Walk into any hawker centre in Singapore and order chicken rice. You will immediately be asked: steamed or roasted? Same dish at its core, yet that subtle difference shapes the entire experience. We care deeply about getting it right. Hearing is no different.
Two people with the same degree of hearing loss can respond very differently to the same hearing aid. One may love the experience. The other may quietly put the device away and never look back. This remains one of the most persistent challenges in hearing healthcare.
On paper, the hearing care industry has made significant progress. Ageing populations, rising awareness, and substantial public investment in subsidies have expanded access considerably. In Singapore, government schemes can cover up to 90 per cent of hearing aid costs, with more than 99 per cent of applicants approved. The financial barrier, in theory, has been largely removed.
Gap Between Access and Adoption
But access is only part of the story. Globally, a 2023 meta-analysis found that only 62 per cent of hearing aid users wear their devices regularly. A separate study found that only about half of people who begin a hearing care journey successfully complete it. While not Singapore-specific figures, the pattern they describe is visible across many markets. Subsidies go underutilised. Clinical time is spent on follow-up that should not be necessary. And patients disengage from a process that was meant to reconnect them to the world around them.
Why People Walk Away
Stigma is often cited as the primary barrier, particularly across Asia Pacific, where hearing loss is still associated with aging and cognitive decline. Design has helped. Today's devices are smaller and more discreet than ever. But perception remains an uphill battle.
Access bottlenecks compound the problem. In Singapore, there is roughly one audiologist for every 47,000 people, nearly three times lower coverage than in New Zealand.
Beyond these measurable gaps lies a more nuanced challenge: the lived experience of sound itself. Hearing loss is typically assessed through clinical tools like the audiogram, which maps hearing thresholds and guides evidence-based fitting. These approaches are essential for restoring audibility. But meeting clinical targets does not always translate into comfort or familiarity. When amplified sound feels unnatural, the cognitive and emotional burden of hearing through a device that simply does not sound right can be exhausting. Over time, that disconnect leads some users to disengage, leaving devices in a drawer, and the hearing care journey incomplete.
New Research: Hearing Is Personal
Hearing is not just about decoding words. It is about connecting to the sounds that matter: a favourite piece of music, a child's laughter, the ambient sound of a familiar place. Patients carry strong emotional attachments to how their world sounds. When that is disrupted, compliance suffers.
New research from WSA reveals something clinically significant: sound preference is real, measurable, and evenly distributed. When individuals were exposed to two distinct sound processing approaches, approximately 40 per cent showed a strong and consistent preference for one design over the other. The remaining 60 per cent were flexible, performing well with either.
This insight has driven the development of clinical tools designed to surface sound preferences before a patient leaves the consulting room. Through structured A/B comparisons across real-life listening scenarios, clinicians can guide patients to identify and articulate their preferences early in the fitting process. The result is a recommendation grounded not just in the audiogram, but in the patient's own auditory experience.
The downstream impact is meaningful. Devices that feel right stay in use. Fewer return visits are required. And the public investment in subsidies and access translates into outcomes that actually hold.
Scaling Personalisation Without Compromising Care
A reasonable concern is whether adding another step to the fitting process places additional burden on an already stretched workforce. In practice, the opposite is true. Sound preference tools are quick, intuitive, and compatible with tele-audiology and hybrid care models. Getting it right the first time saves considerably more time than repeated follow-up and adjustment.
For governments and healthcare systems bearing the costs of abandoned devices, this approach reframes the conversation from volume to value. Personalisation is not a premium offering. It is increasingly a clinical necessity.
What Success in Hearing Care Looks Like
Access and affordability matters. But if a device ends up in a drawer, neither the patient nor the system has benefited. The true measure of success is long-term engagement: how many lives are meaningfully reconnected to sound, and how durably.
That requires seeing patients not as clinical profiles, but as individuals with distinct preferences and emotional relationships with sound. Sound Preference is not the endpoint of that shift, it is the beginning. Realising its potential will require new tools, new training, and a new clinical mindset: that in hearing care, the right sound is as personal as the right prescription, and just as important to get right.
A Note for Patients
If you or someone you know has hearing aids sitting unused, do not give up. The problem may not be the technology. It may simply be that the device does not match your listening preferences. Ask your audiologist about alternative sound processing approaches. When hearing feels right, it changes more than how you hear. It changes how you connect with people and loved ones.
