Re: lactation professionals - licensure?

[Guest guest]

Oops, I meant to address that to Dana, not Deirdre. Sorry. Becky

[Guest guest]

God I hope so! Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, December 1, 2011 10:32 AM Subject: RE: Re: lactation "professionals" - licensure?

Deirdre, I agree that we all want to be respected healthcare professionals. The question is, how will licensure help with that? As I said, almost no one here seems to have any understanding of my credentials so licensure will just add more words. The doctors and hospitals here refer to me because of my reputation, not because of my credentials. I really don’t think anyone will care about “licensed†any more than they care about “board certifiedâ€. I seriously doubt that licensure by itself will increase my referrals enough to cover the cost of licensure. Do you think that being able to say you are licensed will really change attitudes where you work? Becky

, IBCLCMilky WayLa Plata, MD

[Guest guest]

I'm not sure how it will help, either. Hopefully it will, though. The thing is, most people won't know or care about a license. They only want a healthcare name that they are familiar with. So many mothers or grandmothers (even nurses and doctors) have said to me, "Are you a nurse? How do you know what you're doing?. One doctor, in particular, has been after me for years to go back to school and get my R.N. He has referred to me, reluctantly (but I hope as respected) with the following, "She doesn't have the alphabet's after her name but she sure knows what she's doing." Alphabet?! I have CLC, CLE and IBCLC after my name but what he wants is R.N. And guess what? Now that the hospital has an R.N., IBCLC he refers to her. Don't know if

walking in with a license to show him would matter, for all he knows, I already have a license. Cheryl n To: " " < > Sent: Thursday, December 1, 2011 10:43 AM Subject: Re: Re: lactation "professionals" - licensure?

God I hope so! Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and

baby To: Sent: Thursday, December 1, 2011 10:32 AM Subject: RE: Re: lactation "professionals" - licensure?

Deirdre, I agree that we all want to be respected healthcare professionals. The question is, how will licensure help with that? As I said, almost no one here seems to have any understanding of my credentials so licensure will just add more words. The doctors and hospitals here refer to me because of my reputation, not because of my credentials. I really don’t think anyone will care about “licensed†any more than they care about “board certifiedâ€. I seriously doubt that licensure by itself will increase my referrals enough to cover the cost of licensure. Do you think that being able to say you are licensed will really change attitudes where you work? Becky

, IBCLCMilky WayLa Plata, MD

[Guest guest]

Good to see that people are discussing this very important issue, so happy to

see everyone's responses, concerns, corrections.

I knew that an Advanced Practice Nurse needed to be an RN(registered nurse) but

did not know that a registered nurse is also a licensed nurse. Though I don't

think that makes much difference. Again, if we look at Licensing non-nurse

midwives, which has been done for decades, it hasn't helped them, it's made

things worse.

As for the cost of licensing, In Oregon for a while, the Licensing fee was over

$1000, (I think $1400) every 2 years... after a few years of those fees, they

started targeting midwives and trying to revoke their licenses over petty issues

that the OB's (not the clients) complained about, sometimes making issues up out

of the air. That being said, Oregon felt like a Midwives Paradise when I moved

to California.

Wanted to make a positive and very important point for those of you who are not

aware - IBCLCs can get an NPI number -easily. I have one. On the other hand,

Non-nurse, non-IBCLC Lactation Consultants can also get an NPI number. The local

CLC here has an NPI number and bills her clients almost the same as my rates.

In any case - I do have an NPI number as a non-nurse IBCLC and that's why my

clients are able to be well-reimbursed for my services. I'm sure that Licensure

for IBCLCs would affect that, but I'm not sure it would affect a positive

change.

Just happy with the way things are in some respects and also seeing other

non-insurance reimbursement issues that do need to be dealt with - I just do not

see how Licensure is going to deal with those other issues.

Band-aids = good for some things, but I wouldn't put a band-aid on a TT baby.

That might cover up the TT, but not help Baby or Mommy - might just makes things

worse.

>

> I am not understanding what being a nurse has to do with licensure? I read

many saying " I will never become a nurse " .  It is my understanding that

licensure will raise our level of respect and hopefully increase referrals in

the community.  I also thought that the purpose of this was that non-RN IBCLCs

can get an NPI number?  Judy, please correct me if I'm wrong.  I am in favor

of it and it has nothing to do with me being a nurse.  I already have an NPI

number. What I need is recognition in the medical community as a fellow medical

professional. I don't want to be a hospital lactation consultant - I want to see

moms AFTER they become engorged or when they are returning to work, etc.  My

vision is having docs call me or send written referrals to me as they would with

any other specialist.  I want to be on a preferred provider list to be THE

breastfeeding specialist in my local area.

>

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

>

>

>

>

>

>

>

>

>

>

>

>

>

> ________________________________

>

> To:

> Sent: Thursday, December 1, 2011 9:57 AM

> Subject: RE: Re: lactation " professionals " - licensure?

>

>

>  

> “To my way of thinking, licensure has the risk of causing all IBCLCs to

become hospital- or WIC-based, and then mothers won't have the option of seeing

an IBCLC in private practice who is free to tell the mother about symptoms that

may be helped by craniosacral therapy or about symptoms of tongue tie. “

>  

> I totally agree with you, Dee.  I don’t know as much about the details of

licensure as many of you do, but I am sure it will not help me, personally, or

the mothers in my area.  I came from a volunteer background and have advanced

degrees in English, of all things.  I will never be a nurse.  I could never

qualify to take the exam with the new requirements.  However, I have earned the

respect of the physicians, hospitals, and mothers in my area because I help

mothers.  Very few people here have any idea of my qualifications and

wouldn’t care two cents if I was licensed or not.  Many of my clients receive

insurance reimbursement, and if someone can’t pay then I see them for reduced

rates.  Licensure would cost me money and get me what exactly?  If I could not

practice according to my own standards (and say tongue-tie whenever I feel it is

appropriate!) then I would not practice, and there would not be anyone here to

see mothers after they

> leave the hospital.

>  

> As Dee says, the future of IBCLCs looks to me like they will all be in

hospitals or in WIC.  The new requirements almost certainly guarantee that, and

licensure is likely to seal the deal.

>  

> Becky , IBCLC

> Milky Way

> La Plata, MD

>

[Guest guest]

I would like to thank everyone who has weighed in on the licensing issues. You have given me much to think about. It has been very helpful to see the issues through so many different perspectives, and I hope that this discussion will continue.

normaNorma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

 

Good to see that people are discussing this very important issue, so happy to see everyone's responses, concerns, corrections.

I knew that an Advanced Practice Nurse needed to be an RN(registered nurse) but did not know that a registered nurse is also a licensed nurse. Though I don't think that makes much difference. Again, if we look at Licensing non-nurse midwives, which has been done for decades, it hasn't helped them, it's made things worse.

As for the cost of licensing, In Oregon for a while, the Licensing fee was over $1000, (I think $1400) every 2 years... after a few years of those fees, they started targeting midwives and trying to revoke their licenses over petty issues that the OB's (not the clients) complained about, sometimes making issues up out of the air. That being said, Oregon felt like a Midwives Paradise when I moved to California.

