Final Word | June 2016 Hearing Review

Fear can motivate youFear. I’m not talking about the kind of fear you see on YouTube videos showing cats startled by cucumbers. I’m talking about the kind of fear that takes over our brains and causes us to change our behavior in the name of self-preservation, or to act irrationally. Let’s look at some of the things that cause us fear. At the top of the list is change. It is an inevitable truth that technology, competition, and even protocols in the hearing care industry will change.


When technology changes, how do we react? As technology is brought to market, there is typically a reason for it, and one would hope it helps promote better outcomes for patients. Do we react with fear because we are uncomfortable with changing our routines to adopt the technology, or do we react with fear that if we don’t offer the newest thing we will lose business? I’d hope that we wouldn’t fear the new technology, but view it with some skepticism. It may sound interesting, and have good promise, but little independent data. Are we afraid of the fact that there are no independent data? It might be the next greatest thing to come along, or it might be the next big promise that is not much different than last year’s technology. We would be justified in being skeptical, but not afraid. Technology in the tools we have for assessment and in the products we have for treatment are improving at a dramatic pace. Some will turn out to be better and worth adopting, and some will not. Part of our responsibility as hearing professionals is to look carefully and skeptically at new technology as it emerges, and with as much evidence as we can gather make informed decisions about adopting the technology in our practice.


When competition changes in our immediate location, we may be concerned about what may happen to our potential and current patients if they visit our competitor. We may be concerned about the viability of our own business if we lose patients to the competition. This may create a sense of fear. But here is where the survival skills that fear is naturally meant to evoke may come in handy. We have more choices than “fight or flight” open to us. It may be that competition can spur us to take some positive action that will strengthen our position without directly challenging the new competition. There may be cooperative arrangements that allow you and the competition to coexist and both thrive. Or, your fear may cause a reassessment of the business plan in force for your practice. In any event, fear should promote careful assessment of the competitive “threat” and appropriate action as necessary.

Today, we are facing a change in the way business is done. Many people do not look for goods and services today like they did a decade or more ago. Disruptive changes in the hearing care industry are changing the attitudes and behavior of consumers. We know that there are many people who need direct, hands-on services to achieve better hearing. If that is what we do best, we need to channel the fear that the disruptive forces have stirred up within us into actions that better connect us with individuals who need our help.


Many of us were taught to follow certain protocols for assessment and rehabilitation. Some of us can look back over a few decades and see how things have changed, and how we have adapted to the changes. Some of the changes are a direct response to data from current research, or scholarly work done by clinicians and researchers collaborating on best practice protocols. For example, have we adapted to using current best practices for hearing aid fittings? The current protocol is to assess audibility and suprathreshold performance of hearing aids over the dynamic range of the fitting with direct probe microphone or Real Ear to Coupler Difference (RECD) measures. Following a protocol and adjusting gain to meet targets is a start, but by no means completes the process. What more could we be doing? The changes we adopt should reflect a true understanding of why we follow the procedures, and what to do when we see something amiss. Our fear of not doing a proper job should push us to look beyond the current protocol, ask more questions of the patient, and listen to what they say about their experience. Until we have specific protocols, we will need to use our clinical skills.

The Final Word? Fear can be a good thing for us. If we give it the respect it deserves, it can help us sharpen our skills, remain careful and competent when performing invasive procedures such as deep ear impressions and cerumen removal, and look beyond protocols to explore other questions we should be asking our patients. Fear should also motivate us to listen to our patients, and then listen some more. There is always more to learn from them.

Dennis Van Vliet, AuD

Dennis Van Vliet, AuD

Dennis Van Vliet, AuD, has been a prominent clinician, columnist, educator, and leader in the hearing healthcare field for nearly 40 years, and his professional experience includes working as an educational audiologist, a private-practice owner, and VP of audiology for a large dispensing network. He currently serves as the senior director of professional relations for Starkey Hearing Technologies, Eden Prairie, Minn.

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Original citation for this article: Van Vliet D. The Final Word: Fear Can Motivate You to Be a Better Hearing Healthcare Practitioner. Hearing Review. 2016;23(6):50.?