Hearing Loss and Stigma: Breaking Down Barriers to Care. Live Panel Discussion from FHH 2025

Well,

here we are at the Future of Hearing

Health Care meeting and our

task as a panel today,

a panel of industry people,

clinicians and consumers.

We’re our task today is to discuss

the hearing loss and stigma issue and

try to break down some

barriers to care.

And

first thing I’d like to do is to have

my colleagues on the panel

introduce themselves.

And so Bill,

would you introduce yourself?

Absolutely. Hello everybody.

I am Bill Schiffmiller, founder of Akoio.

Akoio is a consultancy on

accessibility and auditory

health manager.

I am a lifelong hearing aid user and

I am former lead of Accessibility

initiative at Apple.

Great.

Tony, would you introduce yourself?

Thanks, Bob. Hello everyone,

my name is Tony Sulsona.

I am the director of the audiology

channel for Nuance Audio.

In other words,

the Nuance Audio OTC hearing classes.

And

Michelle?

Hey there, I’m Michelle Wiebke.

I’m an audiologist and I’m joining

today as the senior Lyric Audiology

and Education manager at Phonak.

Great Andy.

Thanks Bob.

Andy Bellavia and I was formally

responsible for marketing and business

development at the hearing health

tech company Knowles.

And then three years ago I split off

to form my own consultancy and I guess

I cover two out of three because I’ve

been now seven years a hearing

aid wearer as well.

Shari.

Hi everyone,

I’m Shari Eberts and I am the founder

of livingwithhearingloss.com as well

as the co author of Hear and Beyond

Lives Skillfully with Hearing Loss.

And I have been wearing hearing

devices since my mid-20s.

Second, Michelle.

My name is Michelle Hu.

I have been a pediatric audiologist

for over 16 years now.

I’m a bilateral cochlear implant user

and I’m founder of mamahuhears.com or

also on Instagram where I help support

hearing parents of deaf children

navigate the journey.

Fabulous.

As you can see,

we have a great group of colleagues

here that are going to help

us navigate through

the issue of stigma.

And it remains one of the most

persistent barriers to

hearing health care.

Shaping how people interpret

hearing loss

delays help seeking and limits

adoption of hearing technology.

Hopefully this panel now can begin

to address those issues. And,

and I think I’ll just start

a little bit with,

you know,

when I had my practice back

in the 70s as we early on

people would have to be about 95 years

old and have about 60 decibel hearing

loss before they would even consider

walking in the door.

Just in general,

how do you see as a group,

how do you see that maybe that

has changed somewhat.

In.

The new century,

and particularly in 2025

relative to say 1975.

I’ll take this one.

I think definitely Covid played a

good part in this. Maybe not.

It was very difficult in the beginning

with the introduction of masks.

It became very difficult for us deaf

and hard of hearing people to

communicate, to feel comfortable.

Especially in doctor’s appointments

when our healthcare providers were

covering up their mouth

and their facial,

their half of their face so that we

couldn’t get those visual

cues to communicate.

That was our superpower and that was

stolen out from under the rug,

from the stigma,

I think is very much an external

societal type of pressure or

creation of story where

you know you were.

Denial is something very

much more internal.

What kind of stories are we making

about either ourselves or what

society is thinking about us?

And stigma just fuels this,

adds fuel to that fire.

I think that because we are much more

expressive and emotionally intelligent

or like we built upon that realization

and opening our awareness.

It’s become less and less because

we’re communicating with each other.

We’re building a deaf and hard

of hearing community

so that we can support each other.

And I don’t think we had that before.

It was very much behind closed doors.

Your business is your business.

And now it’s like, you know what,

let’s share, let’s grow together,

let’s grow stronger.

I think that’s part of melting it.

Away a little bit.

Great.

Some other comments on that,

on that one statement about how maybe

things have evolved to some

degree over the years.

I think that’s probably the

key benefit for OTC.

Even though we all know right now OTC

has not really fulfilled its promise.

It’s barely making a dentist in a

number of people seeking hearing

care of one kind or another.

But on the other hand,

there were a tremendous number of

positive messages in the popular press

surrounding the release of otc.

And then subsequently,

like Apple’s entry and Luxottica’s

entries for example,

but really mainstream.

A ton of mainstream press coverage on

the importance of hearing care and

what OTC is meant to address,

which even if people didn’t go for an

otc, they were hearing those messages.

And I have to believe that that caused

the dent in the Stig slash

denial problem.

Some other comments.

So I have a profound healing loss.

So I use prescriptive hearing

aid that’s non negotiable.

I do not have any other choice.

I need it.

And in the years of building

our consultancy on auditory matters,

no matter how you reframe hearing

loss, no matter how Much.

You put a name in term,

people won’t address it.

What did change to Michelle’s point

with the pandemic where

you had the mask?

There was a startup called Listen

Lively and Listen Lively suddenly was

going after tech Savi people in their

40s saying I got power in my hand,

I like technology,

I like the Internet,

what can I do to take care of myself?

And I think as we were waiting

for FDA approval on occ,

this enlivening which was acquired by

GN that became Jobbering Hands

started something.

They started to recognize

younger COHORTS,

not the 95 year old that you

mentioned, Bob, from the 70s,

but now for years where the uni

manufacturers have been trying to get

those outside of the baby

boomer generation.

Like how are we looking at human loss?

How can we approach it differently?

And I think we started to do that.

