Hi all,
In reply to Nikki's post, I think it is very hard for a primarily USA based
organisation to turn global or
international without input from other nations!!
Being a Board Member of LLLI, I can tell you the process is not easy. After
so many years (LLLI will be 50 years old this year!!!) of being culturally
influenced by only Western standards, "USA think" we all are beginning to
realise that the USA standard is not the only one. As these organisations
originated in the USA, it was taken for granted that decisions were made,
due to the large number of members from the USA. Most organisations who are
trying to go global are trying to vary the constituency of its Board
Members, and doing a fine job. (LLLI by the way has done this already for
many years) But, we are not quite there yet. By we, I mean LLLI, ILCA and
IBLCE.

It is not enough to determine that everyone worldwide must report to the
HCP. Here in Israel, when a mom comes to see me when the infant is 4 days
old, she herself does not even know the name of her physician. We have "well
baby clinics" who in theory are there to keep track and make sure that
babies are weighed, tested periodically and reach their milestones in a
reasonable time. This service is virtually free, in some clinics, or is
incorporated as part of the family's healthplan. Every week I am seeing
moms, who tell me that the nurses in the clinics do not want to see them
until the baby is two weeks old, and some even invite the moms after a
month!!!!!! So even in the best of scenarios, this mom can not even tell me
who the nurse in that particular clinic will be taking care of her or if it
is even constant. Whichever nurse is on duty, that is the one the mom will
see. SO..........................to whom am I expected to report??? I find
it virtually impossible. In my 20+ years I have to admit, I have seen
probably thousands of moms, and I can probably count on two hands the times
I have felt compelled to confer with the HCP. (suspect child abuse, ftt,
etc...)  So, if i understand correctly, guess I will have to close up shop?
Well, if that happens, at least i won't have to sit the exam next year!!!
(Don't get me onto that topic..............)

I guess my point is, there is so much variety and cultural aspects to our
practice, that it is a bit offensive that the new document does not seem to
take this into account .

My other question regarding this was, which other HCP's are required to do
this? The only example I can think of in reciprocal treatment might be in an
emergency setting. Are the paramedics or nurses, doctors who are on call
required to report to the HCP who usually takes care of the patient.?? Nice
idea, but here, I would be handed a report and then they tell me to give
this to my physician in my healthcare plan. which inevitably I forget to do
and I file them away with all the others!!

Just my $2000 worth. (it is just so much more than 2 cents, I know)
Ellen Shein,
Tel Aviv

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