Dr. Humes begins by outlining the current state of hearing healthcare in the United States, emphasizing that despite the prevalence of hearing loss, particularly among older adults, a staggering 80% of those in need of hearing aids do not use them. Using data from the National Health and Nutrition Examination Survey (NHANES), he illustrates how both audiometric and self-perceived hearing difficulties increase with age, yet the majority of adults—especially those with mild issues—do not seek help or get fitted with hearing aids. He attributes this gap to several systemic barriers, including the traditional dependency on professional intervention (e.g., audiograms), high costs, lack of accessibility, and broader social and psychological factors such as stigma and self-efficacy.
The core of the presentation advocates for a self-driven model of auditory wellness, where individuals take a more active role in recognizing, assessing, and addressing their hearing problems. Dr. Humes argues that self-perceived hearing difficulty—not audiometric thresholds—should be the foundation for determining candidacy for hearing assistance. He promotes tools like the Hearing Handicap Inventory for the Elderly (HHIE) as reliable, self-administered assessments that can effectively replace audiograms in many cases.
He also presents evidence from multiple studies, including randomized controlled trials, showing that adults—particularly those aged 60 to 79—can successfully self-fit OTC hearing aids and achieve outcomes comparable to those who receive audiologist-fitted devices. However, success is highly contingent upon the individual’s confidence in their fitting and the availability of support. Dr. Humes stresses that audiologists have a critical role to play—not necessarily in fitting OTC devices, but in providing optional, tiered support services that can improve user confidence, device retention, and long-term satisfaction.
In conclusion, Dr. Humes calls for a reimagining of the audiology profession’s role in a changing marketplace. He encourages audiologists to embrace the OTC model as a gateway to engage a broader segment of the population and offer support that enhances accessibility, affordability, and successful hearing outcomes. He closes with the reminder that even modest improvements in hearing aid uptake among the underserved 80% could dramatically increase the overall impact of hearing healthcare in the U.S.