Hearing Matters Podcast
Welcome to the Hearing Matters Podcast with Blaise Delfino, M.S. - HIS! We combine education, entertainment, and all things hearing aid-related in one ear-pleasing package!
In each episode, we'll unravel the mysteries of the auditory system, decode the latest advancements in hearing technology, and explore the unique challenges faced by individuals with hearing loss. But don't worry, we promise our discussions won't go in one ear and out the other!
From heartwarming personal stories to mind-blowing research breakthroughs, the Hearing Matters Podcast is your go-to destination for all things related to hearing health. Get ready to laugh, learn, and join a vibrant community that believes that hearing matters - because it truly does!
Hearing Matters Podcast
Your Ear Is the Boss: How Proper Impressions Transform Hearing Aid Performance with Ray Woodworth, BC-HIS
Ever wondered why some hearing aids feel invisible while others never quite sit right? The secret lies in the impression-taking technique—and Ray Woodworth is the master.
Ray joins Dr. Douglas Beck on the Hearing Matters Podcast to reveal the artistry behind deep canal impressions. As a Board-Certified Hearing Instrument Specialist at Starkey's Center for Excellence, Ray has tackled some of the most challenging fittings nationwide, refining techniques that transform patient experiences.
"The ear is the boss," Ray emphasizes repeatedly. This fundamental philosophy drives his approach to custom fittings, respecting each ear's unique anatomy rather than trying to force technology where it doesn't belong. His insights overturn common practices—revealing why cotton trumps foam for blocking, and why video otoscopes revolutionize the process
The conversation demystifies technical aspects like material viscosity and shore values while making a compelling case against the overreliance on dome fittings. Ray explains why he opts for custom solutions 80% of the time when many practices do the opposite, demonstrating how proper canal impressions deliver superior sound direction, better retention, and often improved cosmetics.
Most fascinating is the window into the factory perspective, where Ray's experience troubleshooting thousands of challenging cases has crystallized into a knowledge, tools, and skills (KTS) approach that any hearing professional can adopt. For practitioners and patients alike, this episode illuminates why those few extra millimeters of impression material can make the difference between hearing aids that transform lives and those that sit unused in drawers.
Want to elevate your fitting technique or understand why your hearing aids might not feel quite right? This conversation is your masterclass.
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Email: hearingmatterspodcast@gmail.com
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Dr. Douglas L. Beck:
Good afternoon. This is Dr. Douglas Beck with the Hearing Matters Podcast. And today my guest is Ray Woodworth. And Ray is a BCHIS, so he's Board Certified Hearing Instrument Specialist. He works at the Starkey Center For Excellence where he has worked with some of the most challenging hearing aid fittings across the US. Ray troubleshoots and solves unique situations of acoustic and physical fittings. And he has taught more classes, I think, than anybody else on deep canal impressions. Ray, welcome. I'm so glad you're here.
Ray Woodworth:
Well, thanks for having me, Doug. It's a pleasure.
Dr. Douglas L. Beck:
Yeah. Well, listen, to be transparent, Ray is the one who took my IIC impressions, my invisible in the canal impressions, which I wear almost all the time. Not now because now I'm using AirPods to connect to the studio. But it's pretty amazing because I think most of us, of course, know how to take ear mold impressions, but there's a special skillset associated with deep canal fittings. And Ray, before we get into the difference between a deep canal fitting and a standard ear impression, Ray, tell me some of the takeaways that you've learned after doing this for many, many years.
Ray Woodworth:
Being here at the factory, I've had an opportunity to work with many engineers and technicians on the facets of our hearing aids and how we build them. And when you look at the facets of hearing aids, you look at the style, the size, the features, and so forth. And what I found was, you can change different parts of the hearing aid when you build it, but you can't change the ear. The ear is very unique because as you know, our ears are like fingerprints. They're all unique, they're all different.
