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Subject:
From:
"Susan E. Burger" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 15 Aug 2004 09:39:29 -0400
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Dear all:

The concept of being "owned" by a practitioner is quite an anathema to me.
I HIRE my health care practitioners.  When I feel they have not kept up
with the research, I do fire them and choose another.  But I guess I'm an
anomaly.

For example, I stopped going to my OBs office when she moved and her former
partners allowed the formula companies to display their products.  I also
stopped going to a well-reknowned tropical medicine specialist to get my
malaria prophylaxis, because instead of providing me with research articles
about the choices, he gave me an inflammatory letter he had written to the
New York Times about a particular form of prophylaxis and in that letter to
the Times he defamed the CDC. He had no idea that my friend had
participated in that research and I knew the real research well (not the
opinion and anecdotes that he presented in his letter to the Times). He was
shocked when I went toe to toe with him discussing the research and it was
clear he was not used to a client questioning his pronouncements.

On the other hand, I adore my son's pediatrician even though everything he
ever suggested for breastfeeding was wrong or didn't work.  I didn't hire
him to give me breastfeeding advice - I hired him to care for my son when
he's ill and periodically check to make sure my son is developing
appropriately.  He at least admits that "breastfeeding is messy" and
difficult to understand and refers clients to LCs. In other words, he does
not present himself as someone who must be obeyed at all costs.

Moving on, this whole topic about MDs and IBCLCs has made me think about
the division between nonMD and MD at the American Academy of Breastfeeding
Medicine.  I am fully aware of the rationale for separating the MDs from
the rest of us.  Yet, I still resent the fact that I am excluded from talks
that I feel I am completely able to comprehend and I feel cheated that this
information is withheld from me.

Since I cannot change the ABM policy anymore than I can convert the subset
of MDs who refuse to refer to IBCLCs, I've been wondering about the many
ways one can start bridging the gap among the MDs who are a little more
receptive to learning about the benefits of a mutual working relationship
with IBCLCs.  One way that has worked with many of the MDs in Manhattan has
been the pediatrician reports and phone calls. It even worked with one very
resistant MD.  And who knows, when I recover a little stamina, I may even
get back to working on Dr. Trendy and in 15-20 years may wear him down.

BUT, I'm wondering if over the next few years, a concerted effort could be
made to entice the Academy of Breastfeeding Medicine to include sessions
for both MDs and IBCLCs at the annual meeting that would deal with the
topic of how to BRIDGE the gap between MDs and IBCLCs, highlighting the
importance of creating diaglogue between the two groups.  As an IBCLC, I
see the importance of this, of course, but I still haven't thought up a way
to make the whole concept "sexy" for the ABM and for the MDs that might be
receptive and consider the idea.  Whenever I think about this, I see the
MDs fleeing as soon as the "scientific" sessions are over so they don't
have to talk to the rest of us.

Any thoughts?

Susan E. Burger, MHS, PHD, IBCLC

PS.  I also think there is a great difference between mutual professional
respect where you don't intrude without invitation versus impeding
someone's ability to seek adjunct care or another professional opinion.

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