Episode Transcript
[00:00:01] Speaker A: You're listening to the Doc Lounge podcast. This is a place for candid conversations with the healthcare industry's top physicians, executives, and thought leaders.
This podcast is made possible by Pacific companies, your trusted advisor, and physician recruitment.
[00:00:19] Speaker B: Welcome back to the Doc Lounge podcast providers perspective series. I'm Stacey Doyle, and today we're joined by doctor Keith Darrow, an expert in speech and hearing, bioscience and technology from MIT and Harvard. Doctor Darrow is not only a tenured professor at Worcester State University, but also leads the hearing and brain centers of America. His work spans clinical, educational, and nonprofit realms, focusing on the critical link between hearing health and cognitive well being. Join us as we uncover how better hearing supports overall health with one of the leading voices in audiology, Doctor Keith Darrow. Welcome to the podcast, Doctor Darrow.
[00:00:57] Speaker C: Well, hey, thank you for having me here, and thank you for all the great work that you do. I love this community of sort of p to p, right? Not just peer to peer, but also physician to physician or c to c, clinician to clinician, because I think that's one of the most important things that we can do, in addition, obviously, to helping our patients, but to helping each other to help more patients. Right. The more we do things together, the better off our patients are. And so great podcast series that you have and honor to be here.
[00:01:35] Speaker D: Well, thank you so much. We definitely agree with that. We definitely want to build a community within the physician community and just know how important it is. With all that you guys are balancing from just work life balance and being able to share the latest and greatest from anything, research wise, we think it's great to build a community here. So I would love to hear a little bit about your career journey. You started, you were in academia. You were at prestigious institutions like MIT and Harvard, and now you're in a current role as a professor. So tell us a little bit about your journey.
[00:02:19] Speaker C: So, basically, right, I don't have one of those sort of tissue, you know, tear jerk stories of a family member or anything. I honestly just stumbled into the field of hearing loss and, you know, communication. And once I sort of fell into it, I absolutely fell in love with it, head over heels with it. And so what started out as becoming a clinical audiologist, that's what all my undergrad and graduate work was in. I noticed very early on that we all think of our sense of hearing, we think of our ears, but in reality, we hear with our brains. Everything is about the brain. We see with our brains, we hear with our brains. And so, as I was completing my clinical work, I had already knew that I wanted more. And that was what I guess you could say possessed me to say, rather than jump right into the field and start seeing patients, I decided to almost take a break from clinical care. And that was when I went and dove headfirst for the next ten to twelve years, working in the labs at MIT and Harvard Medical School, I enrolled in their PhD program, for which I have a PhD in neuroscience, where I basically spent years dissecting hundreds of brains, thousands of years, all trying to understand how hearing impacts the brain, right? And I learned very quickly that the entire brain is driven by sound. And so it made abundant sense to me that if you take away hearing, which happens to all of us as we get older, that it's not just about our ears, it's not just about, oh, you can't have a conversation in a restaurant. It's about what's happening to your brain. And so I studied that for many years. And now, yes, I'm on this crusade, be it, you know, teaching at the university.
I am, you know, one of the co founders of the hearing and brain centers of America. It was New England, but now we actually have over 16 locations that are across the country. We continue to grow because we continue to get more and more patients seeking the best level of care.
[00:04:41] Speaker D: And I know right now, with kind of this, the aging population and obviously a lot more, you know, boomers are getting into, you know, so I'm assuming that there's just more and more need for kind of, you know, the support. Like you're saying you're expanding across the country. Is that kind of one of the trends you're seeing?
[00:04:59] Speaker C: Yeah. So basically, right, if you just follow the science, and I tell that to my team, I tell them to my students, follow the science, and that will help you to provide remarkable patient care. At the end of the day, in the United States alone, there are 73 million adults with documented hearing loss.
