By Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP (About | YouTube | Podcast | LinkedIn)
Date Published: January 29, 2026 at 10:30 AM
You made a huge financial investment in hearing aids, convinced they'd solve your hearing problems. But months later, you're still struggling in the situations that matter most. Family dinners are still exhausting. You're still anxious about social gatherings. The technology sitting in your ears cost thousands, but it's not delivering on the promise.
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Table of Contents
- The Real Problem: It's Not the Device
- Why Price Doesn't Equal Performance
- The Missing Step That Changes Everything
- What Best Practices Actually Look Like
- How to Protect Yourself
- Get the Hearing Care You Deserve
- Frequently Asked Questions
The Real Problem: It's Not the Device
Here's the truth that the hearing aid industry doesn't advertise: most patient dissatisfaction has nothing to do with the technology itself.
The devices people purchase today are genuinely impressive. Modern hearing aids use sophisticated signal processing, artificial intelligence, and wireless connectivity that would have seemed like science fiction a decade ago. The engineering is real.
But here's what happens in practice. You walk into a clinic after months of denial, finally ready to address your hearing loss. The audiologist shows you three options at different price points. The message is subtle but clear: the more you spend, the better you'll hear.
So you stretch your budget. You choose the advanced model. You leave feeling hopeful.
Then reality hits. You're at your grandchild's birthday party, and you still can't follow the conversation when multiple people are talking. You're at church, and you're still missing parts of the sermon. You go to lunch with friends, and the background noise is still overwhelming.
What happened?
In most cases, those hearing aids were never properly configured for your unique hearing loss and ear anatomy. You paid for sophisticated technology, but nobody verified whether it was actually working for you.
Why Price Doesn't Equal Performance
The hearing aid market has created an assumption: higher cost equals better outcomes.
That's simply not how it works. And this misconception keeps people from getting the help they actually need.
Think about prescription glasses. You can buy designer frames that cost hundreds of dollars. But if the lenses aren't ground to match your exact prescription, those expensive frames won't help you see better than a cheap pair from the drugstore. The frame quality matters, but the prescription accuracy matters more.
Hearing aids work the same way. Every person's hearing loss is different. Even within the same diagnosis, two people need different amplification at different frequencies. Your ear canal shape affects how sound resonates. Your brain's ability to process speech is unique.
Default programming—even on expensive devices—is just an educated starting point. Without verification, your provider has no idea whether that device is delivering the right sound at the right volume across all the frequencies you need.
I see this constantly in our Utah County clinics. Someone will come in from Orem or Springville, frustrated after spending considerable money elsewhere. When we test their current hearing aids, we find they're either over-amplifying some frequencies and under-amplifying others, or they're programmed for a completely different hearing loss pattern.
The technology was fine. The fitting process was inadequate.
The Missing Step That Changes Everything
So what separates a successful hearing aid fitting from an expensive disappointment?
The answer is verification—specifically, a procedure called Real Ear Measurement.
Real Ear Measurement is the only objective way to confirm that your hearing aids are delivering the correct amplification inside your actual ear canal. The American Speech-Language-Hearing Association recognizes it as the gold standard and recommends it for optimal hearing aid fitting outcomes.
Here's what it involves: Your audiologist places a thin probe tube in your ear canal while you're wearing your hearing aids. This probe contains a microphone that sits near your eardrum. Test signals are presented at various frequencies and volumes, and specialized software displays exactly what sound pressure levels are reaching your eardrum.
Your audiologist compares these measurements against validated prescriptive targets—formulas like NAL-NL2 or DSL that are based on decades of research into auditory perception. If the output doesn't match what you need, adjustments are made immediately and re-verified until the fit is correct.
The research is clear. Multiple studies documented in peer-reviewed journals have confirmed that manufacturer's first-fit algorithms provide inadequate amplification and often deliver less gain than necessary. Real-ear measurements provide objective confirmation that hearing aids are delivering appropriate gain relative to audiometric thresholds—making them absolutely necessary as part of routine patient care.
Yet despite this evidence, studies show that less than 30% of clinics perform Real Ear Measurement regularly. In any other field, skipping this critical verification step would be considered below standard care.
This is the single biggest reason people are unhappy with their hearing aids.
What Best Practices Actually Look Like
Real Ear Measurement is part of a comprehensive approach called Audiological Best Practices. When properly implemented, here's the process:
Understanding Your Specific Needs
Before discussing any technology, your audiologist should understand where you're struggling most. Is it one-on-one conversations? Group settings? Restaurants? Watching TV? Your lifestyle drives which features actually matter for you, not which model has the most impressive spec sheet.
Comprehensive Diagnostic Testing
This goes beyond the basic hearing test. Proper evaluation includes middle ear function testing, cochlear health assessment, and—critically—speech perception testing in both quiet and noisy environments. These measures reveal not just how much hearing loss you have, but how it's affecting your ability to understand speech.
