Kathleen writes:
...for the lc to spend time researching and sending references, etc, when
in fact, many lcs do not get
 paid for this time, seems to me to be a large cause of the frustration.

When I do this because I want to help somebody become a little more BF
knowledgeable [to make my job easier and to better help patients] I compare
it to planting seeds in a garden.  Some grow, some don't -- it usually
takes more time than I'd like (they have instant coffee-why can't they
invent instant tomatoes?)
and often something comes up later that I had given up on ever seeing a
result from... a pleasant surprise!


 "if a physician,... does not research and know what recent
 research shows on a partciular subject such as breastfeeding...."

" With professional control and power come the responsibility to be as
 knowledgeable as possible about every issue one deals with..."

I entirely agree, we should.  I loved KA's recent list of journals she
makes time to read - I have several of those on my list, as well as stacked
on the counter next to the mail I haven't opened, piled on the floor next
to my desk and the most practical place of all - the bathroom...   Often
it's a matter of priorities and reality of what can be done in 24 hrs.
Besides attending grand rounds and lunch time presentations, physicians
usually have a limited list of journals they scan, and an even more limited
list that they read cover to cover.

Often when physicians read journals it is a "problem oriented search" [is
sleep apnea a common complaint in 6 year olds with sickle cell disease and
which treatments have proven most promising in that population?]. This
brings me to another point about the importance of professional
communication:  If someone regularly gives guidance that is counter
productive - say routine ABM supplements in healthy newborns - and the
patients DON'T follow the advice and do well, BUT THE HCP DOESN'T KNOW THE
ADVICE WASN'T FOLLOWED... the success of trying to change that provider's
routine is going to be limited --- after all, the HCP is assuming the
success is following their recommended intervention.  So going back to the
"problem oriented search" ... no problem = no search.

Gail Hertz, MD [pediatric resident, author of the little green
breastfeeding book for residents and owner of Pocket Publications]