You can change receivers, you can change features, you can change vent size and so forth on custom hearing aids, but the ear is the boss. And if you've been to my classes, those that have been in my classes, you'll know that I always say that phrase, "The ear is the boss." And the reason why is because we have to respect the ear, because the ear tells us what we can and cannot do. So the answer to your question, Doug, shooting a deep ear impression is very important because it gives us all the information we need to leverage what we have available to that ear. If I could change the ear, my job would be a lot easier.
Dr. Douglas L. Beck:
Well, presuming you cannot change the ear, what are you looking for when you're looking at a deep canal candidate? What are the factors you're looking at?
Ray Woodworth:
You're a good example, Doug. Your ear is small.
Dr. Douglas L. Beck:
Yeah.
Ray Woodworth:
I mean, someone like you, if you want an IIC or something very small, you have to give us the full length of the ear canal because of the sound direction for the parts to fit deep down into the ear canal, for retention. So the more information you give us about that ear, the more we can fit the components in the ear, nice and deeply, especially for an IIC. Now, with your ear, Doug, if I didn't get a deep ear impression, I couldn't recess the plate as much as I did for you and to make it invisible. So I think that when it comes to small, I see hearing aids, it's very important for deep ear impressions. On top of that, I found that people that have more profound hearing losses, that have worn hearing aids for many, many years, and if you look at the previous molds, they're typically longer because they like [inaudible 00:03:17].
Dr. Douglas L. Beck:
Yeah, exactly. Yes.
Ray Woodworth:
So I found that with people with more profound losses that worn hearing aids for a long time, they typically like longer canals because it gives them more sound pressure level and it gets louder for them.
Dr. Douglas L. Beck:
So the point is, that as we go from a standard ear canal, the volume between the medial tip of the hearing aid and the eardrum, supposing that's 1.75, maybe 2.0, but when you're talking about an invisible in the canal or a deep canal fitting, what we have to do is go closer to the eardrum. And when we go closer to the eardrum, the cavity between the hearing aid and the eardrum is reduced, requiring less sound pressure in total with regard to gain, to give us the sensation of hearing.
Ray Woodworth:
And not only that, Doug, when you do that, it also helps with feedback because you don't have to push the hearing aid as hard.
Dr. Douglas L. Beck:
That's right, that's right. And of course, now when you talk about a deep invisible in the canal fitting, do you always vent them or do you vent them sometimes. Or how do you make that decision?
Ray Woodworth:
That's a good question. So by theory they say is the further the IC is in, the less the occlusion because the bony portion of the ear canal.
Dr. Douglas L. Beck:
Right.
Ray Woodworth:
But I found that people that have really good hearing in the lows typically need bigger vents. So we gauge off the lower frequencies. If somebody needs their lows brought up for power, typically we go with smaller vents. Smaller vents gives you more lows. A bigger vent [inaudible 00:04:45] out the lows.
Dr. Douglas L. Beck:
Sure.
Ray Woodworth:
[inaudible 00:04:46] somebody complains about the voice not sounding natural, especially if the lows are in the normal range, typically, I like to get bigger vents. Now again, like I said earlier, the ear is the boss. So if the ear allows me to get a bigger vent, that's great. But people have to understand with the invisible IICs, it's not one size. There's different size of IICs.
Dr. Douglas L. Beck:
Sure.
Ray Woodworth:
[inaudible 00:05:06] called a second bin, a first bin and an aperture fit. And those three are the way where we can put the faceplate for the IICs. And it depends on the ear. Some ears, you need to bring the faceplate a little further out to get a bigger vent. Some ears you can go deeper because you don't need a big vent, you can go with the pressure vent. So we gauge off the ear and that's why the impression is so important because if you don't give us that room to work with, we can't give you the best fit.
Dr. Douglas L. Beck:
Yeah, and I want to just advocate what you're saying here because I'll tell you, I've got a 35, 40 dB loss, so not hard to fit. But when I don't have amplification, I can tell a world of difference. The IICs that you made for me, quite frankly, are the first IICs I've ever had that nobody has ever said, "Oh, my gosh, what's in your ear?"
