An integrated telephone and hearing aid that has a single in-ear speaker is disclosed. The illustrative embodiments automatically adapt the operation of the hearing aid based on whether a telephone call is in progress or not. For example, when the user is not engaged in a telephone call, the illustrative embodiments function as a normal hearing aid. But when the user does become engaged in a telephone call, the illustrative embodiments alter the hearing aid function so that the user can hear the telephone call. For example, the illustrative embodiments attenuate the hearing aid function while a call is in progress so that the user can hear both the telephone call and retain some, albeit diminished, auditory input from the environment. This enables, for example, the user to still hear loud sounds (e.g., a car horn, a fire alarm, a person screaming, etc.).