Wanted to make a positive and very important point for those of you who are not aware - IBCLCs can get an NPI number -easily. I have one. On the other hand, Non-nurse, non-IBCLC Lactation Consultants can also get an NPI number. The local CLC here has an NPI number and bills her clients almost the same as my rates.

In any case - I do have an NPI number as a non-nurse IBCLC and that's why my clients are able to be well-reimbursed for my services. I'm sure that Licensure for IBCLCs would affect that, but I'm not sure it would affect a positive change.

Just happy with the way things are in some respects and also seeing other non-insurance reimbursement issues that do need to be dealt with - I just do not see how Licensure is going to deal with those other issues.

Band-aids = good for some things, but I wouldn't put a band-aid on a TT baby.

That might cover up the TT, but not help Baby or Mommy - might just makes things worse.

>

> I am not understanding what being a nurse has to do with licensure? I read many saying " I will never become a nurse " .  It is my understanding that licensure will raise our level of respect and hopefully increase referrals in the community.  I also thought that the purpose of this was that non-RN IBCLCs can get an NPI number?  Judy, please correct me if I'm wrong.  I am in favor of it and it has nothing to do with me being a nurse.  I already have an NPI number. What I need is recognition in the medical community as a fellow medical professional. I don't want to be a hospital lactation consultant - I want to see moms AFTER they become engorged or when they are returning to work, etc.  My vision is having docs call me or send written referrals to me as they would with any other specialist.  I want to be on a preferred provider list to be THE breastfeeding specialist in my local area.

>

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby

>

>

>

>

>

>

>

>

>

>

>

>

>

> ________________________________

>

> To:

> Sent: Thursday, December 1, 2011 9:57 AM

> Subject: RE: Re: lactation " professionals " - licensure?

>

>

>  

> “To my way of thinking, licensure has the risk of causing all IBCLCs to become hospital- or WIC-based, and then mothers won't have the option of seeing an IBCLC in private practice who is free to tell the mother about symptoms that may be helped by craniosacral therapy or about symptoms of tongue tie. “

>  

> I totally agree with you, Dee.  I don’t know as much about the details of licensure as many of you do, but I am sure it will not help me, personally, or the mothers in my area.  I came from a volunteer background and have advanced degrees in English, of all things.  I will never be a nurse.  I could never qualify to take the exam with the new requirements.  However, I have earned the respect of the physicians, hospitals, and mothers in my area because I help mothers.  Very few people here have any idea of my qualifications and wouldn’t care two cents if I was licensed or not.  Many of my clients receive insurance reimbursement, and if someone can’t pay then I see them for reduced rates.  Licensure would cost me money and get me what exactly?  If I could not practice according to my own standards (and say tongue-tie whenever I feel it is appropriate!) then I would not practice, and there would not be anyone here to see mothers after they

> leave the hospital.

>  

> As Dee says, the future of IBCLCs looks to me like they will all be in hospitals or in WIC.  The new requirements almost certainly guarantee that, and licensure is likely to seal the deal.

>  

> Becky , IBCLC

> Milky Way

> La Plata, MD

>

[Guest guest]

Yes, good discussion. Guess I've always known that R.N. were licensed as is an L.P.N. NPI numbers are not hard to get if you are designated a DME. I've had one for they first started. I now have a non-RN NPI, also since they became available. I wonder if I put both numbers down if it will help moms get re-imbursed any better. Cheryl To: Sent: Thursday, December 1, 2011 2:03 PM Subject: Re: lactation "professionals" - licensure?

Good to see that people are discussing this very important issue, so happy to see everyone's responses, concerns, corrections.

I knew that an Advanced Practice Nurse needed to be an RN(registered nurse) but did not know that a registered nurse is also a licensed nurse. Though I don't think that makes much difference. Again, if we look at Licensing non-nurse midwives, which has been done for decades, it hasn't helped them, it's made things worse.

As for the cost of licensing, In Oregon for a while, the Licensing fee was over $1000, (I think $1400) every 2 years... after a few years of those fees, they started targeting midwives and trying to revoke their licenses over petty issues that the OB's (not the clients) complained about, sometimes making issues up out of the air. That being said, Oregon felt like a Midwives Paradise when I moved to California.

Wanted to make a positive and very important point for those of you who are not aware - IBCLCs can get an NPI number -easily. I have one. On the other hand, Non-nurse, non-IBCLC Lactation Consultants can also get an NPI number. The local CLC here has an NPI number and bills her clients almost the same as my rates.

In any case - I do have an NPI number as a non-nurse IBCLC and that's why my clients are able to be well-reimbursed for my services. I'm sure that Licensure for IBCLCs would affect that, but I'm not sure it would affect a positive change.

Just happy with the way things are in some respects and also seeing other non-insurance reimbursement issues that do need to be dealt with - I just do not see how Licensure is going to deal with those other issues.

Band-aids = good for some things, but I wouldn't put a band-aid on a TT baby.

That might cover up the TT, but not help Baby or Mommy - might just makes things worse.

>

> I am not understanding what being a nurse has to do with licensure? I read many saying "I will never become a nurse". It is my understanding that licensure will raise our level of respect and hopefully increase referrals in the community. I also thought that the purpose of this was that non-RN IBCLCs can get an NPI number? Judy, please correct me if I'm wrong. I am in favor of it and it has nothing to do with me being a nurse. I already have an NPI number. What I need is recognition in the medical community as a fellow medical professional. I don't want to be a hospital lactation consultant - I want to see moms AFTER they become engorged or when they are returning to work, etc. My vision is having docs call me or send written referrals to me as they would with any other specialist. I want to be on a preferred provider list to be THE breastfeeding specialist in my local area.

>

> Â

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby

>

>

>

>

>

>

>

>

>

>

>

>

>

> ________________________________

>

> To:

> Sent: Thursday, December 1, 2011 9:57 AM

> Subject: RE: Re: lactation "professionals" - licensure?

>

>

> Â

> “To my way of thinking, licensure has the risk of causing all IBCLCs to become hospital- or WIC-based, and then mothers won't have the option of seeing an IBCLC in private practice who is free to tell the mother about symptoms that may be helped by craniosacral therapy or about symptoms of tongue tie. “

> Â

> I totally agree with you, Dee. I don’t know as much about the details of licensure as many of you do, but I am sure it will not help me, personally, or the mothers in my area. I came from a volunteer background and have advanced degrees in English, of all things. I will never be a nurse. I could never qualify to take the exam with the new requirements. However, I have earned the respect of the physicians, hospitals, and mothers in my area because I help mothers. Very few people here have any idea of my qualifications and wouldn’t care two cents if I was licensed or not. Many of my clients receive insurance reimbursement, and if someone can’t pay then I see them for reduced rates. Licensure would cost me money and get me what exactly? If I could not practice according to my own standards (and say tongue-tie whenever I feel it is appropriate!) then I would not

practice, and there would not be anyone here to see mothers after they

> leave the hospital.

> Â

> As Dee says, the future of IBCLCs looks to me like they will all be in hospitals or in WIC. The new requirements almost certainly guarantee that, and licensure is likely to seal the deal.

