If you’re an audiologist, ENT, or primary care provider, you’ve probably had this moment:
- A patient describes constant ringing, buzzing, or hissing in their ears.
- You’re already behind in clinic, and there’s no time for a 45-minute counseling session.
- You know there’s no instant “cure,” and you may not have a structured tinnitus program in-house.
- You find yourself saying some version of: “Your hearing looks okay — there isn’t much else we can do.”
Most clinicians have been there. But patients hear something very different: “You’re on your own.”
This article is written for you — the professionals who care deeply about your patients, but don’t have the time, tools, or training to build a full tinnitus program from scratch.
Drawing on the work of Dr. Emily E. McMahan, AuD — tinnitus specialist, Lenire® researcher, and owner of Alaska Hearing & Tinnitus Center (All Ears Alaska) — and our experience at California Hearing Center, we’ll outline:
- Why it’s okay (and ethical) to say “I don’t know” about tinnitus.
- When to manage tinnitus yourself vs. when to refer.
- How to refer to a tinnitus specialist in San Mateo without losing continuity of care.
- Language you can use so patients feel supported, not dismissed.
“There’s nothing we can do” is understandable — but harmful
Most clinicians who say “there’s nothing we can do” aren’t uncaring. They are:
- Overbooked and working in 10–15 minute templates.
- Trained in hearing loss and pathology, not long-term tinnitus counseling.
- Concerned about overpromising when no single cure exists.
From the patient’s perspective, though, that phrase often lands as:
- “This is permanent and hopeless.”
- “My suffering isn’t worth anyone’s time.”
- “If my doctor can’t help, nobody can.”
That emotional injury can:
- Increase anxiety, hypervigilance, and sleep disturbance.
- Push patients toward questionable online “cures” and supplements.
- Delay their path to evidence-based tinnitus care.
As Dr. McMahan often tells colleagues: it’s perfectly acceptable to say “This isn’t my area of expertise” — as long as it’s followed by “Let’s get you to someone who can help.”
It’s okay to say “I don’t know”… if you know where to send them
No one expects every audiologist or ENT to be a tinnitus specialist. Tinnitus management is its own subspecialty, with:
- Dedicated counseling time.
- Sound therapy frameworks.
- Familiarity with CBT-style approaches and habituation.
- Experience with devices like Lenire® where appropriate.
What patients do need from you is:
- An honest acknowledgment: “Tinnitus is real and distressing.”
- A clear statement: “There are people who work with this every day, and I’d like to connect you.”
- A concrete next step: a name, a clinic, a link, or a phone number — not just “try Dr. Google.”
That’s where a defined referral pathway to a tinnitus-focused clinic can change everything for your patients — and for your own sense of professional integrity.
When to manage tinnitus yourself vs. when to refer
Every practice is different, but here is a simple framework many providers find helpful.
You can often manage in-house if:
- Tinnitus is intermittent, mild, and not distressing.
- There is a clear, treatable medical cause (e.g., acute otitis media, obvious cerumen impaction) and you’re addressing it.
- The patient mainly needs basic education and reassurance (“This is common; here’s what we know; here’s when to return if it changes.”).
In these cases, a brief explanation plus a handout or link to an evidence-based source (e.g., the American Tinnitus Association) may be enough.
You should strongly consider referring if:
- Tinnitus is chronic and bothersome (impacting sleep, mood, focus, or quality of life).
- Patients are expressing distress, panic, or depressive symptoms related to tinnitus.
- Standard hearing care (or “ignore it and see what happens”) has not helped.
- The case is complex (co-existing hyperacusis, misophonia, sound sensitivity, or prior trauma).
- They are asking specifically about advanced options like Lenire®.
In these situations, a structured program with a tinnitus-focused audiologist is usually the best option — whether that’s a local partner clinic or a specialist with a hybrid field-clinic / telehealth model.
What a tinnitus referral to California Hearing Center looks like
California Hearing Center offers tinnitus-focused care from our clinics in San Mateo and San Carlos, in partnership with Dr. Emily McMahan for advanced and Lenire cases.
Your referred patient can expect:
1. Comprehensive tinnitus evaluation
- Detailed history (onset, triggers, variability, impact).
