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BackTable / ENT / Podcast / Episode #29
Improving Access to Hearing Care Services
with Dr. Carrie Nieman
We talk with Dr. Carrie Nieman about improving hearing health disparities among older adults, particularly among vulnerable populations. Her practice and research focuses on an innovative, community-delivered approach to affordable, accessible hearing care.
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BackTable, LLC (Producer). (2021, August 17). Ep. 29 – Improving Access to Hearing Care Services [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Carrie Nieman
Dr. Nieman is an Associate Professor in the Division of Otology, Neurotology and Skull Base surgery in the Johns Hopkins Department of Otolaryngology-Head and Neck Surgery.
Dr. Gopi Shah
Dr. Gopi Shah is a pediatric otolaryngologist and the co-host of BackTable ENT.
Dr. Ashley Agan
Dr. Ashley Agan is an otolaryngologist in Dallas, TX.
Synopsis
In this episode of BackTable ENT, Dr. Carrie Nieman joins Dr. Gopi Shah and Dr. Ashley Agan to discuss disparities in hearing care for older adults and different care models to address these.
Dr. Nieman begins the show by sharing some striking statistics: of the 26 million older Americans who currently experience a clinically significant degree of hearing loss, only 3 million actually use hearing aids. Disparities in hearing care may arise from individual factors such as financial situation and patient education, but they can also arise from structural factors like physical distance from ENTs and audiologists.
Dr. Nieman believes that the conventional model of clinic-based hearing care can be augmented by different models of care delivery, specifically one that makes use of community health workers. She describes the HEARS (Hearing Health Equity Through Accessible Research and Solutions) Program that she developed and how her team trained older adult peer mentors to guide patients through education about over-the-counter hearing devices, communication strategies, and living with hearing loss. She emphasizes that these devices can be a gateway that leads patients to feel more comfortable with hearing aids later on.
For ENTs looking to reduce hearing care disparities, Dr. Nieman recommends that they learn how their patients want to engage with the world, provide patients with multiple options for hearing care, and collaborate with other players who are working towards the same goal.
Resources
HEARS Program: https://jhucochlearcenter.org/hears-hearing-equality-through-accessible-research-solutions.html
Access HEARS: http://accesshears.com/
Hearing Loss Association of America: https://www.hearingloss.org/
Dr. Nieman’s Twitter: @CarrieNiemanMD
Transcript Preview
[Carrie Nieman MD]
When I think about what is equitable, I am thinking about it as a gerontologist in terms of what are those big picture things that matter in terms of, "Am I helping older adults engage in their life or stay engaged, and do what they want and need to do on a daily basis? Is the device the most perfect setting and fit for them? Maybe, maybe not, but if it is a tool that enables them to stay connected, to stay engaged, to do those big picture things that matter to them and matter to aging well, then I think that is the success.
And I think that's what equitable hearing care needs to look like. And so, I think that's also the tension between thinking about things from a two-medical perspective versus a public health and person driven perspective. We do not, for example, in the HEARS randomized controlled trial, our primary endpoint is not number of devices fit or number of how much they gained from their devices, they are things like communication function, social isolation, depression, those are the outcomes that we're looking at that matter.
So, I think that shift and perspective and focus of, "What is the big picture? Why do we do what we do? Why do we want to provide the care we think everybody should and have access to?" So, I think that's a big part of it as well.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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