What's the difference between an audiologist and a hearing instrument specialist?

Chelsea Walters, BS, BC-HIS

Hearing Healthcare Provider in Broomfield

23 May 2016 - 36.3K Views

I think everyone has made great points about differences in required training, education, and scope of practice.  Before visiting any hearing care practitioner, it is important to consider their credentials, reviews, and knowledge base.  There are varying degrees of education required in this field.  Some professionals go beyond the minimum requirements for education and training.  I myself have a Bachelor's Degree in Audiology & Speech-Language Science and Board Certification in Hearing Instrument Science, meaning 4 years of education and 2 years of training.  As many Audiologists have also noted, their scope of practice includes more services.  This does not necessarily mean that they perform all of those services.  Many audiologists do not help assess or treat balance/vestibular or auditory processing issues.  Some don't remove ear wax.  On the flip side, some Hearing Instrument Specialists may go well beyond a basic hearing test and fitting hearing aids.  In my practice, we do speech in noise tests, verification of hearing device programming, education programs, hearing conservation for industrial workers and musicians, wax removal, and counseling for those with hearing loss and their families.  We also improve their quality of life through better hearing.

In my experience, graduate degrees don't always equate with the ability to translate that knowledge into a solution that works for every client.  After doing your research, go in for an evaluation with any of these professionals and if you don't feel comfortable get a second opinion.  I truly believe that hearing care professionals found this field because they want to help people.  We have every guests' best interest at heart and you have trust your gut about the one that feels the best for you in addition to evaluating the results you are getting. 

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Chelsea W
Chelsea W 27 September 2016
One thing that others have mentioned is that Hearing Instrument Specialists have a limited scope of practice compared to that of an Audiologist or ENT. Should any result be found during an evaluation and case history that requires a referral to someone with a greater scope of practice, all of these providers will refer to the appropriate professional. Hearing Instrument Specialists and Audiologists refer to ENTs, Otologists, and sometimes other professionals should that be in the best interest of the patient. We are all well trained on what is within our range of abilities and what is beyond it.

Samina Khan, MA

Hearing Healthcare Provider in Westborough

23 May 2016 - 36.3K Views

One key difference between an audiologist and a “hearing aid specialist” is the minimum amount of education required. Audiologists must currently earn a professional degree (the

Doctor of Audiology, or Au.D.) which typically involves 4 years of academic and clinical training in audiology, following a traditional 4-year bachelor’s degree. By contrast, very few educational requirements need to be met (they vary by state) before a non-audiologist can sell hearing aids; in fact, in many states, the minimum requirement is a high school diploma, passing a license exam, and some form of brief apprenticeship with a licensed hearing aid specialist. Another major difference between an audiologist and a hearing aid specialist lies within their scopes of practice. Audiologists are licensed and trained to manage many areas of hearing healthcare including:

  • Comprehensive audiological evaluations including tests of hearing sensitivity, speech understanding, middle ear function, inner ear and auditory nerve function

  • Diagnostic tests for balance/dizziness disorders

  • Auditory processing evaluations for infants, children and adults

  • Design, selection, fitting and verification of hearing instruments and

    assistive listening devices

  • Design, selection, installation and monitoring of classroom amplification


  • Rehabilitation therapy for hearing disorders which

    might include strategies to improve aided and unaided hearing, speech-reading (including lip- reading) and sign language

  • Rehabilitation for auditory processing disorders

  • Patient and family counseling about living with hearing loss

  • Development of hearing conservation programs

  • Research and development of new evaluation techniques and rehabilitation strategies

• Rehabilitation for vestibular (balance) disorders

• Cerumen (earwax) management

• Evaluation and management of tinnitus and


By contrast, the scope of practice for hearing aid specialists is very limited. They perform the following services:

  • Basic hearing tests exclusively for the purpose of selling hearing aids to adults

