[Laurie - love your 40 week gold standard of pregnancy comparison]

This stuff about ethics fascinates me. I am wondering...if the hospitals
are running their own pump rental stations, as many are, is this not also
conflict of interest? What's the difference? They have enormous power to
persuade Moms to rent pumps if they want to, and they profit either from
insurance co. payments or  private payments from the Moms.

This also affects me personally (please don't all jump on me at once). I am
a pump rental station. I take Medicaid. One nearby hospital fell on its
face with delight because they finally got a Medicaid person to deliver
pumps to the NICU. They are so pleased about how much time and effort I put
into helping and following up Moms that they want me to start working on
the unit part time (and are applying for grant $ to fund me). This means I
will be self-referring on the unit.
What do I do if they get money to pay me? Do I have to stop renting pumps
to them? There is no doubt whatsoever that these moms of 26 week premies
need pumps. They cannot get them elsewhere, or so the nurses tell me.
BEcause I am now known as the pump person, the nurses call me whenever
anyone needs a pump. If a Mom has a different insurance co., I chase the
other company and get the pump delivered to the unit and I show the mother
how to use it.
I am uncomfortable about the conflict of interest thing (though when I
mentioned it to one manager he laughed and said 'everyone else gets paid
here'!) On the other hand I have no personal dilema whatsoever about what I
am doing. I never persuade a MOm to rent a pump if she does not need it,
and I feel  am providing a superb service. Does personal integrity simply
not count in these situations?
My only option is actually to refuse to work there because I could not
afford to take a part time job and ditch my rental business. Is this what I
have to do?
I wonder if other Lactnetters are in a similar situation but are afraid to
post in public because of the potential flaming they might get?
Anne Merewood
Nursing Mothers Council