Ray Woodworth:
Yes. And Doug, your ears are small. So it's tricky.
Dr. Douglas L. Beck:
Yeah. Yeah, yeah.
Ray Woodworth:
And I think if we didn't get a good deep ear impression, it would've been more challenging to build it for you.
Dr. Douglas L. Beck:
That's right. When I was a child, I had swimmer's ear and blah, blah, blah. Nobody cares about those details anymore. But my ear canal is rather tiny. So Ray, the question would be, how do you take a canal fitting that is that deep? Because I can tell you, it was painless. I can tell you there were no issues with pain or with anything. It was fine. How do you go about doing that? Tell me step-by-step what's required to get a fitting like that?
Ray Woodworth:
So first of all, I like to use what's called a video otoscope. The video otoscope, it's a 40... I use it on a 40 to 45-inch screen and it really magnifies it. When I was in private practice, this is what I used a lot of. This is common right now, like you mentioned, Doug. This is very common in the industry, the handheld scope. And people use an otolight to place the cotton in the ear. Right? But I use a video otoscope. And so what I do is, I always use cotton. Cotton is very important because you can flatten it, you can make it any shape you want. You can go down really deep. A lot of people, I see people use this, Doug, and I think this is okay to use. These are foams.
Dr. Douglas L. Beck:
The foam dams, yeah.
Ray Woodworth:
Yeah, the foam dams. And there's different sizes of foam. And I'm glad you brought this up because I see this a lot that come to production. These are all foams and they're pretty big, right? And so what happens is, we get impressions that come in and this is what they look like. So what happens with foam is if you look at this canal, Doug, you see there's no ear canal. [inaudible 00:07:41].
Dr. Douglas L. Beck:
Yeah. This is just a concha.
Ray Woodworth:
See, I took the foam off. You see that right on the tip?
Dr. Douglas L. Beck:
Yeah.
Ray Woodworth:
So what happens is when if you take that foam off, you lose the length of the ear canal.
Dr. Douglas L. Beck:
Yeah, sure.
Ray Woodworth:
And I can tell you, if you use cotton, you can make a big difference on length. You can shorten the canal and make a length. Here's one. There's another one that was used. And actually, you can see this. Actually, there's no ear canal.
Dr. Douglas L. Beck:
Right.
Ray Woodworth:
See that?
Dr. Douglas L. Beck:
It doesn't even go to the second bend.
Ray Woodworth:
No, not even near the first, even close enough to your first bend. But my point is, you can actually get stuff like this, Doug, even with cotton, if the cotton's too big. So the first thing I would do is make sure I have the right size block. Some use-
Dr. Douglas L. Beck:
And let me ask you, Ray, are you trying, with cotton, are you trying to pack it just to the eardrum or are you packing it against the eardrum?
Ray Woodworth:
That's a good question. I tell people at least get to the second bend or past the second bend. I quite honestly, I do most of mine really close to the eardrum.
Dr. Douglas L. Beck:
So I know that when you took my impression and when I've watched you take others while I'm observing through the video otoscope display, you actually use a two-hand technique where you're illuminating it with one hand and you're packing it with the other. So tell us more about that.
Ray Woodworth:
So what I do is I use the video otoscope in my right hand. And the thing is, is... You know what Doug, what's interesting is, and this is something we can discuss further, technique is so important. So the way we use our tools, like I said, some people use a handheld scope and a otolight. I like to use a video otoscope with a curette. And what I do is, I position that video otoscope, which gives me the image on the screen to where I need to be positioned. And I leave it there. And then I get the curette and I go from the top.
