Dear Kathleen A:  Thanks for your comments about specialist referrals.  I
guess as you can see by Terry Lynn Dise's response, I'm not the only family
doctor bothered by the prevalent attitude about specialists.  I was not
referring to that particular case, however, and if you've found a lactation-
friendly dermatologist, by all means cultivate him.  As the recent survey by
Gary Freed demonstrated (JAMA Feb. 8/95), physicians overall (both residents
and practising physicians) have abysmal knowledge levels about lactation, so
finding an MD with any useful lactation knowledge is a challenge, regardless
of their specialty.  This of course is no big surprise to anyone on lactnet!
Insofar as finding a primary doctor locally who would be helpful with
lactation-related issues, I don't know anyone in your area.  However, I would
recommend two avenues:  La Leche League's directory of Medical Associates,
and the local chapter of the Academy of Family Physicians(the AAFP has a very
positive statement about breastfeeding promotion and recently endorsed the
"ten steps"; this is purely anecdotal, but I find family physicians to be
among the most supportive of breastfeeding, although not always more
knowledgeable).  As for writing to family practice journals, I did recently
have a paper published in American Family Physician (March 1995), entitled
"Overcoming Social and Medical Barriers to Breastfeeding".  Good luck,
Alicia.  [log in to unmask]