Carol really hit the nail on the head - it cannot be that we don't cost a
facility money but that we produce revenue. The fact that pump rentals cover
some of the costs of providing lactation is really not at issue. It's how
much money is generated on the bottom line. PT and OT and Radiology bill for
each service provided to the patient and are reimbursed by insurance - they
generate a profit for the hospital. Being billable/revenue producing is
going to be the key - and the insurance companies are the key to THAT, which
again goes back to membership in your professional organization (who can
lobby for such things when they have the money and numbers behind them) as
well as universally recognizeable credentials and advanced education. 

While it stinks that profit has to be a bottom line in healthcare, without
it, healthcare could not be provided - the money has to come from somewhere.
I am not defending the Austin systems decisions, someone else was very right
when they stated that sometimes it seems hospitals cut back on one thing
only to have to spend twice as much as a result later. 

As the IBCLC becomes the standard, it may be that we will see LC's -
especially those with advanced education and other licensure that confers
prescribing rights - working in either private practice in tandem with
physicians, or as a hospitalist sort of position with the focus on
lactation. 

This certainly stinks for those of you in Austin - and many of others
everywhere else who fear that lead may be followed, but it also opens up a
whole new way of thinking for moving the profession in a direction that will
allow for revenue generation. People put their money where their mouths are
- and when insurance companies and patients spend money on lactation
services, and insurance covers it, then hospitals will see what a valuable
service it is and decide they want a piece of the action - the difference
will be that those in that position will not be at the whim of a hospital
who hires and fires, but rather in place because of market demand. 

Michelle

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