Ann, I feel for you!  You are to be commended for attempting to help a
mother, who has the right to expect that from an IBCLC!  You may refer
moms to whomever you want.  The only time that is an issue for a doctor
is when it requires their referral.  If the mom is willing to self-pay,
the doc has no reason to object nor you, the mom or the OT to fear
consequences from the doctor.  She doesn't *own* her patients or their
mothers!  There is no way you could be legally in trouble for this
referral.  It is frustrating enough when you work in a hospital and the
physicians make these ownership-type claims on your practice, but to be
in private practice, they have no right to say what you can or can't do.
Neither does she have the right to tell this mother what she can or
can't do.  This is still a "free country", after all!  Now, the caveat
to that is, if you want good working relationships with doctors (which
serves the mothers better) you should find ways to work in tandem and
keep the lines of communication open.  In the spirit of the words of
David Brinkley, you've just had a brick thrown at you, begin to lay a
foundation with it!  Be professional in your communications with the
doctor.  Tell her you're sorry she felt left out of the loop and you'd
be happy to give her a call in the future in such situations if that is
what she would prefer.  Just remember that you have standards of
practice to uphold as an IBCLC and what some doctors would require us to
do (like 'You can't tell a mom that her baby's tongue-tie is causing
their breastfeeding difficulties, because I don't believe in it') would
cause us to fail to live up to those standards.  Mothers have a right to
know your professional assessment and make informed choices.    You
might also send the mom to someone who does cranio-sacral.  Didn't quite
get what the problem is with the baby exactly, but there are some really
wonderful results with it. IN short, if the mom is willing to pay cash
for the consult, she can go to whomever she wants!
This is a difficult position for you to be put in and you are not in
that boat alone by a long shot! Good luck.  Now take a warm relaxing
bath, sip a cup of your favorite beverage and take a few deep breaths to
calm your heart.  There are no teeth in this bark!

Marsha, who knows that hot seat feeling well!

~~~~~~~~~~~~~~~~~Marsha Glass RN, BSN, IBCLC~~~~~~~~~~~~~~~~~~~~~
Mothers have as powerful an influence over the welfare of future
generations as all other earthly causes combined.
~~~~~~~~~~~~~~~~~~~~~~~~~John S. C. Abbot~~~~~~~~~~~~~~~~~~~~~~~~~



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