Issues in Ethics: Issues Related to Competition in Professional Practice
About This Document
Published 2011. This Issues in Ethics statement is a revision of Competition (2004). The Board of Ethics reviews Issues in Ethics statements periodically to ensure that they meet the needs of the professions and are consistent with ASHA policies.
Issues in Ethics Statements: Definition
From time to time, the Board of Ethics determines that members and certificate holders can benefit from additional analysis and instruction concerning a specific issue of ethical conduct. Issues in Ethics statements are intended to heighten sensitivity and increase awareness. They are illustrative of the Code of Ethics and intended to promote thoughtful consideration of ethical issues. They may assist members and certificate holders in engaging in self-guided ethical decision-making. These statements do not absolutely prohibit or require specified activity. The facts and circumstances surrounding a matter of concern will determine whether the activity is ethical.
The Board of Ethics has received inquiries and comments regarding ethical behavior among members and certificate holders who compete for the opportunity to provide services to clients. Audiologists and speech-language pathologists are involved in marketing their services, advertising, negotiating contracts, recruiting and hiring staff, establishing fees, dispensing products, working with manufacturers and publishers to offer various products to clients, and other practice management activities. Competition for business in the marketplace influences these activities and how we engage in them.
The Code of Ethics provides us with guidance as we competitively design and market services, as well as guidance regarding our responsibility to the public and our professional relationships. It also guides our conduct as we engage in professional practice and function in the professional community. The Code of Ethics also gives guidance concerning misrepresentation, deceit, and dishonesty. The Code embodies concepts and requirements to be considered in practice management as it relates to competition for business in the marketplace.
There are two overarching principles that relate to competition:
Principle of Ethics I states “Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a humane manner.”
Principle of Ethics III states “Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including the dissemination of research findings and scholarly activities and the promotion, marketing, and advertising of products and services.”
Both of these principles indicate that speech-language pathologists and audiologists should consider the welfare of the persons they serve as their most important commitment. Our responsibility to the public is clear: Services must be designed to serve the public by providing accurate information in all aspects of our professions. While competition is healthy, any manifestation of competition must be accurate and presented in a way that is not detrimental to the professions.
In attempting to obtain a competitive advantage, individuals must handle many issues including (but not limited to) referrals, representation of services, statements about services/products, and conduct that reflects positively on the professions as we engage in practice matters. The ASHA Code of Ethics addresses our professional relationships as well as our treatment of each other as we engage in professional practice and function in the professional community. These rules can help guide us as we engage in activities and relationships that involve competition.
Principle of Ethics IV states “Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of other professions and disciplines.”
This principle indicates that professionals must maintain well-balanced, collegial relationships with colleagues. As we compete with other professionals, whether within or outside of our disciplines, we must compete in a dignified manner that exemplifies our professional standards.
Principle of Ethics I, Rule O states “Individuals shall not charge for services not rendered, nor shall they misrepresent services rendered, products dispensed, or research and scholarly activities conducted.” It is important to keep this rule in mind as we market our services and products to ensure that there is no distortion of facts in client/practice information, advertisements, or claims.
Other code provisions that address competition are Principle of Ethics III, Rules D and E. Rule III-D states “Individuals shall not misrepresent research, diagnostic information, services rendered, results of services rendered, products dispensed, or the effects of products dispensed.” Rule III-E states “Individuals shall not defraud or engage in any scheme to defraud in connection with obtaining payment, reimbursement, or grants for services rendered, research conducted, or products dispensed.” These rules relate to misrepresentation of services as well as engaging in deceptive schemes. While we compete for clients/patients, we must be open and honest about the services we provide, the charges that will be incurred, and procedures for obtaining payment from third parties or clients, as we market our services to the public.
Principle of Ethics III, Rule G states “Individuals' statements to the public when advertising, announcing, and marketing their professional services; reporting research results; and promoting products shall adhere to professional standards and shall not contain misrepresentations.” This rule is clear about the information that we give to the public in marketing materials, research that we share, and in conversations with potential clients, referral sources, and the public we serve.
There are several rules that consider misrepresentation, deceit, and dishonesty. They include Principle of Ethics I, Rule O; Principle of Ethics III, Rules D, E, and G (as noted above); and Principle of Ethics IV, Rule C, which states “Individuals shall not engage in dishonesty, fraud, deceit, or misrepresentation.” The clinician must be honest in written and verbal statements to the public and to other professionals, including advertising and promotional materials.
With regard to referrals, Principle of Ethics III, Rule C states “Individuals shall refer those served professionally solely on the basis of the interest of those being referred and not on any personal interest, financial or otherwise.” In other words, we must not refer clients to other professionals solely for the purpose of financial gain.
In attempting to gain a competitive edge, we must adhere to the following rules regarding accuracy of statements made in writing or verbally.
Principle of Ethics I, Rule J states “Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis.”
Principle of Ethics III, Rule E states “Individuals' statements to the public shall provide accurate information about the nature and management of communication disorders, about the professions, about professional services, about products for sale, and about research and scholarly activities.”
Principle of Ethics IV, Rule I states “Individuals' statements to colleagues about professional services, research results, and products shall adhere to prevailing professional standards and shall contain no misrepresentations.”
These rules indicate that honesty and truthfulness are of utmost importance when discussing our services with clients and other professionals. Successful competition may require that we set ourselves apart from competitors, but accuracy and truthfulness should prevail.
Together these Principles and associated Rules of Ethics embody concepts and requirements to be considered in practice management and competition for business in the marketplace.
Competition among service providers is not unethical. When handled properly, competition can lead to positive growth and continued improvement in the quality of services delivered by audiologists and speech-language pathologists. It is expected that speech-language pathologists and audiologists will be involved in marketing services, bidding on contracts, and competing for business in appropriate ways. It is incumbent on the individual to be aware of legal requirements that guide competition and practice management in the marketplace. Finally, it is essential that the quality of services to clients not be adversely affected by competition for the opportunity to provide those services.