Beyond the AI Hype: Why Advanced Technology Still Needs Expert Audiology Care

Every few years, a new technology comes along that shakes up the hearing health industry. Right now, all eyes are on artificial intelligence (AI). 

I recently had a patient reach out to me, asking about Fortell AI hearing aids and whether we carried them. While Pacific Hearing & Balance Inc. currently doesn’t carry Fortell, I decided to dig a little deeper and found a report on their 50-hour NYC real-world trial, highlighting just how much buzz these devices are generating. 

It’s easy to see why people are excited; hearing clearly in a crowded restaurant or a noisy family gathering remains the single biggest challenge for anyone with hearing loss, and Fortell AI hearing aids are touted as solving that issue. 

As an audiologist, I love seeing innovation in our field. However, it’s crucial to understand both what AI hearing technology does and why high-tech hardware is only half of the equation when it comes to hearing well. 

Beyond the Technology: Understanding the Limitations of Direct-to-Consumer Hearing Aids 

You may have seen headlines about new direct-to-consumer devices, such as Fortell AI hearing aids, which promise to revolutionize hearing in noisy environments through advanced machine learning algorithms. 

However, Fortell currently has only physical patient clinics in New York City, Boston, Greenwich, and Palm Beach, while selling to customers across the United States. Although the company may expand into other cities, it’s still a startup, and access to in-person appointments may be limited. 

It’s also important to consider the long-term availability of service, repairs, and replacement devices when choosing hearing aids; many large corporations have introduced their own hearing aids only to later discontinue their products or exit the market. For example, companies such as 3M, Jabra, Bose, Bausch + Lomb, Siemens, and Eargo have all had changes in their hearing aid offerings or market presence.When manufacturers discontinue products or cease operations, patients are left with limited options for ongoing support. 

The Difference Expertise Makes in Hearing Healthcare 

People often think of hearing aids as products, but they are more like artificial hips or knees. You can purchase the best artificial hip or knee in the world, but if it is not properly implanted, you won’t regain optimal mobility. Similarly, the skill and expertise of a Doctor of Audiology in selecting, fitting, and programming hearing aids is just as important, or even more important than, the device itself. 

As legendary Green Bay Packers coach Vince Lombardi once said, “Practice does not make perfect. Only perfect practice makes perfect.” 

At Pacific Hearing & Balance Inc., we have 10 nationally regarded Doctors of Audiology available to provide expert, personalized care designed to meet and exceed your individual hearing and balance healthcare needs. 

How AI Is Transforming Hearing Aid Technology 

When people hear "AI in hearing aids," they often wonder if the device is thinking for them. In reality, AI in modern audiology primarily refers to Deep Neural Networks (DNN) and machine learning algorithms. 

Here’s how it works: 

• Sound Scene Classification: Traditional hearing aids use basic rules to adjust settings (e.g., "If loud, turn down"). AI-driven hearing aids have been trained on millions of real-world sound scenarios and can analyze your acoustic environment thousands of times per second to instantly distinguish between speech, background noise, music, and wind. 

• Intelligent Noise Reduction: Instead of just turning down all background sound, which can make speech sound muffled, AI attempts to separate the speech signal from competing noise, isolating human voices while suppressing unwanted background chatter. 

This technology holds incredible promise. When applied correctly, it can reduce listening effort and make conversations in noisy places much more natural. 

Why Great Technology Isn't Enough: The Limits of Telehealth-Only Models 

While direct-to-consumer, telehealth-only models make ordering hearing aids as simple as buying a pair of headphones online, hearing health is far more complex than a standard consumer electronics purchase. 

AI can process sound, but it can’t examine your ears or adapt to your unique physical anatomy. The clinical, in-person side of hearing care remains essential for not just your best hearing at the moment of fitting, but better outcomes in the long run. 

There are several aspects of hearing care that can’t be adequately addressed without in-person professional care. 

1. Physical Ear Health & Earwax (Cerumen) 

An AI algorithm can’t examine your ear canal for physical issues, such as excessive earwax, fluid behind the eardrum, or blockages. These conditions can significantly reduce hearing ability and may affect hearing aid performance. In fact, earwax buildup is the most common cause of hearing aid malfunction and repairs. 

