Hearing and balance screening and referrals for Medicare patients: a national survey of primary care physicians

J Am Acad Audiol. 2008 Feb;19(2):171-90. doi: 10.3766/jaaa.19.2.7.


Hearing and balance problems are prevalent among the elderly. Primary care physicians (PCPs) are important pivotal points of entry for ensuring that patients receive needed audiology services. New Medicare beneficiaries are entitled to one-time preventative examinations including hearing/balance screenings. A 35-item questionnaire was developed to assess physicians' participation in, knowledge about, and attitudes toward hearing/balance screenings and referrals for the elderly. The survey was mailed to 710 PCPs (19 undeliverable; 95 returned; response rate = 13.7%) in major metropolitan areas in the United States. Generally, these PCPs were not conducting hearing/balance screenings, aware of patient self-report screening questionnaires, or likely to screen in the future. They referred to audiologists and otolaryngologists mainly when patients complained of having hearing/balance difficulties, and they stated that these problems were important in the elderly and that the Medicare program was worthy of funding but that they had little time and were not reimbursed appropriately for screening. Therefore, PCPs could benefit from informational outreach campaigns on the prevalence of, negative HRQoL (health-related quality of life) effects from, and screening procedures for hearing/balance disorders in the elderly.

MeSH terms

  • Aged
  • Audiometry, Pure-Tone
  • Female
  • Hearing Disorders / diagnosis*
  • Hearing Disorders / epidemiology*
  • Humans
  • Male
  • Mass Screening / methods*
  • Medicare / statistics & numerical data*
  • Postural Balance*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data*
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • United States