Update: since this article was written, Bose announced that it would be closing their health division and cease sales of their SoundControl™ devices following an independent review that determined that “Bose should no longer be selling hearing aids”

When the professional is taken out of the process, then simple to complicated medical issues can be missed. Here are just a few examples:

Asymmetrical hearing loss – when one ear is better than the other

In hunters and military members, we commonly see the left ear worse than right in right-handed shooters. A difference between ears can also point to a tumor on the auditory nerve.

Conductive hearing loss

Online hearing tests do not do bone conduction, which shows a difference between the hearing nerves and the mechanical parts of the ear (ear drum, middle ear bones).

Mild-moderate conductive hearing loss can often be treated medically and resolved without the need for any type of hearing aid.

Ear wax

Mild conductive hearing loss and asymmetries can be caused by something as common as ear wax! Before an in-person hearing test, the ear canals will be carefully inspected using an otoscope to ensure the canals are clear and there are no abnormalities (holes, infection) of the ear drums.

The audiologists at Alabama Hearing Associates know more about ear wax and how and when to remove it than most other medical professionals. In fact, patients are often referred to us by their primary care physicians for ear wax removal and hearing evaluations.

Hearing beeps vs. understanding speech in noise

The number one complaint for consumers who think they have hearing loss is the inability to understand conversations when competing noise is present. Whether receiving the test online or in person, the traditional hearing test asks you to push a button or respond when you hear a soft tone or beep.

Responses to tones across a range of frequencies or pitches are plotted on a graph called the audiogram. The audiogram provides useful information, such as how much hearing loss you have, and even gives the basis for the hearing aid prescription.

But the audiogram does not tell us how your brain understands speech in quiet or noise, nor does it tell us which hearing aids work best or how to program them for optimal performance.

What advice would you give to somebody that is unsure which option they should choose and is feeling confused?

The intent of OTC is to make hearing healthcare more accessible and affordable to the millions of Americans who could benefit from hearing aids. If OTC encourages more people to address their hearing loss sooner, this would be a win for everyone.

However, in my experience, the intended consumers, adults with mild hearing loss, do not think they have a problem. These are not the consumers who are shopping for hearing aids.

It takes the average person 7-10 years to admit there may be a problem with their hearing. Hearing loss tends to occur gradually and it’s difficult to pinpoint whether the problem is their hearing, the speaker is mumbling, or room acoustics and noise would make it hard for anyone to hear.

By the time most people are ready to take the plunge and get tested, years of auditory deprivation have passed, and auditory processing (speech in noise) issues have developed. These are the consumers who are shopping online and calling our office.

At Alabama Hearing Associates, we believe that hearing care is healthcare. “It is a health issue before it is a commodity purchasing issue.”

Overwhelming research links untreated hearing loss to cognitive decline, falls risk, diabetes, cardiovascular disease and more. Our “Connect 365” Functional Hearing Assessment was developed for those who want a full and detailed assessment of communication, from ears to brain.

Consumers who want to ensure that there are no sacrifices or short-cuts when it comes to medical care for themselves, and their families should call 256-319-4327 to schedule a Functional Hearing Assessment. After the assessment, we will work together to develop a treatment plan, which may or may not include hearing aids.

Finally, for consumers who are confident in their decision to self-diagnose and go with OTC hearing aids, we would urge you to read the fine print, know the guarantees and return policies, and ensure ongoing support.

Electronics, including hearing aids, are not trouble-free and they will require ongoing maintenance to work properly. Ear wax and moisture are common causes for electronic failure.

At Alabama Hearing Associates we have the tools and expertise to provide ear wax and moisture removal for all hearing aids, including Apple and Bose earbuds. We are also happy to “adopt” patients who have purchased hearing aids elsewhere, but find they are unable to manage their hearing needs on their own.

If you have questions or concerns, please call 256-319-4327, and one of our friendly team members will call you back shortly.

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Dr. Jan Liles

Dr. Liles earned her bachelor’s degree from the University of Montevallo and her master’s degree from the University of Alabama. From 1991 to 2001, she worked with two ENT medical practices and initiated one of the first newborn hearing screening programs in the state. In 2002, she was awarded a doctorate in audiology from the University of Florida. Dr. Liles and her longtime best friend, Dr. Sheehy, founded Alabama Hearing Associates in January 2002.
    Real World Adjustments

    Your hearing loss didn't occur overnight, so it will take some time to adjust to the hearing aids. Your patience and persistence will be well worth it.

    AHA Continued Care & Coverage Plan

    $395 Per Year

    Hearing Aids are not a quick fix, and better hearing is truly a journey.

