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Get your patients “in the loop”

Myers, David G.

doi: 10.1097/01.HJ.0000286677.80214.36
Cover Story

William Diles, MA, has been in private practice in Santa Rosa, CA, along with his wife, Christine Diles, AuD, since 1981. He is a third-generation hearing care professional whose grandfather was an executive with a major U.S. hearing aid manufacturer and whose father was a well-known hearing aid dispenser. Readers may contact him at Santa Rosa Audiology, 52 Mission Circle Suite 203, Santa Rosa, CA 95409; at 707/538-1000; or at

People with hearing loss often struggle to catch television's fast-paced dialogue, even if they wear well-fitted, advanced digital hearing aids. A patient of mine—we'll call him John Smith—has been fitted with the best hearing aids available. On a follow-up visit, John told me he is hearing his wife much better, doing much better in noisy restaurants, and enjoying live music again. But, he said, he still relies on captions when watching television.

I have asked myself, “What am I missing here?” Could it be that in our quest to help people overcome their hearing difficulties, we have overlooked one of the most important activities in their daily lives, TV viewing?

I have found a very effective solution to this problem: the inductive teleloop. Over the past 3 years, our practice has been steadily looping more and more of our patients' homes.

In the beginning, we sold the loop as an added feature. But then we conducted a survey of patients with and without a home loop (see Figure 1) and found greatly increased satisfaction with TV watching among those with the loop. Moreover, over 90% of our patients also reported high satisfaction with their hearing aids when combined with an installed teleloop (see Figure 2). After seeing those data, and talking with many of our delighted patients, we decided to include the loop with every fitting.

If you think about it, the loop can be looked upon as simply another option available with a hearing aid. So, why not treat it as such and give our patients a feature they will use so often? Moreover, by equipping their hearing aids with a mic-plus-telecoil (M/T) option, we can enable patients to enjoy hearing aid-compatible TV listening while still being able to hear conversation in the room or the ring of a telephone or doorbell.

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We have found that three things occur when we “loop” our patients' homes:

1. (1) The patients are more satisfied with their current hearing aids.

2. (2) They are more loyal to our office, and thus more likely to return for their next hearing aids.

3. (3) They often refer friends to our practice.

Having installed loops in 500 homes in our county, we know there are 500 locations where people talk about our office and what we have done to help them hear better and improve their quality of life.

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The physical installation of the loop system is undoubtedly one of the main factors deterring hearing professionals from recommending these products to their patients. However, installing a room loop in a house or apartment requires no special considerations and can be done without a professional. So, there's no need to hire an expensive electrician or carpenter. I hired my 17-year-old son to do these installations, which require scarcely more sophistication than hooking up a DVD player.

With just a few handyman skills, you can run the wire around the edge of the room and over the doorways or under the carpet (see Figures 3–6) To snake wire under carpet, we use a fishtape, which is a $15 item found at any hardware store. Securing the wires to the basement below or the attic above with a staple gun so that they encircle the TV room is also an effective installation technique.

The loop system we use is the Field from Phonic Ear. Each unit comes with an easy-to-follow installation guide complete with pictures, including those in this article.

Often patients do the installation themselves, or the hearing care professional can arrange for installation. Installers are easy to find and the job usually takes less than an hour. Once it is in place, the loop system is virtually maintenance free.

When the loop is not included in a new hearing aid fitting, we typically charge $200 for the hardware and $100 if we provide installation, which yields our office a small profit. But, more importantly, it leads to noticeably happier patients whose hearing aids now serve them not only as microphone amplifiers but also as TV loudspeakers.

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Our office is now equipped with four separate loops. We give demonstrations to patients, using cable television during regular fittings or follow-up appointments or even while the patient waits in the reception area.

The loop system in the reception area is connected to the “audio out” port of the TV, and there is no acoustic signal sent to the room. We have a sign instructing people to switch their hearing aids to the “T” position to hear the TV. People are amazed by the clarity and audibility, and it generates many questions and much interest. Our front office staff is well prepared to explain the technology.

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Loop systems are not just for public places anymore. Home by home, looping is making a difference in the lives of our hearing aid users. Using a loop system eliminates the problems of background noise, distance, and reverberation. The way we see it, a loop in the home gives our patients one more reason to love their hearing aids!

© 2006 Lippincott Williams & Wilkins, Inc.