The value of expertise

Besides Audiology, one of my passions is photography.  I actually had a small side business creating nature and fine-art photographic prints, and was represented in a local gallery.  During an opening event I had someone come up to me and say “Wow, your camera takes great pictures!”  I smiled and thanked them, and then we proceeded to discuss photographic equipment and image processing software for ~20 minutes.  All the while I was thinking to myself ‘not once has my camera ever scouted a potential photo site, calculated the position and time of sunrise, awakened at 5:00 AM to take itself out to that site, set itself up on a tripod, composed the shot, attached the correct filter(s), selected the correct aperture and shutter speed, bracketed carefully and make the correct post-shot adjustments in software that resulted in a great photo.

Yes, the camera technology is incredibly sophisticated, the lenses are of superb quality and the post-processing software is amazing; however, it is the skill of the photographer, not the equipment that makes a great photograph.

This is analogous to modern hearing instruments.  As with modern photographic equipment, the technology is indeed incredible.  Today’s instruments have beam-forming directional microphone systems, deep-neural-network sound processing capability, postural awareness, automated adjustment of multiple systems, and connectivity to Bluetooth devices.  Despite this, a top-of-the-line hearing instrument, programmed poorly, can actually make the wearers’ ability to hear – worse!  It is not simply the technology that results in maximum benefit, but rather the expert implementation of that technology.  Understanding the nature of the pathology, the duration of disability, the lifestyle and expectations of the user, the residual function of the wearer’s cochlea, and their tolerance to acoustic stimulation – and then knowing how to use that information to program a hearing instrument is critical for success.  Further, it is rarely the ‘best sound quality to the listener’ which results in the best word understanding.  The path to better hearing begins with expert assessment of the problem, careful provision of rehabilitative acoustic stimulation, detailed counseling of best-use practices, and an ongoing relationship where the wearer’s hearing and lifestyle changes are monitored and accommodated.

The day hearing instruments can read our minds and automatically provide a best-fit is the day I retire.  Until then, expert Audiological services are the gold standard for optimal diagnostic and rehabilitative hearing healthcare.

– Authored by Dr. Matthew MacDonald