Hearing aid prescribing: is the specialist opinion necessary?

A restructuring of the service for provision of hearing aids has been proposed by the Royal National Institute for the Deaf. This is based on the assumption that very few patients referred for hearing aids have significant ear disease and it is not necessary for them to see an ENT specialist. The case notes of 200 consecutive patients referred to the Hearing Aid clinic were reviewed. In only half of these would a hearing aid have been prescribed without a specialist opinion. The remainder either did not need a hearing aid or required further investigation and surgical or medical treatment. In addition there was significant evidence of lack of expertise amongst General Practitioners in recognizing ear disorders. It is imperative that any patient requiring a hearing aid be seen by someone experienced in otology rather than be dealt with by the General Practitioner alone.