News: ACCC to investigate the hearing aid industry

ACCC to investigate the hearing aid industry

06/07/2016 - Audiologists, Ethics, Insurance, Treatment

Failures of the current system of self-regulation within the audiology field were highlighted in a Radio National documentary (aired on 30 November 2014 and 26 April 2015) that showed common business practices in non-audiologist owned businesses conflict with the codes of ethics that audiologists sign up to when they join professional associations. The documentary revealed that the public has no protection from business practices that involve undisclosed business ownership, sales targets and commissions even though they may be referred to such practices by their general practitioner who similarly may be oblivious of these practices, and expect services delivered to be regulated to standards that apply to other sectors of healthcare (highlighted from extract from Independent Audiology Australia submission for Senate Select Committee on Health 10 July 2015)

This was highlighted by comments given regarding Audiologists been forced to work in high pressure conditions where they had to meet sales targets.

Furthermore in the absence of a registration body that the public can consult to check qualifications, the public has no way to independently verify if they are receiving services from qualified audiologists or unqualified staff employed in such businesses. Anybody can call themselves an Audiologist or hearing specialist and sell hearing aids and nothing can be done to stop them.  This is further concerning given that NDIS is rolling out and with funding for paediatric Audiological services potentially been moved to NDIS. Although there has been an initial attempt to establish some clear guidelines there is still no clear framework for scope of paediatric practice in regards to Audiological qualifications, experience, training, commissions etc. NDIS for paediatric services rolls out in Townsville within weeks.

Partially in response to this the ACCC launched an investigation into the hearing aid industry. https://consultation.accc.gov.au/compliance-enforcement/hearing-aid-survey

Besides the lack of consumer protection when it comes to qualification the main points of contention is the lack of transparency of ownership by vertically integrated hearing aid clinics that are owned by a hearing aid manufactures, or that clinics may have supplier agreements which may limit or skew the ability to actually prescribe what is required should it be from a competing manufacturer. But probably the biggest concern is the lack of disclosure by the Audiologist themselves that they are receiving a kick back commission for the device they are recommending and common practice is that it is linked to the price of the device recommended. So the more expensive the hearing aid the more commission the audiologist gets. This is illegal and highly frowned upon in other regulated areas of health yet this is standard common practice in Audiology.

Further to this there is no regulation to ensure that evidence based practice has been applied to the decision undertaken by clinicians. Furthermore what most independent research evidence suggests is that there is little significant difference between many of the levels of technology (and subsequent price).

(Eg. ‘there was minimal evidence of greater improvements in hearing when older individuals with mild to moderate sensorineural hearing loss used hearing aids with premium technology versus basic technology. In fact, only one contrived situation (localization of high frequency filtered speech in a quiet laboratory) demonstrated better performance with premium hearing aids compared to basic and this incremental improvement did not translate to perceived benefit in the real-world.’ Choosing hearing aid technology for older adults: examination of user outcomes JANI A. JOHNSON, JINGJING XU, ROBYN M. COX University of Memphis, TN, USA). http://audiology.asn.au/public/1/files/Publications/Audiology%20Now/audiologynow61-std.pdf

I feel perhaps there is deliberate trend for hearing aid manufactures, their affiliated clinics and Audiologists themselves to spread misinformation and focus on the hearing aid and its features to justify the exorbanent expense with limited independent evidence. Furthermore the largest factor in success of hearing aids is actually in the Audiological assessment and rehabilitation accompanying the hearing aids. This has been independently verified as one of the most significant factors yet it gets little mention in regards to pricing in the industry. In a perfect world hearing aids should all be the one set price and Audiologists would only charge for the rehabilitation and assessment services removing any link to sales and commissions

Regulation is the obvious answer and I urge the public to get behind their politicians to raise awareness because regulation decisions are made by state governments in COAG.

Grant Collins – Owner and Principal Audiologist, Clarity Hearing Solutions

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