Current events have created a major shift in the hearing aid delivery system. The passage of the FDA Reauthorization Act of 2017 and its mandate to introduce over-the-counter hearing aids has been a Pandora’s Box waiting to open. After a delay due to COVID, the FDA finally released the proposed standards for OTC devices at the end of 2021. At the time of this writing, these standards are out for comment with the final rules expected later this year. As a result, the hearing aid landscape has changed from a setting that clearly defined ENT and audiology practice to a cacophony of encroaching professions and service providers. The new FDA standards will introduce the parameters by which we, as hearing professionals, need to appreciate in order to prepare and participate in the changing hearing aid culture. The provision of hearing technology is no longer limited to traditional professionals but rather, the marketplace has embraced independent patient empowerment where decisions to obtain amplification may not be guided by medical providers. Tele-practice has become a viable method for product dispensing and management of instruments and hearing loss. Hearing services are now and/or will be available from entities that include representatives from hearing aid manufacturers, consumer electronics, big box stores, pharmacies, and on-line suppliers of amplification. The misconception common among these delivery service providers is that the hearing aid alone is the solution for people living with hearing loss and it, therefore, minimizes the importance of the professional expertise necessary for successful outcomes. Over-the-counter hearing aids are a reality. Physicians must assess and address the impact that the new FDA standards and growing on-line service provision have on clinical practice. This session will review the impact that OTC hearing aids might have on our practices and provide suggestions for embracing the changes affecting today's clinical settings.