That is, I mean, that blows every other medical condition out of the water, right? And when you think about those older adults, the vast majority are living with what society has termed a mild hearing loss. But a mild hearing loss is a major problem because it significantly increases your risk of cognitive decline and dementia. It significantly increases your risk of hospitalization, early retirement, traumatic fall, premature death. So hearing loss, which is seen by most people in society as a nuisance, is actually not only a fact of life that will happen to all mammals if we're fortunate enough to live long enough, but it's a chronic neurologic condition. That has profound impacts on the brain.
[00:06:20] Speaker D: Wow. Yeah. I honestly didn't know that they were highly linked.
What are some of the things that are causing this erosion of hearing?
[00:06:32] Speaker C: Are there things that are in terms of hearing? The erosion of hearing is easy. It's just genetic. It's part of what happens as we get older. We don't see as well, we don't feel as well, we don't hear as well. I mean, it's just part of our system that generally breaks down as we get older, and that's all genetically driven. But yes, we live in a post industrial revolution society where things are very loud.
We live in an era where medications significantly impact hearing, be it chemotherapy, strong antibiotics, even just over the counter pain meds that people take regularly can impact their ability to hear. So throw on top, if you take all those environmental factors, nutrition factors, put that on top of your genetics, it's kind of a recipe for disaster in that you're going to lose your hearing as you get older. Like I said, we have to accept the fact that hearing loss, as we age, it impacts the brain physically. We know that the brain shrinks in people with hearing loss, and brain shrinkage is a hallmark feature of cognitive decline in dementia. We know that the brain physiologically reorganizes itself, and it almost abandons the parts of the brain that are involved in hearing, which is very scary because you're losing a lot of real estate in the brain. And so it ends up taxing the other sensory systems to try to make up for hearing. That's not good. And then we know functionally, people with hearing loss tend to do poorer on processing, decision making, memory recall. So hearing loss, really, I sort of summarize it physiologically and functionally affects the brain, or I should say it impairs the brain. And cognitive impairment is on the pathway from normal aging to cognitive decline in dementia.
[00:08:43] Speaker D: Is there links between this? And obviously you're saying dementia, but like Alzheimer's or any of those, or, I.
[00:08:50] Speaker C: Mean, so most of the studies right now. So dementia is that umbrella term which is a significant decline in your ability, whether it be social, language, communication, be it visual spatial memory, memory recall. There's all these cognitive aspects that go into it. Alzheimer's is the primary form of dementia, but there are many other types, including cardiovascular, Lewy body, Parkinson's related, you know, the most recent DSM five, which sort of categorizes dementia as a neurocognitive disorder. There's upwards of 200 types of dementia, but, you know, there's the big five of which Alzheimer's is hands down, accounts for nearly 70% of all cases of dementia. And so, yes, there is definitely a lot of data to indicate that hearing loss and something we haven't talked about yet, tinnitus, the ringing in your ears are almost precursors, like a warning sign that your hearing is bad, that it's affecting your brain, and that you may be at risk for cognitive decline.
[00:10:04] Speaker D: Okay. Wow, that's. Okay. That's really interesting. And things that. I'm sure some of your peers are familiar with this, but as a layperson, it's really, really fascinating to hear that. I'm wondering, too. I know our culture now. I always have my airpods in.
I see all the young kids with the headsets, the speaker, headset, earphones.
Do we know what that does yet, in terms of your overall, here's what I say.
[00:10:36] Speaker C: You know what I call that? I call that job security.
But all kidding aside, yes, it's very troubling. Right? So we went from a world where things were just loud out in the environment, walking down the street, be it the sirens, this, that. Now we've got these personal sound amplification devices, and there's nothing scarier than walking by somebody and you can actually, like, sing along with the music that's supposed to be in their ears. That's how loud it is, right? So, yes, there's been a number of studies that have shown that the rates of hearing loss are increasing the age at which people are experiencing hearing loss. Antonidus, the ringing in the ears is actually sliding down. I feel like when I started in the field, my average patient was 73 years old. Now the average age is about 60. So there's been quite a transformation in the last 20 years or so because of. I shouldn't say because of, I can't draw, you know, a straight line between the two, but it's definitely a factor that our world is getting louder and that we're just continually exposing ourselves to, you know, traumatic noise.
