Our last blog on this topic brought hearing aid dispensing practices into the early 1970s. Audiologists were primarily engaged in evaluation of hearing and for some, evaluating and recommending hearing aids to the dealer for the fit and sale. However, the seeds of discourse over the role of audiologists relative to hearing aids had been sown – some audiologists were suggesting what had been considered anathema – not only evaluating hearing aids, but also selling them! But it was a few years before this qualified as an event that had an impact on the historical development of hearing aid dispensing practices.
A New Attitude
A new attitude among a limited number of clinical audiologists surfaced in 1971 that challenged the hearing aid specialist’s traditional role as a member of the hearing health team to select, fit, adapt, and dispense hearing aids. Part of this was related to clinical audiologists having a more difficult time to find employment.
Donald Schaeffer, writing in the May 1972 National Hearing Aid Journal, said, “The fact is that only ASHA members are asking ASHA to allow them to dispense aids, and this is because the pipeline is now filled with audiologists with no job opportunity in the field of audiology, other than those in teaching, research, and a few clinical jobs. Most of these jobs are controlled by the hierarchy of ASHA [which] leaves the motivated audiologist with no alternatives except to comply with the dictates of ASHA rules and regulations.”
The need to create employment opportunities was echoed in a New York University News bureau Bulletin (May 17, 1974), that “we have to create new employment opportunities for our students.”
Change the ASHA Code of Ethics to Allow the Sale of Hearing Aids
A growing desire to increase clinic revenues and audiologists’ incomes led to a movement rising among this small group to eliminate the section of the ASHA Code of Ethics that prohibited the sale of hearing aids by clinical audiologists. The group drafted a program that would:
- Place into motion a procedure to amend the Code of Ethics to allow the sale of hearing aids by clinical audiologists
- Prepare a program to eliminate the hearing aid specialist as a competitive factor in the sale of hearing aids, and lay the foundation for clinical audiologists to monopolize this activity. This was to be accomplished by the following means:
- Stimulate a nationwide program to disparage hearing aid specialists to reduce their effectiveness in countering this program,
- Reduce the number of existing hearing aid specialists by limiting referrals from clinical audiologists and hearing clinics to a “favored dealer.”
- Thereafter, eliminate the “favored dealer” by undertaking the direct sale of hearing aids and eliminating any referrals to the “favored dealer.”
This group, which became known as the “Task Force,” drafted a position paper for presentation at the general membership meeting at the ASHA 1971 convention. It was titled, “Comprehensive Audiologic Services for the Public: A Position Paper of the American Speech and Hearing Association.” In what some audiologists thought was a definite attempt to have this adopted, the meeting was held in the early morning of the final day of the convention, thereby assuring a limited number of persons in attendance who might object to this proposal. The proposal was hurriedly passed on November 20, and came to be known as Resolution 13. It marked a 180-degree turn regarding audiologists and hearing aid dispensing.
Resolution 13 effectively divided audiologists into three camps:
- Those in favor of hearing aid dispensing
- Those opposed to hearing aid dispensing
- Those apathetic about either
Contrary to what most might think, hearing aid specialists, being dedicated to the concept of free enterprise and open competition, actually expressed support for Resolution 13 with certain understandable limitations. Their national trade association, the National Hearing Aid Society, adopted such a resolution at its October 1972 General Membership Meeting. The limitations were that applicable State or Federal Statutes or Regulations must be met and that no effort be made to secure an advantage by the direct or indirect use of public funds or tax exemptions.
In effect, the ASHA Legislative Council had taken three actions to establish Association policy concerning the dispensing of hearing aids by audiologists.
- In 1971, it passed a resolution stating that the Association “supports the general intent of the role of certified audiologists in the dispensing of hearing aids as a part of a program of auditory rehabilitation. This was, “Comprehensive Audiologic Services for the Public: A Position Paper of the American Speech and Hearing Association.”
- In 1973, the Legislative Council defeated a resolution to permit the commercial dispensing of hearing aids directly from ASHA-certified audiologists to those needing them. The rejection was based on the judgment that dispensing hearing aids at a profit would violate the Association’s commitment to the general philosophy that public trust is the foundation and sine qua non for all service professions.
- The 1973 Legislative Council also reaffirmed its endorsement of the concept that audiologists may dispense hearing aids under certain conditions, which were considered ethical by the Ethical Practice Board but endorsed by the Executive Board. The Board was instructed to disseminate to the Membership information concerning these conditions. This was the “you can sell, but not for profit” recommendation, and “we will tell you what you can and cannot do, and how you have to set your prices.”