I am in somewhat of a similar situation to you.

I work full time at a University and see IBCLC clients on evenings and 
weekends.  I have 3 young children who have lessons, commitments etc.  I 
work very part time in my practice and have become better at turning 
down clients when I don't have time to meet with them.  I typically see 
about 4-5 women a month.  I offer free email follow-up, but point blank 
say I don't have time for phone follow-up with a toddler at home.  I am 
open with my clients that I do this part time and that I work full time 
during the day in research.

If follow-up is more complicated than can be dealt with by email I 
suggest booking a follow-up appointment.  I only get maybe 1/10 clients 
requesting a second appointment.

I am happy with this arrangement for now.  When I was sitting the exam 
and planning my business my family circumstances were different than 
they are now.  I have adapted and keep my business to a minimum for now. 
  When my kids are older, my dh health improves, then I will be able to 
take on more clients.  For now I am happy to keep my skills updated and 
help the women I have time to help.

Over the course of a year I only take home about $4000 after expenses, 
which is nice extra money to have, but not enough money to leave my day 
job.  I charge about $100 for an initial consult.  I have thought about 
raising my prices, but I am trying to stay affordable for the women in 
my community while balancing what my time is worth (missing out on my 
kids etc).

Women here also have to pay out of pocket for my services.

The midwives and public health have had very positive feedback from 
clients about my services, and I am now seeing clients with subsequent 
children, or seeing women who have found me through recommendations from 
friends.

By keeping the number of clients I see small, I can give each client the 
attention they deserve, maintaining my reputation.

  --
Tania Archbold B.Sc., IBCLC
Mother's Nectar Lactation Consultant Services
Ontario, Canada 519-400-7098
www.mothersnectar.ca
www.facebook.com/mothersnectarIBCLC

On 2015-01-12 15:54, Sarah McCann wrote:
> Hi all,Since going into private practice 8 years ago I haven't
> increased my fees.  I think I charged too much at first and now I have
> less time for follow up. This is concerning me though. Currently I am
> mixing private practice with studying for a Post-grad Diploma and the
> studying should be over by the Summer. I used to offer as much phone
> follow up as a mother needed - there is no health insurance system
> where I live to cover my fees, so I really am in Private Healthcare
> and most clients can't/don't want to pay for a second consultation. I
> rarely seem to have time to do follow up phone calls anymore.  I worry
> about the ethics of this, let alone my reputation. I am genuinely
> tired during term time and I am naturally limiting the number of
> clients I take on to 4 or 5 max per week. Many of my clients are
> having their baby's tt clipped. However I could earn as much by
> working part-time in a shop.
> How do others out there balance clients and follow up? Is anyone
> earning a half decent wage by being in private practice?What about the
> ethics of follow up?
> I love my job and some of the issues will sort out with time, but any
> thoughts would be appreciated.
> Best wishes,Sarah McCann BScHons, LLL Leader,
> IBCLC.www.BreastfeedingResourcesNI.co.uk
>              ***********************************************
> 

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