For Physicians

When to Refer

At Heartland Hearing Center, we are dedicated to making hearing health care easier for physicians and their patients. The following is an overview of common hearing health concerns that may warrant a hearing evaluation by an audiologist. If you encounter any of the symptoms or conditions below, please refer your patient to us for an evaluation.

Fax: (319) 826-6595


Common symptoms:

  • Ringing/hissing/buzzing one or both ears, or the head
  • Frustration and/or anxiety about tinnitus

Tinnitus is a conscious awareness of a sound in the ears or head that is not caused by an external noise. While it is a symptom associated with many forms of hearing loss, it can also be a symptom of other health problems.  Many people experience tinnitus. Others suffer from tinnitus. This distinction is very important and should be diagnosed by one of our specially trained audiologists. We will also be able to provide tinnitus counseling and management strategies.

Hearing Loss and/or Communication Difficulties

Common symptoms:

  • Increased difficulty hearing in noisy environments or groups
  • Complaint that people mumble or don’t speak clearly
  • Frequently asking for repetition
  • Straining to hear, turning their “good ear” to the source of sound

For many, hearing sensitivity changes very gradually, and individuals compensate for the diminished ability with other available cues.  Hearing loss often goes unnoticed until it is affecting your patient’s quality of life. Therefore, even if your patients aren’t complaining about their hearing, any patient over the age of 40 should have a baseline hearing test in a sound booth.  Please refer your patients for a hearing evaluation as part of their overall health and wellness plan.

Sudden Sensorineural Hearing Loss (SSNHL)

A sudden hearing loss (SSNHL) should be assessed by a physician on an emergency basis.

Sudden hearing loss – or sudden sensorineural hearing loss – is defined as a loss greater than 30dB in three contiguous frequencies, occurring over a period of less than three days.

Common symptoms:

  • Rapid onset of hearing loss in one or both ears that occurs within a 72 hour period.

Steps for the Family Physician:

  • Patient should be referred immediately for a hearing evaluation with an Audiologist. Stress that it has been a sudden hearing loss, and your patient will be seen the same day.
  • If confirmed to be a SSNHL, some physicians prescribe corticosteroid therapy at their discretion, or immediately refer for an ENT consultation.

The incidence of sudden sensorineural hearing loss is mostly unilateral, with only 2% experiencing bilateral sudden sensorineural hearing loss. In 55% of cases, the hearing loss occurs in the left ear. The incidence increases with age: 4.7 out of 100,000 people aged 20-30, and 15.8 per 100,000 in those 50-60 years of age.


Common symptoms:

  • Light-headedness
  • Feelings of unsteadiness or off-balance
  • Feel as though the room is spinning around them, or they are spinning (i.e. vertigo)
  • Headaches

Steps for Family Physician:

  • Refer to an Audiologist for a comprehensive hearing evaluation with an extensive case history.
  • We will provide you a report that will guide you in your decision-making if your patient requires further referral.
  • Most Otolaryngologists (ENTs) require a hearing test by an audiologist to schedule an appointment.