It is actually a problem for many people that their chiropractor has an xray machine or sells stuff. It kept me from going back to chiropractors for many years after an experience (my first with that treatment modality) where I felt I was hustled for a lot of expensive supplements when I went for an adjustment. There is an appearance of conflict even when the practitioner is scrupulous. This debate goes on a lot in medicine, where there is an on-going discussion about whether dermatologists should sell creams, etc. Doctors have lots of ethical problems of their own, and they need to clean their own houses, too, but I will share one aspect of how the medical community looks at this issue. In general, the medical profession's ethical discussion suggests asking some questions to help reason out if there is a good ethical reason to provide a product along with a service. Does the equipment provide recourse during an emergency? In otherwords, if the patient can't make it to the car to go home without a pair of crutches, the orthopedist may rent or sell crutches on an as-needed basis. I think (by this reasoning) there is justification to provide a hospital grade pump on an emergency basis. Or to immediately provide a larger flange if a mother has an ill-fitted one that isn't working and she is engorged or in pain. However, if the product is not needed for emergency care, the question becomes is there somewhere else in the community where a patient might reasonably access the same product? If so, the person should be directed to that resource rather than have the patient/care giver relationship compromised by profit motive. These considerations, once I became aware of them, led to my discontinuation of selling or renting products. In my city, there are many alternate resources for any product. I only direct clients to rental depots where they will get clean pumps, reasonably priced parts, and some service. I personally trained as rental depots two of my clients who wanted to stay home with their kids. I don't have any financial relationship with either of them (one on each side of my city.) But I do send clients to them who need immed. access to pumps/kits/feeding tube devices, etc. There are places that sell herbs, my clients all have doctors for meds, and bras and pillows and all that stuff can be found all over the place. I hope this post won't be seen as a slam against LCs who are still grappling with the realities of staying in practice without renting or selling stuff. I wasn't sure how that would work, but I am much more comfortable today about the ethics of my own practice. We do have to talk about this -- esp. as it does impact the credential. As a fledgling profession, we have to hammer out these issues even if they are difficult and may make us uncomfortable. Barbara Wilson-Clay, BS, IBCLC Austin Lactation Associates LactNews Press www.lactnews.com *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html