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REMedial treatment US/UK/Other countries?

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So, I have to wonder:

Does the UK provide general practitioners and/or audiologists or with gear?

I hear what seems to be universal reporting of REM experience(s) from UK posters.

I also have been exhorted to do REM on my hearing.

Yet, extensive searching, via solicitation of ENTs and various hearing aid providers has come up blank.

Universally, the excuse for why the solicited provider doesn’t have it has been “It’s too expensive.”

Yet…

Everything I read here seems to say, "If you haven’t had REM, your fitting is compromised or worse. The sole place I found which did REM refused to deal with me (see prior discussions of DING! under my name) unless I bought my aids from them.

As I’d already entered into the purchase of my Phonak Sphere Infiinio I70 (because the I90s weren’t covered by my insurance), I declined to do that again, never mind that I’d have gone from a 40-minute to a 90-minute one-way trip to do that REM. Oh, and PS they don’t take insurance.

Why is it that virtually every post I see from UK discusses REM, and yet (at least in NE GA/NW SC, Downstate Western NC) there are virtually (or very well hidden) no providers in the US within a couple of hours of where I live?

What am I missing, eitther/or/and in properly framing my search/obtaining such enhancement of my prescription?

For those who are seeing my name for the first time, I’m an Ex-Beltone Soft Mold/3HP user, currently relatively newbie Phonak Titanium Mold user with 3P receivers, but continued struggles in speech acuity and music accuracy…

Based on what I read here, I can’t imagine that REM wouldn’t improve my outcomes - and yet, at least in my area of the country, providers of that measurement are virtually unfound.

Sigh…

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Edited
@Skip said:

Does the UK provide general practitioners and/or audiologists or ENTs with REM gear?

GP’s no, but certainly hospital based audiology departments yes. Large chains which were selling mainly optical products and moved into hearing, few and far between. Although one independent audiologist I used did REM, I’m sure many do but not all. Of course Costco always.

is standard in UK in NHS audiology departments. in private the big chains like boots, specsavers, hidden hearing and amplifon don’t do it because in order to make as much profit as possible they reduce the appointment times to bare minimum and the equipment is expensive. the independents often do REM as it sets them apart from the corner cutters and justifies their prices.

@Baltazard You maybe right regarding postcode lottery. Although I was at audiology last Friday given new bluetooth aids, , using my existing from February 2025.

Not sure if it still is but it was in their code of practice. Someone once gave the reference on here so i read it.

Our local hospital (North West - England) has a machine, but it didn’t work!

My private Audiologist (ex NHS) didn’t have one, probably because the fitting software has processes which go some way to detect and fix differences between the hearing aids output, and (Audiogram Direct, Feedback Real Ear - Phonak Target). My Private Audiologist did use Audiogram Direct.

Healthcare is devolved in the U.K. so each of the home nations has different policies and each Trust/Comissioning Area has different budgeting priorities.

A client came in the shop today, fitted in 2016 by the NHS: aid recently replaced apparently with no adjustments done: based on the original test. New test would take up to 3 years and replacement mould likely to be up to 6 months after ears were de-waxed etc.

I’m not saying this is typical, but if tests/fittings/follow-ups are being rationed like this, I wouldn’t expect is routinely available, just in terms of resource allocation and time. That said, perhaps they are using it at initial fit, which is why the general wait list and follow-ups are so slow.

wow ok. that sucks! here in england, never had a NHS fitting without . new test every 3 years with new pair of hearing aids unless i requested a test sooner. reprogramming then always done with REM. again i may just have been lucky.

More or less the same where I live. I can usually get an appointment with audiology within a couple of weeks if I have a problem. For tubes, domes and batteries etc. a volunteer usually comes around to my GP surgery once each month. I’ve had 4 pairs of aids since my first fitting in 2016.

I have had done on my last visit to the NHS at Raigmore Hospital Inverness, that was 2022… I have never seen an REM machine at any other private Audiologist, nor at Boots or Specsavers, Boots were I believe going to roll out their own REM service, but I believe that must’ve been put on the back burner? Cheers Kev :wink:

@PeterH, if your ear canal shape conforms to the standard that manufacturers use to calculate their prescribed gain settings, then you might get decent results without .

In my case, the difference between being fitted without REM vs with REM is night and day.

I do , so maybe it would be possible to start without REM and then, through trial and error, get to something that is closer to the REM results. But that’s not easy and I don’t think the results would ever be as good as with REM.

If I were to select a new provider, my first question would be whether they do REM. Luckily, it seems that most clinics here in Canada do it.

The fact that should ever be a controversy is so funny.

I get that some places don’t have it and won’t have it and can still help you. That’s great! Glad you hear better.

What is funny is that REM is like a thermstat. The temperature, that you feel, tells you it is cold. So you set your thermostat for the temperature that you want.

You could:
Set the thermostat for a temperature based off of the temperature the weather report/your thermometer said and say that’s fine. Maybe it is!

Or you could:

Take the temperature measured by your calibrated thermometer and decide on a comfortable temperature to set the thermostat. Then you could measure the temperature that was acheived by the heating system with that thermostat setting so that the heating requirements take into account the room that they are placed.

I’m a huge fan of REM. I would say the most specific reason I am a huge fan is that I have found people wearing hearing aids that are SO much louder than needed, and when I fix that issue, they LOVE their hearing aids.

@mindsil said:

I’m a huge fan of REM. I would say the most specific reason I am a huge fan is that I have found people wearing hearing aids that are SO much louder than needed, and when I fix that issue, they LOVE their hearing aids.

Ha ha, mate you hear it all right here on hearingtracker first!

@mindsil said:

A lot of rejection is from aids set too loud because of lack of verification

Do you have actual data for that?

In the adult population with sensorineural losses: First fits are usually underfit by some margin. There’s lots of cases where people dislike their full target at inception, simply because their recruitment hasn’t supported/doesn’t like the new dynamic range. Or they can’t cope with the loudness/extra listening activity.

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