  • Hearing aid fitting and sales 

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Scot F
Scot F 07 January 2017
One important thing to note is that while most states require only a high school diploma to obtain a dispensers license, this does not mean that dispensers are uneducated. Nationally, the average education of dispensers is a bachelor's degree, not the high school diploma, meaning some have more education and some have less. Chelsea Walters, who commented above, has a BA in Speech and Hearing. I also obtained a BS before becoming a dispenser back in 1994, with the intention of continuing on for my masters (2004) and then doctorate (2016--finally!) in audiology. I have dispenser friends who have their MBAs and PhDs in unrelated field (sociology, psychology, business, etc.). These aren't stupid people, just ones who started down one path and then found--and fell in love with--hearing science.
Jim M
Jim M 24 January 2017
ENT and audiologist told me permanent damage to my left ear and no hearing aid would help. Hear aid specialist fitted me and I can hear in the bad ear. Hooray!!!
Member 14 February 2017
This person is bias with Hearing Instrument Specialist. I know because I have been a Licensed HIS for over 17 years and 2 years prior working in a hearing center. Experience is just as important as the medical understanding. HIS cannot do some things on this list but we do most of it. Many AUD.'s work and do the exact same job as a HIS. It is important to get a good comfortable feel with your HIS. Know they are more than just a 'sales' person. That they have your best interest at heart and refer you to your doctor or ENT when it is important to do so.
Professional Member
Professional Member 25 May 2018
So, let me set the record straight here.... Hearing Aid Specialists are extensively immersed in the education of HOW TO FIT A HEARING AID. Audiology is the study of sound and the Human ear. The fact is, most Audiologists have not been educated in the fitment of a hearing aid until they begin to dispense. Yes, they do endure many years of "Higher Education," which is why they have ONLY ONE AUTHORITY BEYOND A HEARING AID SPECIALIST: THEY CAN SUPPLY AN OFFICIAL DIAGNOSIS OF VARIOUS REALTED AILMENTS.

Christopher S. Frink, AuD

Audiologist in Salem

20 May 2016 - 36.3K Views

The primary differences between an audiologist and a hearing instrument specialist (or "dispensers") is their level of training and scope of practice.  Audiologists have either a masters degree or doctorate in the field of audiology ( total of 6 - 8 years of higher education), and as such have an extensive amount of training in just about everything relating to the ear.  By contrast, hearing instrument specialists have primarily on-the-job training in a less formal manner, although a few community colleges offer 2-year associates degrees in hearing instrument science (but the majority of dispensers do not have this).  Because they relay primarily on on-the-job-training, the dispenser is initially only as good as their trainer, although some excel in the field and actually become better than their trainers.  You could apply a similar logic to audiologists, in that they are only as good as the program they graduated from, but since their training is more formal and involves a greater number of instructors, the quality of training is usually very good for audiologists.

Experience and attitude do count for something, however, so regardless of training the personality of the audiologist or dispenser counts a lot when it comes to a patient's success with hearing aids.  There are many dispensers with a vast amount of experience who can actually run circles around newly-graduated audiologists simply because of their time in the profession.  However, the lengthy training program required for audiologists provides an excellent screening system to find people who are dedicated to the patient; someone who invests as much as eight years into higher education isn't getting into it just for a paycheck, but is looking for a long-term career.  For most hearing instrument specialists, however, this is often a second or even third career for them.

The scope of practice is another consideration, for while both professions work with hearing aids, audiologists have a significantly larger wealth of knowledge.  Dispensers are trained strictly in hearing evaluations for the purpose of fitting hearing aids, while audiologists are trained for full diagnostic evaluations of the patient's entire auditory system, from the outer ear to the brain.  This being the case, audiologists are best suited for diagnosing the actual cause of the hearing loss for determining the best treatment methodology for the patient, which is especially important for patients who are considering hearing aids for the first time and don't know for sure what the cause of their hearing loss is.  Since hearing loss can have many causes, some of which should require medical attention BEFORE getting hearing aids, it's recommended that the first hearing evaluation be conducted by an audiologist for a clinical diagnosis, regardless of whether the person decides to purchase hearing aids from a dispenser or an audiologist.

Their training also isn't limited strictly to hearing, but also to the balance system of the ear.  As much as 70% of our balance system relates to the vestibular portion of the ear, so audiologists have the evaluation of these problems included within their scope of practice.  There are also quite a few other lesser seen aspects to an audiologists scope of practice, such as interoperative monitoring, industrial audiologist (for protecting workers in high noise environments) and forensic audiology (lending their knowledge and expertise to court cases relating to hearing and sound in general).  