Fitting a hearing aid in an ear canal blocked by wax won’t address the underlying cause of hearing difficulties and may push wax deeper into the canal, affecting comfort and device performance. An in-person ear examination before fitting helps identify earwax buildup and other conditions that may affect hearing or require medical attention. Under California law, audiologists must recommend a physician consultation when significant earwax accumulation or other specified warning signs are present. 

2. Physical Fit: Domes, Venting & Receivers 

No two ear canals are shaped the same. The physical fit of a hearing aid, including correct dome sizing, custom tubing, and acoustic venting, dictates how sound behaves inside your ear. 

• If a vent is too large, low-frequency sound escapes, and speech loses richness 

• If a vent is too small, your own voice sounds like you're talking inside a barrel (the occlusion effect) 

• Incorrect receiver (speaker) wire length or dome size can cause physical pain, poor retention, or feedback (whistling) 

3. Sound Quality vs. Clarity 

Noise reduction sounds great in theory, but aggressive digital processing can sometimes create artifacts, making sound feel artificial or over-processed.  

Balancing noise suppression with crisp speech clarity requires precise, personalized fine-tuning. A Doctor of Audiology can program hearing aids to each individual’s specific hearing loss and listening environments, making adjustments that automated software or a brief remote consultation are unable to fully address. 

4. Hardware Maintenance & Repairs 

Hearing aids operate in a warm, moist environment every single day: your ears! Component issues like receiver failures, clogged wax guards, or Bluetooth connectivity glitches require hands-on maintenance, cleaning, and, occasionally, physical part replacements that can't be handled over a video call. 

Technology Is a Tool; Expert Care Is the Solution 

AI is a fantastic tool, and many prescription hearing aids from leading medical manufacturers already incorporate sophisticated AI and DNN features.  

But a hearing aid is not a plug-and-play gadget; it is a specialized medical device. 

The most advanced algorithm in the world cannot deliver optimal results if: 

• The device isn't programmed to your precise diagnostic audiogram 

• Real-Ear Measurement (REM) verification isn't performed to confirm that sound levels match your ear canal acoustics 

• The physical fit is incorrect or uncomfortable 

At Pacific Hearing & Balance, Inc., our goal is to help you navigate the noise, both acoustic and technological. We continuously evaluate emerging technologies, including new AI developments, to ensure our patients have access to solutions that are both cutting-edge and medically sound. 

If you’ve read about a new hearing technology and want to know how it compares to your current setup, or if you’re ready for a comprehensive hearing evaluation, give us a call.  

We’re here to ensure you get not just the right technology, but the right care to go with it. 

Frequently Asked Questions (FAQ) 

Q: How does artificial intelligence actually improve my ability to hear in noisy places? 

A: Traditional hearing aids rely on simple preset rules, such as lowering overall volume when surrounding sounds reach a certain decibel level. AI technology, on the other hand, analyzes your environment thousands of times per second to separate human speech from competing background noise. This allows the hearing aid to isolate and enhance speech while suppressing unwanted background sounds like chatter or traffic, significantly reducing the mental effort required to follow conversations in busy settings. 

Q: What are the risks or downsides of buying direct-to-consumer AI hearing aids through telehealth? 

A: While ordering online is convenient, a remote-only approach misses critical physical health checks and precise acoustic fittings. An online platform cannot perform an otoscopic examination to check for earwax buildup, fluid, or canal blockages that directly impact your hearing. Without in-person Real-Ear Measurement (REM) verification, even the most advanced AI chip may underperform because it isn't accurately calibrated to the physical acoustics of your unique ear canal.  

Research indicates that approximately 20-50% of over-the-counter (OTC) hearing aids are returned, highlighting the challenges consumers face when selecting and fitting devices without personalized professional guidance. 

Q: Do prescription hearing aids fitted by an audiologist also offer AI features? 

A: Yes, absolutely! Leading medical-grade hearing aid manufacturers integrate advanced AI, deep learning, and machine learning into their prescription devices. The key advantage of choosing prescription AI devices is pairing cutting-edge software with expert clinical care: Your audiologist precisely programs the AI algorithms around your diagnostic audiogram, ensures proper physical fitting and venting, and fine-tunes sound processing to maintain speech clarity without distortion. 

There are six major hearing aid manufacturers that account for approximately 96% of the global market, and at Pacific Hearing & Balance, we offer hearing aids from all six, allowing us to recommend solutions tailored to your individual hearing loss and listening needs.