> Â

> Becky , IBCLC

> Milky Way

> La Plata, MD

>

[Guest guest]

Dana hit the nail on the head! Even if we did have licensure, those who practice

as consultants that are not IBCLC or aren't even LCs at all are still going to

be out there pretending to be lactation professionals. Licensure will be an " in "

to other medical professionals that recognize us as the ONE to go to when

referring their patient to a lactation consultant. What's more, it will open up

the doors for good, non-RN LCs to enter the hospital arena if that's what they

want.

>

> I am not understanding what being a nurse has to do with licensure? I read

many saying " I will never become a nurse " .  It is my understanding that

licensure will raise our level of respect and hopefully increase referrals in

the community.  I also thought that the purpose of this was that non-RN IBCLCs

can get an NPI number?  Judy, please correct me if I'm wrong.  I am in favor

of it and it has nothing to do with me being a nurse.  I already have an NPI

number. What I need is recognition in the medical community as a fellow medical

professional. I don't want to be a hospital lactation consultant - I want to see

moms AFTER they become engorged or when they are returning to work, etc.  My

vision is having docs call me or send written referrals to me as they would with

any other specialist.  I want to be on a preferred provider list to be THE

breastfeeding specialist in my local area.

>

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

>

>

>

>

>

>

>

>

>

>

>

>

>

> ________________________________

>

> To:

> Sent: Thursday, December 1, 2011 9:57 AM

> Subject: RE: Re: lactation " professionals " - licensure?

>

>

>  

> “To my way of thinking, licensure has the risk of causing all IBCLCs to

become hospital- or WIC-based, and then mothers won't have the option of seeing

an IBCLC in private practice who is free to tell the mother about symptoms that

may be helped by craniosacral therapy or about symptoms of tongue tie. “

>  

> I totally agree with you, Dee.  I don’t know as much about the details of

licensure as many of you do, but I am sure it will not help me, personally, or

the mothers in my area.  I came from a volunteer background and have advanced

degrees in English, of all things.  I will never be a nurse.  I could never

qualify to take the exam with the new requirements.  However, I have earned the

respect of the physicians, hospitals, and mothers in my area because I help

mothers.  Very few people here have any idea of my qualifications and

wouldn’t care two cents if I was licensed or not.  Many of my clients receive

insurance reimbursement, and if someone can’t pay then I see them for reduced

rates.  Licensure would cost me money and get me what exactly?  If I could not

practice according to my own standards (and say tongue-tie whenever I feel it is

appropriate!) then I would not practice, and there would not be anyone here to

see mothers after they

> leave the hospital.

>  

> As Dee says, the future of IBCLCs looks to me like they will all be in

hospitals or in WIC.  The new requirements almost certainly guarantee that, and

licensure is likely to seal the deal.

>  

> Becky , IBCLC

> Milky Way

> La Plata, MD

>

[Guest guest]

I do think licensure has potential -- if done correctly -- compensate for the

current deficiencies of the IBLCE.

Right now the IBLCE seems pretty toothless when it comes to the very few among

our profession who engage in what I consider to be malpractice. I consider it

malpractice when someone routinely gives advice that leads to failure to thrive,

jaundice, plugged ducts and mastitis. There is one IBCLC in Manhattan who has

already been reported to the IBLCE by another lactation consultant -- we all

have followed up after really terrible cases of mothers and babies suffering

under this advice. Yet even though many of us have case after case after case

of abysmal outcomes that we have to follow up -- IBLCE won't take our word for

it (since this is always secondhand) and parents are always too tired to report

this malpractice. Have you ever tried to fill out a complaint form? It is a

daunting process even when you are not in a postpartum state.

Quite frankly, I also blame the pediatricians who don't pay attention but this

IBCLC also completely ignores SENSIBLE pediatrician advice. I have seen six

week old babies who were still AT BIRTH WEIGHT who were yelled at by this IBCLC

for giving formula. I have seen nipples that were infected for three solid

months -- practically rotting off -- on mothers who were told they had to keep

putting the baby back on the breast and should NOT pump. I have also heard

complaints from parents who were scared to hire an IBCLC because they witnessed

a totally intimidated shy woman put on display in their prenatal breastfeeding

class by this IBCLC. The woman on display was told that the only way she could

have a consultation was to become the " Guest Breast " for this prenatal class at

Roosevelt Hospital. This violates all sorts of ethical considerations. And,

right now, nothing can be done by the IBCLE which is overburdened and probably

underfunded. I still don't understand why Roosevelt Hospital permits this to

happen since it violates privacy concerns AND is coercive. This practice would

have NEVER passed the Human Ethics Review boards at Hopkins or Cornell where I

did my masters and doctorate.

I also know people who cheat on their hours. I do believe that there are more

who took the exam this year that really had far less supervision than on

previous exams, at least here in New York City. Fortunately, there are those

that I know really did a good job of making sure they had good supervision and

really did not cheat on the practice hours. It is unfair to those who don't

cheat and it is unfair to parents when verification of these prerequisites are

not routinely conducted. I blame this new phenomenon on the " random audit "

system. I really am sorry, just a few woman and fudge your hours and take a

five hour course and really have much to offer to women and babies with

complicated situations. Sometimes I feel that those five day courses do more

harm than good because there are always a few people who take the courses and

then become so arrogant that they think they know everything. Then the rest of

us who took a much longer time and were much more humble about our lack of

knowledge have to mop up after them. Even after a PhD, a MHS, an IBCLC --- for

which I had to actually do 2,500 practice hours -- I still am learning. If I

still am learning -- then why do so many people think it is OK to just take a

few weekend courses and fudge a few hours and somehow they will become

competent? Quite frankly, I find that scary. Again IBLCE is not adequately

ensuring that all IBCLCs are really competent. Its really easy to cheat.

Empathy is not sufficient. Education is not sufficient. Evidence is not

sufficient. Experience is not sufficient. You need all four together. There

are no shortcuts. Your own baby or babies may help you have empathy, but if

you just use what you learned from your own baby or babies -- you will not serve

all women well. Education and evidence need to be tempered with the pragmatism

that comes from working with lots of different situations and being able to put

yourself in the place of the person who is experiencing difficulty. If you

cannot adapt what you learn, then all the evidence and education in the world is

not going to help you gently guide women to take the baby steps towards better

practices. And you will lose out on learning from those mothers who are really

adept at developing creative solutions. Similarly, experience is not

sufficient. Experience tends to be self-referrential. If you become good in

one particular area -- mothers who need those particular skills are more likely

to come to you. If you never look beyond your own experience and gather new

knowledge and test new ways of doing things -- you will never improve or expand

your scope beyond the skills you have learned. And someday, it may turn out

that there is a much better way of doing things and all your experience will not

help you make that leap to better practice unless you are open to new

information.

Licensing by itself won't ensure that someone it competent, but at least you

have a place to start the complaint process when someone is repeatedly

practicing incompetently. If there is no licensing it is entirely a " let the

buyer " beware situation. I'm tired of mopping up after those who haven't

bothered to put in the time to get appropriate in depth training in lactation.

I'm tired of mopping up after those who use their own experience as a basis to

make suggestions to others -- when the " others " have completely different

problems, different babies, and/or different cultural backgrounds. I'm tired of

mopping up after those who don't have enough of a background in math -- really

you don't need much -- and misjudge a baby's milk intake -- by a lot. And then

the mother either ends up supplementing when she doesn't need to or the baby

fails to thrive when a quick and easy intervention could have fixed the problem

early on.

