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From:
Cathy Bargar <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 10 Dec 1998 15:43:19 -0500
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I see several postings from LC's entering private practice; I too have just
started out on my own (after WIC & hospital), about a month ago. I have to
say, I'm going about it in a kind of "relaxed" manner; I have to laugh when
I compare starting my "business" with the typical way I imagine a man would
do it! There's one other IBCLC in private practice in my town (Diane
Wiessinger - I know you hear from her on these pages!), with whom I've
collaborated for a lot of years, and she has been enormously helpful to me,
cluing me in on things like insurance company paperwork and very generously
discussing things like her fees and income with me. Without her, I know I
would just be floundering around aimlessly and probably conclude that it's
all too much trouble.

I "launched" my business ("Milky Way Breastfeeding") by doing a mailing to
local physicians, midwives, Public Health & PCAP nurses, childbirth
educators, a couple of wholistic physical therapists, etc., announcing my
practice and letting them know a little bit about how I could help them with
their clients. (It was unbelievably gratifying to immediately receive a
phone call from a physician seeking my assistance, and terribly exciting to
actually have an answer that helped!) I plan to next put up fliers at likely
spots for new parents - doctors' offices, the food coops, maybe some
laundramats, etc. At this point, I've chosen to do all visits in clients'
homes, partly because I don't want the stress of keeping my house up to
standards but mostly because I well remember what it's like to be a new
mother, and I can't bear the thought of these poor souls dragging around out
of their homes with a new baby. So I go to them.

I charge $65. for the initial visit, and theoretically $40. for subsequent
visits if it should be necessary (so far it hasn't been). In theory, I
charge for phone consultations - no charge for the 1st 15 or 20 minutes or
so (whatever it takes to get "the story"), then $8/quarter hour of actual
working on the problem. In practice, I give away a lot of "quickie" advice -
straightforward questions, referrals for pump rentals, reassurance that yes,
some newborns poop 12 times a day, and stuff like that. I charged $10. for
some research and photocopying and mailing of info - next time I may charge
more for that, as it seemed like kind of a lot of time spent. So far, I've
chosen not to get into the whole pump rental thing - it's easy for me to
refer that stuff to Diane. How do these rates sound to those of you with
more experience at this? It blows me away to work for women who can afford
to pay me like this - so far, no one has batted an eyelash at paying my
rates. Quite a change from the WIC population I'm used to! I do plan to
offer a discount to WIC clients, since BF resources for low-income women are
poor in my area, and it is with them that my heart really lies. I help fill
out insurance forms for (theoretical?) reimbursement, but I get paid
up-front. I also send a report to their physician (usually the ped), over
which I take quite a bit of care - I think that that has got to be a pretty
important part of what we do, if we ever hope to establish a collegial
relationship with the docs. In my area, I already know and am known by most
of the doctors around, from working at the hospital for a long time; I'm not
sure if that's a good thing or a bad one, guess it depends on what they
think of me, but I figure about all I've really got to trade on is my
professional reputation as a nurse and IBCLC and a sensible person.

Any advice?? I'd love to hear from others who're doing the same thing,
either new or established - working alone can be kind of isolating, and it's
a field where there's not a lot of company. What kind of advertising/PR have
people found to increase business? What's not worth doing??

Cathy Bargar, RN,IBCLC [log in to unmask]

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