A comprehensive hearing test involves pure tone audiometry, speech testing, tympanometry, otoscopy, and often real-ear measurement, not just “can you hear the beeps.” At The Audiology Place, our standard diagnostic hearing assessment takes 90 minutes because we’re measuring how your entire auditory system functions, not screening you for a product sale.
Do I Need a Referral for a Hearing Test in Australia?
No. Audiologists are primary contact practitioners in Australia, which means you can book directly without a GP referral. If you hold a Pensioner Concession Card or a DVA Gold or White Card, you may be eligible for a subsidised assessment under the government’s Hearing Services Program. You apply to the program online or through a provider such as us. People under 26 are also eligible, but are seen through Hearing Australia. Private health funds don’t require a referral either. Whether you get a rebate, and how much, depends on your fund and level of extras cover, so check with your fund before the appointment.
If you’ve got sudden hearing loss, vertigo, ear pain, or discharge, see your GP first. We can’t treat infections or prescribe medication, and some symptoms need medical imaging or ENT review before we start testing.
What Actually Happens During a Hearing Test: The Step-by-Step
Case History and Symptom Discussion (15–20 minutes)
Before any equipment comes out, we talk. I need to know when you first noticed the hearing change, whether it’s in one ear or both, if you’ve had noise exposure, what medications you’re on, whether there’s tinnitus, and crucially, what situations are hardest for you: restaurants, meetings, the TV, phone calls. This isn’t small talk. The pattern of your hearing loss, your medical history, and your communication needs determine which tests we run and what we’re looking for. A 70-year-old tradie with noise-induced loss needs different assessment and counselling than a 30-year-old with sudden unilateral loss and tinnitus. The latter might need an urgent MRI.
Otoscopy: Looking Inside the Ear Canal (5 minutes)
We use a video otoscope to check your ear canals and eardrums on a screen you can see too. We’re looking for wax occlusion, perforations, skin conditions, foreign bodies, fluid, or signs of infection. Plenty of patients arrive with enough wax to affect test accuracy, and we’ll either remove it on the spot with microsuction or refer you to an ENT if there’s something that needs medical attention. You can’t reliably test hearing through a blocked canal, and you’d be surprised how often people have been walking around with impacted wax for months assuming they’ve lost hearing permanently.
Tympanometry: Testing Middle Ear Function (5 minutes)
This test measures how well your eardrum moves. We place a soft probe in your ear canal, it changes air pressure briefly (feels like your ears blocking on a plane), and the machine graphs eardrum compliance. We’re checking for fluid, Eustachian tube dysfunction, ossicular chain problems, or perforations. A flat tympanogram with conductive hearing loss might mean glue ear or otosclerosis. Normal middle ear function with hearing loss points to a sensorineural cause: inner ear or nerve. It’s quick, objective, and tells us whether the mechanical part of your hearing system is working.
Pure Tone Audiometry: The Beeps (20 minutes)
This is the test most people picture. You sit in a sound-treated booth wearing headphones, and you press a button every time you hear a tone, even if it’s faint. We’re testing air conduction at octave frequencies from 250 Hz (low rumble) to 8000 Hz (high pitch), and bone conduction using a headband that vibrates sound directly to your inner ear, bypassing the ear canal and middle ear. The difference between air and bone conduction thresholds tells us where the problem is.
We measure thresholds in decibels hearing level (dB HL). Normal hearing is roughly 0–20 dB HL. Mild loss is 21–40 dB, moderate 41–70 dB, severe 71–90 dB, profound beyond that. But those numbers mean nothing without context. A 40 dB loss at 4000 Hz affects speech clarity far more than a 40 dB loss at 250 Hz, because consonants, the sounds that distinguish “cat” from “hat”, live in the high frequencies.
Extended high-frequency testing (9000 Hz to 16,000 Hz) is sometimes included if there’s noise exposure history, ototoxic medication use, or early presbycusis. It picks up damage before it shows on a standard audiogram.
