I am originally from the Detroit area, where the community standard was follow-up withing 2-3 days.  I now live in Milwaukee, WI, where it varies widely.  I work as a Certified Nurse Midwife (CNM) in a multi-specialty group with two of our own Peds.  One does all the hospital rounds, and routinely tells Mom to bring the baby back in 1-2 weeks, despite +GBS, jaundice, 37 weeker, etc.  I was shocked by this, and talked it over with the other Peds, who sees kids in the same clinic as I do.  We agreed that I can and should advise the Mom's differently, and I try very hard to let her know about any babies that I have concerns over.   I usually say something like "I grew up in a different area, and there, we bring babies in pretty soon after discharge.  I'd feel much more comfortable, and you'd probably feel more reassured, if you'd bring the baby in by ______.  Besides, if you come in on a day when I'm also there, I can help you with any BF problems, or just get to see how you're doing."

I think the nurse-run follow up clinic is a wonderful idea and has HUGE potential to stabilize LC jobs and could probably pay for itself.  You would need to figure out how to bill, but possible involvement of a CNM or NP or physician as director who could delegate the work might work.  What do others think?


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