Gonneke asked:
 
<<  How does  reaching the highest score in a daylong multiplechoice test 
make someone  automatically fit for serving in a board?>>


 
Actually, it is the person who  receives the highest score on the exam the 
previous year who is invited to sit  on the exam writing committee for the next 
year, not on the IBLCE board.   The exam committee includes a few people from 
the board (like the president),  but is a different group than the board 
itself.  They only meet one time  for several days.  
 
Quite frankly, sitting on the  exam committee and helping write the exam was 
one of the most fun and  instructional things I've ever done.  I had the 
privilege of being that  person (much to my SHOCK!) one year, and I learned a great 
deal about writing an  exam.  I will tell you, whatever you may think about 
the exam itself, it is  NOT an easy thing to write, given that you have to have 
a certain number of  questions that fit into each category -- disciplines and 
chronological  ages.  Ain't easy, folks.  And you have to have primary 
references for  each.  
 
If you are ever invited to sit  on the exam committee, DO SO.  It is a 
fabulous time.  
 
Also, there is nothing unethical about helping mothers over  the phone or by 
e-mail.  Sometimes by e-mail is the only way I can keep up  with my moms when 
I'm traveling.  And certainly, like Jaye, I do a lot of  triaging over the 
phone.  Many times a mom is unable to come and see me --  I have missionary 
friends whom I might be helping in other countries -- I'm  certainly going to do so 
to the best of my ability -- and will try and help her  find an IBCLC if 
warranted -- but I'm not going to stop helping over the  phone.  So please don't 
worry about doing that -- just document, document,  document!!  
 
HIPAA is another elephant in the living room.  You can  fax, e-mail, or phone 
your reports into the primary HCP.  Make sure there  is a cover letter on it, 
so only the primary HCP sees it.  If you are  struggling with how to get your 
reports to the HCP, do read the HIPAA guidelines  over again.  Once again, 
this is an excellent example of a good idea run  amuck, where people are not 
using common sense in communicating with HCPs, and  offices, in their zeal to not 
be fined for doing something wrong, are getting  nuts over what can and 
cannot be done.
 
Like Barbara, I fax my reports to the HCP -- at this point,  haven't had any 
difficulty with that.   And no, I don't fax a  report if I do a phone 
consultation, only if I see a mom in my office.  And  yes, I have a consent form that 
includes permission to touch her and the baby  and communicate with her HCP.  
I've not had anyone that doesn't have one --  I think the concern here is that 
she doesn't view the IBCLC as her primary  health care provider since we are 
part of the team.
 
Please keep those letters going into IBLCE.  As of this  morning, the SOP is 
still up on their website.  
 
Jan Barger, RN, MA, IBCLC
Wheaton IL




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