All this discussion of fees has been interesting.  What I see as the big
issue is not seeing the "professionalism" of the LC.  Volunteering is
great!  Being an LC is great!  The two are not the same.  We would never
expect to go to a job and have our employer say, "You have been
invaluable to me today.  I don't know what I would ever do without you.
Thank you so much for giving of you time and energy."  Then patting us on
the back and sending us on our way with no paycheck!  We would never
stand for this.  But, because we are "helpers" we feel the need to do
this with the women we see.  When we see clients for free, we are no
longer LCs, we are volunteers and will be treated as such by everyone
(i.e., hcps, insurance companies, etc.).

Don't get me wrong, I'm a huge proponent of sliding fee scales and free
services when necessary.  I just don't think everyone I see is poverty
stricken.  I also feel people need to pay something for my service.  Even
if that is $1.  It all evens out in the end.  The wealthy women I see
have no problem paying for my service.  Thanks to them, I can see someone
who can't pay.

I have spent lots of time and money getting to where I am today.  I have
a job.  I am a private practice LC.  I charge for my services, just as a
lawyer, doctor or plumber would charge (I'm cheaper than any of those
professions).  We need to start seeing ourselves as employed individuals,
even if we pay ourselves.

Johanna Berger, LSW, IBCLC
Bala Cynwyd, PA

p.s. to Sandy: Just keep telling yourself it's your job.  If someone else
employed you, you'd be suing for back wages if you didn't recieve your
paycheck.


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