Dear Anne,
Having had a few of these myself, I have a few bits of advice that may be
helpful.  First, your clinical observation sounds absolutely right on and of
course you want to help this mom.

Second, this OB will learn in time to trust those observations of yours (and
your advice on treatment) after this mom and many others get relief.  In the
mean time, be absolutely professional and make sure your communication in
words and writing is excellent.  Ask her how she would like you to approach
these situations in future.  Would she like you to call her?  Send women
directly from group to her office?  There are some OB's in my area who would
rather have a mom seen right away, and some who just ask "What do you want
and we will call it in".  It adds an extra element of work to our job, but
they really are the primary caretaker.  It can be frustrating also when the
treatment is different -more, less or just different than we might advise.
Except for those few of us working as IBCLC with prescribing abilities, this
is the nature of the work.  I say this to the moms in a very open way.  "I
am not a physician and I can report what I see and recommend, but your
provider may have a different approach to treatment.  In medicine there are
many good approaches that may work well."
good luck,
tracy

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html