And NONE of this has anything whatsoever to do with being an RN or not an RN.

No offense to any RNs, but I am STILL shocked that being an RN is at all

considered to be an appropriate background for becoming a lactation consultant.

I would have thought the profession would have drawn from the field of nutrition

or from the field of child development. Both would be more appropriate to the

long term development of healthy interactions and healthy eating patterns.

I'm not sure if licensing will be the answer -- but I don't see demanding MORE

competency and prior education from our profession as a problem. I think the

bigger problem is WHAT TYPE of education, supervision, and practice we have

before and continue to have after we certify.

Best regards,

E. Burger, MHS, PhD, IBCLC

[Guest guest]

I am a non-nurse *but* 'Licensed' Midwife in California. No hospital I know of

will let me or any of the other Licensed Midwives have a job in the hospital, or

even have hospital privileges if we need to transfer. Actually they harass us

when we transfer - and we are LICENSED to practice Midwifery in the state of

California.

The only Midwives who get jobs in the hospital are Nurse-Midwives. Being an RN

is the magic ticket - not having a license.

Whether or not Licensing for IBCLCs moves forward or not, it's so important that

it is informed consent. I would urge every IBCLC not to leave this decision up

to 'people who seem to know more about it'. I feel that an Egalitarian decision

making processes is in order here. Each of us should be researching the issue as

it will affect each of us. We should each be weighing in on the powers that be

(USCLA, ILCA, IBCLE, any others?) about what we want.

Where do we put our money? In a way we support ILCA and USCLA to support mothers

and in turn they support us as we are on the frontlines supporting mothers. They

should know exactly what our educated opinions are on the Licensure issue.

USCLA, ILCA and IBCLE have done such wonderful things for Breastfeeding mothers

and those who support them, if we have concerns about Licensure or any issues,

we need to each individually voice our concerns to them so they know what we

want, what we will be putting our money forward to support, and what we will not

be supporting.

Also, I myself don't know a lot about these issues, I know what I know from my

little niche which is a short amount of time being an IBCLC, a longer amount of

time being a midwife, and a lifetime of being an well-informed consumer and

human being. Nobody's voice is less experienced or knowledgeable than anyone

elses. We each have something to contribute -and we each should.

> >

> > I am not understanding what being a nurse has to do with licensure? I read

many saying " I will never become a nurse " .  It is my understanding that

licensure will raise our level of respect and hopefully increase referrals in

the community.  I also thought that the purpose of this was that non-RN IBCLCs

can get an NPI number?  Judy, please correct me if I'm wrong.  I am in favor

of it and it has nothing to do with me being a nurse.  I already have an NPI

number. What I need is recognition in the medical community as a fellow medical

professional. I don't want to be a hospital lactation consultant - I want to see

moms AFTER they become engorged or when they are returning to work, etc.  My

vision is having docs call me or send written referrals to me as they would with

any other specialist.  I want to be on a preferred provider list to be THE

breastfeeding specialist in my local area.

> >

> >  

> >

> > Dana Schmidt, BS, RN, IBCLC

> > Cradlehold, Director

> > Breastfeeding Education & Support

> >

> > www.cradlehold.net

> > http://breastfeedinghomevisitservices.weebly.com/shop.html

> >

> > Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ________________________________

> > From: Becky <beckybutler@>

> > To:

> > Sent: Thursday, December 1, 2011 9:57 AM

> > Subject: RE: Re: lactation " professionals " - licensure?

> >

> >

> >  

> > “To my way of thinking, licensure has the risk of causing all IBCLCs to

become hospital- or WIC-based, and then mothers won't have the option of seeing

an IBCLC in private practice who is free to tell the mother about symptoms that

may be helped by craniosacral therapy or about symptoms of tongue tie. “

> >  

> > I totally agree with you, Dee.  I don’t know as much about the details of

licensure as many of you do, but I am sure it will not help me, personally, or

the mothers in my area.  I came from a volunteer background and have advanced

degrees in English, of all things.  I will never be a nurse.  I could never

qualify to take the exam with the new requirements.  However, I have earned the

respect of the physicians, hospitals, and mothers in my area because I help

mothers.  Very few people here have any idea of my qualifications and

wouldn’t care two cents if I was licensed or not.  Many of my clients receive

insurance reimbursement, and if someone can’t pay then I see them for reduced

rates.  Licensure would cost me money and get me what exactly?  If I could not

practice according to my own standards (and say tongue-tie whenever I feel it is

appropriate!) then I would not practice, and there would not be anyone here to

see mothers after they

> > leave the hospital.

> >  

> > As Dee says, the future of IBCLCs looks to me like they will all be in

hospitals or in WIC.  The new requirements almost certainly guarantee that, and

licensure is likely to seal the deal.

> >  

> > Becky , IBCLC

> > Milky Way

> > La Plata, MD

> >

>

[Guest guest]

“What's more, it will open up the doors for good, non-RN LCs to enter the hospital arena if that's what they want.” V (don’t know your name since you didn’t sign your post),What makes you think this? From my experience, hospitals who really just want LCs will already hire non-nurse LCs. There are several non-nurse LCs on this list who work for hospitals. The problem is that most hospitals want someone who can be pulled off of the LC job to do the RN job when they are very busy. This is the case with 2 hospitals close to me. In that situation, licensure will have no effect since licensed LCs still will not be able to do the RN work. Becky , IBCLCMilky WayLa Plata, MD

[Guest guest]

I have worked for every hospital system in my area at one point or another as my

career in maternal child health began as an educator and I worked myself into a

schedule of classes that did not cancel all the time.

In my area the issue is not pulling RNs out of the lactation department to do

nursing tasks.

It's a complete absence of understanding of the job functions an IBCLC performs

by Human Resources and job recruiters that results in the RN requirement in the

hospitals in my area (although I am NOT a RN, and I work as an IBCLC in a

hospital).

AND it is an absence of understanding of the job tasks by the upper

administration. I have worked extensively with our HR department on the job

descriptions for our childbirth educators and boy did they get a lesson in what

qualifies one to teach CBE, and no it is not a nursing license, (although I have

taught with bunches of wonderful RN CBEs they were ALL internationally

certified).

Your area recruiters and HR folks do not understand and so it makes sense to

them to just place the position into nursing because from their uninformed

perspective that is what these 'Lactation Consultants' do.

The USLCA and ILCA should be working with employers to better inform them of the

job functions of the IBCLC and why lactation staff should be IBCLC (regardless

if RN or no). The organizations that utilize the IBCLCs for RNs sometimes don't

have a patient load sufficient enough to consume a FTE devoted to lactation

services, so they multi task them.

For the sites with a census high enough to support some FTEs they should be

ashamed of requiring the RN/IBCLC, makes no sense. But honestly it is a lack of

knowledge among the people who write the job descriptions and describe the work.

oogroups.com, " Becky " wrote:

>

> " What's more, it will open up the doors for good, non-RN LCs to enter the

> hospital arena if that's what they want. "

>

>

>

> V (don't know your name since you didn't sign your post),

>

> What makes you think this? From my experience, hospitals who really just

> want LCs will already hire non-nurse LCs. There are several non-nurse LCs

> on this list who work for hospitals. The problem is that most hospitals

> want someone who can be pulled off of the LC job to do the RN job when they

> are very busy. This is the case with 2 hospitals close to me. In that

> situation, licensure will have no effect since licensed LCs still will not

> be able to do the RN work.

