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From:
Phyllis Adamson <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 6 May 2006 02:16:27 -0700
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.. the later the hour, the longer the rant ...

In my area, we do have people hanging out their private practice shingles
and taking fees for consultations on the basis of their introductory
breastfeeding education program. New moms see a store front with pumps and
clothing. Some have IBCLCs and some have a variety of other certificate
letters. How is the average new mom to know the difference? Many will just
go to the one who charges the lower consultation fee. As one of them said
to me, "You don't need to be an IBCLC to rent pumps!" True - until they
begin to expand their services.

Worse yet: how is an insurance provider to know the difference?

Now comes our Board wanting to make an official lower level credential.
That will only legitimize these private practice non-IBCLCs.
It will also be a gold mine for hospitals trying to save salary dollars.
They really can send an interested RN to Educator or Counselor training and
put them to work, with their RN license, under the hospital's job position
of Lactation Consultant. After all, Lactation Consultant is still a generic
term.

Maybe this will force us into our only real defense: state by state
licensure with successful completion of the Board's examination as the
basic qualification. We will have to be very careful to NOT include this
lower credential in any of the licensing laws. That is the only way I can
see to reinforce the necessity of having someone with this new credential
to work under the supervision of a licensed IBCLC. This also may be the
only way to codify, or give a legal definition to the term, Lactation
Consultant. The licensure law must also clarify that a licensed RN who
passed an education program is not the equivalent of a licensed Lactation
Consultant / IBCLC. S/he would also have to get the second license after
passing the Board exam to be called a Lactation Consultant. Isn't someone
at ILCA working on a standardized recommended wording for state licensure
laws? I think Texas in Taking Point on state licensure.

Example: I have paralegal training, but I'm not an attorney. And I haven't
worked as a paralegal for almost 6 years. Just like it would be illegal,
and almost laughable, for me to pretend to be an attorney and to take fees
for legal consultations, I want it to be illegal for a "lower credential"
to pretend to be an IBCLC and take fees for lactation consultations.
Paralegals usually work under the direct supervision of an attorney, but
not always. There are some who prepare and file basic, undisputed legal
documents. Paralegals have their own Standards of Practice and their own
professional association. The paralegal / legal assistant is obliged to
clarify with the client that s/he is NOT an attorney. Both the ABA and NALA
would come down hard on any paralegal who professionally steps out of line
and questions would be asked of the supervising attorney.

I'm still waiting to read the Standards of Practice that will apply to this
new credential - not that they will make a difference to hospitals, or
individuals who want to have a private practice with little more than a 24
to 40 hour education program. Since the Board says they should practice,
whenever possible, under the supervision of an IBCLC, maybe the Board
should include in their Registry the name of the supervising IBCLC for each
of these lower-credentialed practitioners. Or make a statement that the
person is not being supervised. Should the person with this new credential
be obliged to clarify with the client that she is NOT an IBCLC? Maybe when
the Board sees how fast IBCLCs line up to be listed supervisors of persons
with this lower credential, they might become enlightened. Then again, if
they work at the same hospital or private practice, the IBCLC will be the
official supervisor by default.

Phyllis ... helmet on ... waiting for brickbats ...
Anyone going to sign up for this discussion session at Conference?


Phyllis Adamson, IBCLC, RLC
Glendale, AZ
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