To sum it up, if a consumer is concerned about their hearing and has never had a diagnostic evelaution to determine the cause of the hearing loss, it is best that they have a diagnostic evaluation by an audiologist first.  After pther medical problems are ruled out and it is determined that a hearing aid is the best solution for the hearing loss, the consumer could choose to go to either a dispenser or an audiologist.  The experience, reputation and training of the hearing professional matter significantly in the ultimate decision of where to go.

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Jennifer F
Jennifer F 07 January 2017
Unfortunately, you Sir are wrong. You are misleading the American people with your biased opinion. First off, there is a difference between being a "Dispenser" and a "Specialist". And that difference is a "Specialist" holds a Board Certification license as well as a State license. And both Dispenser's and BC HIS licensees have a lot more educational training than just "on-the-job" training as you have put it. And excuse me for stating so but, a lot of Audiologist's are not as smart as you would like them to be. I have seen plenty of their mistakes (more than I care to have). From fitting paitents with HP hearing aids when there was not loss, to causing extensive damage to one patients Auditory system by over amplifying an already fragile middle ear. Now I am not saying that being a Dispenser/Specialist is better or more valuable than being an Audiologist mind you. All I am saying is that both are respected professions and should be regarded as such. Instead of working against each other, we should be working together with the mutual goal of helping the world hear. Thank you. Sincerely, Jennifer Frazelle HA 8174
Scot F
Scot F 07 January 2017 Replied to Jennifer F
I think you're taking offense at a portion of what I'm saying without reading it entirely. Please re-read it after this and you will understand more. I'm uniquely qualified to offer an opinion in this area, as I was a dispenser for ten years before starting my audiology degree. Here's my final statement for your review, however: "After other medical problems are ruled out and it is determined that a hearing aid is the best solution for the hearing loss, the consumer could choose to go to either a dispenser or an audiologist. The experience, reputation and training of the hearing professional matter significantly in the ultimate decision of where to go." The last sentence applies to BOTH professions, and I've seen good and bad in both. So, while you may feel I have disparaged hearing instrument specialists (or dispenser; I do acknowledge and concede the difference), I was stating that while education is important, a "go-to" attitude on the part of the AuD OR HIS plays a vastly more important role in providing results for the patient. I think on this we can agree. Yes, there is a difference between a "dispenser" and a "specialist", the latter having more formal training and experience as you indicated; I listed both simply for the fact that a consumer reading this will see either advertised, and technically they are in the same category; states and the federal government recognize the difference between audiologists and dispensers, but do not necessarily acknowledge the difference between dispenser and HIS. As an example, dispensers are licensed in some states, but not in others. Some states also do not recognize or require the BC-HIS. But I agree with you: having the BC-HIS, which is typically acquired after someone is a dispenser and had years of experience and training, is a higher level within the profession, similar to how some audiologists have masters degrees and others have doctorates. I will also acknowledge that yes, some audiologists DON'T know what they are doing when fitting hearing aids. The difference in educational training I mentioned for dispensers was in relation to a formal version (i.e. university) vs. training on-the-job. As I stated before, most dispensers have not sat in classes in a university specifically for hearing science (also, as I also stated, there are some very good specific programs (AA and BA) in Washington, Missouri, and Canada which serve as an excellent foundation and a more formal training than most dispensers receive. Dispensers very often make up for it with continuing education and networking, which can sometimes provide a better basis for real-world application of the knowledge than what is trained in the university. Having been a dispenser prior to my audiology degree, I was frequently at odds with my professors when they presented viewpoints that were contrary to my experience (I worked at an audiology clinic for over 10 years prior to entering my masters program). Most of the academicians, by contrast, hadn't been in clinical practice for over 20 years. When you mention over-amplification, neither profession is immune to making mistakes. Formal training and general experience can overcome this, and both groups have this available. I remember an experience with an audiologist on my staff who was essentially overamplifying his patient. He had fit the patient with a power BTE and non-occluding earmolds in an attempt to reach the high frequencies (where the thresholds were 90dB or worse). The patient was complaining of occlusion, of course, since their low frequency thresholds were around 25-30dB (steeply sloping loss). Not only was there occlusion, but upward spread of masking was likely reducing speech intelligibility as well. The highs were likely dead zones (later proven by administration of the TEN test), so I took over the case, refitting the patient with traditional skeleton molds and appropriate venting. Guess what? better word recognition and no sense of occlusion. So, this story helps to prove some of your point, but I wouldn't say my opinion was overly biased or self-serving. You'll find I probably agree with you more than I disagree, so I'd suggest you re-read my statement with a more open mind and see if you might agree a bit more than you originally did.
Scot F
Scot F 07 January 2017 Replied to Jennifer F
See also my comment(s) on the other posts, below.

