Kudos to Kathleen Feather for her wonderful post.
 
Kathy E. and Karen and Catherine W.G. hit the nail right on the head.   Being 
a League leader is a tremendous amount of work.  It's more than  leading a 
meeting every month, and taking a few calls.  I think some people  think it's 
easier because of the "automatic 500 hours a year" rule in the  eligibility 
requirements, but in effect, if you added up all the time an average  Leader 
spends, it would be far more than 500 hours.  (By the way, if you  are accumulating 
hours to sit and are a LLLL and you think you spend more than  500 hours a 
year, document it and those extra hours will count toward your  required total.)
 
I don't agree that everyone is saying the way they became an IBCLC is the  
best way.  I did it largely through LLLL hours, pathways G and H,  volunteering 
at hospitals, and a few other bits and pieces.  I don't think  that it was the 
best way to do it.  No one way is best, but what we have  been saying is that 
a standardized education program (like the UCLA program or  something 
similar, or something, someday that each program creates itself and  competes for 
students based on the excellence of their program and faculty)  would in theory 
be the best.  
 
Pam H. is thinking along the lines that I was/am.  So many people  collect 
their hours with little or no exposure to the beauty of the  multidisciplinary 
nature of our profession.  Yes, a standardized education  program should 
absolutely include other allied health professions, SLP, OT, PT,  RD, as well as 
physicians.  It should include a contribution by  mother-to-mother support 
groups. That's one of my biggest reasons for supporting  formalized education.  
 
It is a tangled web, and considering the history and genesis of the  
profession, it is remarkable that we have come so far.  In some ways, we  are light 
years ahead of other professions who are only now, after many, many  years, 
beginning to require recertification as a way to guarantee quality care  and 
protection of the public.  There are a few certification  organizations who are 
trying, or who have tried, and failed, to go  "international" with their exam and 
certification process.  There are other  professions that require so little 
for certification that is scares me that I  put myself in the hands of these 
'professionals'.  We need to celebrate  what we have done right, and 
congratulate those who have gotten us there.
 
At the same time, it is not 20 years ago.  Medicine and consumer  
expectations, insurance, hospitals' concern with the bottom line, and other  factors 
worry me.  My concern is that if we do not move with more  urgency, 
professionalism, and cohesion, to fix what is broken the lactation  consultant as a credible 
allied medical health care provider will cease to  exist.  
 
Now, say "we" somehow figure all this out.  Are the new  "standards" going to 
be applicable only to the US?  How do we keep the  playing field level for 
every candidate worldwide?  Is it time to consider  whether or not it is 
realistic to keep the "international" nature of the  credential?  How could one 
reasonably expect a country like Zimbabwe or  Turkmenistan, or even Brazil or 
Mexico to implement the same standards we are  discussing here, when some of these 
countries have no university systems at  all?  If you all think there's 
territorialism with how we view what the  best way of training is, I can assure you, 
if/when this discussion moves to a  deeper consideration than the 
intellectual conversation of Lactnet, European,  Australian, Canadian and other IBCLCs 
are going to have something to say about  it.  By trying to improve and advance 
our profession, we might well end up  breaking apart the "international" 
foundation of both IBLCE and ILCA.  
 
If you think about it, MDs, RNs and other medical professionals can  practice 
in other countries, no matter where they were trained, provided they  meet 
that countries standards.  That happens all the time in the US.  
 
I've talked enough.  Some of you are probably wondering why I can't  stop 
talking.  Fact is I'm on medical leave for some minor surgery and  can't work.  
Not to fear, though, I go back on Thursday.  But let's  continue this thread, 
please.
 
Barbara

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