>

>

>

> Becky , IBCLC

>

> Milky Way

>

> La Plata, MD

>

[Guest guest]

said...

I also know people who cheat on their hours. I do believe that there are more

who took the exam this year that really had far less supervision than on

previous exams, at least here in New York City. Fortunately, there are those

that I know really did a good job of making sure they had good supervision and

really did not cheat on the practice hours. It is unfair to those who don't

cheat and it is unfair to parents when verification of these prerequisites are

not routinely conducted. I blame this new phenomenon on the " random audit "

system. I really am sorry, just a few woman and fudge your hours and take a

five hour course and really have much to offer to women and babies with

complicated situations. Sometimes I feel that those five day courses do more

harm than good because there are always a few people who take the courses and

then become so arrogant that they think they know everything. Then the rest of

us who took a much longer time and were much more humble about our lack of

knowledge have to mop up after them. Even after a PhD, a MHS, an IBCLC --- for

which I had to actually do 2,500 practice hours -- I still am learning. If I

still am learning -- then why do so many people think it is OK to just take a

few weekend courses and fudge a few hours and somehow they will become

competent? Quite frankly, I find that scary. Again IBLCE is not adequately

ensuring that all IBCLCs are really competent. Its really easy to cheat.

My additions...

The stories told make me feel both sad and angry for the parents who are

on the receiving end of such bad advice. From the posts has shared in the

past about this same person, it sounds like she routinely gives hideous clinical

advice and makes no effort to learn, grow or improve. I would want to see

action taken against her too. However, I do think it is important to

distinguish inexperience from negligent incompetence. Before I sat for the

exam, I was a LLLL for 5 years and I did a clinical internship with a local

IBCLC. In my area, at that time, I had exactly three choices for local

supervision. I didn't cheat on my hours and I did learn a lot from her but

there were a lot of gaps in what she taught me. I didn't know how to seek out

any supervision that could fill in what she didn't know to teach me. I never

willfully gave bad advice to a patient but sometimes my early patients were

victims of my inexperience and lack of access to highly skilled clinical help.

I think if we want to make sure that aspiring IBCLC's are well supervised then

we have to continue to focus on making good supervision easily identifiable and

accessible, especially to those who have aspirations to be in private practice.

If I didn't have this group to turn to, I would feel very overwhelmed by just

how much I still have to learn and the challenges (both logistically and

financially) to acquiring that knowledge.

The freedoms of private practice are great but I think overall we tend to see

more complicated cases that have fallen through the cracks or failed to be

resolved with in the first or second tiers of breastfeeding support, make

excellent supervisory access even more important. Even though I passed my exam

in 2008, I still long to have a mentor I can meet with on a regular basis to

talk shop and help me sort through my toughest cases.

Warmly,

Carroll

>

>

[Guest guest]

Dana,

Chiropractors are licensed professionals. Hell, they are doctors. They have been

around a lot longer than us and their preparation is very rigorous. That has

guaranteed them no respect from the medical community. Mothers are told all the

time that they are dangerous and not to take their babies to them.

In many states, non-CNM midwives are licensed (obviously all CNM-midwives are)

and yet they get NO respect from the medical system at all. Licensure is not a

path to respect. The fact is that our own certifying body and the people who

thought it would be a great idea to create 53 additional certifications made

this mess and we cannot fix it by licensing anyone.

Tow, IBCLC

> >

> > I am not understanding what being a nurse has to do with licensure? I read

many saying " I will never become a nurse " .  It is my understanding that

licensure will raise our level of respect and hopefully increase referrals in

the community.  I also thought that the purpose of this was that non-RN IBCLCs

can get an NPI number?  Judy, please correct me if I'm wrong.  I am in favor

of it and it has nothing to do with me being a nurse.  I already have an NPI

number. What I need is recognition in the medical community as a fellow medical

professional. I don't want to be a hospital lactation consultant - I want to see

moms AFTER they become engorged or when they are returning to work, etc.  My

vision is having docs call me or send written referrals to me as they would with

any other specialist.  I want to be on a preferred provider list to be THE

breastfeeding specialist in my local area.

> >

> >  

> >

> > Dana Schmidt, BS, RN, IBCLC

> > Cradlehold, Director

> > Breastfeeding Education & Support

> >

> > www.cradlehold.net

> > http://breastfeedinghomevisitservices.weebly.com/shop.html

> >

> > Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ________________________________

> > From: Becky <beckybutler@>

> > To:

> > Sent: Thursday, December 1, 2011 9:57 AM

> > Subject: RE: Re: lactation " professionals " - licensure?

> >

> >

> >  

> > “To my way of thinking, licensure has the risk of causing all IBCLCs to

become hospital- or WIC-based, and then mothers won't have the option of seeing

an IBCLC in private practice who is free to tell the mother about symptoms that

may be helped by craniosacral therapy or about symptoms of tongue tie. “

> >  

> > I totally agree with you, Dee.  I don’t know as much about the details of

licensure as many of you do, but I am sure it will not help me, personally, or

the mothers in my area.  I came from a volunteer background and have advanced

degrees in English, of all things.  I will never be a nurse.  I could never

qualify to take the exam with the new requirements.  However, I have earned the

respect of the physicians, hospitals, and mothers in my area because I help

mothers.  Very few people here have any idea of my qualifications and

wouldn’t care two cents if I was licensed or not.  Many of my clients receive

insurance reimbursement, and if someone can’t pay then I see them for reduced

rates.  Licensure would cost me money and get me what exactly?  If I could not

practice according to my own standards (and say tongue-tie whenever I feel it is

appropriate!) then I would not practice, and there would not be anyone here to

see mothers after they

> > leave the hospital.

> >  

> > As Dee says, the future of IBCLCs looks to me like they will all be in

hospitals or in WIC.  The new requirements almost certainly guarantee that, and

licensure is likely to seal the deal.

> >  

> > Becky , IBCLC

> > Milky Way

> > La Plata, MD

> >

>

[Guest guest]

Not bickering, Dana. Discussion -- good, healthy discussion. And each time someone posts, we come away with more food for thought. And that's a good thing.

Jan

Well isn't this all unfortunate. Bickering amongst ourselves and not finding a clear solution. I don't know that there is a guarantee that licensure will give me more business or won't give me more business but I can tell you that it's pretty damn hard to make a living at this. I do the in-services, get special training and give my all - as I"m sure you all do - just to have mom go to a MD and CLC to say "well maybe she was right but we just can't agree". I don't want to fight with docs. I don't want to fight with you all. The truth is I don't know what our futures are in PP, licensure or not. And by the way, I am a registered nurse who gave up working in a large university setting to concentrate on working as a PP IBCLC. I still have the accountability of the nurse but certainly not the pay, benefits or recognition. Think what you will. For all the education and responsibility we have as IBCLCs I"m not sure I can make it on my own. Love you all and realize that I didn't learn shit until I joined this group

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyWe do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation.

