As a HBLC in a hospital where the LCs rent pumps, I feel I need to
speak out.  I would never "walk into the moms room with the pump and
the contract" and give her the impression we are the only place to
rent.  We do this when the mom has asked us where to rent and we
tell them we have them available or I can give her other locations.
If she lives some distance away I will also mention other rental
locations closer to her and/or give her the company's 800 number.  I
carry a pump and the paperwork on my "LC cart" which generally stays
in the hall unless I need something from it.  This is only because
at the present time our office is the equivalent of 2 blocks from
the birthing center!  Most moms are glad for the convenience.  They
have enough demands on their time and energy and the vast majority
express relief that this is one thing they don't have to deal with
once home.  (We are talking here about the NICU mom or other mom who
has an immediate need for a pump.)

If a mom is planning to rent immediately for possible need in the
future I usually point out that for now hand expression or a less
expensive manual pump (which we do not carry at this time) will
probably be sufficient.  It always amazes me when a mom who is not
planning to work outside the home and who says she doesn't anticiate
a need for a pump will want to have either a rental pump or one of
the purchaed "Cadillac" models right away.  (Warning sign for early
weaning if I ever heard one).  I will suggest to her that that is
"overkill" and the money would probably be better spent elsewhere.
If she is still adamant about using one now, and will do so in spite
of our suggestions, we will certainly let her know we are one source
for such pumps.

In our case, there are few private rental sources probably because
most (if not all) hospitals in the ares rent pumps either through
LCs or through the hospital pharmacy.  Private practice LCs I know
in the area often prefer to refer to a nearby source such as a
pharmacy they work with.  Pump rental can certainly be a good income
source when income from consulting alone doesn't being in much, but
isn't this the same motivation that the hospitals are being accused
of?  Don't get me wrong, I'm not saying PPLCs shouldn't rent pumps,
just that that shouldn't be the prime aim any more than it is for
the hospital.  The mom renting a pump, in the vast majority of
situations, needs more than just instructions on how to put the
parts together.  Therefore, renting from LCs or via LCs in hospitals
is preferable to just going into a store where the person filling in
the paperwork knows nothing about breastfeeding.  This was the prime
motivation in our LCs taking over rental from our retail pharmacy.
We were doing much of the education in use of the pumps and
referring moms to the sources, but pharmacy was getting all the
profit and basically reaping the income for the work we were doing!
And there are times when a mom comes in think she MUST have a pump
and after working with us, it turens out she didn't really need one
in the first place.

As to who to  refer to outside, we usually tell moms to check with
their insurance to see if they will cover and if so who their
preferred DME provider is.  I wonder if there isn't some concern
about liablility on the part of the institution if referrals are
made to those with no connection.  If the mom goes to a source that
the hospital recommends (or gives the impression of recommending by
including it in a list) and later feels she has a reason to sue, the
hospital can also be sued for referring her to a source that she is
accusing of being "incompetent" or "negligent".  The current
litigous nature of our society is most unfortunate and frustrating
and it is usually the "little guys" (in this case LCs practicing on
their own) that suffer the most.

Winnie

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