Dear Barbara, when I was first hosp LC in area in 1986 I was also private
pump rental station.  To say that it made me uncomfortable to tell a mom
she needed a pump and I just happen to have one here, is an understatement!
 Later other sources of pumps became available and I was able to give the
business to my daughter.  It still made me kind of uncomfortable to send
people to her...but since I didn't recommend pumps indiscriminately, only
when really needed, I coped.  But it does put the LC in a very awkward
position.  If the LC is receiving no financial reward this takes away the
temptation to offer pumps when not really necessary.  However, if the
sucess of the hospital pump business pays her salary then it is a problem.
And I know this is the situation in some locations.  Puts LCs in an ethical
bind.

One hospital that I know of got around this by having their Out Patient
pharmacy stock pumps.  So if the LC needed to tell a mom she needed a pump,
at least it was handy.  It was also handy for those of us in the community
who needed to tell mom where she could get a pump.

I totally agree that health promotion people (like LCs and RDs) need to be
hired for the ultimate savings they give to the health care system, not for
what $ they generate.  I'm not altruistic or anything like that.......
Sincerely, Pat in SNJ, USA