Brenda -

I figure my reports are 1) required, 2) a chance for dr education, 3) an easy way to write up notes on the consult, 4) something the mother may end up reading.  (It will be in her chart, after all, and I've recently added an option on my permission form for her to have me e-mail her copies as I send them.)

1)  I send a doctor report with every first visit, unless that visit was merely a preliminary to a soon-to-happen second visit (a baby who doesn't latch, say, and who is coming back in a couple days).  I send no reports on women I talked to only by phone, because I don't have their written permission to do so.  Often, my final report on a mom is about how we're clearly getting there now, in which case I don't send a final one saying we got there.

2)  After the first report, I send reports only when there's something new that the dr wouldn't know about otherwise.  In the case of your mom, the Reglan issue was between him and her, so I wouldn't bother... unless I had information about Reglan that I wanted him to have.  In that case, I'd send a report "giving him a copy for his files of the information I shared with the mother."

3)  I print a hard copy of my reports and add them to my file on the mom.  I've lost too many reports, changing computers and programs, to want to store them only on computer, and it's an easy way to see what happened when.  Once in a while, I'll write an unnecessary report, write NOT SENT on it, and add it to my file - extra information for me.

4)  I'm upbeat in my notes, and try to convey to the dr how hard this mom is working; she needs praise from him as well and I hope this will help trigger it.  And, of course, I want *her* to gain satisfaction from reading it if she ever does.  Once or twice *ever*, I've added a post-it asking an HCP I know well to read between the lines and check for such and such, not wanting that subtlety in print in her file where she might see it.

By the way, if anyone wants information on conforming to HIPAA, Elizabeth Brooks sells a really cool disk on it - all the forms, what to post, and so on.

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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