I've been following this thread with interest as an MD, IBCLC.  There's some
"cultural dynamics" here that you should know about.  And by cultural
dynamics, I don't mean that we do it in the US and not other places, but in
the physician culture [at least the part of the one I'm part of - this is
not by choice, it's just the rules]. Someone mentioned doctors consulting on
other doctor's patients. Nancy mentioned times when she has not been
consulted and has had to wait until her "own" patient had arrived before
being able to speak with the parent. That's one of the "unwritten" doctor's
rules - you don't consult on, meddle with, or advise another doctor's
patients unless you've been expressly given permission to do so.  The only
exception I can think of is when someone's "coding" [trying to die suddenly]
and then as soon as the patient's doctor arrives you turn the code over to
him. That's culturally acceptable.

The only thing I can compare it to for overall understanding is when you're
minding your children and your mother-in-law comes over and decides to put
her 2 cents in and "correct" what you're not doing correctly in her eyes. As
a physician, I wouldn't consult on another physician's patient without
invitation. It's just not done. Now sometimes I get self-referrals and those
are handled as referrals, but they generally don't happen in the hospital
setting. Many times doctors will "curbside" each other which is "By the way,
I have a patient with..... what do you think?".  But again, you don't give
curbside  advice unless you're invited to. I'm not saying this is right or
wrong, I'm just trying to tell it like it is.

Which brings me to my next point: It doesn't matter what you know, it
matters what you can convince people of. I am a physician, an IBCLC and a
previously breastfeeding mom. I find myself in positions where I have to
talk to other docs about breastfeeding practices. As many of you have noted,
you can have all the documentation in the world and some people won't be
convinced and change the way they practice. That's not just an LC thing.
Physicians have that problem too.

We would probably all be better off if we were to take a class in persuasive
speaking. I do think that that is something the formula companies do better
than we do.  Anyone know of any online?

Gail S. Hertz, MD, IBCLC
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