Re: Modified Private Practice

[Guest guest]

Thanks for the encouragement, all.  I'm sure this has been covered, but do many of you run a PP without much in the way of inventory?  No pump rental station?  Nipple shields, SNS, etc?    Or did you start out with out doing that and have grown inventory as the need arises? 

 

,I do not bill. I am clear before I make an appointment what my fee is and how I accept payment - at the visit. I give all of my clients a Superbill and let them handle the insurance. If I had to do billing I could not run my practice.

I also came to this as a LLL. There is a difference - many similarities - but it is different. Leigh Anne Sent from my Verizon Wireless BlackBerry

Sender:

Date: Wed, 21 Jul 2010 09:01:02 -0400To: < >ReplyTo:

Subject: Re: Modified Private Practice

 

Thanks for your input, all!  Just to clarify, I've started doing consults at a pediatric practice VERY part time (looks like a few a week) so I'm getting good hands on time, which I agree will help with my teaching (although so far I feel like the years and years of calls have given me pretty good exposure to the range of issues that can arise).  Doing the actual consults is helping with my own confidence in working physically, hands on, with mothers and babies (and grandmas and dads). 

My main hang up seems to be about creating all the systems and forms and policies re: private practice.  I think I'm overthinking it, but I'm also a realist about how much work it actually is.  Just showing up and walking into a room at a ped practice is a way different animal since I don't have to field their calls, make appointments,  bill them, fill out insurance forms, etc.

-

 

,I agree with the others. The other thing to consider it takes time to build a busy practice. So, if you start now you can manage as much or as little as you like. Then in a couple or few years you could be  in a place where you can manage a busier practice. Jump in! Have fun! Take a risk!

 

Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.com

[Guest guest]

HI ,I live in NYC, Manhattan. I carry very little inventory - I cannot store it in my apartment - I can't carry it around - my bag and scale are plenty to drag up and down the subway stairs and onto the bus. I do carry nipple shields, SNS, very little in the gadgets as you can get them in many places here.~Leigh AnneThanks for the encouragement, all. I'm sure this has been covered, but do many of you run a PP without much in the way of inventory? No pump rental station? Nipple shields, SNS, etc? Or did you start out with out doing that and have grown inventory as the need arises? On Wed, Jul 21, 2010 at 9:28 AM, <LeighAnne625rcn> wrote: ,I do not bill. I am clear before I make an appointment what my fee is and how I accept payment - at the visit. I give all of my clients a Superbill and let them handle the insurance. If I had to do billing I could not run my practice.I also came to this as a LLL. There is a difference - many similarities - but it is different. Leigh AnneSent from my Verizon Wireless BlackBerryFrom: Eden <claireedenlcgmail>Sender: Date: Wed, 21 Jul 2010 09:01:02 -0400To: < >ReplyTo: Subject: Re: Modified Private Practice Thanks for your input, all! Just to clarify, I've started doing consults at a pediatric practice VERY part time (looks like a few a week) so I'm getting good hands on time, which I agree will help with my teaching (although so far I feel like the years and years of calls have given me pretty good exposure to the range of issues that can arise). Doing the actual consults is helping with my own confidence in working physically, hands on, with mothers and babies (and grandmas and dads). My main hang up seems to be about creating all the systems and forms and policies re: private practice. I think I'm overthinking it, but I'm also a realist about how much work it actually is. Just showing up and walking into a room at a ped practice is a way different animal since I don't have to field their calls, make appointments, bill them, fill out insurance forms, etc.-On Tue, Jul 20, 2010 at 9:01 PM, Leigh Anne <LeighAnne625rcn> wrote: ,I agree with the others. The other thing to consider it takes time to build a busy practice. So, if you start now you can manage as much or as little as you like. Then in a couple or few years you could be in a place where you can manage a busier practice. Jump in! Have fun! Take a risk! Leigh Anne O'Connor, IBCLCleighanne625rcnwww.leighanneoconnor.com Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.com

