Frequency transposition (moving sounds around) can only be done in the programming software, at least with the manufacturers I work with.
I work in a pediatric hospital, but I do have some patients who are adults. We always do real ear here (especially working with kids) - there’s no other guaranteed way to make sure the aids are set how they are supposed to be! I wonder if it may be related to equipment availability in Pakistan (more likely an education issue), but it is the gold standard to verify hearing aid output this way.
There are TONS of audiologists that use it in the United States, so as long as you find a provider that does real ear measures you should be fine! I know that Dr. Olson has gotten lots of traffic due to his videos so I don’t think it would be easy to get in to see him, plus the east and west sides of the United States are pretty far apart, so I’m sure you could find someone much closer who can do excellent work for you.