Selecting a hearing aid and hearing healthcare provider can be a challenging feat. Public advertising is often confusing and contradictory for consumers. Being educated about modern hearing healthcare and hearing instruments allows you to make a more informed decision that will likely result in better outcomes.

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Dr. Megan Johnson, Au.D., discusses hearing health with a patient.

There are two professionals that are licensed to sell and fit hearing aids in Tennessee, audiologists and hearing instrument specialists. Audiologists have gone through extensive training in order to receive a clinical doctorate in audiology. They earn their bachelor's, master's, and doctorate degrees, over the course of eight years. During this time, they learn the neural pathways for transmission of sound from the inner ear to the cortex of the brain, the circuitry and components of a hearing aid, theories of tinnitus and sound perception, ear and hearing dysfunction and appropriate treatment options, hearing conservation programs, acoustic and digital modification strategies for hearing instruments, inner ear balance maladies, and counseling techniques for patients and their family members in regards to hearing loss and intervention.

With extensive time spent at a graduate level in a university setting, audiologists cultivate an environment of critical thinking and life-long learning related to hearing function, amplification strategies, and tinnitus management with a concentration on superior patient care with compassionate counseling.

Throughout the graduate-level study, audiologists are supervised in clinical rotations in various settings (university clinic, hospital, public school system, otolaryngology/ENT practices, Veteran's Administration, and private practice) with exposure to all age levels, assessment styles, and treatment options. During a typical semester at a Tennessee doctoral program, an audiologist graduate student will participate in 12 hours of coursework in addition to 6 hours of clinical work with patients.

They also routinely participate in clinical work with aural rehabilitation therapy to gain a better understanding of the work performed by their speech-language pathology colleagues. During their fourth year of graduate school, audiologists are enrolled in a year-long clinical rotation residency where they log nearly 2,000 patient contact hours in addition to their previous hours acquired during their first three years of graduate study. Applicants for licensure as an audiologist in Tennessee must possess a doctoral degree with an emphasis in audiology from an accredited institution, a current certificate of clinical competence (CCC-A) from American Speech-Language Hearing Association (ASHA) and/ or complete 1,820 clock hours of supervised clinical practicum by a licensed or certified audiologist and pass the Praxis exam for audiology. Licensees must complete ten hours of continuing education per calendar year to maintain their license.

A dispenser is the second professional permitted to sell and issue hearing aids. For initial/apprentice licensure in the state of Tennessee, a person must be at least 18 years of age, have an education equivalent of 2 years of accredited college level coursework, and have passed a written exam. When awarded this apprenticeship, the person must function under the direct supervision of a sponsoring, licensed hearing instrument specialist (HIS) for a period of at least 3 months. The apprentice must complete 60 hours of classroom coursework. Each licensee registered with the Council for Licensing Hearing Instrument Specialists is required to successfully complete 20 hours of continuing education during the two calendar years that precede the licensure renewal year. Two hours of the 20-hour requirement shall pertain to Tennessee statutes and rules concerning hearing instrument specialists.

Hearing aid dispensers often claim that an Audiologist's education concentrates on the diagnostic procedures whereas the dispenser is a hearing instrument specialist (HIS). Unfortunately, this information misleads consumers to believe that audiologists are not as well trained in fitting, programming, and adjusting hearing aids.

Audiologists formally study hearing aid technologies from multiple manufacturers and other amplification technologies while in graduate school. Additionally, they are kept aware of new innovations through their routine office trainings and continuing education hours required to keep their license current. Moreover, most of the professionals from the hearing aid manufacturers that lead trainings are audiologists.

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Furthermore, as many audiologists are providers for Medicare, it is considered insurance fraud for audiologists to bill Medicare for one patient and then provide free evaluation for another patient. Therefore, contrary to many dispenser's advertisements, audiologists cannot legally provide free hearing testing if they are a Medicare provider. Additionally, hearing instrument specialists are not licensed to perform audiological exams. Therefore, their assessments are not considered diagnostic exams.

The true difference between an audiologist and a dispenser is education. When assessing, diagnosing, intervening, and treating hearing dysfunction and tinnitus, an audiologist has more training and expertise in this field of healthcare. When wanting the best services and treatment available to ensure the best quality of life, an audiologist has the more extensive training, knowledge, understanding, and experience.

Here are some tips when searching for your hearing care professional:
1. Ask for the provider's credentials.
2. Look for an Audiologist who deals with several hearing aid manufacturers.
3. Ask if you're entitled to a trial period.

Each patient is a unique individual. You deserve to work with a professional who spends times assessing and addressing your personal hearing concerns and desires. Do not buy hearing aids by mail or internet that claim patients do not need direct contact with their hearing healthcare professional.

Noteworthy: The true difference between an audiologist and a dispenser is education. When assessing, diagnosing, intervening, and treating hearing dysfunction and tinnitus, an audiologist has more training and expertise in this field of healthcare


Johnson Audiology is located at 1618 Gunbarrel Road, Suite 102. They provide diagnostic hearing evaluations and consultations, hearing aid adjustments and repairs to patients ages 10 and up. For more information about their services or to schedule a consultation, call 423-710-1432 or visit