When Hearing Aids Aren’t Helping Enough: The Role of Real Ear Measurements (REMs) Technology

Many people try hearing aids expecting a noticeable improvement in how they hear conversations, especially in real-world settings like restaurants, meetings, or family gatherings. But for some, the results fall short, even if the hearing aids cost thousands of dollars. Voices still sound unclear, background noise is overwhelming, and the overall listening experience just isn’t what it should be.

If that sounds familiar, you're not alone — and there's a good reason this might be happening. One key factor that often gets overlooked is whether real ear measurements were used during the fitting process... technology that is now available at Fauquier ENT Hearing Aids (free service for those patients who purchased hearing aids through our practice; a small fee for those who purchased hearing aids elsewhere)!

What Are Real Ear Measurements?

Real ear measurements (REMs), also known as probe microphone measurements, are a method used by audiologists to verify that your hearing aids are delivering the correct level of amplification for your ears — not just based on your hearing test, but on how sound actually behaves inside your ear canal.

Unlike standard fittings, which rely on pre-programmed settings and manufacturer averages which may work for many folks, REMs provides precise, individualized custom data. It measures exactly how much sound is reaching your eardrum while wearing the hearing aids, and it allows for real-time adjustments to ensure you’re getting the most accurate amplification for your hearing loss.

To use an analogy, it is kind of like getting custom fit shoes instead of a standard size 9 shoe off the rack. Even if the shoe is very expensive, if it does not fit right, people will hate wearing it.

Why They Matter

Everyone’s ears are different. The shape, size, and acoustics of your ear canal can significantly impact how sound travels and how hearing aids perform. Without real ear measurements, audiologists are essentially estimating how well your hearing aids are working for you — and those estimates can be off, sometimes by a lot.

This is one of the most common reasons hearing aids may sound:

- Too soft or muffled

- Too sharp or overwhelming

- Inconsistent between ears

- Just “not quite right”

With REMs, audiologists can ensure that speech sounds are clear, soft sounds are audible, and loud sounds remain comfortable — all based on verified, measured data from your ears.

Why Aren’t Real Ear Measurements Always Used?

Despite being considered best practice by organizations like the American Academy of Audiology, not all hearing care providers use REMs. Sometimes it’s due to the extra time and equipment required, or because the provider hasn’t been trained in how to use the technology.

However, this is something you can — and should — ask about if hearing aids are not working as well as you may have hoped. It’s your hearing, and you have every right to ensure it’s being supported with the most accurate tools available.

A simple question at your next appointment can make a big difference:  

“Do you use real ear measurements when fitting hearing aids?”

If the answer is yes, great. If not, it may be worth considering a provider who does.

Bottom Line

If your hearing aids aren’t performing the way you expected, it doesn’t necessarily mean the devices are wrong for you — but the fitting process might be incomplete. Real ear measurements can take the guesswork out of hearing aid programming and help you get the clarity, comfort, and confidence you were hoping for.

You shouldn’t have to settle for “good enough” hearing. With the right fitting process, including REM, better hearing is truly possible.