And then when I go from the top, I always know when I'm going in. And what happens is, when you keep doing that over and over, you understand depth perception. So when you get the curette and you place the cotton in the ear. You get the curette and you push the cotton, I usually go around the cotton. I never touch the ear canal because you know as well as I do, the ears are sensitive. And I found Doug, what's very fascinating to me is, there's some people, especially previous users that have worn hearing aids for a very long time, their ears are not as sensitive. I can put a cotton right on the eardrum and it doesn't bother them at all. Then you have other-
Dr. Douglas L. Beck:
Yeah. I'm not going to recommend that, but I know you can in some people. Yeah.
Ray Woodworth:
And there's some people you can't because they've never had anything in the ear before.
Dr. Douglas L. Beck:
Right.
Ray Woodworth:
So the sensitivities are different, but I think that if you learn the skill and you master it, you can shoot really good ear impressions on everybody.
Dr. Douglas L. Beck:
Yeah. And this is so important, what you just said. I want to just underscore that when you're using a video otoscope with high illumination, even though it's one directional, it's not stereoscopic vision, but you do get a sensation of a three-dimensional image. And again, I saw this on this 40-inch screen. And honestly, you could identify individual hairs around the eardrum. And it was so important to have that resolution. And I don't think I could ever take a deep canal impression with a handheld otoscope. I just don't think it's possible.
Ray Woodworth:
And you know what, I'd like to add to that. I'll be quite honest with you, Doug. I would never do a surgical ear without a video otoscope. And the reason [inaudible 00:11:06] surgical, like you just mentioned, the detail is important on a surgical ear because you've got cavities, you've got pockets. And when you use a video otoscope, you can see all the crevice, you can see all the pockets, and you know where to fill in. And so I've learned that it's a skill and it's all based on repetition. The more you do it-
Dr. Douglas L. Beck:
The more you do it. Yes. And I've worked with a lot of neurotologists in my career, and every one of them, when they're looking at an ear, they pull in a microscope and then they look through binocular vision. So they get 3D, then they do their thing. But very few people will look at an ear with a handheld otoscope, other than to see is there fluid behind the eardrum or any gross deformity. I mean, that of course, you can tell with a handheld otoscope. I have no issue with that. I've been using handheld otoscopes for 40 years.
But I wouldn't use them any longer to take deep canal impressions because it's a whole world of difference. And when we're using a video otoscope, we have the same visual benefit that any ENT or any neurotologist would have by examining that ear, perhaps with a speculum or not, but still having the very high magnification and having the 3D image. So tell me, so if we're talking about cotton and we're talking about going deep into the ear, what type of ear mold impression material do you prefer?
Ray Woodworth:
That's a good question, Doug. In my classes, I tell people... It amazes me how many different viscosity materials out there in the industry. [inaudible 00:12:37]. If you look at these cartridges, a lot of people use the gun and it's very common. And if I was back in practice 24 years ago, when I started in 2000, I would today, have a lower viscosity material and a higher viscosity material. And the reason why I'm saying this is because, and I would say, the shore value... You know, the difference between viscosity and shore, viscosity is the thickness of the material. The shore value is how hard it gets.
And I found that the higher the viscosity and the higher the shore values are, it's harder to remove from the ear because there's no compliance, there's no give. So I [inaudible 00:13:14] that if you use a lower viscosity and a lower shore value, sometimes you'll find that it's easier to remove from the ear. So people don't pay attention to the material, as far as the viscosity and the shore values. I like to use a lower shore value. I would say, 18 to 20, if you're looking at the numbers. So I would do 18 to 20 shore values, and sometimes I would use a 25 to 26.
Why would I use two different shore values? If someone that's [inaudible 00:13:43]. Like you and I, we've been in the industry for a while. You've been here a lot longer than I have. But the shore value, I found that if you have a really profound loss and you need a really tight fit, a shore value of a higher shore value, will stretch the ear more so you'll get a better seal. And those [inaudible 00:13:59] patients, I like to use a higher shore value. If you have a patient that's a new user and has a mild hearing loss, that never had anything in their ear, I would probably go with a lower shore value. So it depends on the ear and the type of loss they have. But typically, I would do an 18 to 20 shore value.
