When patients call our clinic for the first time, one of the questions I get most often is: “Are you an audiologist?”
It’s a fair question. And the honest answer needs more than a yes or no, because the credentialing landscape in hearing care is genuinely confusing — even for people in the industry. There are at least three professional titles you’ll run into when shopping for hearing care, and they don’t mean the same thing.
I’ll walk through what each one is, what training it requires, and what it actually changes for you as a patient. This isn’t about claiming one credential is “better.” It’s about giving you the information to understand who you’re sitting across from. Understanding credentials is part of choosing the right hearing clinic for you.
The three main credentials you’ll see
There are three professional titles you’re likely to encounter at a hearing clinic. They overlap in some places and differ sharply in others.
Hearing Instrument Specialist (HIS) is a state-licensed professional who specializes in evaluating hearing and fitting hearing aids. HIS training varies by state but generally involves apprenticeship under a licensed provider, formal coursework, and a state licensing exam. HIS providers are licensed to perform hearing evaluations, fit and program hearing aids, and provide follow-up care. They are not licensed to diagnose underlying medical conditions or perform surgical procedures — that’s not what the credential is for.
Board Certified in Hearing Instrument Sciences (BC-HIS) is a national board certification that goes beyond state HIS licensure. It’s awarded by the National Board for Certification in Hearing Instrument Sciences (NBC-HIS) and requires passing a national exam, demonstrating clinical experience, and meeting continuing education requirements. BC-HIS is the higher-tier credential within the hearing instrument specialist track. Not all HIS providers pursue it.
Audiologist (AuD or PhD) is a doctorate-level credential. Audiologists complete four years of undergraduate work plus a four-year Doctor of Audiology (AuD) program, totaling eight years of post-high-school education. Audiologists are trained in the full scope of hearing and balance disorders, including diagnostic testing for conditions like vestibular disorders, neural hearing issues, and pediatric hearing care. They can fit hearing aids, but their training extends well beyond device fitting into clinical diagnosis.
I am Board Certified in Hearing Instrument Sciences (BC-HIS), in addition to holding a medical doctorate (MD from Ross University). That combination is unusual in this field and I’ll explain why I went that route in a moment.
What each credential is actually trained to do
The cleanest way to think about credentials is by what they’re built for.
A hearing instrument specialist — HIS or BC-HIS — is specifically trained in the evaluation, fitting, programming, and ongoing care of hearing aids. That is the focus of the training. If you have age-related hearing loss, noise-induced hearing loss, or most common patterns of adult hearing decline, a skilled HIS or BC-HIS provider can take you all the way through the process: testing, recommendation, fitting, real-world adjustment, follow-up, and long-term maintenance.
An audiologist has the same hearing aid fitting capabilities, plus broader diagnostic training. That broader training matters in specific cases: complex balance and dizziness issues, sudden hearing loss with unclear cause, suspected nerve involvement, pediatric work, or cases where there’s a possible underlying medical condition that needs differential diagnosis before treatment.
The honest reality is that for the vast majority of adult patients walking into a hearing clinic — folks experiencing gradual age-related or noise-related hearing loss — both credentials can do the work well. The variable that matters more than the credential is the individual provider’s skill, time, and approach.
Why titles can be misleading
Here’s the part that gets confusing.
The term “audiologist” is often used loosely in marketing copy and in conversation, even by people who don’t hold the credential. Some clinics call themselves “audiology practices” when the actual provider is an HIS or BC-HIS. Some patients assume any hearing care professional is an audiologist. Even in some Google reviews of our practice, patients have referred to me as “Dr.” or “audiologist” because they know I have a medical degree — but my hearing care credential is BC-HIS, not AuD.
I prefer to be precise about this. We’re a hearing clinic, not an audiology practice. I’m a BC-HIS with an MD — not an AuD. The distinction matters because the words have specific legal and clinical meanings, even when they get used loosely. If a clinic is calling itself an “audiology practice,” it’s worth asking whether the providers actually hold AuD credentials.
What I’d actually look for as a patient
If I were shopping for hearing care for a family member, here’s what I’d weigh.
Match the credential to the case. For straightforward adult hearing loss — the most common situation — a skilled BC-HIS provider with a strong fitting track record will give you excellent care. For complex diagnostic questions, balance issues, or suspected underlying medical conditions, an audiologist’s broader training is more relevant. If your case is on the simpler end, the credential itself isn’t going to be the deciding factor.
Look at the provider, not just the letters. I’ve worked alongside both AuDs and HIS providers in my career. There are excellent and mediocre providers in both groups. Years of focused experience, willingness to take time with patients, real-world testing methodology, willingness to fit multiple manufacturers — these matter more in actual practice than the letters after the name.
Ask about referrals when they’re appropriate. A good hearing care provider, regardless of credential, will refer you to an ENT or audiologist for issues that fall outside their scope. That referral discipline is a sign of a clinic operating ethically. If you have warning signs of something beyond standard hearing loss — sudden loss, vertigo, ear pain, drainage, ringing only on one side — a referral is the right call, not a fitting.
Ask about continuing education. This field moves quickly. New device technology, new fitting methodologies, new research on hearing loss and cognitive health — all of it changes how the work gets done. Ask any provider how they keep current. The answer should be specific.
Why I went both directions
Quick personal note. I started in medicine — earned my MD from Ross University after spending my childhood around my father’s family practice. Deciding to choose my own path I ended up in hearing care, which has turned out to be a perfect fit for me. I pursued BC-HIS certification because I wanted the credential focused on the specific work I do every day: helping adults hear better through well-fit hearing aids.
The MD adds context. I understand the medical picture surrounding hearing loss — the connections to cognitive health, cardiovascular health, fall risk, depression. When I see something in a hearing test that suggests a referral to an ENT or neurologist, I recognize it. That’s an unusual combination and I think it makes me a better hearing care provider, but it’s not the only path to good care. There are wonderful providers in this field with very different backgrounds.
Come meet us
If you’d like to come in and talk about your hearing — and you have questions about credentials, training, or anything else — I’d be glad to answer them in person.
Come Experience Hearing for yourself at our Asheville or Hendersonville office. Reach us at (828) 274-6913 and we’ll set up a time.
— Dr. Brent Steele, MD, BC-HIS
The Hearing Guy