[00:11:54] Speaker D: Got it. Now tell me a little bit about, you know, obviously, I think a lot of this has to do with public awareness, you know, and really kind of, you know, we know, like, from everything you're saying, how important hearing really is, what strategies like, you know, do you think are effective in educating more people about, you know, hearing and kind of being a little bit more cautious? Or are there tips that you're giving to, you know, to patients?
[00:12:24] Speaker C: Well, look, so what dawned on me several years ago, what I guess I should say really disturbed me, was that the more you dive into the data I've already mentioned, there's 73 million adults in the United States with hearing loss.
What's more troubling is that less than 10% are currently undergoing treatment for their hearing loss, or tinnitus. So that leaves 90% of people. And after a lot of soul searching, a lot of conversations, a lot of looking into the research, I basically landed on, the primary reason so few people do anything about their hearing is because of the lack of health literacy. And so that, for me, was my prompt. My very first book, stop living in isolation, because so many of my patients talk about feeling isolated, came out in 2017. It instantly became an Amazon.com number one new release and a number one seller. Right? And I'm not bragging, because I promise if you read the book, you would find all sorts of grammatical errors. I am no, like, English major whatsoever, right? I can't even help my kids in school with English. It was never my thing. But I, to me, and that was the first book, right? You can find that on Amazon. I wrote another book, preventing decline. I wrote another book all about tinnitus.
I wrote a cookbook. I've just continued to put out more and more information. I believe so many people were attracted to it is because they're sitting at home saying, I can't hear. I heard something about maybe the cognitive decline, dementia. I'm worried about this. I want to maintain my independence. What do I have to do to prevent decline? So I think the information caught like wildfire because there's so many, 90% of people are just looking for more information. And unfortunately, look, there's bad apples in every orchard. But too often when we think about hearing loss, we just default to hearing aids that don't work.
You spend a lot of money, they don't have value. And that's just not the way treating hearing loss looks like anymore. There's new categories of prescriptive hearing technology. Patient satisfaction is over 97%. I mean, it's just a wildly different world when it comes to being able to give people back not only sound and hearing and the ability to communicate with others. But we now understand treating hearing loss can prevent cognitive decline and dementia. It's actually considered the number one modifiable factor for preventing dementia. That's how important treating hearing loss is.
[00:15:19] Speaker D: Wow.
Tell me, I'm very curious, what are the latest advances with technology to help? Like you're saying, hearing aids, it sounds like that's come a long way. Tell us a little bit more about that.
[00:15:34] Speaker C: So, you know, the strategy used to be. And it's very simple.
Traditional hearing aids made things louder. They were amplifiers. That's it. They were just, that's all they were designed to do. And so every patient would say, when I'm home alone, things sound okay, but as soon as there's two or three people in the room, or if I go out to a restaurant, everything's really loud.
And I would almost say, yeah, because that's what your limited technology could do. And this was like the standard of care through even maybe five years ago. But as we all know, I mean, look at the. Look at the technology we carry around in our pockets, on our wrists. Look at the new artificial intelligence. Well, thankfully, all of that technology has made its way into prescription hearing aids that now the target, or I should say the intended outcome, isn't just making things louder, it's actually properly stimulating the brain. And so it actually takes more of a brain first approach. And it says, okay, well, what is it that the brain is missing?
The brain is missing vital information. There's a whole set of nerves that connect the ear to the brain that are limping along. How do we restimulate those? How do we sort of take advantage of the neuroplasticity to reduce the ringing that's caused by these out of control neural networks? Like, it's just a totally different experience. And what's cool is from the patient's perspective, and I get this all the time, because when my patient says, you know, doc, everything sounds natural, it sounds normal.
