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Guessing is easy. Verifying is better, and in hearing aid fittings it can be the difference between “good enough” and genuinely clear speech. We sit down with Madison Levine, BC-HIS and Dr. Dave Fabry to unpack what real ear measurement actually looks like in a busy clinic, starting with a simple question: when should you run REM, at the first fitting or later? 

We share a first-fit workflow that’s built for speed: prep the room, connect devices ahead of time, set expectations the moment the patient sits down, and run verification before anything else steals the clock. Then we zoom out to the bigger “why” behind probe microphone measures, including how REM helps confirm audibility at the eardrum regardless of prescriptive targets, proprietary algorithms, or fitting software defaults. 

Dr. Fabry also lays out a practical verification protocol: multiple input levels, automated REM to match targets efficiently, and the often-missed safety-and-performance checks like MPO sweeps and LDL/UCL so comfort is protected without throwing away dynamic range. We end with the uncomfortable question: if the evidence is strong, why isn’t real ear measurement universal, and what can clinicians do to remove the time, cost, and confusion barriers? 

If you care about hearing aid verification, audiology best practices, and better patient outcomes, hit play, then subscribe, share with a colleague, and leave a review. What’s the biggest obstacle keeping REM consistent in your workflow?

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