Give your patients an extra pair of earmolds, so they hear well all the time

I believe that you should make a “spare” set of earmolds for every one of your patients with significant hearing loss. The wisdom of this advice may not be evident, so let me elaborate.

Hearing aid technology is complex. However, few hearing aid users understand this complexity until they have worn hearing aids for a number of years. Unlike other electronic devices, hearing aids have their own unpredictable nature. Often, they don’t perform the way people expect them to perform. At times they work much better than expected, at other times much worse.

Our job is to help people hear—not just part of the time, but all of the time. Unfortunately, sooner or later your patients’ hearing aids are going to “break.” When that occurs, you need to send the hearing aid(s) to the factory. The problem is that the patient will likely become desperate, telling you “I can’t hear without it.”

You can make these problems disappear—if, before the hearing aid broke, you had the foresight to make the patient a “spare” set of earmolds. In that case, you can simply give him or her a loaner behind-the-ear (BTE) instrument to wear until the hearing aid comes back from the factory repaired.

Providing a patient with a loaner takes some time and effort on your part. Not all patients will like the idea of a backup when you first suggest it. Also, you will have to work out the costs of making a spare earmold and of keeping a large handful of loaner BTE hearing aids in the office.

Nonetheless, doing this is well worth the hassle. Spare earmolds spare me headaches and make my job much easier. When a hearing aid acts “goofy,” I have a backup plan in place.



To understand why a backup plan is so important, consider this situation: The patient and her family are going away on vacation for two weeks. She comes to see you and expresses her fear: “This thing keeps going on and off. What happens if I’m in New York City and it dies?”

If you have made this lady a spare set of earmolds, you simply attach a loaner BTE to the earmold and show her how to use it. Put her name on the “loaner” list, so you get the hearing aid back, and the problem is solved. She goes on vacation with her “spare” equipment confident that she is assured of hearing well.

Spare earmolds allow hearing aid wearers to lead their lives without any interruption in their ability to hear. To appreciate the importance of “hearing all the time,” just ask yourself, “How happy would I be to go on vacation without my cell phone or my laptop?”



The idea of spare earmolds has another huge advantage—both for you and your patient. Not all your patients are fitted with a type or style of hearing aid that is ideal for their hearing loss. If the patient has a spare set of earmolds and if you have developed a good working relationship with the patient, you can suggest that they try “an experiment”: Ask them to wear the spare earmolds with a temporary set of BTE hearing aids.

I love this approach when I am working on a complex issue like bandwidth enhancement or noise reduction. A typical set of open-fitted RIC (receiver-in-the-canal) instruments is not going to provide wide enough bandwidth. Switching (for the experiment) to hearing aids with wide bandwidth and good noise-reduction microphones allows you to show the patient that these hearing aids markedly improve their hearing in quiet environments as well as providing better noise reduction in a restaurant or other noisy place.



The idea of backup aids is worth its weight in gold if you ever send a hearing aid to the factory for repair and it comes back still not working right. Troublesome hearing aids sometimes require two or three trips between the office and the manufacturer. If the patient is trying to live without hearing during this time, things can spiral out of control very quickly. But if the patient is wearing a set of “loaners,” you have the luxury of dealing with a happy patient, rather than a frantic one.

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