What's better than that, right? Because it used to be, it sounds mechanical. It sounds like a robot. Everything's too loud now. It's, I can't leave home without them because I can't go about my day. My brain is, like, mad at me if I can't hear.
[00:17:38] Speaker D: And I feel like, has the appearance of them evolved as well? Because I think, you know, I see some, and they look really kind of tiny and modern, and it's like you barely even notice. Yeah.
[00:17:48] Speaker C: Yeah. I mean, that is definitely one of the cool things, right? We're no longer in the day and age of the beige banana, and everybody knows what I mean when I say beige banana, right? That big thing that hangs behind your ear. So those days are gone, although you can still get them on, you know, be it Amazon or at a big box store or something like that. They're still out there somewhere. But in terms of prescription grade technology, which is not, this is actually set by the FDA, right? It's its own category of prescription level technology. The cool thing is, they've actually become nearly invisible. Right? And you're right. Sometimes you might catch a glimpse of somebody wearing something, but now it looks like a new Airpod, something maybe Sony made or Bose or, you know, some fancy cool company. It's nothing your grandmother's hearing aid at all.
[00:18:41] Speaker D: That's so cool. Well, that's exciting. It's exciting when technology and medicine merge. And I'm assuming you're involved with a lot of nonprofit organizations around, focused on hearing health. What motivated you to start these, and what impact have those had?
[00:19:00] Speaker C: Well, I think, look, a couple of problems I realized a long time ago. One is the health literacy, which we already talked about. So we have to educate more people. And if I ever have an opportunity to stand on a stage or get behind a microphone on a podcast, I'm going to jump in feet first so that I can try to just spread the good word about hearing healthcare, about how hearing healthcare is preventative medicine that can potentially prevent cognitive decline, prevent a traumatic fall, help older adults remain independent.
But also, I've come to realize that, look, treating hearing loss carries a price tag, okay? And so we can't avoid the conversation. And of all the fights that I try to fight and win, there's one I know that I sort of back away from because I don't. I've yet to figure out how to move mountains. But in terms of the government and insurance companies, like, there are a lot of other big organizations that are fighting that good fight. And I do believe someday we'll get to a point where the government and insurance says, hey, wait, treating hearing loss is preventative medicine, and that's a much better way to spend our money than caring for all these older adults who end up with cognitive decline, end up in an institution, being hospitalized, et cetera, et cetera.
So with the price tag comes, you know, some people aren't going to be able to access and afford it. And so, yes, through our nonprofits, of which my team members have traveled globally, I've had team members go to the Galapagos to help people that live there in utter poverty to hear better. We've been to, you know, tribal, tribal communities, even within the United States, Native Americans, to help them in terms of increased access. I mean, you have to give back, right? We can't limit great hearing to those who can afford it. Right? That's always been a little bit of a pet peeve of mine. And so through our nonprofit work at the Sound of Life foundation, we've been able to help so many people globally to hear better.
[00:21:15] Speaker D: That's amazing. And I love that you're giving back and, you know, obviously realize the importance of this. And it sounds like there is really this correlation between, obviously, hearing and cognition decline. So it sounds like it is very preventative, but sometimes the legislation and the insurance companies may be a little bit behind on that.
[00:21:39] Speaker C: Yeah, yeah.
[00:21:41] Speaker D: Tell me a little bit about the future trends, like, what are you foreseeing in audiology, and how should professionals, you know, in the field, preparer for these changes?
[00:21:54] Speaker C: Yeah, I think the cool thing, at least from the patient perspective, is with, with changes in technology, with, with. We're just on the cusp of artificial intelligence.