Speech Testing: The Part That Actually Matters (15 minutes)
Hearing pure tones in quiet tells us your sensitivity. It doesn’t tell us how you process speech. We use recorded word lists presented at different volumes to measure speech recognition thresholds (the softest level you can repeat words) and word recognition scores (how accurately you understand words at comfortable volumes).
Then comes speech-in-noise testing, which is where things get real. We play sentences with background babble noise and measure the signal-to-noise ratio you need to understand speech. Most people with high-frequency hearing loss can follow conversation in quiet but fall apart the moment there’s competing sound: the pub, the café, family dinners. This test quantifies that. If your speech-in-noise performance is disproportionately poor relative to your pure tone thresholds, we’re also considering auditory processing issues or cognitive factors.
Otoacoustic Emissions (OAEs): Checking Inner Ear Hair Cells (5–10 minutes)
OAEs measure sounds produced by healthy outer hair cells in the cochlea. A tiny probe in your ear canal emits clicks or tones, and we record the echo that comes back. If the outer hair cells are damaged, by noise, ageing, or ototoxicity, the emissions disappear. This test is objective (you don’t have to respond) and useful for confirming sensorineural loss, checking for non-organic hearing loss, or monitoring ototoxic drug exposure.
Results Explanation and Recommendations (20–30 minutes)
This is not a quick “you need hearing aids” conversation. We go through your audiogram, explain what the results mean for your day-to-day communication, discuss whether hearing aids are appropriate (sometimes they’re not), talk about different technology levels, realistic expectations, and next steps. If there’s an asymmetry, a sudden loss, or results inconsistent with your symptoms, we’ll refer you for further investigation: MRI for acoustic neuroma, ENT review, vestibular testing.
There’s no pressure to buy anything at this appointment. You leave with results, a clear explanation, and usually a follow-up booked after you’ve had time to think.
Why a 90-Minute Assessment Is Different from a 20-Minute Screen
Walk into a retail hearing clinic or a pop-up booth and you may get a quick pure tone test, a chat, and a same-day hearing aid fitting. That’s a screen, not a diagnostic assessment. There’s no middle ear testing, no speech-in-noise measurement, no OAEs, and limited time to discuss whether the loss is medically significant or requires further workup. The incentive structure is different when the business model relies on device sales.
We’re diagnosticians first. Our job is to identify the type, degree, and probable cause of your hearing loss, rule out red flags, and work out whether amplification is the right solution. Sometimes it’s not. Sometimes you need wax removal, medical referral, or assistive listening devices instead. Sometimes your hearing is fine and the issue is auditory processing or cognitive load. A 20-minute screen doesn’t have the time or scope to differentiate.
Questions to Ask Your Audiologist
If you’re comparing clinics, ask whether the test includes tympanometry, speech-in-noise testing, and otoacoustic emissions as standard. Ask how long the appointment is. Ask whether they’re independent or affiliated with a manufacturer. Ask what happens if they find something medically significant. And if they recommend hearing aids, ask whether they perform real-ear measurement to verify the fitting, because programming a device to manufacturer defaults without measuring what’s actually happening in your ear canal is guesswork, not audiology.
We’ve written a separate guide to the questions worth asking about pricing, trial periods, warranties and ongoing support.
What to Bring to Your Hearing Test
Bring a list of your medications, especially if you’re on chemotherapy agents, antibiotics like gentamicin, or high-dose aspirin: all potentially ototoxic. Bring any previous hearing test results if you have them. If you have trouble hearing your GP or following conversations, bring a support person. And if you wear glasses, bring them: many people lip-read more than they realise.
The Bottom Line
A comprehensive hearing test is not a sales pitch disguised as healthcare. It’s a diagnostic process that takes time, uses calibrated equipment, and requires clinical judgement to interpret. At The Audiology Place, we spend 90 minutes because that’s what thorough assessment requires. You’ll leave understanding your auditory function, your options, and what happens next, whether that’s hearing aids, medical referral, a watch-and-wait approach, or just reassurance that your hearing is fine and the issue is something else entirely.
