Elsevier

American Journal of Otolaryngology

Volume 27, Issue 1, January–February 2006, Pages 18-23
American Journal of Otolaryngology

Original contribution
Physician hearing loss

A portion of these results was presented at the Connecticut Academy of Family Practice Annual Scientific Symposium, October 2004.
https://doi.org/10.1016/j.amjoto.2005.05.014Get rights and content

Abstract

Purpose

Hearing is an important sense for physicians, making communication and stethoscope use possible, yet not much is known about the impact of hearing loss on professional function. The purpose of this study was to explore hearing-related issues affecting physicians.

Materials and methods

We administered a hearing test and questionnaire to 107 physicians and medical students.

Results

The proportion of physicians reporting trouble with their hearing increased with age, reaching almost 100% in those older than 60 years. Audiometric hearing loss also increased with age. Perceived hearing trouble was significantly associated with audiometric hearing loss, yet 46% of physicians with hearing loss described their hearing as good. Older physicians more frequently reported difficulty communicating with patients, staff, and colleagues owing to hearing problems (P = .007). Reported stethoscope difficulties did not significantly increase with age; there was no association with hearing thresholds. No physician reported use of electronic stethoscopes or hearing aids. Noise exposures were common, yet 51% of respondents never used hearing protection. Younger physicians were less likely to use protection (P = .002).

Conclusion

Physicians lose hearing with age but may not notice or report the loss. Physician hearing loss is associated with difficulty communicating with patients, staff, and colleagues. Neither age nor hearing level predicts problems with stethoscope use; possible explanations include a training effect or denial. Many physicians, especially younger ones, never use hearing protection around noise. Strategies to recognize and reduce the impact of hearing loss on professional function throughout a physician's career deserve greater attention.

Introduction

As the American population ages, adult hearing loss is receiving greater recognition in clinical care [1], [2] as one of the most common chronic conditions [3]. Physicians, as they grow older, face the potential impact of personal hearing loss on their professional duties. Clinicians must communicate effectively with patients, staff, and colleagues, often in situations of background noise or by telephone. The interference of hearing loss with a physician's daily clinical encounters can lead to fatigue and psychological distress [4]. Despite advances in diagnostic technology [5], the ability to auscultate a patient's heart and lungs using a stethoscope remains the basic occupational skill for physicians who could be affected by hearing loss.

Not much is known about the hearing of physicians. Physical examinations for medical school and residency training do not routinely include audiometric testing. The scientific literature on this topic consists largely of case reports of medical students or physicians coping with severe congenital hearing loss [4], [6] or resources for physicians who are hard of hearing [7]. The purpose of our study was to evaluate the subjective and audiometric hearing status of a group of physicians.

Section snippets

Methods

We recruited volunteer subjects at 2 annual scientific conferences for internal medicine and family medicine state medical societies. Attendees at the conferences included medical students, residents, and physicians in practice or in teaching positions. The Yale University School of Medicine's Human Investigation Committee approved the study instrument and protocol. Subjects were asked if they wished to participate in an anonymous study of hearing status and, after giving verbal consent,

Demographics

A total of 107 physicians and medical students completed the questionnaire and audiometric testing. Table 1 shows the demographics of the study population.

Most of the respondents were family physicians or internists, with an average age of 42.8 years (SD, 13.9 years; range, 24–82 years), who spend an average of 73.9% (SD, 29.7%) of their time in clinical activities. Only 2 subjects reported hearing loss during childhood, and none of the subjects reported using an electronic amplified

Discussion

This study found that older physicians were more likely to demonstrate evidence of hearing loss and more likely to report difficulties with communication owing to hearing problems. At the same time, we did not find a clear relationship between self-reported problems with stethoscope use and either age or measured hearing levels. Many physicians with hearing loss described their hearing as good. Physicians reported exposure to recreational sources of loud noise but low rates of hearing

Acknowledgments

We thank the Connecticut Academy of Family Physicians and the Connecticut chapter of the American College of Physicians for their cooperation with this survey. Elizabeth Malarney assisted with questionnaire design and administration, Maria Slade provided data entry services, and Deron Galusha gave technical assistance. PMR, OT, and OA wrote the manuscript and PMR, MDS, and KS performed the statistical analyses.

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