    Our "Continued Care & Coverage Plan" allows you to have the continued support of a hearing expert throughout the year.


    • Dedicated team of hearing care experts at your service
    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance evaluation
    • 100% moisture removal by Redux and cleaning
    • Two tele-audiology appointments
    • Bi-annual hearing aid software update and reprogramming
    • Hearing aid supplies (stock receivers, batteries, domes, and filters)
    • Access to our "speed of light" repair specialists within 2 business days
    • $100 discount on any out-of-warranty factory repairs
    Assessing Outcomes

    To ensure the most success with your hearing devices, we measure the benefits of amplification at the end of your adjustment period—some of the surveys and tests included in the “Connect 365” Functional Hearing Assessment will be repeated to evaluate progress, quality of life, and patient satisfaction with the hearing aids. 

    Wireless Connections

    Most hearing aids automatically come with wireless streaming from smartphones and it has been a lifesaver for those that are working remotely and spending hours on teleconferences. As for other wireless accessories, the two most popular solutions are a small microphone used in less-than-ideal listening environments and a TV streamer that streams the TV’s sound directly into your ears—which can be a lifesaver when watching British TV shows or during football season. If your audiologist believes they would be beneficial for you, they will discuss your options and demonstrate the device in the office.

    Orientation, Counseling, and Follow-up

    Dr. Cliff (the creator of the Best Practice Pro Network) said it best:

    “Having a detailed orientation can dramatically improve how much success you have with hearing treatment.  Counseling & Follow-up care can also ensure that you have success for years to come.  Regular visits to a hearing care provider who spends the time to discuss treatment related information and who will maintain your devices is extremely important.”

    During the orientation, your provider will give you the tools you need to be a successful hearing aid user. Everyone has different learning styles and we want to make sure whatever works best for you is what’s used. After the 75 day adjustment period, routine checkups are necessary to maintain the hearing aids and to ensure optimal hearing healthcare. 

    What Is Real-Ear Measurement?

    Real-ear measurement (REM) is how an audiologist knows that hearing aids are working the way they should in each patient’s ears.

    Ears are as unique as a fingerprint. Because of this, every ear will collect sounds differently.

    Even if I had two patients with the exact same hearing loss and hearing aids, there’s almost no chance the hearing aids would be programmed the same way.

    How do I know my new hearing aids are working properly?

    Without verifying that the hearing aid is working correctly from the start, all of the other steps in the hearing aid fitting process are useless. The most sensitive quality control measure is something called Electroacoustic Analysis. We complete EAA on every new set of hearing aids, before delivery of repaired devices, and on an annual basis.

    Prescription Hearing Technology with a Methodical Plan

    Our community understands better than most what can be achieved when you combine technology with human intelligence and persistence. It is much the same with hearing technology.

    The latest prescription hearing aid technology is incredibly powerful, offering stellar sound quality and performance. Wireless connections allow phone calls, music and television to stream directly to your hearing aids for exceptional clarity.

    But hearing aids do not fit and program themselves! For best outcomes, you also need the human touch and expertise provided by our Doctors of Audiology.

    A Comprehensive12-Step Functional Hearing Assessment

    If you struggle to understand conversations in social situations, restaurants, or other noisy environments, you do not need to schedule a basic hearing test. You certainly don’t need to schedule a “free” hearing screening or online hearing test.

    You need to schedule a “Connect 365” Functional Hearing Assessment at Alabama Hearing Associates!

    Schedule Appointment



    Comprehensive 5-Year treatment plan with premium prescription hearing aid technology

    If you want premium “out of this world” technology and the highest level of service and expert support, our All-Inclusive treatment plan is the right investment for you.

    The All-Inclusive treatment plan offers long-term value for your on-the-go lifestyle, providing everything you need to connect with family and friends for years to come.


    • Stellar  prescription hearing devices from top manufacturer (rechargeable option available)

    • Wireless accessory included at no charge

    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance valutaion

    • Bi-annual hearing aid software update and reprogramming

    • Same day diagnosis and in-office repair during weekdays for devices dropped off before 3:00 p.m.

    • 5-Year full-service repair warranty

    • Unlimited remote hearing aid adjustments

    • 100% moisture removal by Redux and cleaning

    • Hearing aid supplies (stock receivers, batteries, domes and filters)

    • $1000 contribution towards purchase of upgraded technology within 48 months

    • 3-Year replacement warranty for loss or damage (no deductible)

    • Dedicated team of hearing care experts at your service

    • Unlimited teleaudiology appointments

    • Access to our “speed of light” repair specialists

    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.