I totally agree with the idea of charging for lactation visits and for your assessment of what a lactation "clinician" does, especially with outpatients. It's my opinion and I there's research - don't have time to cite - that most low supply issues are related to poor initation of lactogenesis II and poor removal of milk from the breast by the baby (or pump). So -- when a mother has a baby with issues, who is going to manage the breastfeeding? I am appalled at my encounters with SLP/OT folks who have not really had any basic education in their advanced degree programs regarding infant suck/swallow. I just loaned my Wolf and Glass text to someone in the position of working with babies with issues. OMG! A job - with no basic education - just a workshop attended! I have educated myself with Catherine Watson Genna's work, Wolf and Glass, Donna Geddes and Hartmann's work via books and seminars plus observation, learning by the seat of my pants. I am nearing the end of my career and I am still blown away by the LACK of respect that I receive from insurance companies that don't have a clue, to medical billers, to md's, nurses, etc. Just venting here - but I am tired of being told that I am a nipple nazi! I deserve to be paid for what I do. Mothers rose up and demanded that epidurals be covered by insurance companies. Who is going to rise up and campaign for moms and babies to get this service covered? Our organization should be as active as the AAP. Maybe lactation consultants should be lactation therapists? AAP's advice on billing only applies if the lc is an employee of the MD. And what MD's office sees volume of breastfeeding patients to warrant hiring a full-time LC? And as Debra pointed out - and Carol's website stated - most of these issues can be solved in 1-3 visits. I do have a few that I see on long-term basis, but mostly for free weight checks after we've worked through the plan to improve baby's issues and protect mom's milk supply. The lack of reimbursement contributes to the problem of trying to catch the train after it's already left the station - the unrecognized issue that drops mom's supply in 2-8 weeks. For you non-USA folks, this may seem not an issue for you, but money equals value. If you are paid well, it signals that society values your contribution. I'm rambling here - but my indignance-meter is sky-high!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Debra Swank
Sent: Saturday, April 18, 2009 4:45 PM
Subject: thank you to Jane Kershaw re: insurance reimbursement
Thank you, Jane, for starting this thread. It's been therapeutic to read your responses.
Debra Swank, RN IBCLC
Ashburn, Virginia USA
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