Dr. Douglas L. Beck:
And what about the give-and-take? So if I'm using silicone versus... Does anybody use powder and liquid anymore or is that just me?
Ray Woodworth:
Powder and liquid is... No, nobody uses it anymore. But I do because I'll be honest with you, because I'm here at the factory, so I can do it in-house and I have quick access to what I need. So with me, when I see someone, when Bill Austin, when I work with Bill Austin. You know who Bill is?
Dr. Douglas L. Beck:
Yes, I think we all know who Bill is. Yeah.
Ray Woodworth:
And so I've learned with Bill that, sometimes Bill says, "Hey, this person has a profound loss. I need a little tighter fit." So what I do is I add a little more powder to my powder and liquid. What it does is, stretches the ear more. So I can change the thickness of the material with powder and liquid. The problem with powder and liquid is, it's hard to ship because if you ship it in the wrong temperature, it will change the shape of it. So powder and liquid is not something good to use, especially if you're from the South because of temperature change. So the silicone is great. It's great to use. Most people use silicone. But again, I change the thickness based on the hearing loss and based on the ear.
Dr. Douglas L. Beck:
Yeah, it makes good sense. And so I think as a standard, silicone has become the standard. I think 99 out of a hundred impressions you get at the factory have to be silicone.
Ray Woodworth:
And Doug, to add to that, when you put the tips on, look how different these are.
Dr. Douglas L. Beck:
So Ray, with the gun tips, they vary in width and in depth. And I think what you were arguing is that many people will remove the tip of the gun prior to the silicone coming over it. And I think that's an important idea that you have to leave it in longer and let the material overrun the tip and then slowly take the tip out. Don't be chasing it, just work with it.
Ray Woodworth:
Yeah, you're right. So what happens is when people put the tip in, like you just said, I count one 1000, two 1000, three 1000, and let the material come out first before I start pulling the tip out because what happens is, if you pull out the tip too quickly, you get voids. And this is a good example. You see how these little voids on the bottom here?
Dr. Douglas L. Beck:
Oh yeah, of course. Yeah.
Ray Woodworth:
Yeah. You don't want that.
Dr. Douglas L. Beck:
Right.
Ray Woodworth:
And again, this foam, I'm not a foam guy, and it takes up space. So if you do it correctly, look at the difference in the bowl. The bowl is much more smooth.
Dr. Douglas L. Beck:
Oh, that's a whole different ear mold. Yeah, totally different.
Ray Woodworth:
Yeah. So this is what you want. You want it nice and smooth.
Dr. Douglas L. Beck:
Yeah.
Ray Woodworth:
No air pockets and voids.
Dr. Douglas L. Beck:
What percentage of ear molds that come into the factory every day, which I'm sure are thousands of them, what percentage get rejected because there's not enough physical information to make an appropriate product?
Ray Woodworth:
That's a good question, Doug. You know, if I had to, I can't give you exact numbers because you're right, we see thousands. I would say 20 to 30%.
Dr. Douglas L. Beck:
What happens then? So somebody sends an ear impression in, it's not suitable to make a hearing aid or an earable [inaudible 00:17:12]. So then does somebody actually physically call the dispensing office and say, "We need a better impression?"
Ray Woodworth:
Yes, we do. Yes. We have what's called the triage. And the triage is where we lay out all the orders and we have a specialist look at each order and making sure that the impression is good enough to build the custom product. Because I tell you right now, working with Bill, I've learned that we don't look at orders as the numbers. We look at these orders as people, and these people need help.
Dr. Douglas L. Beck:
Yeah.
Ray Woodworth:
And so we take a lot of pride in what we do. And so we have somebody look at these orders, the ear impression and what they're asking for it, and making sure we got everything we need to make it successful for the patients.
