I spent some time thinking about the recent posts on whether practicing LCs
were being selfish or saintly, by offering or not offering opportunities to
others for clinical observation or free joint consultations on private cases.
I think it depends, and I would hesitate to pass judgement without
 recognition of some issues which go way back to the mind-set many of us
bring to our profession:  ie volunteerism and a sense of being called to the
work. Boundries and limits are sometimes hard for us to set and to respect.

Personally, I do a lot of free mentoring and am usually happy and interested
in discussing cases with others.  But I like to be able to pick and choose
the who and the when because I am very busy.  I am approached almost weekly
by people who get mad at me for refusing to allow them unlimited access to my
time and energy.  I have had women call me who plan to open pump depots and
want me to tell them how to set up their businesses and how to reach their
target audience by advertising, etc. etc.  I have had home health care agency
administrators call to tell me they are going to go into the business of
supplying lactation nurses for home health care but don't have anyone
trained, so could I please (for free) look around for PAMPHLETS to train the
nurses to provide the service!!!!

 Many people want me to allow them to come in and watch consults, explain
what and why etc. and basically have me train them to function as LCs and
provide them with enough hours to sit for the exam.  Thats a lot of work for
me and a disruption for my staff and clients.  I take teaching seriously, and
the 3 people I have apprenticed (uncharged) will tell you this involved a lot
effort.  I have decided that I will still allow people to come and observe
for free if its just a couple of visits or if I feel like doing it.  But in
general, I have decided to charge a fee for what is essentially an education
and training component of my work.  I am making up a flier, and inquiries
will be handled by mailing back the pamplet and letting people decide if they
are serious enough about the work to do what I did to get training --
sacrifice and spend money on it.

The issue of fear of competition isn't a sign of deficient character.  With
the pump companies willing to open up depots all over, the entry into any
local market of new service providers is a legitimate concern for anyone in
business.  Private practice has loads of financial risk.  To train ones
competition for free is perhaps not a bright idea.  I am much less concerned
about having collegial relationships with peers -- ie people who  have as
much to offer me as I have to offer them. We have a number of members of our
HOT LC ILCA affiliate who are technically my "competition"  but who are
actually my friends and peers and support group.  But the public has no idea
that the person just starting out with a pump depot, say, and no clinical
expertise, is any different than the person with yrs of experience. Its
especially confusing if that person is sent to you as a home health care
nurse to help you with lactation.

I have called Chele once or twice over the years and she has been gracious
enough to give me some feedback, but these were LLL calls.  If I were to
phone her today about a paying client, I would offer her the courtesy of
asking her if there is a fee for her advice.  I imagine she could spend all
day every day on the phone helping (particularly newcomers to the field) sort
through problems.  I bet Chele's a lot like the rest of us, busy, and
sometimes hurt from feeling like no matter how much you give there are going
to be people who say its not enough.

The volunteer spirit is not, in my opinion, supposed to translate into
codependency.  Its ok to say yes when you feel like it, and it ought to be ok
to value our expertise enough to have limits on when don't feel like giving
it away.  Do other professions have this problem, or am I just a groucy woman
in the midst of mental-pause?

Barbara Wilson-Clay, BSE, IBCLC
Austin, Tx (priv. pract. LLL, HMHB, ILCA affill officer, PTA in 3 differ.
schools, church duties, mother, wife, writer, LACTNET addict, etc)