Finding Care
LSTN Editorial Team · Editorially overseen by Dan McCoy
Before you book your first hearing appointment, there's one question worth answering: who should you actually see? Audiologists and Hearing Instrument Specialists are both licensed to fit hearing aids, but they have different training and different scopes. The distinction matters more at first evaluation than it does later.
An audiologist holds a Doctor of Audiology (Au.D.) degree: a 4-year clinical doctoral program following undergraduate education. Licensure is required in all 50 states. Audiologists are trained to evaluate the full range of hearing and balance disorders, interpret diagnostic test results, and identify conditions requiring medical co-management.
A Hearing Instrument Specialist (HIS), also called a Hearing Aid Dispenser in some states, completes a certification program and apprenticeship with requirements that vary by state. Training focuses on the selection, fitting, and dispensing of hearing aids rather than diagnostic evaluation or medical interpretation.
Neither credential is universally 'better.' They are trained for different purposes. An audiologist is the right starting point when the cause and character of your hearing loss is uncertain. An HIS is a reasonable follow-up provider when diagnosis is established and you need ongoing device care.
Audiologists can: perform comprehensive diagnostic audiological evaluations including air and bone conduction testing, speech discrimination, and tympanometry; assess for retrocochlear pathology and refer medically when indicated; evaluate central auditory processing disorders; perform vestibular assessments; provide aural rehabilitation; and fit and dispense all classes of hearing aids.
Hearing Instrument Specialists are typically licensed to: conduct hearing assessments for the purpose of hearing aid fitting, recommend and dispense hearing aids, and provide follow-up care for devices they have dispensed. They are generally not licensed to perform diagnostic audiograms, assess vestibular function, or make medical diagnoses.
The practical implication: if you have never had a professional hearing evaluation, start with an audiologist. The evaluation itself will determine whether hearing aids are appropriate, whether medical referral is needed, and what kind of provider is right for your ongoing care.
In many markets, HIS-staffed hearing aid retail clinics offer lower prices for fittings and device-related follow-up. Some operate on commission tied to device sales, which is worth knowing when evaluating recommendations.
Audiologists may have higher fees for evaluation, but diagnostic audiograms are often covered by insurance when ordered by a physician. Hearing aid fittings themselves are less consistently covered, regardless of provider type.
Geographic access matters: audiologists are concentrated in metro areas and medical settings. HIS providers are often more widely distributed, particularly in rural and suburban markets. Teleaudiology (remote hearing aid fitting and follow-up) is expanding access significantly.
See an audiologist first if: you have never had a professional evaluation, your hearing loss is asymmetric or one-sided, you have tinnitus or dizziness, you've experienced sudden hearing changes, you are a child or teenager, or any prior test suggested medical follow-up. These are the situations where diagnostic expertise matters most.
An HIS is a reasonable choice for: ongoing device fitting and adjustment if you have a recent audiological evaluation confirming stable, symmetrical hearing loss, and your primary need is hearing aid selection and maintenance.
Many people use both at different points: an audiologist for diagnosis and initial fitting, an HIS-staffed retail clinic for affordable ongoing adjustments. The two roles are complementary.
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