Cough syrup, aspirin, toilet paper … and hearing aids. That may be some consumers’ drugstore shopping list this fall, thanks to a new FDA rule making some hearing aids available without a prescription in pharmacies, electronics stores such as Best Buy, and online.

Is that good news or bad news for the 38 million American adults estimated to have trouble hearing?

It depends on whom you ask. Some advocates for those with hearing loss lobbied for the rule change, which they hope will make hearing aids cheaper, easier to get, and less stigmatized. Hearing aid makers are cheering expanded opportunities to market and sell their products.

But audiologists, even those who generally support the idea of non-prescription hearing aids, worry that without an initial evaluation and ongoing care, people will buy the devices without understanding how to use or adjust them. In addition, they won’t know the cause of their hearing loss, which could be triggered by earwax, fluid in the ear or, in rare cases, a tumor requiring surgery.

“Can you imagine going into Walgreen’s, buying a hearing aid, and expecting the girl at the counter to sit down and teach you how to use it?”

Sherrie Davis, AuD, associate director of audiology and the Dizziness & Balance Center at Penn Medicine in Philadelphia, notes that it’s hard for someone to tell whether their hearing loss is mild, moderate, or severe; without a test, there’s no chance to catch other causes of poor hearing – from mild conditions like allergies to more serious ones such as an acoustic neuroma, a benign tumor on the nerves leading from the inner ear to the brain.

Some audiologists fear that consumers could damage their hearing by setting the devices at too high a volume; they advocated for limits on the “gain output” – the difference between the unamplified sound a patient hears and that same sound heard with a hearing aid. The FDA did not include limits on gain, though – in response to some of the more than 1,000 public comments received on the rule – it did cap the maximum sound output of over-the-counter hearing aids at 117 decibels (nearly the level of a jet plane during takeoff).

The current market includes a wide array of hearing aid types – from tiny buds that tuck inside the ear canal to behind-the-ear models with a transparent wire; rechargeable and battery-operated; and hearing aids that sync with a smartphone and can be used with Bluetooth.

“It’s naïve to think people can just buy something, program it, put it on their ear, and have it work for them” says Ashby-Scabis. “I think there needs to be some thought to how we’re going to provide follow-up. I’m not sure [over-the-counter] hearing aids are going to be as simple a fix as was desired.”

She and other audiologists worry that consumers will try an over-the-counter hearing aid, find it frustrating to use on their own, and give up on the devices entirely. “We don’t want people to think, ‘Hearing aids don’t work,’ ” she says.

On a community health level, hearing loss amounts to far more than missed conversation at the dinner table or exasperating phone calls with Grandpa. Untreated hearing loss can lead to isolation, depression, anxiety, a higher risk of dementia, and increased risk of falling.

It’s possible, audiologists suggest, that having hearing aids more visible – right next to the revolving kiosk of over-the-counter reading glasses at your local pharmacy – will raise awareness about hearing health while also reducing negative stereotypes and shame about hearing loss.

That stigma is already changing, they say, because ear buds and Bluetooth devices have gotten more popular; it’s become normal to see people of any age with bits of plastic in their ears.

At the least, say audiologists, the buzz about over-the-counter hearing aids will make hearing loss a less-taboo topic. “Patients say, ‘I hate my hearing aids, and I can’t live without them,’ ” Ashby-Scabis says. “I hope there’s more awareness of the impact hearing loss has on health. I hope we’ll see that change in the years moving forward.”