I feel like the benefit to the patient is going to be the simplicity of treating hearing loss, the simplicity of stimulating the brain to reduce, maybe even eliminate the ringing that so many people suffer with in their ears and in their head. Because nowadays, you know, and I hate to, you know, sound like a 1980s infomercial, but it's getting to a point where you can set it and forget it. Right? A lot of people will remember that from that old toaster oven thing. You can set it and forget it. You know, the trend a few years ago was how many buttons and wheels, how much control can we give the patient over trying to hear their best? And you saw all these old people walking around pushing their ears and buttons, and that never made any sense to me, because the way you and I go about our day hearing, we don't think about it. It just happens. It's a natural thing. We've been hearing our entire lives. So three months before we came out of our mothers, we were able to hear. So it's a natural thing that we don't think of. The best way to treat hearing loss, Antonitis, is to make it a natural process. And so with artificial intelligence, it can do all sorts of cool things. I think for me, the two best examples are the biggest complaint of older adults is difficulty hearing and background noise. Well, with artificial intelligence, we can now clean up the signal that's coming in, reduce background noise, and help people to hear what they want to hear, and not be distracted by all that loud background noise, because that's actually, when you're younger, you can hear everything and hone in on certain conversations. Well, with AI, you can do that. Then another cool feature is look older adults. One of the biggest fears is a fall, and hearing loss is a major risk factor for falls, taking too many medications. Just getting older is a risk factor for falling. Well, pretty cool feature if you're wearing the prescriptive technology, and you do fall.
The technology, I still don't know how it works, has the ability to alert family members. Um, you know, can get an EMT to your house. Like, it's got some pretty cool features that really help you to live independent because, because that's what aging is all about, is being able to. Right, add life to your years, remain confident, remain fiercely independent, and, and through prescriptive technology, we're getting a lot better at it.
[00:24:49] Speaker D: That's, oh, wow. I didn't even know that. That's really cool. So, yeah, this technology is really, yeah, really changing things up in Inda, the audiology space. I love that. That's really.
[00:25:00] Speaker C: Oh, definitely, definitely. We are definitely benefiting from, right, be it the advent of the cell phone to now the wireless, Airpods, bluetooth, I mean, and now with AI, it's just with every leap, every few years is a dramatic change in prescriptive hearing technology that just continues to simplify the process for the patients and provide them with the best cognitive stimulation possible.
[00:25:28] Speaker D: One thing I was curious about when you were talking about, you know, tinnitus and the ringing in the ear, obviously, I'm assuming that really can impact somebody's quality of life and maybe even, you know, bring on, you know, depression, things like that. So I'd love to hear a little bit about that and kind of, you know, your, your thoughts and just, you know, I'm sure that must be fulfilling when you're able to kind of help patients with that.
[00:25:49] Speaker C: Oh, sure. It can be, you know, see, heres what I try to help a lot of people understand. People think about hearing loss as one thing. Tinnitus is something else, when, in fact, tinnitus and hearing loss are actually one in the same. And what I mean by that is, theyre both symptoms. So as we get older, the nerves that connect the ear to the brain start to wither away and die. We talked about this. As a consequence, we don't hear as well, and the brain will actually start to make up its own sound signal to make up for the missing signal. And so it creates this false perception of sound, which is tinnitus. So they're just symptoms of the same neurologic disorder. And so what we have found is that about 60% of people with ringing in their ears will say it it significantly impacts their daily life. And anywhere from ten to 20%, we'll say it's catastrophic. It's almost disabling. And so there are millions of Americans that are suffering, I mean, countless millions, tens of millions of people worldwide that are suffering with these noises in their ears and in their head. And I would think one of the worst things is that too often they're told there's nothing that can be done about. And what we have shown in not just our offices, but what science has taught us in the last few years, be it the American Medical Association, American Academy of Oral Anthropology, has taught us that tinnitus is a treatable condition, and we can actually help about 90% of patients. Some of them, they say that tinnitus goes away. Most of them say it's just gotten so much better that they don't even notice. So that's truly a life changing process where somebody is literally, because it happens all the time on the verge of committing suicide, and we can then change their lives by treating them properly, stimulating the brain, and reducing those just maddening noises.
[00:27:59] Speaker D: Oh, wow. Yeah. I mean, that I can imagine. And with a 90%, you know, treatment rate, that's incredible. That really is. And that's why, you know, just recently.
