Hello Margery and all of you on the Lactnet,
I want to address the issue brought up by Margery.  It is increasingly difficult to justify one's
existence in a healthcare setting that seeks to be profit-making.  I find myself in the same position
as Margery where I started 6 years ago, idealistic and eager to impart whatever lactation
knowledge I had to my nursing and medical staff.  Ever since, the shift to a new location and a
change of top management, the teaching portfolio and "service" orientation has given way to "
justifying" the use of clinic space or office space.  In order to justify my very existence in my
hospital, I have to offer a wide range of services and charge my "customers".  It has been a
struggle trying to maintain a balance between the " preventive" side of lactation consultancy and
the "treatment" side of lactation consultancy.  Each one of us have to figure out how to best use
our talents and contribute as much as possible - I have finally decided to aim for a 50% emphasis
on clinical help, 30% of my time to research and teaching, and 20% to the inevitable -
administrative work - which includes correspondence, filing, cataloguing, sourcing for
information, photocopying and making new slides/ transperancies and taking photographs.  I wish
we have more emphasis on "preventive" help and that the facility be more "service" orientated
with more public health education emphasis.  I hope this helps with the discussion.
Doris Fok, in Singapore, 21st May, 1000hrs.