A focused history and the corresponding time course help internists distinguish between diseases that appear with hearing loss. A complete otologic history and physical, including an otoscopy, a facial nerve exam, and a tuning fork test, should be performed on every patient who complains of hearing loss. Sudden sensorineural hearing loss is the most serious type of hearing loss and requires immediate treatment with oral steroids and/or intratympanic steroid injection. It also requires audiometry and referral to an otolaryngologist. Age-related hearing loss is very common, and mounting research shows that it has significant effects on healthy ageing. There is a demand for accessible, affordable hearing care, and more options are now available to older people thanks to recent national initiatives and federal legislation.