Linda and listmates,

First, I cringed when I read this post, because I'm supervised by
administrators who either have no children or if they do have children,
they weren't breastfed.  They also do not have a background in
Maternal/Child Health.  So hearing that a manager doesn't place a value on
this service due to $ loss makes me wonder, "did she breastfeed her kids?"
and "Is her background in MCH?"  (BTW, I'm supervised by an administrator
who's background is trauma and critical care, has no children).

How MUCH money is being lost?  Is the service at least close to breaking
even?  Are you getting any reimbursement for her services from third party
payors?  Does she do rounds on inpatient breastfeeding moms?  Does she
teach a prenatal breastfeeding class?  Does she follow-up at least by phone
to all moms (or at least bf moms)?  Our fulltime LC (1000 births/year) does
all of this, doesn't rent pumps and also does outpatient consults with some
reimbursement.  She's the only LC in town.

Just my managerial 2 cents here, but 0.6 FTE (26 hours a week) is a lot of
time for only 5 to 10 moms.  I know I've spent up to two to three hours
with some moms plus follow up work, but that's not always the case.  Does
that include follow-up or not?

I manage the Educational Services Dept at our hospital, which partially
encompasses your area of management as well (Community Education, Patient
Education and Continuing Education are my responsibilities).  It is a
challenge to break even some years.  However, we are a not-for-profit
hospital and community service is top of the list in our hospital's
mission.  To justify our NFP status to the IRS, we must show a large
community service component, charitable work if you will.  I presently do
not receive a lot of heat about my bottom line dollars because education is
not a "money maker", compared to other services like surgery or
rehabilitation or obstetrics.  If my budget breaks even each year or if we
generate a little revenue, that's great in the eyes of my administrators.

The benefits to the organization comes via the positive public relations
through this clinic, the new parents who will continue to come to the
hospital for their families needs because they  are pleased with the care
they received.  We just did a community survey- top of the list was the
need for caring compassionate care, which all LCs provide.

Just an off the wall question for those of you in private practice...do you
feel like you are making lots of money??  After you pay for your overhead
and pay yourself, I'd be surprised if any of you are "rolling in dough".
Money isn't the main reason we do what we do, but that's the direction
health care seems to be taking.  There are other rewards to our business...

Maurenne Griese, RNC, BSN, CCE, CBE
Birth and Breastfeeding Resources
Manhattan, KS  USA
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