**Abstract**

Given the anticipated changes to hearing aid distribution, it is imperative for hearing care professionals to identify new approaches to providing services for persons with hearing loss. One of the primary challenges associated with over-thecounter and self-fitting hearing aids is that all of the control is placed into the hands of the consumer. Although a considerable number of aging Baby-boomers prefer to self-direct their healthcare, when provided that option, a relatively small number of persons with hearing loss are likely to successfully complete the entire process of self-assessment, and self-fitting of hearing aids. Building on the two cornerstones of clinical audiology: diagnosis in the medical arena and rehabilitation in the delivery of services for individuals with chronic conditions, this chapter proposes the new, third pillar of audiology is the provision of comprehensive follow-up and counseling. Moving beyond simply instructing persons with hearing loss on how to use their hearing aids, this chapter lays the groundwork on guiding individuals on becoming independent self-managers of their condition and how these services can be provided in an ethical and profitable manner in a typical clinic.

**Keywords:** self-directed care, patient decision aids, patient centered communication, self-fitting hearing aids, shared goal setting, device mastery skills, self-management skills, service packages