Dr. Douglas L. Beck:
Yeah, that, it's such an important and basic point. It's the old garbage in, garbage out. I mean, I can tell you that when I would take impressions, which I haven't done for a couple of years now, but back in the day, you know, I would have to reject of my own, I don't know, one out of five, one out of seven, that I would take it out and it would be terrible, and I would just have to redo it. And I think though now that we have these tools, we have video of otoscopes, we have the ability to see what we're doing. We're not doing it blindly. I would really urge people to look into this. Now, the number one pushback on a good high quality video otoscope is probably the price. And this is the thing to know. Number one is a video otoscope in 2025 is a hundred times better than one from 2015.
You won't believe the difference. You have to see the new stuff. It's amazing. It's like having a TV from 30 years ago versus a TV now. The resolution is so much better, it's not even close. So Ray, I think the number one pushback that people say, I think everybody looks at the video otoscope that you use and they go, "Oh, my goodness, this is really something." Because it is. And the video otoscopes now in 2025 are probably a hundred times better than they were just 10 years ago. So if you've got an old one and you're using it and you like it, that's great. But if you upgrade, you'll be blown away by how much better the resolution is and the illumination. But what do these things cost? Because I know that that's a major concern.
Ray Woodworth:
Yeah. So I looked into that, Doug, because I do have questions like that, how much they cost. And I found that they cost... I've seen them cost from $400 to $500, all the way up to $8,000. And at the end of the day, what you pay for is what you get. So the one I use, it costs about 7,000. And it has an LED light.
Dr. Douglas L. Beck:
Yeah.
Ray Woodworth:
It's very bright. When you look at an ear, sometimes you get moisture. This video otoscope prevents moisture in the ear and it has a very bright light and the definition is amazing on the screen.
Dr. Douglas L. Beck:
It is.
Ray Woodworth:
[inaudible 00:19:48] very light, easy to handle. It's not bulky, it's not big. So I think the size, the weight and the light source that it uses, it uses an LED light and the image is so important. But Doug, at the end of the day, if video otoscopes is something that people... I know, and I've heard this, I know people that have video otoscopes in their offices, Doug, that they don't even use them.
Dr. Douglas L. Beck:
Yeah, that, I'm sure that happens. So one of the other options that people have, virtually, any of the major hearing aid manufacturers, I think would work with any dispensing office to make sure they have the right tools because it's in their best interest. They don't want to have to reject ear mold impressions. They want the best possible. That gives them an easier job making an excellent product, whether it's an ear mold or a hearing aid. Now Ray, you told me off script that there's another use for video otoscopes. What else can you do with them besides packing an ear and taking an impression?
Ray Woodworth:
There's a lot of things that we can do. Sometimes I have patients tell me, "You know, Ray, when I chew, I hear clicking or when I chew, the mold is walking out." And then I say, "Well, let me take a look in your ear." So I get the video otoscope, and again, it's a big screen and you see the ear moving while they chewing. Say open and close your mouth and say, that's why. When you show them, it validates what the problem is. Also, when you see an ear that, let's say you put a mold in and say, "Ray, when I put it in, it tends to walk out." Sometimes, the texture of the ear.
So you can look on the screen and see the skin wrinkles. And when you put something in the ear, the skin moves with it. So looking at texture, looking at the canal moving, looking at... If somebody has a perf or they're like, "Hey, I have drainage." And you look in there and there's a hole in the eardrum. What I'm trying to get at, Doug is when you validate and show the patient, there's [inaudible 00:21:40]. There's value. So I think there's a lot of value to the video otoscope that I think is undermined or not looked at that I think is huge. We use a video otoscope every day. [inaudible 00:21:51].
Dr. Douglas L. Beck:
Yeah. Just walking by your lab is impressive because you always see, when you're working on an ear and you always look at it and it's always interesting, it's fascinating. But it's revealing because it tells you what to do. By knowing that anatomy, by having an excellent look at it, it allows you to figure out how are you going to take the next steps. Ray, tell me a little bit more detail about KTS and the available tools and knowledge and skillsets that are required here.
