This comes to me anonymously..and the sender would like comment on this
important issue of LCs getting compensated (as deserved) for the services
they perform. Might I add that I believe that the prevalent attitude among a
lot of folk (not LCs, but parents needing services, or docs with clients
needing services) is that THEY give the same advice over the phone, and
what's the big deal....if it doesn't work out, honey, you can *always*
supplement with abm. I also live in a rural place, but people here pay more
to get their dog groomed than they will for LC services. I do get an
occasional client, but it is the "If insurance doesn't cover it, I guess I
won't bother" attitude that prevails.  Insurance companies would most
certainly rather pay for a failure to thrive or rule out sepsis
hospitalization than they would a minimal LC visit charge. It is disgusting,
short sighted, and damned ignorant, in my opinion. In my community, a
majority of OBs do not recognize, or treat yeast infections, for instance,
and I shudder to think what happens to those women who go undiagnosed and in
pain, thinking they must "tough" it out...this to me is stupidity,
ignorance, and the ultimate disregard....why don't people think LCs are
worth it? Because they don't think breastfeeding is worth it either, so why
bother keeping up with the literature on lactation...now if it is a new
discovery in diabetes,...THAT"S worth reading. .......

 I must say that I thank goodness for LLL, that is able to provide help to
those who need it and who cannot pay. LLL is a mainstay of breastfeeding
support in this and in many other communities and countries around the world.

Just to reiterate, exact prices cannot be discussed on Lactnet (prices per
hour for LC work...comparing what people in NY charge to those of Chicago,
etc.). This could be construed as price fixing, I hear. So, as the writer
says, LET THE FUR FLY.

Please respond on Lactnet, or forward private ones to me, and I will send
them to the writer of the message. Thanks. The Cynical list owner...Kathleen

+++++++++++++

Dear Lactnetters:

Without violating Lactnet rules about posting specific prices, may we
discuss how you convince docs and potential clients in your area that your
services as a private-practice LC are of value and worth paying money for?
I'm sure I'm not the only LC who finds herself also the only person charging
for lactation services in the area. LLL has a long presence here and very
knowledgeable leaders; their services are, of course, free. One hospital has
a CLE on staff, and another hospital in the area has a nurse/IBCLC on staff
who manages lactation problems and takes calls (no charge) from moms who
deliver at other hospitals. Both of these nurses receive staff salaries--no
extra time or compensation for their lactation management work. The basic
feeling around here among the pediatricians is "Why should I refer to
someone who charges when my patient can talk to a nurse I've known for a
long time, or a Leader I respect, for free?"

What I offer is 10 years of LC experience as well as a maternal-child
nursing background, home visits (not just telephone management), and
unlimited follow-up phone calls for less than a fancy manicure at the local
mall. I charge the average fee for a physical therapist's home visit in my
rural/small city area.
I am under no illusions about making a mint, or even a living wage as a
lactation consultant. I have no plans to quit my half-time job doing
something else. I do, however, know that what I offer to moms is VERY
valuable and is not duplicated by what my colleagues do.

How do I market this difference in a place where charging for this service
is previously unheard-of? How do I point out to docs that telephone
management of a situation you have not observed is not legally very safe--or
do I? Also, may I ask fellow-Lactnetters to describe the differences in
scope of practice of a CLE and an IBCLC? At one local hospital, they appear
to be interchangeable.

What type of advertising have you found effective? Must I become a pump
rental station to make money? (I dread the paperwork involved.) How do we
get a community to get "unstuck" from this "you can't charge for this"
mentality?
Please share your successes and frustrations. In a way I'm reminded of my
nursing history class in college when we discussed nursing's fight for a
living wage versus the "angels of mercy" concept--as in "angels don't need
to eat, pay bills, support a family, etc.". In a place where lactation
services have always been and continue to be free of charge, is it possible
to be compensated for your services?

Let's let the fur fly,
Anonymous IBCLC, who's had 2 paying clients in 4 months
Kathleen B. Bruce, BSN, IBCLC, LLLeader, co-owner Lactnet, LLLOL, Corgi-L
LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
Personal WWW page: http://together.net/~kbruce/kbbhome.html