IBLCE does list on their website the Clinical Competencies, and Competency 
Statements, that describe what an IBCLC should be able to handle in a 
clinical setting.  See http://www.iblce.org/competency%20statements.htm 
(and) http://www.iblce.org/clinical%20competencies.htm.

There are ascending ways to look at the issue of IBCLC clinical competence.

Square one:  The IBLCE Clinical Competencies and Competency Statements 
describe what your basic IBCLC should be able to do, when s/he's on the job, 
anywhere in the world.  Having a valid IBCLC certification assumes that you 
can handle these sorts of clinical situations.

Square two is:  Can we use anything *other than* certification to measure 
the IBCLC's competence?  IBLCE does have several different Pathways to 
obtain certification ... some of which are designed to include supervised 
clinical work.  But that is a before-the-exam mentoring system, not an 
after-the-exam process to evaluate competence.  Different work places may 
have patched together different systems to make sure their IBCLCs are up to 
snuff -- but that would be an internal policy, springing from the individual 
institution.

Square three is:  What can we do if we think the IBCLC is *not* clinically 
competent?  Ahh -- there's the rub.  In those professions that have a 
license (in addition to, or in lieu of, certification), there is the option 
to have the license revoked.  It can be revoked if the licensee practices 
outside the scope of practice for that license (podiatrist performs 
brillliant brain surgery) ... or if the licensee practices incompetently 
(podiatrist removes toe rather than bunion).

BUT -- licenses are administered by boards with *small* jurisdiction.  The 
board has authority to monitor (and yank) licenses within its jurisdiciton, 
but that may only cover a few counties or a state.  Perhaps a country.

IBCLCs are internationally-certified allied health care providers who are 
*not* universally, globally  licensed.  An IBCLC in the USA is supposed to 
practice according to the same standards as an IBCLC in Australia or South 
Africa or Peru or Thailand.

The irony is that compensation (here in the USA) is often tied to licensure. 
  HCPs who are getting paid for the work they do, by the insurance 
companies, need to have a license to be "recognized" by the payors.  
State-by-state licensure may be the only way IBCLCs can start to get paid 
(and respected for) their work.  But we already see variations on the theme: 
  some states are thinking about pulling IBCLCs in under the Nursing (as in 
RN) Board; others are thinking about the physical therapist/occupational 
therapist Boards.  Some folks are investigating creation of whole new 
Boards, to license only lactation consultants.

And licensing boards look for a profession to have a scope of practice... 
one reason ILCA has empanelled a Task Force to create a draft which we hope 
will become a Model Scope of Practice for the IBCLC, available to those 
groups of IBCLCs who are seeking licensure in their [smaller] areas.

Liz Brooks, JD, IBCLC (ILCA Secy 2005-08)
Wyndmoor, PA, USA





>From: Ruth Vishniavsky RDH MS <[log in to unmask]>
>To: [log in to unmask],              [log in to unmask]
>CC: Ruth Vishniavsky RDH MS <[log in to unmask]>
>Subject: Clinical Education and Evaluation and of IBCLC's
>Date: Tue, 17 Jul 2007 17:40:05 -0400
>
>I find it interesting that IBCLC's have no standardized clinical education 
>or
>evaluation requirements even though most LC's seem to work in direct 
>clinical
>contact with clients. Has this ever been discussed? Many other health
>professions have a clinical component to their certifying or licensing
>procedures. Maybe Liz Brooks or others would like to comment.
>
>Ruth Vishniavsky, RDH, MS
>[log in to unmask]

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