What's going on with OTC Hearing Aids?

I'm not really sure what's going on with these OTC hearing aids.

Hey guys, welcome back to the Dr. Cliff AuD Vlog. This is Vlog number 177, and today I wanna talk to you guys a little bit about over the counter hearing aids and kind of what's been happening over the course of the past eight months and really kind of prior to that, I guess as well, cause I'm getting a little bit disappointed. But before I get into today's video, do me a huge favor, click that like button. It really helps out my channel. And if you are not yet subscribed, go ahead and hit that subscribe button with notification bell and that way you get notified every single time I publish a new video. That being said, really appreciate it. Now let's get to the topic at hand. So I, the reason I wanted to record this video is because I had someone, uh, purchase OTC hearing aids from my clinic because yes, you can purchase over the counter hearing aids from an actual clinic.

Um, you don't necessarily have to go through an actual fitting with those devices, but a lot of patients who want to purchase OTC devices from our clinic, they want to go through an actual fitting of those devices to make sure that they are, you know, coming close to their prescriptive targets to learn how to use them a little bit. Um, but like I said, it's by no means a requirement, but what that's allowed me to do is learn more about the capabilities of over-the-counter hearing aids for a variety of different people. Now, let me just kind of rewind here a little bit and go back to when over-the-counter hearing aids were basically, uh, created, like signed into law. So President Donald Trump signed the FDA Reauthorization Act of, 2017. And from that point forward, the FDA started working on the guidelines to create a new category of over-the-counter hearing aids.

So a completely separate category than prescriptive devices. And at the time I asked myself, okay, which direction could this potentially go? And I think that there's three different logical directions. Number one is having an over-the-counter hearing aid category will do absolutely nothing. It won't change anything. Uh, people may try them and adopt them and, and go throughout their normal course of action with treating their hearing loss, or it could be a second option, which is a lot more people try them and either have success with these over-the-counter hearing aids or they transition to prescriptive level care. And then the third option is that people actually try them. They hate them completely, and then they avoid going and doing treatment. So those are kind of the, the three avenues that I thought would be a potential. Um, at that time I had to ask myself, do I think that there's more likely, uh, rather, do I think that it is more likely that people will have success with over-the-counter hearing aids and treat more hearing loss?

Or do I think that they would go one of the other two routes? And I still strongly believe that having an over-the-counter hearing aid category will be beneficial to the overall hearing aid adoption rates. So more people potentially treating their hearing loss because they can get devices at a lower price point. But I've been getting a little bit disappointed with over-the-counter hearing aids since the final guidelines went into act in, uh, about eight ago now. Now I've been seeing some reports that certain, you know, hearing aid manufacturers have been selling O T C hearing aids like hotcakes. One was like 60 million of in here in over-the-counter hearing aids sales, and I'm just like, I'm not seeing it. Uh, I've been selling over-the-counter hearing aids online and in my clinic since they basically came out and I've not seen like this massive uptake in them. In fact, I've seen, um, if you compare the prescription hearing aid return rates, meaning how many people in our clinic, uh, went the prescriptive hearing aid route and did not have success in return them for credit was about a half of a percent.

Uh, and that's been consistent inside of my clinic. And we've seen hearing aid return rates be up almost close to 50% of over-the-counter hearing aids that people have purchased either from my clinic or had purchased online. And I'm just like, oh gosh, what is actually happening here? So I had a patient come in, like I said, had a patient come in, wanted over-the-counter hearing aids, I ended up recommending a particular over-the-counter hearing aid to this individual and he decided that he wanted to go through a fitting of those devices inside my clinic. So it's an hour long appointment and I go in and I check the physical fit. I had them do the hearing test inside the app. I I do a first fit measurement with realer measurement, and then I try to optimize with the app for the realer measurement to try to help them hit their prescriptive target as closely as possible.

And what I was finding with this individual is that no matter what I did from a manipulation of the programming, I could not get these devices to match the prescriptive target or even come close. Uh, he was actually over amplified in his ear canal residence range, and then he was substantially under amplified at 4,000 hertz and above. And when I started making these adjustments, I could not get it to the point where he was like, oh yeah, this sounds really good. Um, because I, they did not have enough manipulations or they did not have enough capabilities for me to do that. Now I've reviewed pretty much all of the, I would say name brand or like quality over the counter hearing aids at this point, and they're, there's more that are rolling out as time goes on. Um, but I, and, and all of my objective testing of these devices, I was like, yeah, they come fairly close to being able to get, you know, within the ballpark at least of these prescriptive targets.

