home visits. vs. office visits

[Guest guest]

i may have missed the orifinal message asking about this, but thought i would chime in with what we do - we used to be a home visits only, and now we are part of a spa and wellness center and we do both.

here is how we work it: we charge more for the home visit flat rate, and for hourly follow up in the home, to cover the extra time required and the wear and tear on cars, etc.

some families ONLY want a home visit, regardless of cost, others ONLY want a center visit, and lower cost is not the reason. the cost is more, but not so much more that most who could afford the one couldn't afford the other.

some of our consultants prefer home visits and others of us greatly prefer center visits, so sometimes we divide up the day like that, according to preference as well. it is a unique service to offer consultation in the home, and mothers who have just had c-sections, mothers of multiples, or mothers who are focused on a true "period of confinement" (home birth, not leaving the house for several weeks, etc.) really love having that option.

so again, not sure of the original question, but this has been our experience. that said, my mentor in another state started out as home visit only, and over the years switched to office only and loves it and would never go back - and she is busier than she can manage - so once a business is well established, i think that is possible - but to build a business, i think having home visits available sets one apart from the numerous hospital lactation centers (depending on where you live of course.)

warmly, Lyla

www.beyondbirthservices.com

[Guest guest]

Casi,I so relate - I too am chatty!I tell everyone I meet what a privilege it is to be invited into someone's home in one of the most intimate points in their lives.From a business perspective I charge a fee that I feel comfortable with in the event I need to hop in a cab - which in NYC can easily be between $12-20.Occasionally a mom will offer cab fare and when it warrants it - I accept - otherwise - it is just part of my fee. I hope to make it to the PPLC conference in Philadelphia and meet some of y'all!~Leigh AnneNew York (but originally from NC)On Nov 30, 2008, at 7:17 PM, Cassandra P. Leahy (MacFadyen) wrote:I love home visits; I try to limit them to the local area. Thoseoutside the area I travel are invited to my home office.The dynamics of a home visit versus the office are very different, andthat is what I like. I like the idea of being invited into a family'shome; I feel I make more of an impact in this situation. There isless awkwardness for moms; I get to see them in their naturalenvironment. We get to experiment with positions that they will beable to duplicate when I am gone. I get to see their nursing area andpump setup. In many situations I can help arrange these areas so theyare more comfortable and efficient. I have also found they are morelikely to have family members there and what an incredible teachingmoment that is. I am very clear on time constraints when the appointment is made and Ireiterate the constraints when I arrive. Yes, sometimes theappointments run over, but I must admit it is most often my own fault(I love to chat).The follow up with the moms I meet in the home are often more personaland in that sense more meaningful. Being invited into the home is aprivilege; I hope I can maintain that feeling and the natural higheach visit provides.Casi LeahyBA, RN, MSN, LCCE, IBCLCCasirngmailTheLactationLadygmailwww.thelactationlady.com Fax: Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.com

[Guest guest]

Casi,I so relate - I too am chatty!I tell everyone I meet what a privilege it is to be invited into someone's home in one of the most intimate points in their lives.From a business perspective I charge a fee that I feel comfortable with in the event I need to hop in a cab - which in NYC can easily be between $12-20.Occasionally a mom will offer cab fare and when it warrants it - I accept - otherwise - it is just part of my fee. I hope to make it to the PPLC conference in Philadelphia and meet some of y'all!~Leigh AnneNew York (but originally from NC)On Nov 30, 2008, at 7:17 PM, Cassandra P. Leahy (MacFadyen) wrote:I love home visits; I try to limit them to the local area. Thoseoutside the area I travel are invited to my home office.The dynamics of a home visit versus the office are very different, andthat is what I like. I like the idea of being invited into a family'shome; I feel I make more of an impact in this situation. There isless awkwardness for moms; I get to see them in their naturalenvironment. We get to experiment with positions that they will beable to duplicate when I am gone. I get to see their nursing area andpump setup. In many situations I can help arrange these areas so theyare more comfortable and efficient. I have also found they are morelikely to have family members there and what an incredible teachingmoment that is. I am very clear on time constraints when the appointment is made and Ireiterate the constraints when I arrive. Yes, sometimes theappointments run over, but I must admit it is most often my own fault(I love to chat).The follow up with the moms I meet in the home are often more personaland in that sense more meaningful. Being invited into the home is aprivilege; I hope I can maintain that feeling and the natural higheach visit provides.Casi LeahyBA, RN, MSN, LCCE, IBCLCCasirngmailTheLactationLadygmailwww.thelactationlady.com Fax: Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.com

[Guest guest]

I do both home and office visits.

I started my PP job only with home visits, but in one year I was tired

and frustrated. I live in a 3-millions-people city, where traffic is

crazy and cabs too expensive and difficult to find.

To do only home visits means I can be in my car for 2-3 hours only to

reach the mom and come back. BTW I am the one of only 2 LCs in all the

city, and noone know here what a IBCLC or LC is, so I have to make some

arrangments so to try to make my business grow up :-P.

I charge fixed prices, not hourly prices. It is a matter of culture.

After some experience I learnt to charge different prices, as with the

same or almost same moms had no advantages in coming to my office.

As nne said:

""So for moms in the first week, I would do home visits, but I really

intend to motivate them to come to me, as I think it will make their

motivation clearer, not so much towards me as well as towards

themselves. Travelling a certain distance makes you more aware of what

you are doing.""

I totally agree.

