Our Breastfeeding Centre allows 2 hours for initial consultation and
normally 1-1 1/2 hours for follow up depending on the problem. This time
allowance includes writing up notes. We can do mother-baby checks sometimes
but not routinely. How can you take a history and observe a breastfeed and
write up your notes in 45 minutes? Does anyone manage this? When I worked in
private practice I would always allow 2 hours for an initial consult also.
Am exhausted at the end of my day after seeing 4 new sets of parents and
their babies or 5 follow ups plus phone calls so couldn't imagine a day
filled with '8' plus phone calls.
Shaughn Leach RM IBCLC DipT
Perth, Western Australia
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Susan Lawrence
Sent: Wednesday, 20 May 2009 12:32 AM
To: [log in to unmask]
Subject: duration of LC visit
I work in a lactation clinic in an HMO where patients come into the clinic
to see us. Schedules are pre-set by management for all providers. Pediatric
MDs get 15 minute appointments for most visits, which I think is probably
what doctors in individual/private practice average in the US.
Our management wants our LC appointments to be 45 minutes in length
(including charting time). Currently we have 60 minutes.
About half of our appointments are lactation visits for issues of all
sorts. The other half are "mother-baby checks", routinely scheduled 2-3
days after hospital discharge--checking mother for postpartum issues; baby
for weight, jaundice, brief overall assessment; brief newborn care/parenting
education--and almost always, lactation issues such as sore nipples,
engorgement, supplementation, etc (occasionally a mom/baby doing great
needing no breastfeeding help!)
We do all the information gathering (there is no medical assistant doing any
part of the intake, unlike the MDs)
So, my question is for those of you seeing mothers NOT in the hospital
setting, but after discharge, whether you are in a clinic or private
practice: How long are your appointments generally? (And how long for
charting if you don't include that in the time alloted for the visit
itself?)
Looking for information for a community standard of practice to present to
our management. We can't quite imagine seeing 8 dyads, answering about 5
phone calls each, and charting in 8hrs--while, of course, making sure not to
get overtime!
And how does one negotiate these things ?? Any ideas for efficiency?
Thanks, Susan Lawrence, RN, IBCLC, LLLL
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