So as long as someone gets it verified and they know what the settings have to be inside of the app for them to get there, I'm like, there's, it's plausible that you would have treatment success with an over-the-counter hearing aid. But as I'm starting to go through more of these fittings over time and testing out all these devices, uh, from a verification standpoint, I'm starting to question whether or not you're gonna have a significant amount of people get benefit with over-the-counter hearing aids. And the, the question still needs to be answered, and this is gonna take time. The question of is having a new category of over-the-counter hearing aids going to actually increase hearing aid adoption rates? Because when you look at this mild to moderate hearing loss, very few people actually treat their hearing loss in this category we're talking, it's about 10% of people choose to treat it with prescription devices.

So for us to be able to see if OTC is actually gonna work, we need to see that 10% increase. And within the next couple of years, I would suspect that it has to increase somewhat substantially because you've had a lot of people postpone hearing aid treatment waiting for over-the-counter hearing aids. Now I know that's, it's a good thing that now that the category is here, they're gonna try these devices, but there's a lot of people who delayed hearing treatment for, you know, five plus years that was not in their best interest to do. And they're in a worse spot now than what they would've been if they would've actually treated their hearing loss five years ago. But you know, the argument here is that it's going to increase accessibility and affordability. And you know, if I'm, if I'm being honest, um, we've had direct to consumer hearing aids for, you know, the past 10 plus years.

I mean, you could go online and buy virtually the same devices that you can buy right now that they're just categorized O tc. And here's the other thing, um, I've been reviewing some of these OTC hearing aids that are actually worse than what the direct to consumer version of that hearing aid was over the past five years. And I'm wondering like, are the over the counter guidelines actually forcing these over-the-counter manufacturers to actually make their devices worse? And I'm having to say maybe, uh, which is, is very unfortunate and, and I don't think it's everybody, I think it's a few of these manufacturers that are out there, but it's actually getting a little bit discouraging on my end, uh, especially since I'm on record saying that I think that over the counter hearing aids are a good thing. And, and really unless I start seeing that return rates go down or unless I start seeing that hearing aid adoption rates start going up, whether it's from a over the counter side of things or from a prescriptive side of things, I don't know if OCC hearing aids are actually gonna work now I'm still in favor of them.

Just so we're clear here. I mean, I have a, a financial interest as well in people purchasing over the counter hearing aids and actually keeping them. So I want them to be successful because it allows me to expand my reach. There's no one in a better position to profit off of over the counter than I am because I have reached across the world at this point with the YouTube channel. Um, but I don't want it to knock my credibility. And that's the thing that I'm worried about. I'm worried that my credibility is gonna be called in the question because I was so pro o tc and if people are trying OTC and they're crashing and burning from a treatment outcome perspective, that does not look good on me. And so the bad news is here is that it's probably gonna take us a good two, three more years before we have any data coming out that shows that the needle was moving at all from a hearing aid adoption rate or if, uh, hearing aid satisfaction rates for OTC devices is going up.

Because right now I'm not seeing extremely high levels of satisfaction and, and, and based on knowledge that I have from working with a lot of, um, people inside the industry inside of the over-the-counter hearing aid industry, they're running into the same issue here, which is hearing aid return rates are for TC devices are really high at this point. And what we don't know is, is that if those people are actually going to get prescription level hearing aids and, you know, um, it's just gonna take time before we figure all of this information out. And I'm just kind of trying to keep my spirits high. But as I continue to do more and more reviews of these objective reviews of these devices, I'm getting a little bit more discouraged with them. And, uh, the more that I actually have patient interaction with using OTC hearing aids, um, until I see them get more satisfied with them, I, I don't know, I think it's gonna be a rough couple of years for o TC devices.

And honestly, if they can't be profitable, they're gonna go away. And uh, we, so we really need them to be profitable so they don't go away if they're actually going to accomplish the mission that they have, which is increasing accessibility and affordability of devices of hearing aids for people with mild to moderate hearing loss. But that is all that I really wanted to say for right now. I'm sure I'll come back with a follow-up video to let you know how this particular patient that I'm thinking of did with these over-the-counter hearing aids because right now he's in his one month kind of trial period to see if they're actually providing benefit. And if he does not get benefit from them, we'll see if he decides to go the prescriptive route. Cuz the prescriptive route is a predictable outcome, right? Like I know exactly what I can do with a prescription level hearing aid for a variety of different types of hearing losses.

I'm not yet sure about what my capabilities are with an o TC hearing aid for these individuals. So we'll see if he still has confidence that I can treat him prescriptively well and we'll see if he actually had success with over-the-counter devices because at this point there's not any more adjustments I can make on these over-the-counter hearing aids for him. He's gonna get what he's gonna get at this point. Um, but it was not good coming out of that actual fitting appointment that we had. But that is all that I wanted to talk about today, guys. If you like the video, make sure that you hit that thumbs up button. And as always, I'll see you next week.