Anyway I agree with other point of view, too:

"The

dynamics of a home visit versus the office are very different, and

that is what I like. I like the idea of being invited into a family's

home; I feel I make more of an impact in this situation. There is

less awkwardness for moms; I get to see them in their natural

environment. " (Cassandra P. Leahy )

"some families ONLY want a home visit,

regardless of cost, others ONLY want a center visit, and lower cost is

not the reason. the cost is more, but not so much more that most who

could afford the one couldn't afford the other. " (Lyla)

So I do both, and see good points in both kind of visits, encouraging

moms to come to my office, heartly encouraging them if the baby is

1-month or older, for example, and not encouraging at all if they had a

C-section only 3 days before :-).

Each situation is different.

I tell them all the different prices and they choose.

Hugs

martina from Italy

[Guest guest]

I do both home and office visits.

I started my PP job only with home visits, but in one year I was tired

and frustrated. I live in a 3-millions-people city, where traffic is

crazy and cabs too expensive and difficult to find.

To do only home visits means I can be in my car for 2-3 hours only to

reach the mom and come back. BTW I am the one of only 2 LCs in all the

city, and noone know here what a IBCLC or LC is, so I have to make some

arrangments so to try to make my business grow up :-P.

I charge fixed prices, not hourly prices. It is a matter of culture.

After some experience I learnt to charge different prices, as with the

same or almost same moms had no advantages in coming to my office.

As nne said:

""So for moms in the first week, I would do home visits, but I really

intend to motivate them to come to me, as I think it will make their

motivation clearer, not so much towards me as well as towards

themselves. Travelling a certain distance makes you more aware of what

you are doing.""

I totally agree.

Anyway I agree with other point of view, too:

"The

dynamics of a home visit versus the office are very different, and

that is what I like. I like the idea of being invited into a family's

home; I feel I make more of an impact in this situation. There is

less awkwardness for moms; I get to see them in their natural

environment. " (Cassandra P. Leahy )

"some families ONLY want a home visit,

regardless of cost, others ONLY want a center visit, and lower cost is

not the reason. the cost is more, but not so much more that most who

could afford the one couldn't afford the other. " (Lyla)

So I do both, and see good points in both kind of visits, encouraging

moms to come to my office, heartly encouraging them if the baby is

1-month or older, for example, and not encouraging at all if they had a

C-section only 3 days before :-).

Each situation is different.

I tell them all the different prices and they choose.

Hugs

martina from Italy

[Guest guest]

Anne Grider wrote:

" My belief is that new mothers are fragile and no matter how many

times we invite them to phone us, most feel it is hopeless if things

don't improve right away or at the pace they had hoped. Many simply

don't believe more can be done. I don't agree with some things we

hear at conferences like " moms need to want it more than we do " - as

an excuse to not follow-up with them. On the occasions when I'm

feeling burned out, overwhelmed and delay follow-ups I can predict

that a few vulnerable mothers will have quit. "

I so agree. I tell moms that I often see progress through my notes

that they cannot see in the moment they are in, and that support is an

important part of my job. I talk to my moms every day, until they are

out of the woods. I don't see any reason to put the need for

follow-up on the mom. Usually, they only realize they need to talk

once I am on the phone to listen.

Tow, IBCLC, CT, USA

Intuitive Parenting Network, LLC

[Guest guest]

I apologize for my poor English.. I need some explanations.

Anne, do you mean that *you* call moms for follow-ups?

I imagine you don't and I misunderstood....

I do believe strongly in follow up. I charge for my visit, and then I

tell each mom to call me ***every time they need***, even if just for a

silly question, as silly questions put them in doubts and afraidness

and I am here to give them info and support, and wipe out concerns....

Some of them tell "oh weeeell, you are too muuuuch kiiind, I wouldn't

like to disturb..." and I told all of them that they do not disturb me,

this is my job, it is very important to know how things are going, and

many time things need some little adjustments for their own unique

dyad, and that they still had payed phone follow-ups in the charge. BTW

some of them then dont' phone me. Some of them then I learn that all

was going well and solved, sometimes I meet or hear some of them

occasionally and they told something like "oh well, I stopped bf

because.. (and a very stupid or less stupid reason that I surely could

solve). I realize that as Amy Spangler said , bf is not for all women,

and some of them were just looking for an excuse to stop. But some

others? Sometimes I am really worried for some moms, as I think they

need a lot of support and encouragment , but I think as nne that

that is not my responsability. Sometimes I would scream, but I quit :-).

I have a strong LLL imprinting :-), as I was born in lactation field as

LLLL and I still am a LLL administrator, and I always tell my LLLLs

that this is not our (as LLL) responsability too... if we want to

empower mothers, responsability has to be in their hands, not in ours.

Anyway, this dont' solve my dilemma: Why some moms do not call after a

while, even if I tell them that it is *into the charge*?

Can I do something else to avoid or minimize this problem?

Do you have this problem too?

Hugs

martina

nne Vanderveen-Kolkena ha scritto:

-----

Original Message -----

From:

Anne Grider

To:

Sent:

Monday, December 01, 2008 3:02 PM

Subject:

Re: Re:home visits. vs. office visits

**Hi Anne,

You wrote:

"I don't agree with some things

we hear at conferences like " moms need to want it more than we do"-

as an excuse to not follow-up with them. On the occasions when I'm

feeling burned out, overwhelmed and delay follow-ups I can predict that

a few vulnerable mothers will have quit."

**You are probably right, but...

is that *your* responsibility...? I think it is nice for someone

with a problem to have some extra attention from a caretaker (or for

every human, for that matter! ;-)), but in the heart of the issue,

everyone has his or her own responsibility. If you would think along

your lines, it would mean that it is *my* fault if she quits. That,

however, is *not* the case, provided I haven't given her bad advice,

like lowering frequency of feeds or taking medication that will dry up

the milk. ;o) I usually compare it to the family doctor or a surgeon or

some other medical specialist. They won't call and ask how I'm doing...

Warmly,

nne Vanderveen, Netherlands

**Y

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