- Full diagnostic audiologic evaluation.
- Middle ear and, where appropriate, inner ear function testing.
- Tinnitus characterization and severity assessment.
We then develop a management plan that may include education, sound therapy, hearing devices, counseling, and/or consideration of Lenire®.
2. Advanced consultation & Lenire clinics in San Mateo
For appropriate cases, we offer Lenire Bay Area clinic days, where Dr. McMahan travels to San Mateo to:
- Evaluate candidacy for Lenire®.
- Provide advanced tinnitus consultation.
- Fit and program Lenire devices.
Ongoing care is shared between our local CHC team and Dr. McMahan via structured protocols.
3. Communication back to the referring provider
With patient consent, we are happy to:
- Send a summary of our tinnitus evaluation and plan.
- Provide updates on major milestones (e.g., Lenire start, response at 12 weeks).
- Coordinate around medical red flags or mental health concerns.
We view ourselves as partners, not competitors. We’re here to extend your tinnitus toolbox, not to replace the relationship you already have with your patients.
For an overview you can share with patients, see our page: Tinnitus Therapy & Lenire in San Mateo — Featuring Dr. Emily McMahan.
How to talk to patients when you refer (scripts you can borrow)
Sometimes the hardest part is the conversation itself. Here are a few scripts you’re welcome to adapt.
For primary care & general ENT
“Your tinnitus is real, and it’s clearly affecting your life. In my practice, I don’t have the time or tools to do the kind of in-depth tinnitus work you deserve — but I work with a clinic that does. I’d like to refer you to California Hearing Center in San Mateo/San Carlos. They collaborate with a tinnitus specialist who focuses on this every day, including options like Lenire. I’ll stay in the loop as your primary doctor, but they’ll lead the tinnitus-specific part of your care.”
For audiologists without a tinnitus program
“We’ve ruled out anything urgent and checked your hearing thoroughly. The next step isn’t just more testing — it’s structured tinnitus management. Rather than telling you to ‘live with it,’ I’d like to connect you with a team that focuses on tinnitus full-time. California Hearing Center works closely with Dr. Emily McMahan, a tinnitus specialist and Lenire researcher. They can take the lead on your tinnitus plan and keep us updated so we’re all on the same page.”
What about patients outside the Bay Area?
If you’re reading this from outside San Mateo County but appreciate this approach, there are still options for your patients:
- Check the American Tinnitus Association’s clinic and provider listings for tinnitus-focused practices in your region.
- Consider referring to Alaska Hearing & Tinnitus Center if your patient is open to hybrid travel/telehealth models with Dr. McMahan’s team.
- Ask local audiology networks which clinics have explicit tinnitus programs rather than general hearing aid clinics that only “dabble” in tinnitus.
How to refer to California Hearing Center & Dr. Emily McMahan
If you’re a clinician in the Bay Area (or have patients willing to travel here), here are simple ways to connect:
- For patient-facing info: Share our Tinnitus Therapy page and our Tinnitus Knowledge Hub.
- For Lenire-specific cases: Point patients to our Lenire in San Mateo page, which explains clinic days and candidacy.
- For direct referrals: Use your usual referral workflow and indicate “Tinnitus evaluation / possible Lenire candidacy” plus your contact details for feedback.
If you’d like to receive occasional updates about upcoming tinnitus clinic days, Lenire data, or shared-care protocols, you can also ask to be added to our professional update list when you send referrals.
Closing the loop: patients deserve more than “just live with it”
You don’t have to build a tinnitus center inside your existing clinic.
You don’t have to become a tinnitus specialist on top of everything else you already do.
What your patients do need is:
- An acknowledgement that their experience is real.
- Honesty about your limits.
- A clear, evidence-based next step.
That might mean partnering with California Hearing Center and Dr. Emily McMahan for patients in San Mateo, San Carlos, and the greater Bay Area — or finding a similar tinnitus-focused resource wherever you practice.
Either way, tinnitus patients deserve better than “there’s nothing we can do.” With the right referral pathways and shared-care mindset, you can offer them something much more powerful: a path forward.