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Informing physicians is crucial in reducing untreated hearing loss

Campbell-Angah, Danielle

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doi: 10.1097/01.HJ.0000286372.84678.39
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Media coverage of hearing health issues is a double-edged sword. The industry has welcomed the media's recent exploration of noise-induced hearing loss associated with iPods. And the attention paid to today's hearing technologies on such popular television shows as Three Wishes, Extreme Makeover, and Extreme Makeover: Home Edition has increased public awareness of advances in hearing healthcare. On the other hand, practitioners sometimes have to overcome misconceptions stemming from inaccurate coverage.

One of the best ways to educate the public about hearing loss and hearing care is to make sure that physicians, especially primary-care physicians, are well informed in this area, since it is medical doctors who field the majority of consumers' concerns about their health.

Jennifer Sylvester, AuD, director of audiology at Medical Center Clinic PA, in Pensacola, FL, would like to see hearing professionals become more proactive in initiating and leading hearing health discussions. “We need to do much more in terms of education,” Sylvester says. She conducts consumer seminars a couple of times a year and has noticed that many consumers are not up to date on advances in hearing aids.

RISING CONSUMER INTEREST SEEN

Fortunately, consumers seem to be interested in seeking out more information. Dean Garstecki, PhD, chair of communication sciences and disorders at Northwestern University, has become very familiar with the common questions about hearing loss, after being interviewed by numerous media outlets about iPods and receiving thousands of e-mails from consumers. “People of all ages want to know more about hearing loss and treatment,” Garstecki observes. “The world is begging for information.”

Because so many consumers have questions about their hearing, it is important for hearing professionals to provide physicians with accurate information to share with their patients and to help them determine when a patient should be referred to a hearing care office.

Sergei Kochkin, PhD, executive director of the Better Hearing Institute (BHI), urges those who work in the hearing industry to talk more about the larger issues related to hearing loss, such as its serious impact on people's quality of life, their income, and their careers, according to BHI research.

While Kochkin feels that the recent wave of media and consumer concern over hearing loss caused by iPods may have been a bit out of proportion to the threat, he counts it as a positive sign that consumers are worried about their hearing. He adds, “If we focus on solutions to people's hearing problems, they will come into hearing health professional offices.”

PCPs: FIRST LINE OF DEFENSE

Because most consumers turn first to their primary-care physicians (PCPs) about any health issue, it's important for hearing professionals to inform PCPs in their community about the impact of hearing loss, how hearing aids can help, and how hearing aids can be made more affordable. Getting that information to PCPs ensures that the information they disseminate to their patients is accurate and should ultimately increase the number of people whom MDs refer to hearing professionals.

Garstecki notes that it's important that physicians and hearing professionals give consumers accurate information, in part to offset some of the messages they receive from other sources. For example, product and concert advertisements often suggest to young people that the best way to listen to music is to turn up the volume. Such ads, he says, fail to warn about the damage excessive noise does to hearing. To counter this, he says, audiologists should inform physicians about proper listening habits so they can pass this information on to patients.

In addition, many consumers still believe that only old people suffer hearing loss. But, BHI research shows, that one-sixth of baby boomers (age 41 to 59) have hearing loss and 7% of Generation Xers (age 29 to 40) have hearing problems. Also, 1.4 million children have hearing loss. If physicians become more fully aware of the true demographics of hearing loss, they will encourage patients to get their hearing losses treated sooner.

ADDRESSING COST

Consumers often balk at pursuing hearing help because they believe that hearing aids are too expensive. Practitioners should make physicians aware of the options that can make hearing aids affordable to more people.

For example, Sylvester says, with third-party financing plans, patients can “take advantage of technology that may not normally be within their budget.” Her practice offers a 3-month, no-interest payment plan offered by CareCredit.

“It does help,” she says of financing. “More patients are willing to try [amplification]. It gives them the opportunity when they might not have had one otherwise.”

Practitioners who offer financing options for hearing aids should let their local physicians know about them. A doctor who is aware of such plans may be able to offer hope to a patient who is convinced that hearing aids aren't an option because of their cost.

Sergei Kochkin adds that physicians should be aware of other options, like Medicaid, assistance from the Veterans Administration for eligible veterans, and help from non-profit organizations such as The Lions Club, Sertoma Club, and Easter Seals. Hearing health professionals also can support and make the public aware of the proposed hearing aid tax credit bill now pending in Congress (HR 414, S. 1060)

Garstecki mentions other concepts to discuss with physicians, including the importance of hearing to a person's quality of life and ability to learn, the need for counseling patients on use of amplification, and the fact that consumers should place the functional benefits of hearing aids over their appearance.

The Northwestern dean adds that hearing professionals need to do a better job of explaining to physicians their role in the hearing rehabilitation process. For example, PCPs can get involved by conducting assessments as part of annual physicals.

Kochkin also favors making screening for hearing loss a routine part of the best practices protocol for primary-care physicians (PCPs), such as family doctors, general practitioners, internists, gerontologists, and pediatricians, who are in a position to detect hearing loss. He suggests offering medical doctors material like that available through BHI's physician referral development program. This includes a 15-question paper-and-pencil exam that tells physicians if patients have a potential hearing loss that needs further investigation.

FACE-TO-FACE MEETINGS

Once hearing professionals know what messages they want to share with physicians, they will likely find that the most effective way to connect with a local PCP is in a face-to-face meeting with the physician and or the physician's staff.

Heather Shenk, AuD, an audiologist at Advanced Tech Hearing Aid Centers in Lancaster, PA, verifies this with an anecdote about a PCP who referred a patient to her: “There wasn't even a flicker of recognition when I was introduced to him. I felt somewhat frustrated, but then I realized I shouldn't take it personally. He is a very busy doctor who sees many, many patients daily.” She adds, “I learned that if we want to relay information to doctors, we need to do so in whatever creative format we can come up with.”

OTHER STRATEGIES

Jennifer Sylvester says that giving referral pads to physicians has worked for her. They look like prescription pads, but feature directions to her facility and a list of the services she provides. She explains, “The physician simply fills in the patient's name, checks the service to be performed, and signs the referral.”

BHI has free educational articles that practitioners can download from its web site (www.betterhearing.org). Titles include “The impact of untreated hearing loss on income” and “Customer satisfaction with hearing instruments in the digital age.” Kochkin suggests that some of the information in them can be sent to local newspapers or fashioned into informative ads.

Additionally, BHI's physician referral development program provides MDs with a CD-ROM course for one continuing medical education hour. The CD-ROM discusses how treating a hearing loss can improve the person's quality of life. The institute also will develop a scripted presentation that practitioners can use at regional professional meetings for physicians.

Another strategy for educating PCPs about hearing loss and its treatments is to use a program like that outlined by Richard Carmen, AuD, in the April 2006 issue of The Hearing Journal. Participating hearing professionals give physicians a copy of his book Hearing Loss & Hearing Aids: A Bridge to Hearing, then follow up with a physician newsletter and a hearing screening device. Carmen says that this approach may be more comfortable for practitioners who are less outgoing by nature and therefore reluctant to meet with the physician in person.

Regardless of how they reach physicians in their community, it's crucial for hearing professionals to take action to build awareness among PCPs about the impact of hearing loss, the benefits of hearing aids, and the options available to make amplification affordable to patients in every income level.

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