Ray Woodworth:
Okay. So when it comes to knowledge, I think it's very important to know what's available. What's an IIC? What's an ITC? What's a half show? What's a full show? What's a custom case versus a snap-and-receiver? Working here at the factory has given me totally different perspective about customs. As you know, as well as I do, domes are phenomenal. They're great, very handy for people that have mild to moderate hearing loss, but there's some ears that don't like domes.
So what I would say to you is, as far as knowledge, knowing what's available for the patient and also when it comes to shooting impressions, like we mentioned earlier, viscosity material, the type of gun you use, the tips that we use, cotton versus foam. So all these things about knowledge of what's available, is so important. The second thing is, is talking about the tools. What tools are we using? Some people use otolights, some people use video otoscopes, some people use a handheld mix, some of these [inaudible 00:23:23]. So there's different tools that you can use to do what you need to do for the patient.
Dr. Douglas L. Beck:
Right.
Ray Woodworth:
And the last thing is, is skills. I think skills is the most important one of all three. And the reason why is because, it's called repetition. The more you do an ear impression, the more you can master it. The more you [inaudible 00:23:43] custom hearing aids, the more you understand what's available. So I think repetition is so important when it comes to skill of working with custom products.
Dr. Douglas L. Beck:
So Ray, before I let you go, the thing I want to discuss is domes. Because the most common dome, of course, is a tulip dome. And those are the ones that have all those holes going around them. Now, I think domes like that are fine for somebody with a mild moderate loss and they're trying hearing aids for the first time or they want to wear it for 30 days to help them make a decision about benefits that they're receiving. But my problem with domes, is number one, they move around. Number two, they allow a lot of sound to get into the ear without being processed by that very expensive hearing aid, and I've never heard anybody say that a dome fitting was better than a custom fitting. So domes have a place because they are an instant fit device. But tell me the difference that you would expect between a dome and a custom fitted device.
Ray Woodworth:
So that's a good question, Doug. So with domes, like you said, a lot of people fit domes in offices. We know that. But it's funny, we're talking about this because where I work, I do 80% custom, 20% domes. So I do the opposite. And the reason why is because with custom fits, you can get better sound direction, you can get better retention, and sometimes, you get better cosmetics. Now, when you put a dome in, if you have a really curved ear, and sometimes, Doug, I get this light, right? And I look in their ear, and sometimes when I see a wall and I can't see the eardrum and I'm looking right into the ear, sometimes when I see a wall, I'm afraid when I put a dome in, the sound's going to hit that wall and you're not going to get the benefit of the sound [inaudible 00:25:22]
Dr. Douglas L. Beck:
That's a great point.
Ray Woodworth:
... of the technology. And then what happens is, they're like, "I can't get it in. It won't [inaudible 00:25:27]." And then what happens is you go like this and then you got to go like this and try to get it in the ear. So I found when you make a custom, the way you detail it, the way you shape it, you can make it easier to go in for the patient. And there's some patients that can't handle domes. So I can make a mold, any shape or size for the patients, for easier for them to handle as well. So there's so many things you can do with the custom that a dome can't do. And to add to that, I think double domes, which means occluded domes, I think occluded domes, I would probably never use those because I would rather do a custom mold. And the reason why, because people use occluded domes for people to have more moderate to severe hearing losses. So I like to use a custom mold instead of a double dome to get a better sound [inaudible 00:26:17].
Dr. Douglas L. Beck:
Yeah. It's a great point. And the thing is, whenever you insert a dome, unless you're highly experienced as a patient, you really don't know where the sound is going. And the idea of a custom product is you want to point it towards the eardrum, not towards the wall of the canal. Yeah. Well, Ray, listen, I know you're a busy guy and I really appreciate your time. You are a joy to know and I want to thank you very much for your hints and tips here on how to do this job even better.
Ray Woodworth:
Well, I appreciate it. Thank you for your time. I really enjoyed it.
Dr. Douglas L. Beck:
You bet. Thanks, Ray.
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