Dear Phyllis,

You and others posting on this thread have run into the crux of the problem of IBCLCs as recognized health professionals.  We can call ourselves anything that we like, we can pass exams, we can publish journals and papers, but unless this is all officially recognized in some way by the government/health care industry, it doesn't mean much as far as someone actually being able to make a living at this. (not withstanding the few that are doing so in freestanding, self-pay clinics, through speaking/writing, etc. - although I wonder how many of them are actually making enough to support themselves and their families).  The fact remains that most of us, even with connections and tons of experience, can't get "official" jobs in the health care industry - we work per diem, we get referrals, we do charity work - but we can't bill insurance companies or get on a weekly payroll unless we have the magical "RN" in addition to IBCLC.

Now, for many IBCLCs, making a living is not really the point, especially I think for the legions of us that came up through the ranks of LLL or similar organizations - we think just making enough to cover our costs or get us to a conference or two is great, compared to nothing.  For many, it's the work that matters - it's a calling (in many ways, I think, similar to lay midwifery).  But many who came to this profession through the RN route assume, I think, that they will be paid their usual wage for their lactation work, and many of them are - they are working as lactation consultants within the traditional health care establishment (and working very hard, usually - this is in NO WAY a slam against RN, IBCLC's - have many who are good friends and colleagues).  I am also a medical technologist and get paid well by a hospital for that work.  What bugs me is that I have spent more money, and possibly more time,  studying and learning to be a good LC than I have spent becoming a good med tech.  The work that I do as an LC is just as important to the health and well-being of this nation as the work I do as a med tech.  And yet, I cannot make any real money as an LC and so I remain a full-time med tech to pay the bills and try to squeeze in my LC work as it fits - not a great way to remain proficient at an occupation.

At least when I was "just" a LLLL, it was clear in my mind what I was doing - volunteer work as best as I could handle it in respect to my family and then also my job.  Now it all seems very blurry.  Will I, as an IBCLC, ever really be a true health care professional in the eyes of the law/government/whatever?  Or will I remain a local volunteer/quasi-professional, the local breastfeeding expert whose fading phone number still is tacked to the wall in the local offices for when they get desperate?  I would gladly open a free-standing clinic, but I have yet to meet anyone who has actually made any real money doing it, and until the college loans are paid off, it is just not realistic to even think about something like that.

I think that for those who have never worked within the medical establishment, this is not such a big deal.  They will continue to help moms and babies, get a little pay for their services when they can, and be happy about it.  I am thinking that I should quit obsessing about some of this and just be the local "breastfeeding crone" and take satisfaction in whatever help that I can be of to the community.  I'll read my Globe and JHL and see what tides are turning in the great battle for LC legitimacy.  Ah, you may say, you should take part in the battle and not let others do it for you.  Probably so.  I guess that I have lost so many local battles, that I am a little weary (today).

Many people never make much of a living doing what they feel called to do (actors come immeditately to mind, not to mention many that I know in the horse business.)  But at least they seem pretty clear up front about what their prospects are and what to expect.  This is such a new profession, although not such a new calling, that we all seem to have different expectations, which is one reason perhaps why the road is remaining so twisted.  I wonder, what are the true expectations of the rest of you out - grizzled veterans as well as the newly certified?  Where do you think we are going, or should be going?  Would really be interested in some honest reflections on this subject.

A little delirious after a week of stomach flu, awesome heat and no AC,
Sharon Knorr
Newark, NY

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