In a message dated 11/17/98 7:04:06 AM Pacific Standard Time,
[log in to unmask] writes:

<< LC assessed the problem, chose the equipment and
 then sold/rented it to the client.  (Although in some cases the physician
 may assist in getting reimbursement for the equipment, the physician did
 not recommend the specific equipment chosen.) In my opinion, the second
 example is not equivalent to the first in the sense that the same
 provider--the LC--assessed mom & baby, chose specific equipment
 recommended, and profited from its use. >>
This may be true where you are but not in my area.  If a mother "requests" an
apnea monitor, she is automatically given one.  There may be absolutely no
true "medical" need for the monitor, i.e., baby stable, without any breathing
problems, etc.  But in this state anyway, just to help control her anxiety, an
apnea monitor must be given out because of the liability issue.

In my practice, 95% of all my clients are referrals from physicians. I get a
referral by fax from their practice or through the insurance provider
requesting a consult, pump, scale rental, etc., I don't see the difference
between my example and the profit of the home health agency in providing their
services after receiving a referral from a physician.  The other 5% of my
sales are from self-referral "walk-in" clients. Yes, as an LC I make the
assessment and choose the equipment, but I am working under the direction of
the physician who referred the client.  Do I make a profit, yes, but I am a
business woman and making a profit is a part of being in business.

Denise Breheny RN IBCLC
Fayetteville, NC