Theresa writes....

There are excellent IBCLCs and scary ones.  Excellent MDs and 
scary
> ones. Excellent RNs and scary ones.  Excellent teachers and scary
> ones... the list goes on.  The point is, what is your solution to the
> problem?  How can any credentialling body really ensure that the
> people whom they credentialed are not giving wacky advice that may
> actually be harmful?  Man, I can tell you I've seen some IBCLCs give
> some truly harmful advice, doctors and nurses, too.  So, what's the
> answer?  We recertify, take ed hours, re-take exams...
>  but none of that is an insurance policy.
> 
The answer is not simple by any means - would annual peer review 
help? Using the professional model of the New Zealand College of 
Midwives I'll explain.

Every year midwives use a set format for data collection and submit 
this report, along with random client records and samples of client 
handouts, to a review committee comprising equal numbers of 
midwives and consumer representatives.

The process is at a cost to the midwife and it's a lot of work for both 
midwife and committee. It's purpose is reflective and educative not 
punitive. For example, if a midwife sees her collated exclusive 
breastfeeding rate is way below the national average or she has a 
high ecbolic rate or a high ultrasound uptake etc. she can look at 
each client and justify to herself and/or the committee what happened 
and if it was justifiable. 

Conversely she may realise or be encouraged to update on a certain 
area of her work. Obviously the committee itself needs to be well 
briefed, skilled and knowledgeable in order to improve the midwife's 
practice if necessary. Again, support by the committee is essential to 
enable the midwife to come out stronger and better not burnt out!

Many years ago I drafted some forms for IBCLC peer review and did 
a conference session on the topic but the idea never took off. I'd still 
welcome being "undressed" at an LC peer review to gain support, 
encouragement and assurance that my practice is OK or wanting!

When some kind of the peer review, attached to practising 
certificates is undertaken, could it be perceived by the community 
that the profession (NZLCA in our case) protects its consumers by 
periodically monitoring the standards of it's lactation consultant 
members thereby adding value to the credential?

Marcia Annandale, IBCLC, LLLL, Christchurch, New Zealand   

             ***********************************************

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(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html