Matt Watson, HIS

Hearing Instrument Specialist in Kitchener

28 September 2017 - 22.4K Views

Just to provide a different perspective here, I am a Hearing Instrument Specialist in Ontario, Canada.  The rules are a bit different up here.

An Audiologist is required to have a bachelor's degree in something, followed by a master's degree in Audiology.  I believe their education requirements are very similar to the ones in the United States, so I won't rehash them.

The difference here is that there are two other categories of hearing care professional.  A Hearing Instrument Dispenser is a designation that can no longer be taken in Ontario.  They are trained in the specifics of hearing aid maintenance and programming, but do not do any hearing testing.  This used to be the designation obtained after one to two years of the Hearing Instrument Specialist college course.  The Hearing Instrument Specialist is a two to three year diploma that you are required to have in order to obtain work in the field.  This is followed by 1,000 supervised hours in a clinic with a Hearing Instrument Specialist or Audiologist with a minimum amount of experience and a written test known as the International Licensing Exam created by the International Hearing Society.  Both the HIS and HID are required to be members of the Association of Hearing Instrument Practitioners of Ontario and must obtain 12 continuing education credits a year to maintain and update their knowledge base.  The biggest difference in scope of practice is that an Audiologist can test children, but their first hearing aid prescription must come from an Ear, Nose and Throat physician.  An Audiologist is also able to prescribe a hearing aid, so long as they are not financially related to the sale of that hearing aid, whereas an HIS like myself provides a hearing aid recommendation to the patient's family doctor, who then provides the prescription.

I believe I speak for most of my colleagues when I say that we are in this for the good of our patients.  It is much more than just a paycheque.

If anyone is interested in more info on the Canadian system our association AHIP's website is www.helpmehear.ca and CASLPO (College of Audiologists and Speech-Language Pathologists of Ontario) is www.caslpo.com

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Christine Pickup, AuD

Doctor of Audiology in Rupert

20 May 2016 - 36.3K Views

There have been some excellent answers already.  I would encourage you to learn about your state's licensure laws.  For hearing instrument specialiats, some states require education beyond high school and hours of supervised training, while others only require a high school diploma and passing the state license examination.  Audiology training is much more consistent.  Audiologists undergo 6-8 years of education beyond high school, in programs that must meet requirements of certification boards.  That being said, each individual provider is ulitmately responsible for how they care for the patient.  Be sure that your hearing healthcare provider assesses your ability to hear in noise, asks about your lifestyle and hearing needs, and uses independent verification of your fitting for optimal results.  

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Sarah Chipman

Professional Member

21 May 2016 - 36.3K Views

There are already lots of great answers here regarding the education, training, and scope of practice differences between audiologists and hearing aid dispensers. I want to bring up one more significant difference between an audiologist and a hearing aid dispenser: federal law specifies that children with hear loss should be evaluated and treated by an audiologist. See Code of Federal Regulations Title 21 801.420 FDA rule for labeling of hearing aids (user instructional brochure must contain this notice):

 "CHILDREN WITH HEARING LOSS In addition to seeing a physician for a medical evaluation, a child with a hearing loss should be directed to an audiologist for evaluation and rehabilitation since hearing loss may cause problems in language development and the educational and social growth of a child. An audiologist is qualified by training and experience to assist in the evaluation and rehabilitation of a child with a hearing loss."