[Guest guest]

what is a micropore tape susan? :-P

I am trying to do the less home visit I can, as i just have my new wonderful big and very expensive site (pictures available to email for who's interested in seeing and giving me advices and suggestions:-)) ), anyway in my bag usually there are: a Medela pump (no many other choices here in Italy), a SNS, nipple shields, breastshells, a Habermann, some free sample of Purelan, a book or pictures of good latching, my visit cards and broshure. If I am going to visit a newborn I usulally have one of my own pillow (I make these, as in Italy they are difficult to find and usually I don't like the ones sold in shops). I have just one Lactina pump, if it is free and I think it could be useful I carry it too, but only if I am going by car , leave into the car and go to take it only if needed

hugs

martina

Re: Modified Private Practice

Dear all:I've been in private practice since 2002 and have actually found I gradually reduced my supplies over time, until quite recently. I used to carry SNS's, Haberman bottles, Lact-Aids, #5 French Feeding tubes, MIcropore tape, syringes and nipple shields in all sizes and I used to share a phone with three other colleagues. Since then, I dropped the shared phone (it was less confusing and easier to just simply refer to other colleagues), the SNS and Lact-Aids, the Haberman bottles, and all but the 24 mm nipple shields. If a mother needs to supplement at the breast, I rig up a Jack Newman's style bottle and then if it works for her, we discuss the Lact-Aid or SNS as an option. Since the supplies I now keep are very low cost, I just fold the expense into my regular business expenses and don't charge the individual mother. So my overhead costs are really just the phone, forms and a minimal amount of supplies.Recently, I did invest in pillows and beach chairs because the parent education center where I worked for seven years went under in a bitter dispute between the partners that rivals the worst of ugly divorces. (The take home lesson here is to make sure you have good legal guidance before setting up any sort of formal partnership to avoid any bitter dispute that may arise should you disband). So, I am now "homeless" and squatting in a Pilates studio. Actually, I am paying rent at the Pilates studio, but since they didn't get the pillows I needed quickly enough, I bought my own. I may regret this if I ever have to move because, like most people who live in New York City, we have minimal space in our apartment for supplies.Best, Burger__________ Informazioni da ESET NOD32 Antivirus, versione del database delle firme digitali 5319 (20100728) __________Il messaggio è stato controllato da ESET NOD32 Antivirus.www.nod32.it

[Guest guest]

Micropore tape is the same tape that is in the SNS kit. It also

comes in a wider strip - 1 inch and in hypoallegenic form -- brown

tape. The white tape is good for women whose breasts are slippery

because it sticks better. The brown tape is good for women whose

breasts are sticky and have a hard time getting the tape off without

damaging their skin. The wider tape is good for everyone -- it is

much harder to tape the tube and then the tube to the breast (or

finger) with skinny tape. The way Medela suggests taping the tube

makes it almost impossible to get the tube in the baby's mouth. It

is nearly impossible to get the tube in the corner of the mouth and

the baby often pushes the tube out of the mouth.

It is much easier and the flow is more controlled if the tube is

taped parallel to where the baby's tongue will be stroking on the

breast. For instance, in a transition (cross-cradle hold) on the

left breast, the tube would be taped parallel to the angle of the

baby's body and taped to mom's Left breast from the inner aspect of

her areola (right side of the areola on the left breast) out to the

nipple. If she were doing a football hold on the same breast, she

would tape the tube from the outer aspect of her areola (left side of

the areola on the left breast) out to the nipple. This way, the

baby's tongue will be stroking along the tube while feeding and as

long as the tube is a bit past the tip of the nipple, the tube

opening shouldn't get blocked by nipple tissue.

Best,

[Guest guest]

I have also pared down over the years. I only need 5 French feeding tubes,

syringes and nipple shields. I also like to stock tea, but my supplier often

runs out. I do have my office in a suite with 2 NDs so my clients can purchase

vit D, probiotics, magnesium and a few other supplements directly from them.

There is also a Whole Foods and a pharmacy across the street if I need to send

mom for anything else. I do not have a scale, but the ND does and I sometimes

use it, but I may be one of the few experienced LCs who just doesn't use a

scale. I also rarely give handouts. I will usually email the info I want the mom

to have within a few hours of our appointment.

This is not for lack of space, btw. I have an office. I just do not find it

useful or necessary to carry " stuff " . Like , I roll the cost into my

visits.

Tow, IBCLC, CT, USA

>

> > Thanks for the encouragement, all.

> >

> > I'm sure this has been covered, but do many of you run a PP without

> > much in the way of inventory? No pump rental station? Nipple

> > shields, SNS, etc? Or did you start out with out doing that and

> > have grown inventory as the need arises?

> >

> >