Family physicians already have sensitive, easy-to-use screening methods at their fingertips, yet routine programs remain rare. The American Academy of Family Physicians endorses the U.S. Preventive Services Task Force recommendation for hearing screening, but without practical tools, billing codes, or quality-metric ties, most clinics simply won’t make it a habit.
Specific steps to integrate hearing screening into routine care could include:
- Aligning Incentives and Quality Metrics – Where necessary, advocate for inclusion of adult hearing screening in preventive care quality measures and secure reimbursement codes for primary care–led hearing assessments, motivating practices to prioritize hearing health.
- Embedding brief validated hearing questionnaires or whisper tests into annual wellness visits to ensure clinicians automatically consider hearing health. We have gone further at Summus by embedding testing and guidance protocols in an EMR platform that several doctors enrol and use. The clinician earns standard fees, and a toll payment is triggered for our tech contribution.
- Offering Targeted Education and CME – Develop concise, case-based continuing medical education modules highlighting the links between hearing loss and cognitive decline, falls, and social isolation—equipping physicians with practical screening and counseling skills.
- Establishing Clear, Trustworthy Referral Pathways – Create standardized referral algorithms clarifying when to send patients to audiology versus otolaryngology, and build partnerships or co-clinic arrangements with audiologists to foster collaboration and reduce perceived conflicts of interest.
- Implementing Universal Design and Communication Supports – Equip clinics with assistive listening devices, captioned educational materials, and staff training on communication best practices—demonstrating a commitment to accessible care and reinforcing the physician’s role in hearing health.
By addressing these system, educational, and workflow barriers—and by aligning incentives and resources—family physicians can be empowered to play a central role in preserving hearing health and improving long-term patient outcomes. That thrust has a number of moving parts.
Implementation will take consistent effort and time. But once momentum is achieved, it will truly be a game changer.
About the Author
Terry Mactaggart, MBA, is the president and CEO of Summus Hearing. He can be contacted at [email protected] or visit https://summushearing.com
