The Big Six and the Hearing Professional: Best Frenemies?

By Kevin Liebe, AuD

It’s a rather complicated relationship that audiologists and other hearing professionals have with the hearing aid industry. Some may even call us frenemies.

The term frenemy is used to refer to: either an enemy pretending to be a friend or someone who really is a friend, but is also a rival. The term is used to describe personal, geopolitical, and commercial relationships among individuals and groups or institutions. The term first appeared in print as early as 1953.{{1}}[[1]][[1]]

I guess one could say the hearing professional’s relationship with industry is something akin to the complex relationship between physicians and the pharmaceutical companies. While the physician community, or in our case the audiology and dispensing community, love the amazing innovation and multimillion dollar research being conducted by these companies that results in some amazing products (be it pills or hearing aids) that benefit our patients, we sometimes find ourselves at odds with these manufacturers as to how best to deliver and advertise these products to the end user.

For example, most physicians don’t appreciate that pharmaceutical companies now have the ability–and desire–to advertise their products directly to consumers. In a similar vein, audiologists often resent the frequent hearing aid advertisements that are very product-oriented and focus solely on the “device” (typically developed and promoted by industry for retail clinic use), rather than touting the actual benefit of audiological care and rehabilitation.

The Dark Side?

Twenty years ago, there were nearly 50 hearing aid manufacturers in the US alone. Today, however, there are six companies that together control 98% of the GLOBAL market share of hearing aids. Truly an astounding amount of control wielded by such a small number of companies.

Understandably, this concentrated level of control has been hotly debated in the audiology and dispensing community, particularly in recent years and months, as the hearing industry continues to evolve.

98% is a lot of control
Admittedly, 98% is a lot. Image courtesy

The past decade has seen a growing encroachment by the major hearing aid manufacturers into the actual delivery of “product” to the end user through the purchase or creation of retail outlets or chains nationwide. Not surprisingly, this has driven more hearing professionals to regard industry with cynicism, and at times anger.


Can’t We All Just Get Along?

There have always been trust issues when it comes to professional interactions with the hearing aid industry. Why else would ASHA, which was the sole professional organization in audiology, have prohibited private-practice audiologists from dispensing hearing aids prior to the 1970s?

Was it fear that an ethical line would be crossed if audiologists came into direct contact with the hearing aid industry, perhaps?

During their student years, a high level of skepticism is ingrained in nearly every audiologist to be extremely careful when dealing with industry. Wise advice. However, this mentality can also backfire if taken too far. Here is a perfect case in point:

“The relationship between those of us who make the products utilized and sold to the professionals in audiology has been, at best, a tenuous one. This has motivated some companies to reduce their presence, and in some cases, end their participation in the American Academy of Audiology Convention. We need to re-establish a more collegial relationship and recognize that we are all colleagues with a mutual interest in advancing our profession and our industry. I remain hopeful that the Directors [of AAA] and decision-makers take time to acknowledge the vast investment many companies offer AAA all through the year and especially at the annual convention. Good luck to you all.” Terry Ross, Vice-President of MedRx

We’ve Both Got Work to Do

frenemiesWhile it is true that fewer companies now control the manufacture and distribution of hearing aids than did 20 years ago, today’s larger companies are far better equipped to spend the large sums of money on valuable research and technological advancement that will ultimately help our patients. It’s also true that most manufacturers have become involved with the retail distribution of hearing aids, but we must remember that it’s still a free market and if you provide better services than the corporate store down the street, you shouldn’t need to worry about going out of business.

Today’s climate may be less than ideal for the independent practitioner, but this change in the marketplace could ultimately lead to  improvements in service delivery and care that benefit not only the patients, but also the bottom line of large and small clinics alike.

Like the pharmaceutical industry, the hearing aid industry gives professionals the tools to help change people’s lives for the better, and we should be grateful for that. However, the industry should be more sensitive to our perspective and understand why they seem to be encountering increased backlash from their customers (hearing professionals).

The hearing professional looks around and sees that the number of independent hearing care businesses has been slashed within the last decade. The professional also sees industry taking an increasingly “aggressive” stance to consolidate retail businesses. The uncertainty of our present economy only adds fuel to the fire.

The truth is, we’ve both got work to do to improve this relationship. It doesn’t need to be a tenuous one.

Recognizing the fact that neither of us can be completely successful without the other is a great way to begin re-establishing a more collegial relationship that would benefit both sides.

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