Hearing Healthcare
Throughout Tennessee

Signs of hearing loss may include:

• Difficulty understanding conversations in noisy environments.
• Frequently asking people to repeat themselves.
• Turning up the volume on the TV or radio.
• Experiencing ringing or buzzing sounds in the ears (tinnitus).

White lab coats can be misleading in healthcare, It doesn’t always mean the provider is a doctor as it once did. It’s important to understand the types of providers permitted to perform hearing related services in Tennessee, their scope of work, and training.

An Otolaryngologist, or ENT as they are commonly referred to, is a surgeon who medically and surgically treats disorders of the head and neck.  You would go to an ENT for things like acute ear pain, ear canal blockage, unexplained sudden hearing loss, and structural abnormalities within the head, face, and neck areas.

Audiologists (Au.D.’s) are who most would refer to as a “hearing doctor”. These are state licensed healthcare providers with an undergraduate degree in communications disorders and a doctorate in Audiology. An Audiologist has a minimum of 8 years of institutional education in hearing health. Continued education is required to maintain state licensing annually with a minimum of 10 hours per year of accredited instruction in the field of Audiology, as well as 30 hours per 3 years to maintain professional board certification through the American Speech and Hearing Association (ASHA). An Audiologist is the highest level of care one can receive specifically for hearing healthcare.

ENT and Audiologist offices often work closely together, referring to each other for care based on the patient’s needs. For instance, an ENT would perform surgery to implant a hearing device when it is appropriate, and an Audiologist would program and adjust the device once healed and ready to begin using. An ENT may refer a patient to an Audiologist for various tests and use those results for diagnosis and treatment plans, such as for Meniere’s disease or other inner ear disorders.

Audiology Assistants or Technicians are also common in the hearing industry. These positions are certified through extensive training programs to assist an Audiologist in the day-to-day functions of an Audiology practice. Audiology Assistants are not doctors and do not require a specific degree level, but they do offer an extension of some aspects of patient care under an Audiologists’ supervision. They cannot practice independently and are limited in what patient care services they can provide.

Hearing Instrument Specialists (HIS) are another category of provider and can dispense and fit hearing devices on patients over 18 years old in Tennessee. HIS’s are not required to have any secondary education in the field and are not hearing doctors. They are required to complete a 3-6 month training program and their licensing and scope of practice is limited to screening basic hearing thresholds for the purpose of selling and fitting hearing aids. A HIS does not diagnose or treat any hearing related matters.

Screening: The messages we receive about hearing testing can be confusing and misleading. Often, we receive a mailer or see signs outside of retail locations offering “Free Hearing Test”. This is a very different test for a different purpose than what you receive from a comprehensive diagnostic clinic by a licensed Audiologist. These “free tests” are typically simple pass or fail screenings, or the test administrator performs a limited number of threshold tones to screen general hearing levels for the purpose of selling and fitting a hearing aid. Retail dispensers often offer “free screenings or tests” because they are not credentialled to accept insurance plans including Medicare or Medicaid programs and are not completing a comprehensive diagnostic exam.

Comprehensive diagnostic hearing exams, which are non-invasive and go much deeper into the hearing health of the patient, should involve these diagnostic steps:

• Review of prior hearing concerns or issues such as surgeries or tinnitus, lifestyle, and medical or environmental factors
• Screening for cognitive decline – due to the significant link to untreated hearing loss
• Visual inspection of the ear canal and ear drum by a doctor trained to check for abnormalities canal prior to testing
• Tympanogram – to check middle ear pressure and health
• OAE and AABR testing – for newborns, infants, and non-verbal hearing testing
• Air conduction
• Bone conduction
• Speech reception
• Speech recognition
• Counseling – to understand and interpret test results
• Diagnose potential hearing loss and if appropriate, prescribe treatment
• Our clinic offers a variety of other diagnostic tools:
• auditory system testing for diagnosing inner ear (balance) disorders including VNG, SCOG, VEMP, VHIT
• auditory processing disorder testing, ages 7 and up

To protect your hearing, it is important to avoid prolonged exposure to loud noises. This can be achieved by wearing earplugs or earmuffs in noisy environments, keeping the volume at a moderate level when using headphones or earphones, and taking breaks from loud activities. Early diagnosis and treatment for most types of hearing loss can slow its progression and reduce the risks of early-onset cognitive decline.

Several types of hearing aids are available, including behind-the-ear (BTE), receiver-in-canal (RIC), in-the-ear (ITE), in-the-canal (ITC), completely-in-the-canal (CIC), and invisible-in-the-canal (IIC) devices. The best type of hearing aid for your needs will depend on various factors, such as the extent of your hearing loss, lifestyle, and personal preferences. It is recommended that you consult with one of our audiologists to determine the most suitable option.

It is generally recommended that hearing tests be performed at least once every year, especially for individuals over the age of 50. However, if you notice any changes in your hearing or have concerns, it is advisable to schedule a hearing evaluation sooner. Hearing aids may need occasional adjustments or reprogramming to ensure optimal performance. This can be discussed with your audiologist during routine check-ups or if you experience any issues.

Yes, there are non-surgical treatment options available for conditions like tinnitus. One such treatment option is Lenire, the only commercially available, clinically trialed, dual-mode tinnitus treatment device approved by the US FDA. Lenire combines sound therapy and electrical stimulation to provide relief from tinnitus symptoms. Other treatments include the Mahana Tinnitus program, and in many cases, hearing aids can be a great treatment plan for tinnitus.