LCs need to be extremely careful when they are also pump depots. I do not
mean to imply anything about any individual, because LCs are among the most
scrupulous people I know, but on a PHILOSOPHICAL  level  I personally have
questions about an employee of an institution marketing any product  in that
institution.  Many hospt. find it in their interests to be lazy and not make
an effort to REALLY provide lactation services.  They often turn a blind eye
to the good-hearted LC who wants to provide the service, and often, as Lori
does, offers the service with no real profit.  Unfortunately, this enables
the institution to avoid delivering a service that is apparantly needed by
some of the patients. And it opens the LC to criticism.   There is an
ethical bind, because even the APPEARANCE of a conflict of interest is an
issue.  Turn it around.  How would patients interpret it if an RN or MD
determined that a mother was vitamin deficient, and then offered to sell
them a supplement from their home business?

One reason I don't sell products any more is that I've become sensitive to
the fact that once a client "bonds" to me, that  gives me an unfair
opportunity to subtly pressure that person.  I wouldn't, but the fact that
it could be PERCEIVED that way has made me realize why the AMA is nervous
about doctors selling cosmetics, etc.  I do appreciate the argument that LCs
understand pumps better than clerks, and that products are the best way
currently to make any money, but it is a slippery slope.  Our Code of Ethics
has sections which relate to chosing equipment with theraputic
considerations foremost.  I wish there were more discussion about this
issue.  The problem is, it hits so many of us in the pocket book.  I
struggled over this for several years before I decided that I was going to
make the committment to be a clinician, period.  My rental depot is much
smaller, is primarily handled by a woman I employ, and doesn't much overlap
with what I do with my consulting practice.

I had a relationship with a local hospt. here in Austin for a while where I
supplied pumps to their institution.  Since I did not work there, there was
no way I could be involved in the recommendation of a pump to any patient.
That advice was given by a nurse or MD who had no connection to personal
profit from rental of the pump.

I would also recommend that Lori consider that being available for free 7
days a week enables the system to depend on her good nature (til she burns
out) without really having to make real inroads into creating programs which
insure that the support will be available even if Lori is not.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html