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Jared Young, AuD

Doctor of Audiology in Utah County

20 May 2016 - 36.3K Views

Education is the fundamental difference between an audiologist and a hearing instrument specialist (HIS).

The current minimum education to become an audiologist is a doctorate degree in audiology.  By comparison to learn everything you need to pass the HIS test and begin working as a hearing instrument specialist can be done in a 3 day workshop.

Both are legally qualified to sell a hearing aid.  Consumer Reports did an article on hearing aids and recommended visiting several places and finding an audiologist you were happy with then buying your hearing aids.  

A second difference between an audiologist and a hearing instrument specialist is what they are legally qualified to do, called a scope of practice.  In some states a HIS is not allowed to clean ear wax out of an ear, Medicare and Medicaid do not recognize an HIS as a qualified person to bill for a hearing test.  In 2005 an HIS could work under a ENT (ear nose and throat physcian and bill the hearing test to Medicare under the doctor, in 2006 they changed and would no longer pay for a test performed by a HIS even under the supervision of an ENT).  Several insurance companies follow what Medicare policies are and therefore will not pay for a hearing test performed by a HIS but would for a test performed by an audiologist. 


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Joshua Patrick, BA

Hearing Healthcare Provider in West Monroe

20 May 2016 - 36.3K Views

Mostly the difference is in level of education and clinical certification. Audiologists have been required for over a decade to obtain a Doctorate level degree and complete certification competency requirements. Hearing Instrument Specialists and their credentials vary from state to state but mostly involve some form of higher education, as well as a length of time apprenticing under a licensed HIS before taking a practical and written examination to obtain licensure to be a state board approved Hearing Instrument Specialist. The clinical difference is that HIS specialises in the fitting of hearing aids, whereas the audiologist may or may not. In my experience as a hearing instrument specialist for over 7 years and having a degree in Audiology it is dependent on how much practical experience the hearing care professional has. Hearing aids are generally considered a luxury item, and therefore a certain amount of sales technique is required by the professional. HIS's tend to be stronger with this than audiologists. Hope this was helpful

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Scot F
Scot F 07 January 2017
As an audiologist, I found your assessment pretty good. Audiologists are trained in a broad spectrum of disorders of the ear, not just hearing aids. Some (like myself) specialize with hearing aids, while other focus on dizziness evaluations, industrial testing, etc. HIS do tend to be better at the sales aspect because of their training and it is their primary source of income. And practical experience and attitude matter a lot, regardless of whether the person is an audiologist or dispenser. If properly trained in the first place (which doesn't always happen), a dispenser with 7 or more years of experience is often better at fitting hearing aids than a newly-minted audiologist straight out of their doctoral program. In my case, I had the advantage of both: 10 years as a dispenser, followed by a masters degree and most recently a doctorate in audiology. I've know great and lousy dispensers, and I've known great and lousy audiologists. I believe that formal training is very valuable, and advocate for 2-year associate programs in hearing science being a good entry-level for the dispenser profession. From there, its about ethics, continuing education, and attitude.
Martin J
Martin J 01 May 2017
Mr. Patrick"s comment of "having a degree in Audiology..." could easily be misconstrued, leading a consumer to believe that he is an audiologist. Obviously he is not, given that his degree is a BA. Martin John, Au.D., Audiologist

Julie Norin, AuD

Doctor of Audiology in Baltimore

20 May 2016 - 36.4K Views

An audiologist must have either a Masters degree or a Doctorate degree from an accredited university and must be licensed by their state in order to dispense hearing aids and perform diagnostic testing to determine any number of hearing and ear-related pathologies. Current requirements are that anyone entering the field must have a doctorate. 

A hearing aid dispenser or hearing instrument specialist does not need a college degree and only needs to complete a several week course followed by clinic observation hours in order to become licensed to dispense hearing aids. They are not allowed to diagnose hearing loss or other pathologies and can only perform testing for the purpose of programming a hearing aid.

