Boy, can I sympathize with your feelings of being crunched for time!  I, too,
have a private practice and pump depot.  I also work part-time as an LC at a
hospital, and have a contract to see the breastfeeding WIC mothers in 16
clinics in town.  And I'm negotiating yet another contract with a home health
agency for LC visitations to their patients.  I frequently feel there are not
enough hours in the day, much less week!

With my office in my home, I feel I have the freedom to schedule office and
home visits during odd hours (early morning, evening, weekends, holidays) to
meet the mother's needs.  My daughters are 13 and 15, heavily involved in
their own activities, which can help (except when I'm playing chauffeur).  My
husband is EXTREMELY helpful, taking messages, cooking dinner the majority of
the time, and only rarely complaining.  The biggest obstacle for me to
overcome was being sure to schedule free-time into the practice.  Unless it
is a dire emergency, I now try to leave one day per week without seeing
clients.  At least once per month, I take a day off with the family and we go
out, away from the phone, pagers, and cellular phone.  That has been the
greatest discovery!  Rarely have I come back from such an outing to find that
someone REALLY needed me.  Usually it is pump rental information requests!

I am seriously contemplating the hiring p/t of a secretary, preferably a
mom-at-home, this year.  Many days are spent with repeating the basic pump
rental information for potential clients.  With call forwarding, I can send
phone calls to the secretary whenever I am with a client or am up to my neck
in paperwork.  Answering machines are nice, but people like talking with a
real person much better.  Has anyone done that?  How successful is it?  Any
negative sides to watch out for?

Paperwork is the other big time obstacle, and that I'm continuing to work on.
 I'm just beginning the third year of my practice (with a profit seen every
year!), and some of the shortcuts have been learned the hard way.  I'm in the
process of computerizing every aspect of my private practice and pump
rentals.  All of my teaching sheets can be printed out from the hard drive
with only a moments notice.  Contracts are the same.  This has been a
valuable lesson in time budgeting.  The accounting on the computer is the one
that is driving me batty!  Anyone use a particular accounting program that
works well for LCs?  Would love some imput on that!

Kathy Parkes, RN, IBCLC