I don't even know where to begin with Judy's comment the "the era of the solo practitioner might be coming to an end".  First of all, there are many different health care systems around the world and lactation consultants work in those other countries.  Second, while it may be a bit tricky right now as new laws are sorted out -- it does not necessarily mean the end of solo practitioners.  Despite a slight drop in some insurance coverage and a little more annoyance as we explain the "geographic gap exception to mothers" I know lactation consultants who are still getting coverage from third party payers without being providers for insurance panels.  More and more practitioners of all kinds in New York City are still finding they can maintain busy practices without joining insurance panels.  

Basically, the message to those of us who work in the United States in solo practice is the same message given to mothers who encounter breastfeeding problems -- that is "your problems are so insurmountable you might as well give up and formula feed".  I am one solo practitioner who is not going to give up the fight for small women business owners.  Everyone applauded Joe the Plumbers right to dream of owning a small business. Why is is so hard to conceive of fighting the good fight for women owning a small business?

Far from responding to my concerns, this just sent the message that we are being abandoned.  

Sincerely, 

Susan E Burger, MHS, PhD, IBCLC

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