It’s not taking off as

much as we’d like,

but we’re starting onto something.

I think a lot of audiologists

split into two,

like anti OTC and supportive of OTC

because they thought the ones anti

thought that OTC would threaten their

jobs. I’m in this camp over here.

It’s another stepping stone to get to

if they need prescriptive hearing aids

or custom programmed hearing aids.

It’s a step of, oh, you know,

like the reader at CVS by the

register, maybe these will help me,

they help me a little bit,

but I think I need some more and

that’s a stepping stone to get there.

And companies like Apple who are

bringing in their AirPods as an and

marketing them as OTC hearing aids

with a hearing test is a very

good step in that direction.

Part of the issue with otc,

at least initially,

was that the first wave of products,

I don’t know,

missed the boat a little bit, right?

They looked like typical devices.

There wasn’t always Bluetooth

streaming.

It didn’t give the consumers

necessarily what they were looking

for from a device of that type.

And I think the media

coverage was great,

but a lot of it contained some of

this outdated imagery, right?

So we weren’t seeing that modern look,

that new look that people with mild to

moderate hearing loss were really

going to be attracted to and that

perpetuated the stigma a little bit.

But like we’ve all said,

I think some of these recent new

products with different form factors

from big names are going

to start to help.

But really what I think is going to

get these mild to moderate people who

are the target obviously for

the over the counter,

over that hump of trying to use that

device is that the devices

need to work well,

they need to meet their needs in the

situations that they’re looking for

them to use that. And so when we show,

I think when these devices

show the benefit,

that’s when the stigma is

going to be fading.

Because if people can talk about,

you know,

I actually use this kind of cool thing

and it actually helped me

in this restaurant,

that’s when that stigma is really

going to start to come down because

people will understand the benefit

that they’re getting from it.

Sherry,

I love the fact that you said cool,

because for many, many years,

and I’ve been in the traditional

hearing aid space for many,

many years as well,

and over 22 years in the industry,

and I used to always say to

colleagues, consumers, et cetera,

you know, when will hearing solutions,

especially as we approach otc,

before it was approved,

what will it take?

And I used to say the same word.

When hearing aids become cool,

they become attractive.

When they become attractive,

become viral, more adoption there.

Then you can branch out into

innovation, etc. And thank goodness,

like other wearables,

hearing aids are,

or in that early stage of looking at

different modalities

and shapes and etc.

That create a sense of attraction or

at the very minimum, intrigue,

not only from the consumer, but,

but certainly from hearing

care professionals.

So while we’re at this,

let’s throw another thing out there.

Do you think

that there’s a real difference between

stigma and denial or does one

kind of feed on the other?

Well, I think like Michelle said,

they’re interrelated.

But, you know,

stigma sometimes comes more externally

and denial, I think,

sometimes comes little

bit more internally.

Denial also is, I think,

part of the nature of the beast,

because hearing loss a lot of times

comes on grass. Gradually. Not always,

but a lot of times it

comes on gradually.

And so we may not really know how much

we’re missing until there’s sort of

an event or. Or something happens,

like the masking in Covid,

or like the TV gets to

a certain level,

or everyone just starts

complaining about it.

So we’re kind of in denial because

we don’t experience,

you know,

the actual external impact of that

hearing loss. But the stigma comes,

I think, from the outside.

But where it really hurts is when

we take that inside ourselves.

And I think a lot of people do.

And part of that is because of the way

it’s portrayed still in

mainstream media.

You wouldn’t make fun of somebody on

a television show who was blind

for bumping into something,

but you can make fun of somebody

for mishearing something.

And until we’re really

not seeing that,

where people with hearing

loss don’t look foolish,

that external stigma is, you know,

we’re at risk of internalizing that.

Yeah, I agree.

And there’s a dimension to that, too,

which is harder to overcome,

and that’s ageism.

In many Western countries,

ageism is pretty prevalent or

perceived ageism, if not real ageism.

I’ll give you one example.

The job site Indeed.com they actually

published an article.

They were forced to pull

it by the outcry,

but they published the article which

showed stages of one’s career

and at 50 or 55,

were in decline.

And so I’ve got.

I’ve actually got the graphic because

people published it before

they pulled it off.

The airline a long time ago.

Andy,

you and me both, right?

I mean, by now, so.

But. But that sort of thing,

those messages are prevalent.

And so if you’re, say,

in your 50s and you’re worried about

your future career prospects or

feeling like you’re being left behind

in favor of younger people,

it may be that the last thing you want

to do is show up with hearing aids

because of that perception.

And so that’s a hard barrier

to overcome.

Go back to your 1970s haircut, guys,

and. Because that’ll help a lot.

Sorry, Shari.

Oh, that’s okay.

I was just saying it is

a perfect example.

That just happened to me the

other day, actually, Andy,

that speaks to that point exactly,

is that a cousin of mine called

and said, you know,

I’m a little bit worried I’m not

hearing so well at work,

and I’m not hearing so well at these

cocktail parties. But, like,

I can’t be that guy with hearing aids.

So, like, what do you got for me?

But I can’t because I’m worried how

that’s going to impact my appearance

and my performance at work.

So it’s a perfect example of what

you were just talking about.

Absolutely.

And I know I’m jumping issues here,

but that’s why I really like the

alternative form factors like

the nuance glasses,

because they don’t,

they won’t combat stigma,

they hide the stigma.

