The hospital committee I worked with to establish an out-pt clinic at our
hospital, told me that with registration, a woman is consenting to have a
consult. They consulted with our legal department to get this info. We do not
bill insurance, and if the mother delivered at our hospital, the
"Breastfeeding Assessment Report" and "Lactation Recommendations" sheet go to
medical records to be filed with her inpatient chart. If she delivered elsewhere,
the forms are sent to a special person in medical records who deals with
them in another way. Therefore registration and an appointment is required,
and there is a way to track reasons for visits, numbers of visits, etc. I
have only seen about 20 out-patients since January 4th.
I do ask the mother before the consult if she gives me permission to
examine, observe, palpate or otherwise touch her breasts, observe a feeding,
examine the baby's oral anatomy and let him suck on a gloved finger if
necessary, consult a medical provider for findings/problems that are out of the
scope of practice and expertise of a lactation consult, and lastly, fax the
report and recommendations to her OB/PCC and to the baby's provider.
I keep copies in a locked file cabinet that only I have access to.
In my private practice, I have the mother sign my consent form (which
includes a clause that she has received a copy of the HIPAA privacy notice for
my practice.)
Hope this helps.
Mary-Jane Sackett, RN, IBCLC, RLC
Pittsfield, MA in the beautiful Berkshire Hills of western Massachusetts
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