The average length of outpatient lactation visits is about 90 minutes. This is a fee-for-service visit. I believe this is pretty standard for outpatient visits. If milk supply is good and it is a "simple" weigh the baby, teach-hand-expression, latch the baby, weigh again and give info, I can get it done in about an hour. If it is more than that or the mother has to pump also, it is at least 90 minutes. The bean-counter person in charge is equating the length of a consult to the usual length of a feeding, not allowing for information gathering, education, physical assessment, etc.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Susan Lawrence
Sent: Tuesday, May 19, 2009 11:32 AM
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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