But on the other hand,

if you’re taking say a 50 year old

person and getting them

hearing care today,

that’s the most important thing of all

because especially in the workplace,

if you don’t treat your hearing care,

you look like that out of touch old

guy, because you’re missing things,

hearing things improperly and so on.

And so that’s an important

part of the equation.

Even though it doesn’t address stigma,

it hides it.

It does get people’s care earlier.

And then as a stepping stone,

which was said before by

a couple of people,

once they’re in that sort of thing

and they get comfortable,

if they need to go beyond what they

can get out of the glasses or AirPods,

then they may be more

amenable to getting

a better prescriptive solution.

I think that’s a really.

All at once.

I think it’s a really great

point you just made there,

especially with that it doesn’t

combat the stigma. I mean,

we definitely have a lot of patients

who wear Lyric who really want it for

its invisibility and that’s

why they come to Lyric.

But they end up telling a lot of

people about it after they’re fit

because they love how they’re hearing.

And so I think if we look at it as

these form factors aren’t helping

push the stigma forward.

I think we have to reshape that

ourselves because it is pushing it

forward because they are getting help,

maybe earlier or maybe they,

whether it’s the stigma or denial,

whatever it is, if,

if we don’t have a solution that

fits whatever they want,

then maybe they go without a solution,

which is not helping any of us.

So it does move everything forward,

I think by having these other options

and certainly giving these interesting

ways to treat something.

And especially as I think the entire

field even advances in looking at

hidden hearing losses and some of the

things that are happening even in the

lower spectrum of the hearing

loss scale as well.

In everything you said.

Yeah.

Go ahead.

Yeah.

For Andrew Michelle,

to your point on that,

two things.

One is whether it’s masking

it or hiding it,

the fact that you can put on or wear a

solution that you have confidence in,

to the extent that you’re even willing

to showcase it to someone,

means that you are sort of promoting

the solution and not necessarily

hiding it,

which is a good thing to be

able to get to that point.

And the second point is just one

for a little comic relief.

There’s not too many hearing solutions

out there right now that you can have

a dramatic effect of putting them

on and taking them off.

Voila.

To Tony’s point,

what he just showed is something

glamorous. It’s a lifestyle choice.

And are you putting on yours too,

Andy? Oh, yeah.

I like what I have with the hearing.

But one of the things that’s

happening now is

there’s a generational distinction

between what we are accustomed to

hearing related to stigma with older

folk to the younger cohort today.

Now you have all kinds of earbuds with

nice features built in

that would discreetly

enhance your hearing,

maybe for communication,

for noise management

or sound wellness.

Now you’re starting to see I am taking

care of my hearing without being told.

Traditionally, we were told,

you need to get a hearing aid.

You can’t hear.

That doesn’t feel good.

That’s why you have this resistance.

But now you have these cool consumer

as well as prescriptive solutions that

have a cool factor to what Tony

was saying. And you know what?

I don’t know why, why it was,

but there’s something in it that’s

making me feel and even hear better.

I think there’s also something

to say about ableism.

I think that more and more people

are starting to spotlight it,

starting to cheer for that

underdog and say, oh,

everybody that is misrepresented

or underrepresented,

do you see how significant they are or

how much value they can

contribute to society?

And I tell parents all of the time,

it’s much harder to acquire a hearing

loss than it is to grow up with one.

Because when I was learning

my life and social skills,

that’s the challenge that I had

presented to me versus going through

life having normal hearing.

And all of a sudden I have to learn

these new skills that I’ve never had

to use. I don’t have that muscle to.

So growing up, Bill, Shari,

you and I, like,

we grew up having to use those skills

little bit by little bit in our

everyday life versus, oh,

I’m a CEO of a company,

and now I suddenly realize

I can’t hear something.

What do I do? Give me a device.

Give me a magic pill.

Give me something.

So I think that we’re shifting

that view of ableism,

the underdog and being much more

adaptive and open minded about it.

I think to further your point,

Michelle,

and what Bill and Tony just said,

I think there’s something about the

psychological impact of treating the

hearing loss and we definitely see it

in the lyric space because patients

aren’t reminded every day

about the hearing loss.

So that tends to add to this

confidence and just an increase in

their overall well being because

they don’t wake up thinking,

I have a hearing loss,

I need to put something on and

multiple times to remember to put

it on. But I think that overall,

as Tony said,

that confidence that the hearing care

can provide in any solution really

speaks to their overall well being as

well as that psychological

benefit too.

And I think confidence in a way is the

exact opposite of stigma, right?

Because confidence is when you feel

good about yourself and your ability

to walk into a situation and be able

to participate in a confident way

versus that stigma of worrying that

you’re not going to be able

to walk into a situation.

So I feel like any type of device

that’s going to give people confidence

is going to break down stigma.

I don’t think it’s really

hiding the stigma.

I think it’s actually building that

confidence which is in turn going

to break down that stigma.

And when you feel that for yourself,

when you feel that confidence,

you feel less stigmatized.

And I think then you’re willing to

sort of talk about it, say, hey, cool,

look at my cool new devices,

or look at this cool, cool thing,

or wow, have you tried this?

This helped me so much at the theater.

And that’s really going to be what I

think over time accelerates and breaks

down that societal stigma which

hopefully becomes that, you know,

virtuous circle. You get more inside.

But it really starts, I think, with,

with that building confidence that

breaks down that stigma you’re

feeling. I think it’s interesting.

Go ahead.