Given the huge variability in requirements between the two, an audiologist has much more extensive knowledge of not only hearing aids, but hearing health and ear-related pathologies, as well as risk factors for hearing loss, other potential indicators of hearing loss, and specifics of programming and how programming changes impact hearing aid use and performance. 

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Scot F
Scot F 07 January 2017
There is much truth to what you said, but know that the licensing requirements for dispensers vary from state to state. As an example, Washington state DOES require a 2-year associates degree specifically in hearing science, as does all of Canada. Oregon requires 520 hours of on-the-job training plus completion of the IHS online training program (30 modules, 30 weeks) prior to obtaining TEMPORARY licensure. Prior to temporary licensure, they have to be directly supervised by their mentor (line-of-site, same room). After obtaining temporary licensure, they have to continue to be supervised (although now they can be semi-autonomous, indirectly supervised) and six for a 2-day practical and written exam after six to twelve months of additional training. Some states, however, match what you described, and a few don't even having licensing or training requirements. So there IS a wide degree of variability in dispenser training from state-to-state, which is why audiology programs, which are much more formal, usually provide a more consistent product. We shouldn't, however, paint a very big brush regarding dispensers. While there are some lousy ones out there, the majority do an adequate or even an exceptional job for their patients. And there are some audiologists out there who stink as well.

Michael Schmit

Professional Member

20 May 2016 - 36.3K Views

Hearing Instrument Specialists, similar to an optician, are trained in the fitting of hearing instruments , which includes a complete hearing test to determine whether or not the individual has a loss that would benefit from amplification.  A Board Certified Hearing Instrument Specialist has at least 2 years’ experience and is typically trained in cerumen (ear wax) management as well.  Part of the process is to do discovery and testing that may lead to medical issues that would be then referred to an ENT (Ear Nose Throat physician).  The Hearing Instrument Specialist is typically the best qualified to properly fit hearing aids and do the required follow up service.  Since their focus is purely on hearing aids and satisfactory of the fittings they are regarded as the experts.  However, as with any profession, the more experience (years and trainings) the better they are at offering solutions.

Audiologists, similar to an optometrist or chiropractor, are now required to have a doctorate level education .  They are highly trained in diseases of the ear and balance disorders.  Occasionally they are able to track down your actual cause of hearing loss.  Until about 20 years ago it was considered unethical for an Audiologist to dispense hearing aids.  Recently however they have been allowed to dispense hearing aids to supplement their income.  An audiologists scope of practice is so large that it is difficult for them to have expert training on both disciplines.

In my 28 years’ experience I have worked with both specialists and audiologists that are very competent and some that are not.  You need to develop a long term relationship with your provider and it is best to interview at least 3 to make sure you are comfortable and trust their expertise. 

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Scot F
Scot F 20 May 2016
Hi Michael. Your comment about audiologists "recently" being allowed to fit hearing aids is a bit misleading, as it has been since 1977--about 40 years, which is longer than your indicated 28 years of experience.
Michael S
Michael S 20 May 2016 Replied to Scot F
It depends on the organization that the audiologist is/was associated to. ASHA had a much different view. No matter the "exact date" it is still important to note that Specialists have been dispensing hearing aids for over a hundred years while audiologists are newer to the practice.
Scot F
Scot F 20 May 2016 Replied to Michael S
I'm referring to ASHA, which changed it's guidelines in 1977. Not sure what other organizations have an official view on it, as both ADA and AAA have held it since their inception that it is perfectly ethical and appropriate for audiologists to fit hearing aids. Again, I don't consider 40 years (ASHA) to be "recent." OTher than that, I pretty much agree with the rest of your assessment, that both audiologists and hearing instrument specialists can be competent fitters of hearing aids. The analogy of audiologists to chiropractors and optometrists is very appropriate, and moreso than comparing audiologists to physicians. Yes, many audiologists have doctorates, but it doesn't make them physicians. I'm personally annoyed when some of my colleagues put on an ivory tower towards dispensers, many of whom I would actually more likely refer to than some audiologists.
Alexandra T
Alexandra T 23 May 2016
I agree with your comment that your relationship and confidence in your provider is of most importance. It is inaccurate and misleading to say Hearing Instrument Specialists are the best qualified and/or the experts over an audiologist, however. Many audiologists specialize in hearing aid fittings and have excellent follow-up care and service. They also have the educational background to support their findings and recommendations. An expert is someone that has the highest level of knowledge in a particular area so it incorrect to report HIS is an expert over an audiologist for hearing aid fittings and dispensing.
Paul D
Paul D 21 January 2017
I finished grad school in audiology in 1976 and at that time it was considered unethical for an audiologist to dispense Hearing Aids. I did not pursue my audiology license because of this. Over the 46 years I have been in practice as a dispenser I have had 15 audiologist work for me. Although I have had several who were top notch, the majority needed more training. Even though I sold out to a manufacturer owned chain store I can't say enough for the private practice. I retired early (at 70) because of my ethical disagreement with the group that purchased me. Even though the chain store seems to be getting bigger, I believe that the private practice will win out, especially for the patient.