To: Sent: Friday, December 2, 2011 1:53 AMSubject: Re: lactation "professionals" - licensure?

Dana,Chiropractors are licensed professionals. Hell, they are doctors. They have been around a lot longer than us and their preparation is very rigorous. That has guaranteed them no respect from the medical community. Mothers are told all the time that they are dangerous and not to take their babies to them. In many states, non-CNM midwives are licensed (obviously all CNM-midwives are) and yet they get NO respect from the medical system at all. Licensure is not a path to respect. The fact is that our own certifying body and the people who thought it would be a great idea to create 53 additional certifications made this mess and we cannot fix it by licensing anyone. Tow, IBCLC> >> > I am not understanding what being a nurse has to do with licensure? I read many saying "I will never become a nurse". It is my understanding that licensure will raise our level of respect and hopefully increase referrals in the community. I also thought that the purpose of this was that non-RN IBCLCs can get an NPI number? Judy, please correct me if I'm wrong. I am in favor of it and it has nothing to do with me being a nurse. I already have an NPI number. What I need is recognition in the medical community as a fellow medical professional. I don't want to be a hospital lactation consultant - I want to see moms AFTER they become engorged or when they are returning to work, etc. My vision is having docs call me or send written referrals to me as they would with any other specialist. I want to be on a preferred provider list to be THE breastfeeding specialist in my local area.> > > >  > > > > Dana Schmidt, BS, RN, IBCLC> > Cradlehold, Director> > Breastfeeding Education & Support> > > > www.cradlehold.net> > http://breastfeedinghomevisitservices.weebly.com/shop.html> > > > Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby> > > > > > > > > > > > > > > > > > > > > > > > > > > > ________________________________> > From: Becky <beckybutler@>> > To: > > Sent: Thursday, December 1, 2011 9:57 AM> > Subject: RE: Re: lactation "professionals" - licensure?> > > > > >  > > “To my way of thinking, licensure has the risk of causing all IBCLCs to become hospital- or WIC-based, and then mothers won't have the option of seeing an IBCLC in private practice who is free to tell the mother about symptoms that may be helped by craniosacral therapy or about symptoms of tongue tie. “> >  > > I totally agree with you, Dee. I don’t know as much about the details of licensure as many of you do, but I am sure it will not help me, personally, or the mothers in my area. I came from a volunteer background and have advanced degrees in English, of all things. I will never be a nurse. I could never qualify to take the exam with the new requirements. However, I have earned the respect of the physicians, hospitals, and mothers in my area because I help mothers. Very few people here have any idea of my qualifications and wouldn’t care two cents if I was licensed or not. Many of my clients receive insurance reimbursement, and if someone can’t pay then I see them for reduced rates. Licensure would cost me money and get me what exactly? If I could not practice according to my own standards (and say tongue-tie whenever I feel it is appropriate!) then I would not practice, and there would not be anyone here to see mothers after they> > leave the hospital.> >  > > As Dee says, the future of IBCLCs looks to me like they will all be in hospitals or in WIC. The new requirements almost certainly guarantee that, and licensure is likely to seal the deal.> >  > > Becky , IBCLC> > Milky Way> > La Plata, MD> >>

[Guest guest]

The more I read the more sure I am that licensure as an IBCLC is NOT a solution.

It is an added expense to be sure but will add nothing over all to the

professional image. Someone said hairdressers have a license and that only

furtheres my belief that a license will not bring respect to health care

providers in general. When it becomes required to be licensed I will change

careers. Oh well. 20 years of experience no longer available to the moms I

serve. What I do hope is this is known before I pay money to recert in 2015

because I am not wasting that money for a credential that will now mean nothing

without a license. I get that some value insurance reimbursement. I get that

some think it will help. But after all these years I am more sure it won't and

instead will sit back and watch exactly what some of us are warning about come

to be. But by then I will do something new. Good luck when they label all things

breastfeeding help related a requirement to be licensed. Thinking that will be

the end of mother to mother support too. This medicalizaton of all things female

bothers me from how it limits my right to choose who cares for me when I birth

to how it seeks to now limit who helps me with breastfeeding. This is more to

me then if a woman can get insurance to pay. Because in the end if it limits who

she can choose to hire it doesn't serve her well at all.

Pam MazzellaDiBosco

Pam MazzellaDiBosco. IBCLC

[Guest guest]

I have thoughts for and against licensing LC's. My question to those that disagree; do you make a "good living" or good salary without billing insurance?Don't throw rocks but many on here talkAbout "not making alot of money or just enough to pay for classesOr you would have never made it without your husband supporting your family".....,,If we want this to be a career a single mom or a as a dual income home seems like licensing may assist in billing ( * IF * the insurance co recognize LC as providers) Sent from my iPhone

The more I read the more sure I am that licensure as an IBCLC is NOT a solution. It is an added expense to be sure but will add nothing over all to the professional image. Someone said hairdressers have a license and that only furtheres my belief that a license will not bring respect to health care providers in general. When it becomes required to be licensed I will change careers. Oh well. 20 years of experience no longer available to the moms I serve. What I do hope is this is known before I pay money to recert in 2015 because I am not wasting that money for a credential that will now mean nothing without a license. I get that some value insurance reimbursement. I get that some think it will help. But after all these years I am more sure it won't and instead will sit back and watch exactly what some of us are warning about come to be. But by then I will do something new. Good luck when they label all things breastfeeding help related a requirement to be licensed. Thinking that will be the end of mother to mother support too. This medicalizaton of all things female bothers me from how it limits my right to choose who cares for me when I birth to how it seeks to now limit who helps me with breastfeeding. This is more to me then if a woman can get insurance to pay. Because in the end if it limits who she can choose to hire it doesn't serve her well at all.

Pam MazzellaDiBosco

Pam MazzellaDiBosco. IBCLC

[Guest guest]

...9 months to receive payment? What??? This must be in part due to the long billing chain of events in hospitals settings...???. If it's from a sole provider and billed promptly they should do sonething as from my understanding insurance companies must adhere to certain rules regarding reimbursement ... Sent from my iPhone

I have thoughts for and against licensing LC's. My question to those that disagree; do you make a "good living" or good salary without billing insurance?Don't throw rocks but many on here talkAbout "not making alot of money or just enough to pay for classesOr you would have never made it without your husband supporting your family".....,,If we want this to be a career a single mom or a as a dual income home seems like licensing may assist in billing ( * IF * the insurance co recognize LC as providers) Sent from my iPhone

The more I read the more sure I am that licensure as an IBCLC is NOT a solution. It is an added expense to be sure but will add nothing over all to the professional image. Someone said hairdressers have a license and that only furtheres my belief that a license will not bring respect to health care providers in general. When it becomes required to be licensed I will change careers. Oh well. 20 years of experience no longer available to the moms I serve. What I do hope is this is known before I pay money to recert in 2015 because I am not wasting that money for a credential that will now mean nothing without a license. I get that some value insurance reimbursement. I get that some think it will help. But after all these years I am more sure it won't and instead will sit back and watch exactly what some of us are warning about come to be. But by then I will do something new. Good luck when they label all things breastfeeding help related a requirement to be licensed. Thinking that will be the end of mother to mother support too. This medicalizaton of all things female bothers me from how it limits my right to choose who cares for me when I birth to how it seeks to now limit who helps me with breastfeeding. This is more to me then if a woman can get insurance to pay. Because in the end if it limits who she can choose to hire it doesn't serve her well at all.