I was just going to say that the,

the, one of the,

one of the most strange things I’d

heard in a long time when we were

doing clinical trials on Lyric and,

and then with patients thereafter,

they would always say, you know,

I wear a hearing gauge,

but you can’t see them.

You know, if you just wait,

look way down in my ear.

You can see it down in

there somewhere.

But so people who were,

who would be very self conscious about

amplification in general if they’re

wearing something else,

walking around,

showing people just exactly where it

is, that way down in their ear.

In fact,

I’m surprised he didn’t have an

otoscope so they could show

them where it was.

But anyway, I do that sometimes.

I definitely do that.

Oh, I bet. So, yeah, I mean,

but, but the bottom line is that,

that I think that those

kinds of products,

the form of the products is,

is making somewhat of a difference to

many people, people who, you know,

were high level executives and didn’t

want to look like they

were losing anything.

Those were,

were big candidates for Lyric and some

products like that. But, you know,

you’ll,

you’ll see the people about the same

age on the other side who,

who will actually be an individual

who doesn’t care,

and it doesn’t make any difference.

And so you’ve got one side

and the other side.

And I think the form is helping.

Helping a lot. Because even,

even instruments that do a lot and

hook up to a lot of things,

they’re getting smaller and smaller

and smaller over time. So,

so if we were,

how can the different stakeholders,

like clinicians and

companies and consumers,

how could each of you guys contribute,

not you guys,

but each of those classifications

contribute to reshaping the narrative?

We’ve been talking about

it a little bit,

but maybe we want to kind of hit that,

that issue just a little bit.

What can we do as clinicians,

consumers and industry to facilitate

the reduction of this,

this issue?

And I will jump in and just say that

there’s many answers to this and we’ll

hear from this distinguished panel.

You would,

because you got the glasses, man.

But there are a lot of other cool

solutions that we all can relate

to that we’re all part of.

It’s not just one,

but part of it is whether you’re a

clinician or you’re in a

storytelling capacity,

it is really the ability to keep,

also from a professional perspective,

not only consistent messaging,

but it’s got to be positive messaging.

Often we talk about hearing loss,

all the things we cannot do,

as opposed to changing the script

and talking about lifestyle and

improvements and enhancements and

empowering and confidence.

This is the kind of language that we

have to move sometimes. You know,

the baseline of clinical audiology and

solution based conversation

is critical.

It adds

validation to what is being prescribed

or being provided.

But there has to be a certain level

of enthusiasm that starts

from the clinician.

And that’s where influencers and

companies and those that

have great messaging,

that are positive and open the eyes to

hearables, makes a huge difference.

And I think also it’s about

setting expectations.

Born with a hearing loss or late

in life with the hearing.

Two very different approaches. I mean,

you,

you know,

we all know about Richard Einhorn,

who was a composer and who late in

life sudden had a sudden hearing loss.

So he’s on a mission

to find a solution.

But we need to be setting the right

expectation to whomever,

wherever they’re at and

what’s out there.

The key thing is

listen to what they have to say to go

in and get a hearing test and

use your audiogram results.

Now,

I’ve been wearing hearing AIDS

since I’m 6 years old,

and it wasn’t until my 50s that I knew

that there was a distinction between

consonant and vowel.

No one ever told me that.

But the important thing is,

what are you experiencing? Talk to me.

What are you going through?

Let’s find a solution for you maybe

prescriptive or OTC or some kind

of awesome assistive device.

And that’s what we need to do is to be

able to have a dialogue

with that individual.

What’s going on in your world?

Let’s talk about it.

I talk a lot about access,

inclusivity.

It’s not that something

changed about you,

like you as your personality

or your being.

It’s.

It’s you don’t have access to certain

sounds that can add to your

quality of life now.

So when I’m counseling patients,

I will say,

what is it that’s important to you?

When Shari mentioned theater,

is that something that really

gives you life,

that really invigorates your soul?

Is it hearing your grandchildren?

Is it just hearing, you know,

the Price is Right on tv?

What is it that gives you so much

excitement to get you through the day?

How can we get you access to that?

It might be a device.

It might be some more visual cues

or practice from your family.

How do we raise that awareness?

We’re also changing the language

around hearing loss. I think, Bill,

you mentioned that I grew up using the

words hearing impaired and now I

shifted over to some people.

I say I have hearing loss.

It depends on my audience.

I say I’m deaf to people who are

hearing and then I’ll say I’m hard of

hearing to people who are

deaf and use asl.

It’s very different in the wording

that you choosing because how you

relate to other people also is a huge

reflection on how do you relate to

yourself and your own deaf identity.

And we need to keep working

on that language too.

Matthew Alsop brought this up.

Why are we calling it age

related hearing loss?

Why don’t we just say that your

ears wear out over time?

And I really like that.

I think about I’m a distance runner

and I can tell you my race times now

are a lot slower than they

were 20 years ago.

And nobody says that I have

age related speed loss.

Why do we have to make that aging tie

in when we have an ageism problem?

Why don’t we just talk about the fact

that our ears get a little

bit worn out over time?

And then with those positive

descriptors you mentioned, Michelle,

I can get you access to the theater or

better access to the theater or better

access to the television and stay away

from the labels that feed

into the stigma.

And Andrew, you know what.

I was going to just say

when it comes to the

to like the terminology,

I think there’s generally a

misunderstanding in the spectrum

that is hearing loss.

I’ve had plenty of patients that show

up with minimal hearing loss,

but they say they’re deaf.

