Dear Carol,

I hope that you do not feel that you are being unfairly flamed on this issue, but I think that most on the list feel that there is absolutely no reason to ever use the term "RN/IBCLC" instead of just IBCLC.  Reading your posts does give one the definite impression that you feel that these are/should be strongly linked, and that is exactly what we are all trying so hard to get away from.  Please don't be offended, but do read over your posts again and see if you can get the drift of where we are coming from on this issue.

While it is true that it is difficult to compete with free services, there is no way to completely eliminate this, in lactation work as well as many other areas where it is not only volunteer services, but also services offered to mothers by government agencies at low or no cost.  It is a fact of life.  Also, many hospitals do provide free or very low-cost follow-up to their patients as part of the package when they deliver at their facility.  Don't know what you can do to prevent this, either.  It is part of the free-market system in this and other countries.  My beef is that unless the profession becomes widely recognized as distinct from others (such as nursing) and IBCLCs are routinely employed by hospitals, clinics, etc. regardless of other credentials, then making money as free agents will be that much more difficult.  The truth is that the more that hospitals do expand their own lactation outreach, the less work there is to go to free agents and if the hospitals will only hire RNs, then most non-RN LCs will be free agents with a very limited capability of making any money at all.  The profession then becomes, in reality, a nursing specialty by default, whether we officially admit to it or not. This does all, of course, take time and I guess that some of us moldy oldies see our time slipping away.  Not an uncommon occurance, in fact, a very common one indeed, but a reality that is sometimes difficult to embrace. I am always heartened to hear of the progress being made by some of my colleagues which then spurs me on to make new plans.

Respectfully,
Sharon Knorr, IBCLC

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