I always start with the assumption that the client may not have understood the
health care provider and go from there.  I tell the client what I think and
then send a written report (or orders) to the health care provider.  In my
findings I explain what I saw, what I told the client and if I think the health
care provider might utilize it, I send the handouts or other written material. 
I have loaned one of our local pediatricians the video on tongue ties and
clippings, have sent references and have made sure that every local office has
at least one, although sometimes outdated, copy of Medications and Mother's
Milk.  I have sent Gail Hertz's Little Green book to local providers as a WBFW
gift.
I find that starting with the assumption that the client wants to work on
breastfeeding and that the health care provider wishes to help works much of
the time. 
I am more concerned that my own physician know how to treat illnesses and hope
that they know when to refer than I am about their breastfeeding expertise, as
much as I sometimes wish they knew more. 
Even though I am quite outspoken, I have managed not to antagonize too many of
the health care providers here.  
I try to remember how much bad information I have given over the years, even
though it was what I had learned previously.  I hate to think about the numbers
of infants I personally tried to screw on breasts like light bulbs. 
Nils Bergman talked at ILCA a few years ago about the bell curve of acceptance
of new information.  I think most IBCLC's are early adapters and need to help
others up the steep slope of change.

Pat Thomas PHN IBCLC

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