I appreciated Linda Pohl's very savvy letter about improvements in pump
technology and the nature of change in business.  I have long thought it a
mistake to tie my own business too closely to the pump business. I have seen
my pump fleet shrink by about 15-20% since the PnS.  All pump companies have
their own bottom line to consider, and we are foolish to think that loyalty
to LCs is going to get in the way of profit.  While it is certainly true
that I have (as I'm sure many others have) made enough profit from renting
pumps to support my clinical practice, I have a master plan which has always
focused on trying to build my consultations to the point where they would
support myself and my two part-time staffers. This plan has included years
of work trying to obtain affiliation with an HMO (I've recently signed a
contract with a local one to become a covered provider with that group) and
to diversify into materials development and educational offerings.  I want
to mainly emphasize on education within my own community in the form of
short, reasonably priced -- morning long -- CE offerings on target subjects
which I hope will draw local nurses who want enhanced lactation support
skills, but who often can't or won't travel to a big conf. I also want to
work on obtaining either liscensure or name protection for LCs as a way of
furthering 3rd party payments for LC services -- a CRITICAL issue if we are
to survive as a profession.

Some LCs I know are emphasizing their retail businesses as a way of
surviving. Diversifying product lines is assuredly another way of reducing
dependance upon pumps and the vagaries of changes in that technology. I
think though, that it carries the focus of those businesses away from
clinical practice -- which may or may not be a problem for those concerned.

  We have criticized other health prof. in the past for being un-paid
marketing reps of drug and formula companies.  We must continue to be very
impartial in terms of seeming to promote one company over another.  I
occasionally slip and use a brand name when I am describing a product, but I
make a conscious effort to refer to items by function, not manufacturer:  ie
"feeding-tube device" rather than Lact-aid or SNS.  We need to stay up on
technological changes and chose all equipment based on functionality not on
loyalty to one company.  This is not only ethical, it is smart.  It restores
balance when pump companies count on us no more than we count on them. I
think it is also smart to always invite several pump companies to exhibit at
conf. so there is no sense that one is being promoted over another.

As always, just my bossy opinion. (JMBO)
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html