Proper Device Selection
Your audiologist should have access to multiple manufacturers, not just one or two brands. Different technologies excel in different situations. Someone who primarily needs help in quiet conversations needs different processing than someone who's constantly in complex listening environments.
Real Ear Measurement Verification
This is where everything comes together. The objective measurements confirm that the selected devices are meeting the prescribed targets. If they're not, adjustments continue until they do. There's no "good enough"—either the measurements match the prescription or they don't.
Ongoing Support and Adjustment
Your brain needs time to adapt to amplified sound, especially if you've had untreated hearing loss for years. Quality providers schedule regular follow-ups during the adaptation period, making refinements as your auditory system adjusts.
The pattern I see with patients who come to us after unsuccessful fittings elsewhere is consistent: they received a hearing test, were shown expensive options, had devices programmed to default settings, and were sent home with a "come back if you have problems" instruction. That's not Best Practices—that's a transaction.
Don't Make This Costly Mistake
Download our free troubleshooting guide: "Is Your Hearing Aid Actually Working?" - see exactly what proper fitting should include and whether you need to seek a second opinion. You'll know in 5 minutes whether your provider skipped critical steps.
How to Protect Yourself
Before you purchase hearing aids from any provider, ask these specific questions:
"What verification procedures do you use?"
The correct answer includes Real Ear Measurement or similar objective verification. If they say "we program based on your hearing test" or "we use the manufacturer's fitting software," that's not adequate.
"Do you perform Real Ear Measurement on every patient, or only in certain situations?"
The answer should be "every patient, every time." If it's situational or optional, that's a warning sign.
"How do you measure whether the fitting was successful?"
They should describe specific outcome measures beyond just asking if things "sound okay." Subjective reports matter, but they should be combined with objective verification.
"What manufacturers do you work with?"
Providers who only stock one or two brands may be limited by business relationships rather than clinical judgment. Access to multiple manufacturers means better chances of finding the right technology for your specific needs.
These questions aren't confrontational—they're standard inquiries that any competent audiologist should welcome. A provider who gets defensive or dismissive when asked about their procedures probably isn't following Best Practices.
Get the Hearing Care You Deserve
The fundamental problem in the hearing aid industry isn't the technology—it's the gap between what's possible and what's commonly delivered.
You deserve more than default programming and wishful thinking. You deserve objective verification that the devices you're paying for are actually configured correctly for your ears.
Here's what most people don't realize: the sooner you address hearing loss with properly fitted technology, the easier your brain adapts. Every month you spend struggling with inadequate amplification makes the eventual adjustment more difficult. Your auditory system is constantly changing based on the input it receives. Give it the right input.
Demand Real Ear Measurement. Demand Best Practices. When you do, you're not just protecting your investment—you're giving yourself the best possible chance at successful outcomes.
Ready to Get Professional Help?
Schedule your free consultation - we'll spend about 2 hours with you to understand your situation, perform a comprehensive hearing evaluation, and show you the best solutions with proper Real Ear Measurement verification. Most patients tell us they wish they'd done this sooner.
Or call us at (385) 332-4325 - speak with our team directly. We serve patients throughout Utah County, from American Fork to Spanish Fork, and we're committed to providing hearing care done right.
Want to do more research first? Visit our Learning Center for detailed information about hearing aids, fitting protocols, and what to expect from quality care.
Frequently Asked Questions
Q: Does Real Ear Measurement cost extra?
A: Real Ear Measurement should be included as part of standard professional care. If a provider treats it as an optional add-on with an extra charge, they're essentially charging you for doing their job properly. At our practice, verification is built into every fitting because it's the only way we know the devices are working correctly.
Q: I already own hearing aids. Can I get Real Ear Measurement done now?
A: Absolutely. If your current hearing aids aren't performing well, you can ask your existing provider to verify them with Real Ear Measurement. If they're unwilling or don't have the equipment, consider getting a second opinion. You may find that your devices just need proper programming rather than replacement.
Q: Why do I need so many follow-up appointments?
A: Your auditory system needs time to adapt to amplified sound, particularly if you've had untreated hearing loss for years. Initial programming is based on prescriptive formulas, but your perception is individual. Follow-ups allow your audiologist to fine-tune based on your real-world experience while continuing to verify against objective targets.
Q: Are expensive hearing aids worth it if cheaper ones can be fitted just as well?
A: Advanced technology does offer genuine benefits in complex listening situations—better noise reduction, more sophisticated directional microphones, and superior connectivity features. But those advantages only matter if the device is properly fitted. A moderately priced hearing aid with excellent verification can absolutely outperform a premium device that was never configured correctly.
Q: How long should a proper fitting appointment take?
A: A comprehensive initial fitting typically takes 90 minutes to 2 hours. This includes counseling, physical fitting, programming, Real Ear Measurement verification, and instruction on use and care. If your entire fitting took 30 minutes, critical steps were almost certainly skipped.
About the Author
Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP is the founder of Timpanogos Hearing & Tinnitus.
Links: About | YouTube | Podcast | LinkedIn
Reviewed/Edited by: Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP
Date: January 29, 2026