But also when it comes to,

like the common terminology that

we used to your point, Andrew,

how we talk about it.

But you’ll even get patients who’ve

had someone say you have a certain

percentage of hearing loss to the

patients who are told they have

a mild or a minimal or.

And so it’s really difficult, I think,

for the population to know how to

break that down or to understand

what they need to do about it.

Obviously,

if I’m told I have a

mild hearing loss,

is that something I should

do something about?

Maybe, maybe not.

But if I’m the person that’s really

struggling to your point, Bill,

and just listening to them,

maybe that person with the minimal

hearing loss does need help because

they are struggling significantly in

those environments that they’re in.

But it seems as though we do lack some

of this common terminology that helps

the general population maybe approach

hearing help with a less stigmatic

way or with less denial.

That’s really important about just

this overall messaging is

expectations, right.

And that it has to be about

more than the device,

because hearing aids,

cochlear implants,

we all know they’re not going to take

our hearing back to normal.

Right?

It’s not going to fix the entirety

of our communication issue.

And I think it’s really important for

people to understand that because if

they don’t and they start using any

type of device, a professional device,

an OTC device,

and it doesn’t solve their problem,

they are going to be disappointed and

throw the thing in the drawer and

not continue to work at it.

But what I think a very important

change and messaging from everyone in

the industry needs to be that

it’s technology plus. Right.

It’s all about the attitudes that we

hold about hearing our hearing loss.

And then also behavioral changes,

visual cues,

other things that combine with the

technology to help us to communicate

better. We have to sort of shift that,

I guess,

focus from hearing better

to communicating better,

because that’s really what we’re all

looking for from our devices.

Plus,

you know, Sherry,

there’s always a point where I walk

down to the bookshelf over

there and get your book.

Don’t make me do it now.

Sorry, I witnessed that before, Andy.

I have. So I’ve seen you go over.

One of the things I would like

to add to that, Shari,

is taking a moment when you

really listen to somebody.

I am shocked to learn I

have a hearing issue.

I have a noise issue.

And now Part of what you were asking,

Robert, where’s the stigma?

What is the stigma?

I think the problem is, okay,

I think I have a noise issue and you

want me to buy a $4,000 hearing aid.

Whoa. Something not right here.

Give me more.

Let’s talk about it a little further.

So,

and like Michelle,

what you were saying,

what is the lifestyle thing

you want to do?

That’s what we need to be finding.

We need to unravel what’s going on

there to get you on the

right direction.

That hearing devices,

the most common misconception about

them is that they level the playing

field. We still have issues in noise.

We still benefit from visual

communications.

Just like closed caption on the TV

were created for deaf and hard

of hearing individuals,

not for the hearing people who just

want to be able to know

the score at the bar.

And I’ll just piggyback on what some

of you have said regarding

expectations.

And that is one thing that OTC does

bring to the table is a reset on

expectations in that early patient

journey to open the door for them to

recognize that they can use this for

situational solutions on the OTC side,

which is hardly ever talked about on

the prescriptive side

for obvious reasons.

Right.

It’s a constant matter of fact

of hearing improvement there.

But I think that opens the door for

early adoption and acceptance when you

look at the possibility of looking at

this as an entryway for situational

opportunities.

The other thing I would say,

and this might be bias from

my position, was,

but the integration of the optical

world and the hearing world

opens up the narrative,

opens up the discussion,

because now you have got another huge

group of professionals in optical

that are saying, look, you know,

now that hearing aids are available,

of course we’re on the glasses side of

it, but they’re populating the story,

the early education of go see a

hearing care professional and

understanding that because we all

know that as we do get older,

as a matter of fact,

both our vision and our

hearing decline.

So being able to just look at

that from a greater scope.

A greater scope and cross referencing

with other healthcare professionals,

even GPs,

at some point is going to be great for

everyone at every part of

the patient journey.

That kind of brings us to our next

kind of stimulation question here,

guys.

That has to do with the role of

primary care physicians

and other gatekeepers,

and I might just say about the

optometry people or the

optical people,

that

early on,

when a lot of optical shops decided to

add hearing aids into their shop,

a substantial amount of those went

bankrupt because they really did not

understand the hearing impaired

individual walking. In the front door.

They kind of worked with them more

like they did on the optical side

rather than on the other side.

Now I see with our entrance more

into some of the optical stuff,

it’s going to make a difference.

So you might mention something about

that. But the big thing now in this,

in this discussion would deal with

more with what do we do with the,

with the physicians and the nurse

practitioners and the,

and the optical people as well as

dentists and everybody else that seem

to be semi gatekeepers to maybe change

their focus toward some

of the things that,

that perplex people that are

considering amplification.

And by the way,

those gatekeepers really should

be defined as door openers.

Oh. Oh, well, that’s good.

That’s a sales way to say it, Tony.

I understand that. So I love that.

Been talking to a lot of pediatricians

and geriatricians as well,

and pediatricians do a lot more

screenings for the development

of things. How are we doing?

How are we growing? How are we,

you know,

at what rate are we doing this?

And they don’t do similar types

of surveys in geriatrics,

which is such a bummer because

as Michelle was saying,

somebody could have an audiogram

mild hearing loss.

But what she didn’t mention is another

person could have the exact same

threshold but be completely different

in their cognitive ability to process

and hear and understand speech.

So they need to figure out,

and work together, I think,

with audiologists to figure out where

are they in that decline?