Pam MazzellaDiBosco

Pam MazzellaDiBosco. IBCLC

[Guest guest]

Me? No. But it is not about money for me. Because I know insurance industry will not be paying what I do make. I hear enough horror stories about insurance reimbursement to know better then to believe that. Can't do enough "volume" to make that balance and provide quality care. We have an entire medical care system to tell us that reality. Ignoring it won't change it. If I thought licensure would open a floodgate of cash I would still not be in favor of limiting a womans right to choose who can legally give her help with breastfeeding. There is always a downside. The question is which downside you prefer. All the promises of licensure are not really "for sure". A license will no more guarantee a quality LC than it guarantees a quality nurse, doc, or even a hairdresser.PamPam MazzellaDiBosco. IBCLCSender: Date: Sat, 3 Dec 2011 21:11:54 -0600To: < >ReplyTo: Subject: Re: Re: lactation "professionals" - licensure? I have thoughts for and against licensing LC's. My question to those that disagree; do you make a "good living" or good salary without billing insurance?Don't throw rocks but many on here talkAbout "not making alot of money or just enough to pay for classesOr you would have never made it without your husband supporting your family".....,,If we want this to be a career a single mom or a as a dual income home seems like licensing may assist in billing ( * IF * the insurance co recognize LC as providers) Sent from my iPhone The more I read the more sure I am that licensure as an IBCLC is NOT a solution. It is an added expense to be sure but will add nothing over all to the professional image. Someone said hairdressers have a license and that only furtheres my belief that a license will not bring respect to health care providers in general. When it becomes required to be licensed I will change careers. Oh well. 20 years of experience no longer available to the moms I serve. What I do hope is this is known before I pay money to recert in 2015 because I am not wasting that money for a credential that will now mean nothing without a license. I get that some value insurance reimbursement. I get that some think it will help. But after all these years I am more sure it won't and instead will sit back and watch exactly what some of us are warning about come to be. But by then I will do something new. Good luck when they label all things breastfeeding help related a requirement to be licensed. Thinking that will be the end of mother to mother support too. This medicalizaton of all things female bothers me from how it limits my right to choose who cares for me when I birth to how it seeks to now limit who helps me with breastfeeding. This is more to me then if a woman can get insurance to pay. Because in the end if it limits who she can choose to hire it doesn't serve her well at all. Pam MazzellaDiBosco Pam MazzellaDiBosco. IBCLC

[Guest guest]

Exactly. No, in our case it has to do with the state not having any money, so they put off paying their bills, robbing to pay , etc etc. (My dh works for the state). But when I was a provider for BC/BS HMO, it would take at least 3 letters and 4 months to get paid. And that had nothing to do with the state.

Please all, I've asked this before, and I'm going to ask again: SIGN YOUR NAME TO YOUR POSTS!! "Sent from my iPhone" (you can change that setting by the way to make it "Sent from my iPhone YourName" or just "my name" if you want) doesn't tell me who you are -- and even if I know who you are based on your e-mail address, not every one does.

And there are several on this list who routinely do not sign their posts.

Jan Barger, RN, MA, IBCLC, FILCA

Wheaton IL

...9 months to receive payment? What??? This must be in part due to the long billing chain of events in hospitals settings...???

.. If it's from a sole provider and billed promptly they should do sonething as from my understanding insurance companies must adhere to certain rules regarding reimbursement ...

Sent from my iPhone

I have thoughts for and against licensing LC's. My question to those that disagree; do you make a "good living" or good salary without billing insurance?

Don't throw rocks but many on here talk

About "not making alot of money or just enough to pay for classes

Or you would have never made it without your husband supporting your family".....,,

If we want this to be a career a single mom or a as a dual income home seems like licensing may assist in billing ( * IF * the insurance co recognize LC as providers)

Sent from my iPhone

The more I read the more sure I am that licensure as an IBCLC is NOT a solution. It is an added expense to be sure but will add nothing over all to the professional image. Someone said hairdressers have a license and that only furtheres my belief that a license will not bring respect to health care providers in general. When it becomes required to be licensed I will change careers. Oh well. 20 years of experience no longer available to the moms I serve. What I do hope is this is known before I pay money to recert in 2015 because I am not wasting that money for a credential that will now mean nothing without a license. I get that some value insurance reimbursement. I get that some think it will help. But after all these years I am more sure it won't and instead will sit back and watch exactly what some of us are warning about come to be. But by then I will do something new. Good luck when they label all things breastfeeding help related a requirement to be licensed. Thinking that will be the end of mother to mother support too. This medicalizaton of all things female bothers me from how it limits my right to choose who cares for me when I birth to how it seeks to now limit who helps me with breastfeeding. This is more to me then if a woman can get insurance to pay. Because in the end if it limits who she can choose to hire it doesn't serve her well at all. Pam MazzellaDiBosco Pam MazzellaDiBosco. IBCLC

[Guest guest]

Judy,  The 'licensing' will LIMIT PRACTICE of anyone providing lactation consultant services.  Period.  Once there is a " licensed " requirement, there is also legal ramifications for practicing without a license.  Surely this is common knowledge.  It is 'not' about some can and some won't and setting the standard for who can.  Which is bad enough and will not be controlled by IBLCE no matter how much they think it will be.  It is about placing legal limitations on the 'practice' itself and that is a limiting and legal issue that is way more than insurance reimbursement.  Using insurance reimbursement creates a misguided hope that it will be all good because of 'money' . 

Pam MazzellaDiBosco, IBCLC

 

Licensing

IBCLCs will not preclude others from practicing. It will require they call

themselves what they are “certified lactation counselors” NOT “lactation

consultants”. This is an issue of defining the lactation consultant and

over time, the understanding to the public, health professionals, public health

administrators and insurers comes that the “lactation consultant”

has a specific  set of qualifications and the other folks don’t have the

same training. Also, licensure is an avenue needed to allow for reimbursement

from third parties. And I realize some of you will not choose to be reimbursed

by insurance, that is fine and you don’t have to.  

 

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

 

[Guest guest]

Judy I am growing more and more concerned about this whole licensing issue. Of course I want EVERY mother to have affordable access to an IBCLC. If we had a real national health service, this would not even be an issue. However...

OTOH, there is no way I could afford (or want) to work UNDER an MD for a pittance. How does it work for MDs?For example, some docs choose not to accept any insurance at all. Everything is self-pay. How does this affect their license? Can they offer reduce rates to lower-income patients, or even free services?

Norma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

[Guest guest]

Yes, it makes me a little crazy to not know who is writing. Signed e-mails and posts are how I got to "know" so many lactation professionals in the last 15 years, give or take a few. Lactnet was such a big resource for me and knowing who is speaking is essential. Cheryl Dawn n, IBCLCAlliance, Ohio To: Sent: Sunday, December 4, 2011 8:33 AM Subject: Re: Re: lactation "professionals" - licensure?

