The primary reason why I suscribe to Lactnet is so that I can obtain information on breastfeeding, how to promote breastfeeding. One of the strengths about Lactnet is the fact that individuals from many disciplines participate including peer counselors. I believe the interaction is fruitful, provided needed bridges between disciplines. Unfortunately as an MD, I find it challenging to continually read posts vilifying physicians. Does it create value and bridges to continually vent about MD's? Yes many MD's do not have much nutrition in their medical school training. When I attended med school in the late 70's and early 80's, I was successful in petitioning my school to start an elective course in nutrition for med students. I was also able to spend a year between my second and third year studying nutrition including breastfeeding as a nutrition fellow. I did not obtain a degreee from this year, however I did learn valuable information. I continue to attend CME on nutrition, lactation and many other issues to broaden and update my knowledge base. I care for infants, children, adolescents and young adults in my practice. I have to stay up to date on many issues, including child safety, learning problems, behavior issues, chronic illness and many other psychosocial and medical issues. One of the key things I learned throughout my career, was the value of interdisciplinary teamwork. I cannot expect to be the expect to be the expert on everything. The best care models I have been involved in encompassed professionals and paraprofessionals from a variety of professions (RN's, LC's, RD's, community health workers, social workers as well as physicians, midwives and other mid level health professionals). Less energy was spent on deciding what each participant did not know, rather encouraging each participant to share their expertise. I hope somehow we can discuss more often how to strengthen relationships between professions. I know it is pretty frustrating working in many of our environments. There are so many issues re child health promotion, changing health care environment that can just suck out all of one's energy. I find though that always being an adversary keeps me from being creative and finding positive ways to affect change in my environment. Just my thoughts, Pierrette Mimi Poinsett MD, FAAP Modesto CA