“The carrot is a long, reddish-yellow vegetable which has several thin leaves on a long stem, and which belongs to the parsley family. Carrots are grown all over the world in gardens, and in the wild in the field.”
This sentence will forever be embedded in my brain. As a child, I would hear this sentence at countless hearing aid fittings, adjustments, and check-ups. As I grew older, and ended up working at the same audiology clinic I’d been going to for years, I continued to hear this sentence as it was played for every single fitting performed there.
This carrot sentence is probably the most common speech stimulus used for performing real-ear-measurements (REMs) on hearing aids, a quick, simple process used to verify that the actual output of the hearing aids is in fact the same output as claimed by the programming software (and to correct the fitting when the software is slightly wrong, which it often is).
It doesn’t take much time and the benefits are significant (here’s a good summary of those benefits – http://hearinghealthmatters.org/hearingviews/2016/real-ear-measurements-are-a-must-for-patient-and-professional-satisfaction/). However, the truth is that less than half of all audiologists regularly perform REMs at fittings. Even when only surveying those who have the equipment, that number improves to just shy of 60%. While fewer hearing instrument specialists report regularly performing REMs, the difference isn’t huge. (See the link at the bottom of this post for a full report on these numbers).
I know there are arguments to be made regarding the time/cost-to-benefit factor here, but if you’ve worn hearing aids and tried them on the manufacturer-programmed settings then you’ll know that these numbers can be way off. However, some manufacturers’s software is much better than it ever used to be. The last pair of hearing aids I was fit with only needed a couple small tweaks to reach targets. Now I know not every fitting will get that lucky, but even if they did, I still believe that performing REMs is a critical part of amplification. Performing REMs is a simple way to clearly demonstrate how the services you are providing meet the needs of the patient.
In a time where patients have more options than ever for where and how they can access hearing services and products, audiologists need to work extra hard and add additional value to their services wherever they can. If you run REMs, and find that you don’t need to make even a single change, you’re still adding value to your patient’s experience because you proved that your service and product reached a real, standardized target illustrated on the screen of whatever device you use to perform REMs. You can’t quantify that bit of value, but it absolutely exists.
Further, I think this same concept of “adding value by proving your work” can be extended to other services. Why can’t every otoscopic examination incorporate the use of video otoscopy? Instead of telling patients their eardrum looks healthy, show them. Instead of having patients try their new hearing aids in the real world, put them in the sound booth and redo whatever speech test you did during the initial evaluation. Demonstrate that your services have made a clear, quantifiable change to their hearing.
In today’s competitive market, audiologists need to do everything they can do demonstrate their skills and add easily apparent value to their services. Adding more carrots to everyone’s experience is one easy way to do just that.