Les Goldmann started losing his hearing in his early 30s. He thought getting some hearing aids would be a simple exercise, but instead he waded into an opaque industry with suspicious practices.
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Now in his mid-40s, he says he's outraged by the inflated prices, sales tactics and hidden commissions that have negatively influenced the supply of an essential medical device to Australians suffering from hearing loss.
"You're in their hands because you need the hearing aids and you're relying on their advice, but they don't tell you they're getting paid big commissions or they're driven to recommend the highest-priced," says the accounting lecturer from Willoughby.
Mr Goldmann is among one in six Australians with some hearing loss, and with an ageing population, this figure is expect to increase to one in four by 2050, according to a Senate inquiry report.
But a worrying number are being sold hearing aids that they don't need or are more expensive than required - a set can cost as much as $16,000 - without being aware that audiologists are driven by sales targets and incentives.
The Australian Competition and Consumer Commission has put the unregulated hearing aid industry on notice, saying it is concerned about its "inappropriate" sales-driven nature.
"Some hearing clinics encourage clinicians to sell more expensive hearing aids by setting sales targets, paying commissions to clinicians, having arrangements that favour certain brands or are owned by companies that manufacture hearing aids," says ACCC commissioner Sarah Court.
"It's a concern because consumers go in to undergo testing, and think they're objective, independent and not influenced by anything," she said.
The ACCC has released a report - to mark World Hearing Day on Friday - that shows commissions can be as big as 15 per cent and are likely to drive audiologists to sell more expensive products.
A concern was that many clinics are run by manufacturers, many of whom "offered inducements to sell their products, including all-expense-paid travel to overseas conferences and consumer electronics".
The report shows that higher-priced devices don't necessarily deliver benefits, especially if the extra functions don't match the lifestyle of the user.
"Some clinicians expressed concern about older consumers re-mortgaging their homes or entering into finance plans to pay for high-end hearing aids," it said.
It also shows there are questions over why the same devices overseas are half the price, and why, if customers bring them into Australia, some audiologists are reluctant to fit and service them.
For his second pair of hearing aids, Mr Goldmann met an audiologist who recommended products for $6000, which he then bought for half the price from a qualified, US-based expert.
He was shocked when another Sydney audiologist told him it would cost $1500 to get them fitted and serviced, which typically takes one to two hours. He received another quote for $500.
"They ought to be struck off for their extortionate behaviour, because it's obvious they're far more interested in selling me hearing aids than fitting them and they're clearly not working on the fee-for-service model," he says.
Consumer advice group Better Hearing says "vertical integration", where clinics are run by the manufacturers, mean that people are buying $16,000 hearing aids that may not help them.
"It's a quirky industry, because imagine if drug companies were allowed to run pharmacies," says the group's chief executive, Michelle Barry.
Audiology Australia, which represents 2500 audiologists, urged consumers to go to certified members.
"In accordance with our code of conduct, members must make recommendations to clients based on clinical assessment and the client's needs, not on the basis of financial gain," says its chief executive Dr Tony Coles.
Consumer group Choice says those with hearing problems should get their hearing checked at an audiology department at a major hospital or by a private practitioner and get an idea of costs and limitations.
"Once you've made your selection, lock in a 30-day trial to make sure the device is right for you. Do your homework on price - it pays to shop around," it says.
Adjunct Professor Anthony Hogan, a hearing loss researcher at Australian National University, says one in three people with hearing aids are not using them.
"The existing system is focused on selling hearing aids and not on client outputs, [such as] assessing the extent to which hearing aids solve people's communication problems or improve their quality of life," he says.
