David Fabry

Hearing aid physical fit: The next revolution?

EDITOR’S NOTE: Recently, several hearing aid manufacturers have begun using computer-aided methods in the fabrication of shells for in-the-ear hearing aids. Other manufacturers of hearing aids and earmolds will soon join them. The following article on “digital mechanics” describes this new approach and its implications for the industry, including the potential benefits for practitioners and hearing aid wearers.

Cochlear implants and hearing aids: Converging/colliding technologies

Alessandro Volta described what he heard in 1790 following what may have been the first experimental electrical stimulation of the auditory system. More than a century and a half later, in the 1950s, reports were published about the use of an electrode to directly stimulate the 8th nerve. Wearable devices became available in the 1960s, and today cochlear implants are a routine treatment for hearing loss for both adults and children. If you have followed the research and progress of cochlear implants, you’ve probably noticed, not surprisingly, that many of the questions raised are similar to those we ask about hearing aids. Candidacy? Best compression technology? Advantages of directional microphones? Speech measures as verification strategies? Bilateral benefits? While hearing aids and cochlear implants have a lot in common, for various reasons (some not entirely logical), audiologists who are “hearing aid people” don’t tend to be “cochlear implant people,” and vice versa. So, to write this article about the convergence of these two technologies, we looked for someone who works both sides. Such a person is David Fabry, PhD. Dr. Fabry is chief of audiology at the University of Miami, Miller School of Medicine, Miami, FL. He is a past-president of the American Academy of Audiology and recently was named editor of one of the academy’s journals, Audiology Today. Dave Fabry also has faculty appointments at the University of Minnesota, Nova Southeastern University, and the University of Miami. He previously served as vice-president of professional relations and education for Phonak Hearing Systems and director of audiology at Mayo Clinic in Rochester, MN. Some of you might even remember his days at the research section of Walter Reed Army Medical Center. Dr. Fabry is known internationally for his informative, insightful, and often innovative workshops. He is also among a select group of professional lecturers who has had an audience response keypad (#45) write its own yearlong blog about its adventures (see www.earTunes.com). Despite spending the majority of his life on the [frozen] tundra (even attending “Lombardi” Junior High), the word on the street (and beach) is that Dave has quickly adapted to the subtropical climate in Miami. His ice-hole auger was sold at a Rochester yard sale, and he is now learning how to snag the elusive barracuda, sea trout, and snapper. But don’t be fooled—this article is not a Florida “early bird special.” Dave has put together a great buffet of what’s happening in the world of cochlear implants.

Acceptance of the wireless microphone as a hearing aid accessory for adults

SUMMARY We are on the cusp of a wireless revolu-tion. When the technology meets theexpectation, we will have reached a tippingpoint and change will occur quickly. Thecombination of generation effects, systemicchanges, component miniaturization, anddevelopments in low-cost consumer elec-tronics will all contribute to furtheringadult acceptance of the wireless micro-phone as a hearing aid accessory. As discussed in this ar ticle, the primar ysub-goals to be met in order to improveACCESS to sound via wireless micro-phones include: ❖ Awareness by hearing aid users, the dis-pensing community, and the public atlarge that this technology exists and ishighly effective ❖ Candidacy requirements that are clearlyestablished ❖ Cost reduction ❖ Ease of use in both private applicationsand public places ❖ Smart design to improve cosmetics,reduce intrusiveness, and simplify oper-ation ❖ Support and counseling before, dur-ing, and after the fitting/purchase. David Fabry , PhD, was formerly Vice-President of Professional Relations and Education at Phonak HearingSystems,Warrenville,IL.Drs

The great debate: Is third-party pay friend or foe to audiology?

The two combatants appeared to be in splendid physical and mental condition, having received training tips from their respective home state politicians, Arnold Schwarzenegger and Jesse Ventura. At the opening bell, Sweetow quickly took the offensive, throwing a series of jabs that highlighted the growing number of third parties becoming involved in reimbursement for hearing healthcare services, including hearing aids. He pointed to state and federal programs, including Medicaid and vocational rehabilitation, as well as coverage by private health insurance companies and employee and union benefits. He also deployed data supplied to him by Tom Powers, PhD, director of audiology at Siemens Hearing Instruments, which showed that of 975 major employers with private insurance plans, 23% offered a hearing care plan, 68% covered hearing aids through flexible spending accounts, and 2% had coverage based on medical/dental plans. Sweetow tried to dazzle the judges with his knowledge of current developments likely to increase third-party involvement in the near future. For example, he pointed out that at the state level, where hearing healthcare coverage has traditionally been reserved for children, policy makers are beginning to recognize that hearing aids can help employed hearing-impaired adults be (or continue to be) productive members of society. Among states considering hearing aid coverage for adults are New Jersey, Hawaii, Illinois, Maine, and Washington. Along with these state initiatives, the battler from the Bay Area also reminded listeners that just this year Congressman Jim Ryun and Senator Norm Coleman had introduced federal legislation to provide a

Dynamic hearing assistance system and method therefore

500 tax credit for hearing aids purchased for people 18 years and under or 55 and older. To drive home his contention that third-party payers are proliferating at an alarming rate, Sweetow displayed a graph (Figure 1) revealing that among patients at his university’s audiology clinic the percentage of hearing aids paid for by third parties has more than tripled, from 20% in 2002 to over 60% in 2005. Having set up Fabry with his opening series of jabs, Sweetow then went for an early knockout with this vicious verbal uppercut: While increasing third-party involvement might appear to be beneficial because it would improve the industry’s dismally low market penetration among hearing-impaired adults, in reality, he triumphantly proclaimed, data from around the world show little correlation between the utilization of hearing aids and government payment policies. For example, the United States government currently pays for approximately 20-25% of the hearing aids dispensed in the United States (15% of U.S. sales are to the During its annual meeting this year in Columbus, the Ohio Academy of Audiology hosted its first Great Debate. For one hour packed with information, good-natured barbs, and surprise attacks with water cannons, two audiology heavyweights (professionally, not physically, speaking) battled over an important topic selected by the academy: “Resolved: Third-party payment for hearing aids leads to a mangled-care environment.” Robert Sweetow, PhD, from the University of California, San Francisco (UCSF), argued in the affirmative, while David Fabry, PhD, from Phonak Hearing Systems, assumed the negative position. A blow-by-blow account (provided by the adversaries) follows.