Is it processing, is it noise induced,

what kind of hearing loss do

they have and identify.

Go to an audiologist who can do speech

perception testing on them.

Not just threshold testing because the

threshold really don’t

tell you that much.

I could probably hear more with a

moderate to severe hearing loss

because I grew up wearing hearing aids

and processing it that way versus

somebody who’s newly diagnosed with

mild to moderate and can’t process as

surely or confidently.

I have a question for

Bob and Michelle.

Since you are experienced

practitioners,

how many referrals have you gotten

over the years from a general

practitioner saying, hey,

we believe this person has a hearing

challenge and would refer

by the physician?

I’ve been educating with people.

I used to get a lot of referrals

from physicians,

Bill. You know,

in fact,

I had a,

a huge referral source in my city and,

and they would actually,

they wouldn’t really write a letter,

but I’d get a lot of little

prescription pads

and, and, and, and phone calls from,

and, and when I, when you first start,

and you start at a time when

audiology isn’t well known

back in the 70s,

what happens is that they don’t

even let audiologists,

when you have a hospital appointment,

park in the physician’s parking lot.

But as it turns out, and you.

And you get to know those guys and you

take care of some of

them in the clinic,

as well as take their referrals,

and their patients come

back and tell them,

then you not only get

the parking spot,

but you get a lot of their referrals

back from those individuals.

So I had a lot of referrals.

So now, Michelle,

you can maybe speak to that.

Some of the other colleagues here

can speak to that as well.

Obviously,

I get more pediatric referrals just

because of my patient population.

But I think that there are more things

set in place to catch hearing

loss in kids.

Preschool teachers are trained

and developmental.

Regular teachers,

pediatricians, optometrists,

all of them are kind of interrelated.

But when they’re talking about adults,

it’s harder because it is

an invisible disability.

Someone who has a spouse can

lean on their spouse. Hey,

can you do this phone call for me?

Can you make this appointment for me?

But now we have new devices and apps

such as Innocaption that closed

captions their app,

but they still have that default, oh,

someone else can do that for me.

My daughter, my son,

my wife will be able to make

that appointment for me.

I think it

has a higher significance of falling

through the cracks when we’re older.

And also a certain amount of people

perceiving hearing loss as cognitive

decline in older populations, too,

they automatically assume it’s

cognitive decline and never

even think about.

Hearing or isolation or depression

or something like that.

Michelle,

I love those points you make,

Michelle, because obviously,

even after preschool or

the younger ages,

you still get hearing tests regularly

throughout schooling until you

graduate at times, right? So, like,

there’s this regularity of

that that does fall off.

And I know there’s been advancements

even in ways to do hearing screenings.

And it would be great if people could

just start setting their own reminders

to just check in and do that once a

year in that interim population,

if you will.

But coming back to the other

caregivers as gatekeepers,

I think

I’m happy that, Bob,

you got referrals, and obviously,

Michelle,

you’re getting them from some

of the pediatric side,

but I don’t think it’s as

common as it should be.

Kind of probably where you

were thinking, Bill,

I think we can absolutely

get more referrals.

We just have to do a lot more

education, which is a challenge.

It’s hard to get time with

some of these physicians,

maybe even how do you change the

narrative in schooling for them when

they’re trying to take on so much

information that seems much more

life and death, if you will.

Even so, it’s a challenge, I think,

but I think their perception

really impacts it.

We know patients trust what

their physicians say.

So if they brought up anything about

ringing or tinnitus in their ears and

they’re like, yeah, everybody has it,

Nothing you can do for it,

that’s a huge disservice to the

patient when there is something you

could do for it just the

same for hearing loss.

So we need to have a way to help those

caregivers build their confidence to

pass that knowledge on to

the patient that, yes,

there’s something you can do for this

and you need to go see this person,

but it,

it just doesn’t exist as broadly as I

think we would all like for it to.

I mean, I agree with that.

I, I have hearing loss, right?

My doctors theoretically know this.

They have never,

other than my audiologist obviously

has never asked me,

how are you doing with your hearing?

It was never something that was

brought up by a doctor ever in

my whole entire life, right,

Unless I brought it up.

So I think what we really need to hope

to do is have physicians make that

just a normal part of the

conversation. They ask you about,

what are you eating? They ask about,

you know,

are you regular in the bathroom?

You know,

there’s a whole host of questions,

but they’re not asking,

how are you doing? Communication wise.

Steve.

And they, and they won’t until the,

in this country,

until the US Presented Preventive

Services Services Task Force

agrees that that’s an important

part of the protocol, right?

Doctors are very overstretched.

And the conclusion when they

reviewed a few years ago,

the USP FDS was that

it’s not efficacious to address

hearing with a peer screen test,

a pure tone screening test

in older populations,

because it’s not an adequate screen

and too many people aren’t

taking action afterwards.

And therefore they are not

recommending that doctors address

hearing loss as part of their

normal health checks.

And that has to change before

overstretched doctors will take it on.

Andrew. To that point,

one of the things that even though

hearing may not be the headline,

more and more news and education that

we hear about, for example,

in dementia takes the lead that allows

us to dovetail hearing loss.

And so when we start talking in terms

of integrated impact on overall

health and societal good,

that’s what we have to utilize and

promote even more so because

that helps everyone.

Education and self care.

Yeah,

a very good reason to drive

that change. I agree.

And hopefully that will start

to take place as a result.

The relationship between

hearing and dementia.