Sheri Gostomelsky, AuD

Doctor of Audiology in Deerfield

20 May 2016 - 36.3K Views

A hearing health provider's title is distinguished by level of education which determines the type of service and care allowed. A dispensing license can be obtained with the minimum of a high school degree. To practice as an audiologist it currently requires completing 8 years of education and training. Both disciplines are able to dispense hearing devices. Only an audiologist can evaluate for balance, dizziness, tinnitus and perform wax removal. Both disciplines can help hearing but the audiologist concentrates on the whole person instead of the isolated concern.
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Scot F
Scot F 07 January 2017
Please note that requirements for dispensers vary by state; Washington requires an associates degree in hearing science, and Missouri has a bachelor's degree program. Canada also requires an AA. One important thing to note is that while most states require only a high school diploma to obtain a dispensers license, this does not mean that dispensers are uneducated. Nationally, the average education of dispensers is a bachelor's degree, not the high school diploma, meaning some have more education and some have less. Chelsea Walters, who commented above, has a BA in Speech and Hearing. I also obtained a BS before becoming a dispenser back in 1994, with the intention of continuing on for my masters (2004) and then doctorate (2016--finally!) in audiology. I have dispenser friends who have their MBAs and PhDs in unrelated field (sociology, psychology, business, etc.). These aren't stupid people, just ones who started down one path and then found--and fell in love with--hearing science.

Alicia D.D. Spoor, AuD

Doctor of Audiology in Highland

20 May 2016 - 36.3K Views

In short, the answer is education and state licensure requirements.  A nice overview can be found on the website for the Academy of Doctors of Audiology here (PDF).  

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Joe Perez

Hearing Healthcare Provider in Salinas

30 October 2018 - 7.88K Views

“Keep it simple simpleton”


A formally educated professional who diagnoses and treats hearing and balance problems. An audiologist has received an Au.D. (Doctorate in Audiology), or a Master's or Doctoral degree from an accredited university graduate program in audiology. 


Hearing Instrument Specialist / Hearing Aid Dispenser-  

A licensed professional specifically educated to perform accurate audiometric testing for the sole purpose of successfully fitting hearing systems. This type of specialist will have a profound knowledge with nano computing and fitting formulas, to best provide solutions for an individual leveraging cutting edge technologies. To hear and understand... 

In summary: If you worry of disease of the ear? Call upon an Audiologist. If you feel your hearing is less sensitive seek an instrument specialist cause there central focus is identifying the reason and providing excellent options in the form of technology...

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Jonathan S
Jonathan S 20 February 2019
Your point about audiologists needing a hearing aid dispensing license in order to dispense hearing aids isn't really all that true.  There are only about 15 states that currently require this.  Most states only require a license to practice audiology, and the ability to dispense hearing aids is including in the audiology license.  Separate licensure for hearing aid dispensing used to be much more wide-spread than it is today.