Exactly. No, in our case it has to do with the state not having any money, so they put off paying their bills, robbing to pay , etc etc. (My dh works for the state). But when I was a provider for BC/BS HMO, it would take at least 3 letters and 4 months to get paid. And that had nothing to do with the state.

Please all, I've asked this before, and I'm going to ask again: SIGN YOUR NAME TO YOUR POSTS!! "Sent from my iPhone" (you can change that setting by the way to make it "Sent from my iPhone YourName" or just "my name" if you want) doesn't tell me who you are -- and even if I know who you are based on your e-mail address, not every one does.

And there are several on this list who routinely do not sign their posts.

Jan Barger, RN, MA, IBCLC, FILCA

Wheaton IL

...9 months to receive payment? What??? This must be in part due to the long billing chain of events in hospitals settings...???

.. If it's from a sole provider and billed promptly they should do sonething as from my understanding insurance companies must adhere to certain rules regarding reimbursement ...

Sent from my iPhone

I have thoughts for and against licensing LC's. My question to those that disagree; do you make a "good living" or good salary without billing insurance?

Don't throw rocks but many on here talk

About "not making alot of money or just enough to pay for classes

Or you would have never made it without your husband supporting your family".....,,

If we want this to be a career a single mom or a as a dual income home seems like licensing may assist in billing ( * IF * the insurance co recognize LC as providers)

Sent from my iPhone

The more I read the more sure I am that licensure as an IBCLC is NOT a solution. It is an added expense to be sure but will add nothing over all to the professional image. Someone said hairdressers have a license and that only furtheres my belief that a license will not bring respect to health care providers in general. When it becomes required to be licensed I will change careers. Oh well. 20 years of experience no longer available to the moms I serve. What I do hope is this is known before I pay money to recert in 2015 because I am not wasting that money for a credential that will now mean nothing without a license. I get that some value insurance reimbursement. I get that some think it will help. But after all these years I am more sure it won't and instead will sit back and watch exactly what some of us are warning about come to be. But by then I will do something new. Good luck when they label all things breastfeeding help related a requirement to be licensed. Thinking that will be the end of mother to mother support too. This medicalizaton of all things female bothers me from how it limits my right to choose who cares for me when I birth to how it seeks to now limit who helps me with breastfeeding. This is more to me then if a woman can get insurance to pay. Because in the end if it limits who she can choose to hire it doesn't serve her well at all. Pam MazzellaDiBosco Pam MazzellaDiBosco. IBCLC

[Guest guest]

And, ack, I'm sorry for not erasing all of the other parts of the post, that clog the list!Cheryl n,(again)

[Guest guest]

Judy and Pam,

This is such a great discussion. I know everyone who has made up their mind is passionate about their choice and I respect that. AS I am still trying to understand all of this may I ask...what will happen to LLL Leaders, WIC peer counselors and CLCs? Will they have to stop practicing if it becomes illegal to practice without a license?

Lou Moramarco IBCLC

Birth, Breastfeeding & Before

International Board Certified Lactation Consultant

Bradley Childbirth Educator

Certified Birth Doula

marylou22@...

www.lunadoula.com

Hidden Booby Trap: Is Your Lactation “Specialist” an Imposter? http://www.bestforbabes.org/2010/03/hidden-booby-trap-is-your-lactation-specialist-an-imposter/

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From: [mailto: ] On Behalf Of Pam MazzellaDiBoscoSent: Sunday, December 04, 2011 9:33 AMTo: Subject: Re: Re: lactation "professionals" - licensure?

Judy, The 'licensing' will LIMIT PRACTICE of anyone providing lactation consultant services. Period. Once there is a "licensed" requirement, there is also legal ramifications for practicing without a license. Surely this is common knowledge. It is 'not' about some can and some won't and setting the standard for who can. Which is bad enough and will not be controlled by IBLCE no matter how much they think it will be. It is about placing legal limitations on the 'practice' itself and that is a limiting and legal issue that is way more than insurance reimbursement. Using insurance reimbursement creates a misguided hope that it will be all good because of 'money' . Pam MazzellaDiBosco, IBCLC

Licensing IBCLCs will not preclude others from practicing. It will require they call themselves what they are “certified lactation counselors” NOT “lactation consultants”. This is an issue of defining the lactation consultant and over time, the understanding to the public, health professionals, public health administrators and insurers comes that the “lactation consultant” has a specific set of qualifications and the other folks don’t have the same training. Also, licensure is an avenue needed to allow for reimbursement from third parties. And I realize some of you will not choose to be reimbursed by insurance, that is fine and you don’t have to.

Judy

Judith L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell Phone

Fax

[Guest guest]

Why do you think that Licensing will assist in billing?

The NPI number and the qualification are what the Insurance companies look at to

decide how much " they will decide to pay. "

Adding a license to the IBCLC isn't going to make the IBCLC worth more to the

Insurance Company. They wont have any reason to suddenly pay more to IBCLC's

just because some IBCLC's are paying more to their Licensing boards.

Having additional qualifications attached to your NPI number sometimes raises

the rate they will pay, like being a CNM, an RN, an MD.

Here's an extreme example...

Let's say someone is an MD, but their License to practice medicine in that state

expired, that person is still a Doctor, perhaps retired, but still an MD. If

that MD happens to also be an IBCLC, he/she will receive a higher rate of

insurance reimbursement for providing lactation services due to that additional

qualifications attached to the NPI number.

The License makes no difference unless someone gets a written contract from all

insurance companies saying that they will suddenly starting reimbursing or

increasing their reimbursement level for Licensed IBCLC's as opposed to when

IBCLC's were not Licensed.

And why would they do that? Why do they care if we are Licensed are not?

I have no reason to believe that they do, and thus that licensing would in any

way affect the reimbursement level of IBCLCs.

The only cost that's going to change is how much we IBCLC's pay yearly to

Licensing boards.

If those licensing boards are connected to the board of Medicine, they are free

to but additional requirements on us, such as " must have Physician supervision. "

Or " must have nurse supervision. " This would end private practice in the states

that choose to do so.

>

> > The more I read the more sure I am that licensure as an IBCLC is NOT a

solution. It is an added expense to be sure but will add nothing over all to the

professional image. Someone said hairdressers have a license and that only

furtheres my belief that a license will not bring respect to health care

providers in general. When it becomes required to be licensed I will change

careers. Oh well. 20 years of experience no longer available to the moms I

serve. What I do hope is this is known before I pay money to recert in 2015

because I am not wasting that money for a credential that will now mean nothing

without a license. I get that some value insurance reimbursement. I get that

some think it will help. But after all these years I am more sure it won't and

instead will sit back and watch exactly what some of us are warning about come

to be. But by then I will do something new. Good luck when they label all things

breastfeeding help related a requirement to be licensed. Thinking that will be

the end of mother to mother support too. This medicalizaton of all things female

bothers me from how it limits my right to choose who cares for me when I birth

to how it seeks to now limit who helps me with breastfeeding. This is more to me

then if a woman can get insurance to pay. Because in the end if it limits who

she can choose to hire it doesn't serve her well at all.

> > Pam MazzellaDiBosco

> > Pam MazzellaDiBosco. IBCLC

> >

> >

>