At our HMO oupatient lactation clinic we are facing a budget crunch and
trying to decide how to triage our services.  And so  we're trying to get an
idea of generally how many follow-up visits do you find yourselves doing?  I
know that need can vary greatly.  Sometimes though it's hard to decide where
to draw the line between support that can be handled in a group vs
clinical/technique need that requires one-on-one.  (I believe that support
is essential--just trying to figure out how a clinic can have a guideline
for number of visits covered under the client's no-fee plan. Ideals vs
money, you know...)  I think in private practice most clients limit visit
themselves due to cost, but I'd still like to know how many times you tend
to see difficult cases.
So I guess the questions are:  How many visits do you average per client
that needs more than one visit (figuring that we all have many one-timers)?
How do you decide when to turn a mom over to an IBCLC-facilitated support
group that includes weight checks? If you had to come up with a visit number
limitation, what would you suggest?
Trying to provide services to as many of our mothers as possible with less
than infinite resources-,
Susan Lawrence, RN, IBCLC

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