Professional Ethics and Business

Metz, Michael J. PhD

doi: 10.1097/01.HJ.0000503457.52105.08
Editorial

Dr. Metz has practiced audiology for over 45 years in university positions, private practice, and as a consultant in many capacities. He has written and spoken on professional ethics for 30 years and maintains a limited forensic and consultative practice in Irvine, California.

Article Outline

As one encounters “professional” plumbers, professional life insurance salespersons, and others who make claims of their professionalism, it's getting harder to define “professional.”

Webster offers three simple definitions:

* Relating to a job that requires special education, training, or skill;

* Done or given by a person who works in a particular profession; or

* Paid to participate in a sport or activity.

While several other definitions rate as modern reflections or a widespread definition, Webster also offers a more specific definition: characterized by or conforming to the technical or ethical standards of a profession.

Simply advertising that one is “professional” then doing little to demonstrate a heightened performance level results in altered characterizations from the public and an erosion of trust awarded the extended group. The ethic of health care has always been that the patient/public good is placed in the primary position. The ethic of business historically places profit in the primary position. Even casual observation will find rationalizations that have risen to support the “merging” of health care ethics and those of business.

Now, the door is opening for over-the-counter (OTC) devices to offer the same benefit as any professional device fit in the past 50 years, all without the help of any professional. One can argue, but it's an odds on bet that technology will eventually do a better job than many professionals do now. If OTC (do-it-yourself) devices prove successful to any significant degree, the public may eventually see devices without professional services as being nearly as user-successful as those professionally-dispensed ones.

If these OTC devices work, how do instrument dispensers maintain their position? They may call themselves “professional,” but by which Webster definition? Without audiology's professional status, where will the field provide value and justify profit? If the hearing aid market changed abruptly tomorrow, how many of those presently in the field could support their businesses in audiology and/or dispensing?

Both audiologists and dispensers should be preparing for the coming changes. If you look closely at the directions of audiology and the innovations of technology, you can make your own observations and draw your own decisions. But, only short-term, “simple professionals” will likely come to conclusions that support the status quo—and even then, only in the near term. Technology is changing the world in which dispensing strives to be professional; definitions and behaviors have changed professional status. Audiologists may end up wishing they had separated and cultivated true professional services and made profits in a strictly specialized manner.

Operating a legitimate, profitable health care business requires more than a cute name, a nicely decorated office, a short- and/or long-term advertising plan, and a computer programmed for patient callback. These are issues for professional sellers. While there is nothing wrong with honest retailers, there will be an inherent conflict with the “professional” definitions and public perceptions. No health care provider should be a professional salesperson. Health care decisions should be made on the basis of science and data. Audiology providers should remember that the sales power of a white lab coat is too often abused, especially when data-shy recommendations are mixed with selling up. Use science and data to help patients make decisions in their best interest, not in the interest of profit.

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