[00:28:11] Speaker C: We'Ve done so much to really try to partner with and promote the American Tinnitus association because. Right. They're a great source of information, they're a great source of education for Americans to turn to and say, hey, there are experts out there. There are people that can help me with this. And so, you know, I always recommend people to give them a shot to look at their website, figure out if maybe you can find a local provider in your own neighborhood that can help.
[00:28:41] Speaker D: Thank you. That's a great resource, and we'll share that with, you know, with our audience. Would love just now to hear, you know, what advice would you give to anybody that's considering going into the field of audiology?
[00:28:56] Speaker C: I mean, do it.
It's one of those, if you're asking me from the, from the clinician side, look, I was half kidding before when I said job security. The great thing about the focus on aging and independence is that we're living longer. Number one, we've nearly doubled the lifespan in the last 120 years. That's pretty cool, right? But not only are we living longer, but we are demanding a better quality of life in those last ten to 20 years. And you cannot have a good quality of life if you cannot communicate with others. And so in terms of, will I be able to get a job? Absolutely. Will it be fulfilling? Absolutely. Will I be able to make a difference and have a significant impact on people in my community, maybe even worldwide? Absolutely. Because the numbers only keep increasing.
It's estimated we're at 73 million Americans today, that number is set to go over 100 million in the next ten to 15 years globally, from 1.5 billion to 2.5 billion in the next 15 to 20 years. So we need a lot more help, I should say the patients, we need a lot more help in the industry, and our patients need a lot more help. So I think at some point, there'll be more hearing providers than there are baristas at Starbucks. So I think it's a great field to go into.
[00:30:32] Speaker D: Well, it sounds like a fascinating field and one that, like you're saying, is highly fulfilling. So I'm glad that you were able to educate our audience. And I know we have a lot of residents and people that are trying to think, okay, where should I go? What field should I specialize in? So wanted to just give you one last chance, Doctor Darth, to tell us kind of about your books and your institutions and how people can get ahold of you and all that great stuff. Yeah.
[00:31:04] Speaker C: So, I mean, look, all, we put all the books on Amazon. Any money that's generated from there goes right into our nonprofits. So you can just look me up. Doctor Keith Darrow started with stop living in isolation.
2021, I believe, is when preventing decline came out. So that's all about the specifics of how we medically treated hearing loss and tinnitus. Then I decided there are so many people who are just focused on that ringing. And I wrote a book that just came out about eight months ago called silenced the medical treatment of tinnitus. So everything you need to know in terms of what is tinnitus, how do you treat tinnitus, how do you live a life with less ringing if you have tinnitus? All of that's out there. A lot of our educational materials. I write about five different articles a month for different publications. They're all posted on excellenceinaudiology.org dot. So right there, that is part of our nonprofit organization wherein that's for patients. I mean, it could also be for other clinicians to go and look and say, hey, I want to get more information about this. Where can I get a link to that book? Where can I learn more about the connections of hearing loss and cognitive decline? And then ultimately, where can I find a hearing healthcare provider in my backyard. So if you're a patient, where can I go? And if you're a referring physician or clinician, where can I. What's a reliable, trusted place to send patients in my community?
[00:32:36] Speaker D: Love it. Well, thank you so much, doctor Dar. I learned so much and this is such an important field, and it's just, it's fascinating to hear how highly linked it is with overall cognitive health. So we appreciate your time for educating and getting more awareness out there on the subject, and we'd love to thank.
[00:32:57] Speaker C: You for the opportunity. I greatly appreciate it.
[00:32:59] Speaker D: Thank you so much.
[00:33:01] Speaker A: Thank you to all of our listeners. If you would like to be notified when new episodes air, make sure to hit that subscribe button. And a big thank you to Pacific companies. Without you guys, this podcast would not be possible. If you would like to be a guest, please go to www.pacificcompanies.com.
[00:33:19] Speaker B: Thank you.
