As she leaves a 12-hour-day on the labor and delivery shift, Dr. Katie Merriam turns off her pager.

“I don’t know what I’d do without it, you know? It’s another limb. I always know where it is,” she says, laughing.

The third-year resident in obstetrics and gynecology at the Carolinas Medical Center hospital in Charlotte, N.C., works in a medical specialty dominated by women, treating women. Merriam says she feels a special connection to her patients.

“You just, you can feel what they feel and understand why they feel certain ways. I do feel a special bond,” she says.

Nationally, 82 percent of doctors matching into OB-GYN residency programs are women. Many OB-GYN patients say they prefer female doctors. Merriam’s residency class is a bit of an anomaly — half of its members are men. Though it’s nice to work with so many women, Merriam says, she and some of her female colleagues also like the perspective that men bring to the work environment.

“No one could really pinpoint about what balance they bring, but there’s something nice about having them,” she says.

It’s important to have men in the field, she says, if only to continue to give patients options in their choice of providers. But most of her friends and other women she talks to, she says, want female doctors.

Blake Butterworth, a fourth-year obstetrics and gynecology resident at the Medical University of South Carolina in Charleston, says he doesn’t take it personally when he hears that sort of thing from a patient.

“I don’t get discouraged; I don’t get offended,” Butterworth says. “I gladly hand that patient off.”

He’s one of only two male residents in the program of 24 at MUSC and says he finds it rewarding when he can win a new patient’s confidence.

“I have patients that clearly express disdain to have to see a guy,” he says. “Then I develop rapport with her. And she says, ‘I expected you to be X-Y-Z, and you were better than that.’ “

Butterworth says he chose obstetrics and gynecology because it lets him develop long-term relationships with patients — providing routine OB-GYN care and more complicated surgeries if need be.

“Once you really get into it, and get involved in it, I don’t think that bias [that the field is best left to women] holds true,” he says.

Butterworth believes it is incumbent on male OB-GYNs to talk to male medical students about the benefits of having men in the field. Students need to know it’s OK to have an interest in the field, he says, and that they will find work.

In fact, says Dr. Ashlyn Savage, an associate professor of obstetrics and gynecology at MUSC, it may be the opposite.

“In an effort to really diversify the applicant pool, we will apply in some cases different screening standards to decide who we are going to interview,” Savage says. “For example, we might consider an applicant with a slightly lower board score — just to enhance how many men we are interviewing and considering.”

It has been a challenge to find male OB-GYNs for the program, she says. The gender that at one time dominated the field is now at some schools considered a diversity hire. But Savage questions whether balancing the number of men and women in the specialty is as important as racial or ethnic diversity.

“The interesting thing to me is the primary motivation to [seek a diverse candidate pool] is so that patients have the opportunity to seek out physicians who might … feel like themselves,” she says. “In this particular case … all of the patients for OB-GYNs are women.”

Among practicing OB-GYNs in the U.S., a little fewer than half are men, according to the American Congress of Obstetricians and Gynecologists. But ACOG predicts that 10 years from now, two-thirds of the doctors in that specialty will be female.

Still, male doctors hold a lot of the key positions in OB-GYN professional organizations.

“Leadership tends to be held by people who are older,” Savage says. “And we are still in a scenario where [more of] our older faculty tend to be men.”

A study published last fall found that women are underrepresented in leadership roles in medical school departments of obstetrics and gynecology all around the country. That ratio was most lopsided in men’s favor in the South.

It’s perhaps only a matter of time before that, too, changes. Savage says she just learned that her program’s incoming class of OB-GYN residents next year will be all female.

This story is part of NPR’s reporting partnership with WFAE andKaiser Health News.

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Last December, Deb Wiese bought hearing aids for her parents, one for each of them. She ordered them online from a big-box retailer and paid $719 for the pair. But her parents, in their 80s and retired from farming in central Minnesota, couldn’t figure out how to adjust the volume or change the batteries. They soon set them aside.

“Technology is not only unfamiliar, but unwelcome” to her parents, Wiese says. “I don’t know what the answer is for people like that.”

A bill introduced by Sen. Elizabeth Warren (D-Mass.) and Sen. Rand Paul (R-Ky.) in March could make it easier for her parents and millions like them to get assistance. It would allow Medicare to pay audiologists to teach beneficiaries how to adjust to and use their hearing aids effectively in different settings such as a crowded room, for example.

Under current law, Medicare generally reimburses audiologists for diagnosing hearing loss in older adults but not for providing assistance to fit, adjust and learn to make the most of hearing aids.

Not being able to afford hearing aid services is one of many challenges older adults who are hard of hearing face. Even if they can afford hearing aids, Medicare doesn’t usually cover the services to fit and service them so many people go without.

The proposed bill comes on the heels of an effort to increase the chances that people who need hearing aids get them. A law signed last summer by President Donald Trump directs the Food and Drug Administration to establish and regulate a new category of hearing aid to be sold over the counter for people with mild to moderate hearing loss.People will be able to buy products off the shelf without consulting an audiologist or hearing aid dispenser, and standards for online sales will be tightened. The agency has three years to develop safety and other consumer protection standards.

The National Academies of Sciences, Engineering and Medicine recommended that the FDA take that step in a 2016 report.

Although it should improve access, the new law doesn’t address one of the biggest barriers faced by the nearly 50 million people with age-related hearing loss: insurance coverage.

Neither traditional Medicare nor most private insurers typically cover hearing aids. (Some Medicare Advantage plans provide some coverage, and some insurers may offer a discount if members use certain suppliers.)

“Cost has for many years been the Number 1 problem in the calls, emails and letters we get,” says Barbara Kelley, executive director and CEO of the Hearing Loss Association of America, a patient advocacy group. “People say, ‘I need hearing aids and I can’t afford them.’ It’s really heartbreaking.”

Only 10 to 20 percent of people with hearing loss have ever used hearing aids, according to studies. In addition to cost, lack of access to care and the stigma associated with wearing a hearing aid discourages people, Kelley says.

But losing the ability to hear well doesn’t just mean people have to turn the volume way up on their favorite TV shows. Hearing loss is associated with depression, social isolation and an increased risk for cognitive decline and dementia in older adults.

Hearing aid prices vary widely, ranging from an average $900 to $3,100 apiece, according to a survey of hearing care professionals by the Hearing Review, a trade magazine. On the high end, devices may be Bluetooth-enabled to stream wirelessly from people’s cellphones to their hearing aids, among other perks.

But not everyone needs or wants that much help. “Some people are very mildly impaired,” says Kim Cavitt, a billing and reimbursement consultant and former president of the Academy of Doctors of Audiology who supports over-the-counter sales. “They don’t have a $3,000 problem, they have a $300 problem.”

Experts say they hope the over-the-counter hearing aid law will spur competition and product innovation and bring down prices.

One of the reasons hearing aid prices are often high is because the devices are typically bundled with a service package to fit, troubleshoot and maintain them.

Disentangling the service from the devices would benefit consumers, says Nicholas Reed, a faculty member at the Cochlear Center for Hearing and Public Health at Johns Hopkins Bloomberg School of Public Health who has studied over-the-counter hearing devices that provide results comparable to hearing aids.

People may still need some help using their hearing aids. In addition to basic hearing-aid fitting and maintenance, hearing care professionals can help people learn strategies to hear better, Reed says. For example, people learn to sit with their back to a wall at a restaurant to eliminate the sound behind them so they can focus on listening to the person in front of them.

“The over-the-counter law will lower the cost and make hearing aids more accessible,” Reed says. “But if the services aren’t covered, people, especially older adults with health literacy issues, will stop using them.”

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