I think it was an interesting point

you made though, Andrew.

It’s a little unfortunate if it’s

being pushed that those physicians

need to do the screening.

Right.

Because I think that’s adding to their

overstretchedness, if you will,

where really it’s just them being able

to refer them on even if they don’t

know if they truly have a problem.

But if the patient says that

they are having an issue,

that’s when the hearing care

professionals need to be treated

as the professionals,

just as equals to these physicians to

say that’s where you need to go.

They’re going to be able to assess

you just as the patient.

That may come to a hearing care

professional that may have

some cognitive decline.

I’m not going to treat it.

I know I need to refer.

Right.

So like there’s that back and forth

versus needing to do

the full screening.

I don’t know that that

has to live there.

As long as they’re open to having that

conversation of you can have someone

help you with this and this

is where you should go.

Yeah, Right.

If the patient is proactive

and brings it up. Right.

Then I know cases where local hearing

care professionals have forged links

with the local doctors to get

that sort of referral.

So it’s not a proactive

check of hearing,

but if the patient brings it up,

they do refer.

Right.

It takes seven years for typically

seven years for somebody to realize,

oh,

I can’t hear something and

get into the office.

I think it’s more like 10 to 14 years.

But how would you know if you’re

missing something if

you don’t hear it?

The words are not hanging in midair.

Like if I can’t read something,

I need to go to an optometrist

or ophthalmologist.

The words are not hanging in there in

midair for me to reread or rewind to

go back to. How would we know, Bill?

Change of mindset,

I think for these physicians is that,

you know,

that hearing is actually an important

part of overall health.

It’s not an afterthought.

It’s not something that,

you know,

it should be recommended against.

And they don’t have to,

like Michelle said,

they don’t have to do the

screening themselves.

They just have to ask about it as a

normal part of somebody’s life.

Are you having any issues

with communication?

It doesn’t even have to be about

hearing specifically.

It can be an open ended question

that addresses hearing.

It addresses vision, it,

it addresses isolation.

It addresses so many things with

just one open ended question.

And it really puts that piece of

health at the forefront rather than

as something over to the side.

And Sherry, to your point,

as part of the routine checkup,

what do they do?

They check in your ear while they’re

checking your rest of your sinuses.

And what a great moment to say,

so how are your ears?

And if the person doesn’t respond

that’s an indication of something.

And repeat it.

Lets talk about that.

And I think if you.

Such a natural way to begin

that discussion,

not just, oh,

do I have impact wax or whatever.

And the other thing that also needs to

take place is my pediatrician once saw

I had something horrible on my eardrum

and it turned out to be a piece of

tissue pressing against the eardrum.

And the pain was

beyond exclusive. So what did he do?

He unravel a paper clip from his

files to take it out?

Now,

I was all better and all that.

I was grateful for the pain.

But there needs to be some kind of

medically responsible approach as to

how you address the hearing issue.

As much as people bash OTC hearing

aids or maybe Apple AirPods,

they have screenings in there.

So I applaud the that they have a

hearing screening built into the

software Apple AirPods

and OTC hearing aids,

they can take a hearing test in

the comfort of their own home.

Now,

I would not put my license on that

audiogram or threshold

test that they take,

but at least it’s a step

in the right direction.

Agreed.

So now one of the things that wasn’t

on our list of topics that

we should talk about,

but I think I’ll bring this up

because we have consumers,

industry and clinicians all here.

Do you think that as audiology moves

into a provider status that things may

change somewhat because we’d

be seen more as colleagues

with our other

providers and so on?

So anybody have some thoughts on what

happens when we become providers?

Will that modify this stigma thing

just a little more or less or not?

I hope so.

That’s what I’m doing online.

I’m trying to erase that stigma.

I’m trying to show people all of the

things and all of the different hats

that I wear as an audiologist.

I’m a counselor, I’m a mentor,

I’m a diagnostician.

Like I am a hearing aid fitter,

a cochlear implant like programmer.

But at the very bottom of it, I am.

I like what Tony says,

I’m a door opener.

I am here to provide information and

resources so that you can make the

best decision for your life or your

family dynamic because you

actually do know it best.

I think there’s a shift in physician

or provider dynamic that, you know,

my parents just heard the physician

and they did what the physician said.

Now there’s more of a shift of, okay,

they’re giving me some information,

but I’m going to be empowered and feel

confident in making the choices.

Now is the choice I don’t have to

do just what the doctor said.

I’m going to get a second opinion or

I’m going to sit on this information

for a little bit. I hope it changes.

I’m trying to do that for

anybody who’s got kids.

I mean I’ve got a daughter who’s 26.

I mean I didn’t come from a point in

my life where I could go onto the

Internet and self learn everything

from how to build a cabinet to how to

really get a self diagnosis of what

might be going on with me.

I think that opens up the door for

addressing stigma as well too and from

a clinical perspective because now I

think that the consumer is much more

empowered and self learned and can

work with professionals and that only

populates or stimulates you

as you were earlier, Bob,

the ability for people to have this

and open that discussion and see the

appropriateness of different

types of solutions.

I think it also raises quality of care

when our community is more empowered

and learning on their own because it’s

like well, I heard about, you know,

a verifit machine.

Do you have that in your clinic?

I would like for you to do that so I

can have a little bit more data

and feel better about myself.

I agree.

