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Subject:
From:
"Barbara Wilson-Clay,BSE,IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 8 Aug 1996 08:55:17 -0500
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I was interested in Diane Barnes recent post about restrictive licensure and
the effect this has on the economically disadvantaged.  My hope for the poor
is that insuring their access to care will not relegate them to access to
POOR care.

I don't know what to think of the examples Diane gave about how strict
liscensing standards made things worse for people. Dentists and hygienists
do such invasive work which involves so much potential risk for both
practicioner and patient in terms of infection.Don't we want very stringent
licensure and the most meticulous practices?  I'd rather have that assurance
when I sit in the dentist's chair. I feel conflicted hearing stories about
liscensing of electricians resulting in more do-it-yourself electrocutions.
What's worse:  that, or houses burning down from faulty wiring jobs done by
unregulated electricians?  I don't like lose-lose situations.  There has to
be a a better paradigm.

My understanding of the intent behind taxpayer funds for WIC is that this
money will identify and target income-eligible women who need help
breastfeeding.  A lot of that money is being spent on pumps in many states(a
good example of throwing money rather than real support at a problem), and
in some places the peer counselors appear to be in place in clinics and
hospt. serving non-income eligible people -- replacing staff LCs.Why would
hospt. pay when the govt pays a stipend to a peer counselor for doing what
the hospt. perceives as the same work? I would hope that great clarity be
used to conserve those WIC funds to serve the target population.  This is an
important mandate which should not be diluted or diverted.   One hopes that
this funding carefully trains the best assistants to advocate for these moms
who are not insured and cannot pay out-of-pocket.

Additionally, all professionals have an obligation, in my opinion, to do a
decent amount of pro bono work, even those of us not on any kind of salary.

Ione raises some interesting points when she describes how the extra money
and effort required to keep up certification actually making this a better
way than liscensure  to assure quality practicioners.  I think we should
keep those requirements too. But as  Ione points out, she cannot afford to
focus on LC work and must depend on the services for which she can be
liscensed in order to make a living.  That is my point.  Because LCs are not
liscensed, it is difficult to focus on that specialty and make a living.  I
am probably in a good position to know that as I have no interest in nursing
or midwifery and am solely obsessed with refining my specialty in human
lactation.I could go to a 2 yr nursing program and become an RN.  Then what?
Go to work in a hospt as a staff nurse who may or may not get to continue to
focus on my passion?

 My income is totally dependant on breastfeeding work. Lactation may have a
chance as a subspecialty in which people can economically survive if it is
liscensed.  Why continue to crank out certified people who have to spend so
much to get and obtain the certs. and have them be unemployable except as
staff nurses or the odd WIC staff counselor?  The salary doesn't change, no
one with any real power pays any attention to what they say, and they are
afraid half the time to tell the truth about the standing protocols for fear
of losing their jobs.  This is not the woman-to-woman empowerment and the
recognition of our skills and our science that we've fought and sacrificed for.

Protectionism is an issue in all trades, and is not new. It is the concept
which spawns the idea of paying your dues and of apprenticing. It fosters
the concept that by the time you arrive you really can represent your craft
well.  It seeks to insure that after arriving, a person is able to make an
honest living which supports a family. It is the concept behind
franchaising.  Most companies (pump companies notwithstanding) refuse to
open up franchaises across the street from each other for obvious reasons.
For some reason we have taken the view as a profession that we should get as
many LCs cert. as possible and perhaps that is not smart.  Some are clearly
not ready to well-represent the field.  The general public has no way of
knowing who has a clue and who doesn't.  This won't nec. change because of
liscensure.  The liscensure is for US.  The certification process being
tightened is for the consumer. Both are valid issues to pursue.



Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html

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