Re: question about referrals and wording in physician reports

[Guest guest]

Thank you Dee, that is really helpful to hear the wording you use.  So, do you send this note to the ENT or to the baby's pediatrician or family doc?By saying, " To evaluate for possible tongue tie, I referred mother to Dr. ________________ " , are you saying that you refer the mother directly to the ENT (or whomever you are referring to for the tongue tie revision), and then you just inform the baby's pediatrician that you referred the mom to them?

Thanks so much again,

Sonya

 

Hello, Virginia.

     I state the symptoms I see:

    " Baby's cheek dimples with each suck, indicating improper tongue movement.  Baby can extend tongue but not lift it very far, and tongue tip notches when lifted.  IBCLC could feel a speedbump with stiff membrane upon fingersweep under tongue.  These can be symptoms of a tongue tie.  To evaluate for possible tongue tie, I referred mother to Dr. ________________ "    I do this because I have had trouble with ENTs for more than 30 years, with them refusing to treat, telling mother there's nothing there or it's mild and won't interfere with breastfeed, telling mothers I am " crazy " (literally), or (the one I hate most of all) if it hurts to breastfeed, just pump and bottlefeed.  So, I don't really care what the peds think since none of them will refer to me anyway because I insist on referring the babies for craniosacral therapy. I tell the mothers what they need to hear.  Since the dr I am

referring to is a family practice, not a specialist, most don't need a referral to go see her anyway.

    Dee Kassing

To:

Sent: Sat, August 11, 2012 9:56:27 PMSubject: question about referrals and wording in physician reports

 

Hello all, If you think a baby may need a frenotomy, how do you word that in your report to the physician?  How do you say that in a way that you are not diagnosing but that you feel what you observed warrants further evaluation?  Also, if you would like to suggest that the pediatrician make the referral to a specific ENT, how do you word that in your report to the physician?  

Can an IBCLC refer someone directly to the ENT, or do you always have to call the baby's health care provider and ask them if they will refer?  (And does asking them sometimes sound like you are trying to tell them what to do?  How do you ask in a way that doesn't sound like that?)

Many thanks for any ideas or opinions,

Sonya Shaver, BS, CHES, IBCLC

[Guest guest]

Yes, I refer directly to the one person around here who really knows what she's doing. I give her name and phone number to the mother. Some mothers go instead to their ped and get the name of an ENT, but the results are always less than stellar. But I can't help it if the mothers won't listen to me. I tell them exactly WHY I'm only giving them one name, and sometimes they still choose to go elsewhere.

I send that wording in the report I send to the baby's doc (usually a ped but once in a while a fam pract doc). To be honest, I write up a single one-page report and send that same report to the mother's doc and the baby's doc. Breastfeeding is supposed to be a *couplet* activity and yet we still keep trying to separate the couplet! I put the info on what's going on with the mom and what's going on with the baby in the same report, in the hopes that maybe someday our culture will look at a breastfeeding couple as a couple instead of two separate beings and this doc doesn't deal with that issue and that doc doesn't deal with the other issue, which makes life difficult!

I don't send the report to the Doc who I am referring to. It seems kind of weird to me not to, but in actuality my consent form only gives me permission to send reports to mom's doc and baby's doc and technically speaking, the doc who treats TTs isn't their doc *yet*. And since I never know for sure who will actually go to see her and who will go somewhere else, I could end up sending reports to the "TT doc" whom she will never see, which seems like a break in confidentiality. The wonderful thing is, this doc knows her stuff so well that I don't have to send her a report--she knows exactly what to do without info from me.

Dee Kassing

To: Sent: Sun, August 12, 2012 2:20:57 AMSubject: Re: question about referrals and wording in physician reports

Thank you Dee, that is really helpful to hear the wording you use. So, do you send this note to the ENT or to the baby's pediatrician or family doc?

By saying, "To evaluate for possible tongue tie, I referred mother to Dr. ________________", are you saying that you refer the mother directly to the ENT (or whomever you are referring to for the tongue tie revision), and then you just inform the baby's pediatrician that you referred the mom to them?

Thanks so much again,

Sonya

Hello, Virginia.

I state the symptoms I see:

"Baby's cheek dimples with each suck, indicating improper tongue movement. Baby can extend tongue but not lift it very far, and tongue tip notches when lifted. IBCLC could feel a speedbump with stiff membrane upon fingersweep under tongue. These can be symptoms of a tongue tie. To evaluate for possible tongue tie, I referred mother to Dr. ________________" I do this because I have had trouble with ENTs for more than 30 years, with them refusing to treat, telling mother there's nothing there or it's mild and won't interfere with breastfeed, telling mothers I am "crazy" (literally), or (the one I hate most of all) if it hurts to breastfeed, just pump and bottlefeed. So, I don't really care what the peds think since none of them will refer to me anyway because I insist on referring the babies for craniosacral therapy. I tell the mothers what they need to hear. Since the dr I am

referring to is a family practice, not a specialist, most don't need a referral to go see her anyway.

Dee Kassing

To: Sent: Sat, August 11, 2012 9:56:27 PMSubject: question about referrals and wording in physician reports

Hello all,

If you think a baby may need a frenotomy, how do you word that in your report to the physician? How do you say that in a way that you are not diagnosing but that you feel what you observed warrants further evaluation? Also, if you would like to suggest that the pediatrician make the referral to a specific ENT, how do you word that in your report to the physician?

Can an IBCLC refer someone directly to the ENT, or do you always have to call the baby's health care provider and ask them if they will refer? (And does asking them sometimes sound like you are trying to tell them what to do? How do you ask in a way that doesn't sound like that?)

Many thanks for any ideas or opinions,

Sonya Shaver, BS, CHES, IBCLC