I really like when you’re talking way

at the beginning of this Michelle,

about the hearing loss community and I

think that’s one of the changes that

has happened too is just how much more

information is more readily out there,

even whether it’s always correct but

just the engagement with

social media as well.

But I think because of that educating

that patients are doing on their own,

it also puts the onus on us as

clinicians for those of us who

are to be well educated.

And if the patient for instance is

coming in asking for an

invisible solution,

convincing them that a Rick is

invincible actually isn’t

meeting their needs.

So are you actually sending them out

the door because they knew what they

wanted but you couldn’t help them meet

that or can you help them find

really what they want?

I always feel like the best solution

for any patient is the one that

they’ll wear and it may not be the one

that’s in your book or my book or any

book as the most technological

advanced or, or something like that.

But if they’re, they won’t wear it,

it’s not the best solution for them.

So I think hearing truly kind of to

some of Sherry and Bill’s

points earlier too,

hearing truly what the patient’s

saying or what they’re looking for,

whether it may totally fit their

audiogram or what we think

is going to work,

may not matter because if they won’t

use it. What good is it?

And if they walk out the door with

nothing, we haven’t achieved anything.

Bill, real quick,

the interesting thing too,

obviously I would never call anyone

out and this could be a little

controversial and maybe grate

some people. And that is,

I had a really wonderful conversation

about a year and a half ago when OTC

was, you know, trying to take off.

And in a conversation with two very,

very phenomenal hearing care

professionals, the debate that we had,

a playful debate, was are you,

is your scope of practice practice a

prescriptive dispensing practice,

or is your scope of practice hearing

health care, which brings early,

early onset OTC all the way through

implant, et cetera?

Because I think that we also have to

look at how are our clinicians

positioning themselves.

And there’s nothing wrong if your

expertise is solely on prescriptive.

But if you back up and look at the

entire journey and we look

at that mentality,

that’s where you’ll be able to draw

in more patients as far as

their understanding,

their acceptance and getting

going on that journey.

That really starts with,

I think the way we’re educating the

students, audiology students,

the way they’re coming up through

their educational system,

is that there’s so much focus on the

device and the programming and the

measurement and not enough focus on

the oral rehab and the counseling and

asking open ended questions of your

clients so that you can determine what

their needs are so that you

can better meet those.

And I think part of the solution,

I think,

is really including advocates and

other people with hearing loss who are

willing to share their experiences and

their stories and their expertise

as part of these curriculums,

whether it’s in the classroom or

at annual conferences. I mean,

there’s just so much room for the

person with hearing loss to share

their expertise with the industry.

And it’s nice that it’s

becoming more typical,

but I think that there’s a lot of room

for additional sharing in that regard.

I precept audiology graduate students,

and if so, I don’t know, is that me?

I precept audiology graduate

students and I tell them,

you know what your appointment starts

the second that your name comes out of

their name comes out of your mouth and

you are starting a potential lifelong

relationship with them.

So you get to know them as a person,

get to know what ticks, what talks,

what bothers them,

what is it that fulfills them.

Get to know them as a person,

not as a number,

not as their audiogram.

And I’m trying to Shift that over to

hearing healthcare provider

versus somebody.

Like maybe you’ll see them one time

because that most of the

time is not the case.

Yeah.

And I do want to add that back in the

day when MFI made for iPhone

hearing aid was introduced,

I was shocked by the stubbornness

of audiologists saying, well,

it’s not my job to be connecting

hearing aid to your iPhone.

I don’t go near iPhone type.

Whoa.

This is a great enhancement.

This is the best thing since sliced

white bread. Come on.

This is a lifestyle thing that

you’re providing. Come on.

You’re in the hearing health care

business. Don’t be stubborn.

You’re almost like a horseshoe.

You’re hard to bend.

I’m trying to get you to

bend and see otherwise.

And each time we introduce a new

technology or a different concept.

Oh, that was just. No, we don’t know.

No,

we come from this old school of

disease. How we do things.

We don’t like change.

Let’s hope most of those old school

people are, are moving on.

Bill.

Now we, we really.

It’s kind of time for us to close up

our discussion as we’ve had a very

lively discussion on this topic and,

and listen to a lot of points of view.

We’ve had a whole lot of orientation

right before we, as we close,

you know, does anybody have some.

Just a short comment about the future

and then we’ll begin to

wind down our session?

I do, Bob.

Okay.

No more excuses when

it comes to stigma.

Hearing technology today and what’s

available to us has never been

greater than ever before.

Okay,

I’ll go, I’ll.

I’ll keep it short as well.

I’m going to continue that thought.

Just a general concept.

As we look at the future

through the perspective of, let’s say,

otc, that early onset,

not only does the consumer need to

have access to cool innovation

and confidence,

but the same applies to those

professionals that are working it.

So moving away from, well,

just try this to this is

a solution for you.

And that enthusiasm and confidence

behind it is critically important for

a patient as well to hear

and experience.

So

with that,

I think we will wrap up our session

and I want to thank

our panel for being with us today.

Michelle Wiebke, Bill Schiffmiller,

Michelle Hu, Shari Eberts,

Andrew Bellavia and Tony Sulsona,

thanks so much for being with us today

here at the Future of

Hearing Health Care.

And yeah,

you had to just put your glasses on

right there, Right there, Tony.

Anyway,

so thanks for being with us at Future

of Hearing Healthcare Today and we’ll

see you around the conference.

Thank you, Bob. Thanks, everyone.

Thanks, Bob and everyone.

Thank you.