Went to Costco recently and got retested. Was referred to an ENT for worsening hearing and an increasing air/bone gap. I need to get some more testing (acoustic reflexes) but ENT said it was most likely arthritis in the middle ear. (I guess technically arthritis in the joints connecting the bones in the middle ear–I think referred to as the "ossicular chain:)
Costco always has done bone conduction testing with me. When I’ve gone to private audiologist they often do not. I’m curious what others experiences are. Do they usually do bone conduction testing? For the professionals out there, are there indicators that you need to do bone conduction testing and when you don’t?
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I was tested at Costco Wednesday past, which included bone conduction.
Has poor testing been ruled out? Did they retest at the ent or just look at the Costco test? Where is this apparently widening air bone gap?
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Many feel impedance testing (tympanometry) is adequate and don’t do bone.
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So if tympanometry looks ok, skip bone? Pretty sure the people that didn’t do bone also didn’t do tympanometry. My gut impression was that they’d decided my loss was sensorineural and I didn’t need bone.
I’ve only been to one private audi, and yes, I got bone testing every time.
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Standard practice here in the UK @MDB… I don’t believe I have ever, not had a bone conduction test done, either with the NHS, or indeed with any private audiologist, although the flip side of that is, I have never had a WRS, in 30 odd years, well apart from one, I assume I got, for a preliminary CI assessment, although they declined to tell me my score! Cheers Kev 
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If air conduction thresholds have not changed from one year to the next, there’s not much use in re-doing bone conduction testing.
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I realise that @Neville… But, perhaps old habits die hard, in my experience, this is the way it’s always been done in the UK… Cheers Kev
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The VA does. Qwertyyu
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I think there are two competing approaches. One is kind of a mindless checklist approach that has the advantage of consistency but may result in doing some things that don’t make sense versus a “use your professional judgement” approach which if done thoughtfully is great, but if one is pressed for time or one is feeling lackadaisical may result in less than optimal outcomes. Likely some sort of combination is desirable.
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BAA standard requires Bone Condition testing with all tests, with at least 4 points established and masked accordingly. Half octave values are only usually measured when there’s 20dB or greater difference between adjacent values, but I like having 1.5 & 3KHz for programming/REM.
If I had a stab at the rules, I’d ban most headsets in use today and handwritten test records.
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Since I get my hearing care through the VA I can only speak to that. Every time I have had my hearing tested since 2000, when I first got hearing aids, they have done a bone conduction test as part of their normal battery of tests.
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