>What I want is a sample letter that will not let my anger come
>through between the lines.

Here's my protocol:

First, I rant to someone at home.  It helps.

To the mother on the first call, after discussing her options:  "I'll put a
pamphlet that covers all of this (LLLI's Sore Breast) in the mail to you."

To the mother on the second call:  "He prescribed amoxicillin?  I'm
surprised.  That's not an antibiotic that's usually used with mastitis.
Tell you what, I'll pop some xeroxes of my information in the mail (or
someone can come pick them up from me *today*), and you can discuss it with
your doctor if you want.  I'll send the same information to him, so you'll
both have copies."   My xeroxes come from a doctor-targeted source
like Hale's Clinical Therapy in Breastfeeding Patients or Lawrence's
Breastfeeding - a Guide for the Medical Profession.

With each of the two mother-mailings, if I'm doing this as a League Leader,
I enclose a nice little generic note saying that mailing costs do add up,
and returning a few postage stamps if she has the time will make it
possible for you to send info to the next mother as well.

To the doctor, in my *totally neutral letter*:  "Mrs X called me on XX,
concerned about XX.  I discussed with her such standard precautions as
nursing frequently to reduce the risk of abscess, and getting plenty of
rest.  Enclosed are copies the information I've shared with her."  I flesh
the letter out a tad more than this, explaining who I am if he doesn't
know, but *I keep it to less than one page*.

I haven't disagreed with anyone, just expressed surprise *to the mom only*
at an unusual course of treatment.  Both the mom and the doc now have good
information in their hands, and it's up to her to work with him on an
effective treatment or to switch doctors.  A client of mine was recently
*told* by her doctor, "If you're going to start doing your own research, I
think you'd better find yourself another doctor."  She did, and she's much
happier with the new relationship.  I can't think of any down side to
putting identical good information into the hands of both patient and
doctor.

After years of responding like this to both good and questionable
recommendations by doctors, I'm finding that that's about all I've had to
do to educate and to acquire a uniformly good reputation.  It's up to the
docs to absorb the information or toss it, but when they keep getting it and
getting it over the years, apparently at least some of it soaks in; it tends
to be the doctors who *haven't* heard from me repeatedly who are most likely
not to treat both mother and baby for thrush, for instance.

Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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