Dear Editor:
With the 2021 Florida legislative session wrapping up this week, it is a good time to discuss the progress made towards modernizing the Sunshine State’s hearing aid regulations. The last 4 months of political wrangling have shed light on outdated rules that are in dire need of modernization. Underneath the noise about the proposed changes, it is important to recognize a growing understanding by all parties that regulations must modernize to improve access to safe, affordable hearing health care.
We started this process because the hearing aid law in Florida is over 25 years old. As HIA President Kate Carr stated, “the Florida statute for testing requirements is archaic and out of date.” Ms Carr and I may have taken different positions on the proposed legislation, but we clearly agree that the time has come for meaningful change. We hoped that change would happen this year, but like nearly all legislation, it often takes more than one year to come to a consensus.
As a reminder, the only change that the final form of proposed legislation would have made was to simply remove the prohibition of the distribution of hearing aids through the mail for everyone 21 years of age and older. That is the compromise at which we had hoped to arrive; nothing more and nothing less. As I said back in March, we wanted to work with all parties to get to common ground. Unfortunately, at the end of the day, even this slight change—one which would bring Florida in line with the rest of the country and allow under-served populations more options in getting quality care—was a step too far for some to accept.
The key lesson from this is that some in the industry are nervous about change. As someone who has worked in this space for decades, I understand. Yet, I also understand that while we delay and fail to modernize antiquated and out-of-touch laws, approximately 75-85% of people with treatable hearing loss continue to go without care. As a recently released report by the Academy of Doctors of Audiology stated:
“New technologies and new applications of existing technologies have aligned with new markets. Quality care cannot be sustained by the execution of a one-size-fits-all set of processes, and excellence will not be defined merely by the presence of a physical location. Consumer demand for alternative hearing healthcare models is accelerating.“
I have heard from many colleagues urging us to keep driving this issue forward to democratize access to safe, high-quality, affordable care. So that is what we will do, and I encourage all the groups in the industry to work together to make these needed improvements. I could not be more proud of the progress we’ve made and the partners we now have around the table. We will continue to work with all of you to support the industry’s modernization.
— Paul Martin
Paul Martin is a long-time hearing industry executive, the founder of Blue Ocean Advisors, LLC, and serves as an advisor to Redesign Health, the parent group of Lively Hearing.
I’m just not sure how LOWERING standards is a recipe for improving the situation. Some apparently feel that a mediocre or poor fitting that lacks the use of most best practices (and even a hearing test itself!) is better than no fitting at all. Our profession and industry has come a long way from the days of having no standards (i.e. back in the 1970s and prior) and has worked hard at creating standards the professionalize us and helps us to earn respect with the rest of the medical community and consumers as well. Rather than open things up and sending us back to being like the Wild West, we need to enforce the standards we’ve worked so hard to create.
Paul, you state that you “wanted to work with all parties to get to common ground.” Yet you have made NO effort to connect with, or engage hearing healthcare providers in the State of Florida to do this. The company you keep (Lively) actively degrades the profession of Audiology in its advertising and marketing to consumers, yet you lament that providers in Florida regard you and your agenda with suspicion. Perhaps it is not that Florida providers do not want to update their licensure legislation to be more reflective of modern practices, but that they take issue with the way you are going about it. Why don’t you take the time to talk to and attempt to win over us “middlemen”? I realize that your business practices don’t really believe in face to face interactions, but perhaps you could make an exception in this instance.
My opinion: ALL industry, whether Redesign Health or the Hearing Industries Association and its members, need to stay out of the activities of licensed practitioners. No one should tell providers how they should provide care. For as offended as many may be by Redesign Health, we should be equally offended by the encroachment of HIA and their members into Florida’s legislative processes. I agree that licensees and consumers in Florida should determine how to evaluate and treat patients in accordance with FDA and FTC regulations and the research evidence and that stakeholders should engage them moving forward.
I wanted to see the bill pass because 1) I want to see more consumers have access to audition, 2) I want licensed audiologists to be able to compete, on a level playing field against their OTC/DTC counterparts and be able to become their own DTC provider, and 3) I want to expand an extremely stagnant hearing healthcare marketplace. The laws hold licensees back; not the unlicensed.
I hope audiologists do not wait to evolve to meet the needs of today’s consumers. I also hope that they will stop letting the hens run the henhouse.
Well stated. Amit.. Paul and all please respect the professionals in Florida’ to know what needs to be done in our state to update these rules and regulations to best serve the consumer. The fact that we never heard anything about this beforehand was sneaky and underhanded. My thought is that the professionals in Florida are willing to work to update or rules and regs but WE want to be the ones working on them. and we would ask for your cooperation regarding this. We are willing to work together to work through this but the “together” piece is the important piece.
Noël Crosby, AuD
Thank you Paul for bringing up this important issue. I don’t think anyone will argue that the dispensing rules in Florida (and other states) are potentially outdated and need updating. Your letter to the editor indicated that your proposed changes “…was a step too far for some to accept.” Who are these people that felt this was a step too far to accept? Audiologists and hearing aid dispensers who work with patients on a daily basis?? Who are your colleagues that are telling you to continue pushing this forward? Other executives in the hearing care space?
This idea, and even the language that was proposed was not vetted nor even discussed the primary stakeholders in Florida. Did you work with the Florida Academy of Audiology – or did they learn about this hidden language only days before it was to be voted on? Did you ask them to work with you on this? The answer to both is no. Even the Hearing Industries Association, American Academy of Audiology, AShA, Florida Academy of Audiology, all came out against this. You quoted Kate Carr, President of HIA, however, her signature was on the HIA opposition letter that stated “Amendment # 302884 to Florida Senate Bill 700 abruptly discards this important protection and removes the state’s existing ban on direct-to-consumer (DTC) hearing aid sales. The amendment fails to thoughtfully differentiate between those for whom this opportunity is appropriate and those who could be harmed. Inevitably, some patients who need professional assistance will be harmed by obtaining the wrong hearing aid or by overlooked ear conditions or co-morbidities that a hearing care professional is trained to consider. ”
The overall opposition has little to do with patient care and access, as many would agree we need to make these changes, but has more to do with the nefariousness of trying to hide this language without audiologists and dispensers knowing about it, causing everyone to scramble last second – and successfully removed this proposal. You are not the victim here, you are the aggressor, the executive of a company who stands to make a lot of money should that bill pass. I am certain, instead of cutting out the doctors who are on the frontlines, which is the modus operandi of Lively Hearing , and engaging and working with FLAA and other stakeholders, we would have seen a more productive change.
If you really care about patient care, work with the doctors and dispensers in Florida. With open communication and collegiality, we can achieve so much for patient care and access, and modernize the rules. I look forward to hearing/seeing you fulfill your statement “I encourage all the groups in the industry to work together to make these needed improvements”. by working with the hearing care organizations in Florida. If you do this, and we see productive changes such as those you mentioned in your letter, then we would all benefit.
Thank you for this Dr. Amit…your response is professional and point on!