Robert J
Robert J 20 May 2016
an audiologist has a degree in audiology. Some audiologists dispense hearing aids. A hearing Instrument specialist does not have a degree in audiology. In California both must take the same test in order to fit hearing aids. There are some very good hearing aid dispensers as well as audiologists that correct hearing loss The most important consideration is the skill set of the provider
Margaret H
Margaret H 23 May 2016
I'd have to disagree with Patrick about the emphasis on sales technique in hearing aid fitting. I realize that some of the audiologists have emphasized their more comprehensive educational backgrounds, as compared to an HIS, and some have pointed out that the scope of audiological practice includes specialized evaluation and remediation protocols, which are not within an HIS' training. However, if we are strictly speaking about how hearing aids are fit, then there are some important things for consumers to consider. First, is the equipment being suggested to them one of the best options (there may be more than one) for their hearing loss, physical situation and other lifestyle considerations, and financial status. This might be a sales technique, but it is one that actually puts the consumer first. Secondly, are there ways for the consumer to know if the suggested equipment really works for them. If possible, do they have a test drive, or other evaluation technique, available to them? Does the entity providing the equipment have any means to verify that the fitting really does work for this consumer (REM, Sound Field, Hearing Aid Satisfaction Survey)? Thirdly, how are the consumers followed by the provider? How well are they trained in the "care and feeding" of their equipment? How easy or hard is it to get information when it is needed? How well does the provider understand auditory processing and physiology, and how well can they translate these abstract concepts into something that the consumer can use? And finally, if the consumer might have a medical problem, how is this evaluated and triaged by the provider? This is the point at which understanding and identifying various types of dysfunction, from CAPD to retrocochlear involvement, may be critical for the consumer's well-being. Some of the evaluation protocols which may used could be utilized to suggest further exploration by a qualified healthcare professional, such as an SLP, neurotologist or otolaryngologist. This brings me back to one of my original statements--the consumer, or patient, if you'd prefer, is the most important party, and should have every possible means of resolving their problem available to them. Whoever can make certain that a patient or consumer receives the highest standard of care, is the best individual to provide that care.
Margaret H
Margaret H 25 May 2016 Replied to Scot F
Thank you, Scott. I think for Audiologists in private practice, at least, our professional identity should be strongly tied to how we provide services to a patient, and why the patients would choose an audiologist as a health care professional.
Duane S
Duane S 24 January 2017 Replied to Margaret H
If audiologists as a whole are better qualified then Hearing Instrument Specialists, please explain why: 1) an extraordinarily high number of my clients came to me after being dissatisfied with their audiologist, 2) most audiograms I see performed by audiologists are missing components of what Oregon law says is minimally acceptable, 3) when I attend hearing technology conferences for CEUs, where there's a presentation on REAL Ear Verification (AAA says is a best practice, MarketTrak says assures highest patient satisfaction) and 90% of the 400 attendees are audiologists, by a show of hands, fewer than 10 actually do REAL Ear for their clients, 4) when I ask these audiologists why they don't do THE thing that assures the highest client satisfaction, they say things like "I don't have the time" or "The equipment costs too much." 5) when I went to three audiologists for a hearing evaluation (all with 15-30 years experience), not one recommended hearing instruments to me, not ONE took an interest in my experience of dealing with mymoderate, high frequency loss (2k @30db, 4k@ 55db), not one asked me where in my life I was having difficulty, not one asked if I was a musician, or whether I attended lots of noisy social situations. I could go on, but the point I want to make is, the quality of a hearing care person has NOTHING to do with their credentials or years of education. When one looks, you'll see that the bulk of that PhD has little to do with the actual testing of adult hearing loss , or fitting hearing instruments, or working with clients in a way that leaves them happy, satisfied hearing instrument users.
Margaret H
Margaret H 24 January 2017 Replied to Duane S
Hello Duane If you are the one providing the highest standard of care to the patient/healthcare consumer, then you are the person I would want to have the patient be associated.
Jennifer A
Jennifer A 05 June 2019

Its pretty simple - you should know how much they care, then care how much they know. A large percentage  of the issues I corrected working for top labs with patient dissatisfaction nationwide in my role were because the practitioner wasnt listening to their patient or properly adjusting and fitting the instruments. A top practice is a top practice, period. Look for patient satisfaction and referrals from current patients to guide you. If you see lots of smiles in the waiting room, thats a good sign. Dont be afraid to ask those waiting how satisfied they are. 

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