Subscribe
Share
Share
Embed
The smart way to create a compassionate and professional lactation private practice, hosted by private practice IBCLCs Annie Frisbie and Leah Jolly.
Leah Jolly is a private practice IBCLC with Bay Area Breastfeeding in Houston, Texas.
Annie Frisbie is a private practice IBCLC serving Queens and Brooklyn in New York City and the creator of the Lactation Consultant Private Practice Toolkit.
Tune in each week to learn all the ins and outs of running a successful private practice lactation business!
Connect with Leah and Annie:
On Instagram: @lactationbusinesscoaching
On Facebook: https://www.facebook.com/lactationbusinesscoaching
On YouTube: https://youtube.com/playlist?list=PLv3-4pMgjlzbXD9KWFCIV3-1LipsTbgsj
Annie: Well, good morning Leah.
Leah: Good morning Annie, how are you?
Annie: I am great. Happy to be podcasting. You know we had these big plans that we were going to record together when we saw each other in person at LCinOffice in early October and that didn't happen because there were too many interesting people to chat with, right?
Leah: Yes. It was like, Oh I don't want to go just be talking on the podcast. I'm like, Oh, I want to talk to all these wonderful people while we're here with them. So it was really hard to break away, but I know we were able to chat a little bit about some fun topics that we wanted to talk about and I'm really excited for that.
Annie: And it was just great being together in person and getting to talk to a group of real people. I mean you guys are all real, listening to this podcast. People whose faces we can see about topics that we love, so we did a session on marketing. We did one on building your corporate structure and then we did one on hiring people and so it was just so fun. We got some great feedback too to help us keep developing all of this business related content that we just have so much fun putting it together.
Leah: I love it. I love it. Can you guess that the marketing one was my favorite?
Annie: It was really fun.
Leah: It was such a fun ending to the conference so I can't wait to present that again
Annie: Before we get into the content for this episode, which is about safety concerns for your clients and for you for in-home lactation visits. We'd like to give a shout out to the sponsor for this episode, which is IntakeQ. A lot of us in lactation land are using IntakeQ for charting. It's one of many great options and we're super excited that they have given us an exclusive URL IntakeQ.com/LBC, because that's going to give you a 20% discount on the first three months of IntakeQ. So not only will you get the free trial that they give to everyone, you're also going to get a discount on your first three months while you're getting your practice up and running. They have great flexible pricing options, including ones for low volume practices so you're not really feeling the stress of having to grow before you can access all the features. You can actually get in on one of these low volume plans, access all the features, get to know them and spend the rest of your energy building your practice so that you can hopefully have the great problem of needing to upgrade to the regular plan. So we really love IntakeQ, I've been it for months and I'm super happy with it. They have great customer service. So thank you IntakeQ for sponsoring this episode. And we'll have a tech tip about IntakeQ at the end of the episode.
Leah: Yes. But I'll start us off with a marketing tip. How about that?
Annie: I love it.
Leah: So today we're talking about safety concerns and also helping your client feel safe. And one of the things that I think is really helpful with helping a client feel safe is that they see you and they kind of get a sense of who you are. So when you're creating content, whether that be for social media or for your website, you really want to think about putting yourself out there as far as your face, kind of your general personality, that type of thing. So they can just feel comfortable knowing that this friendly, comfortable person is going to come to their home, because I think that's a hard thing to do. I know like even when the plumber comes to my house, I'm like, okay, please be a nice person. You know, I don't even know what this person is supposed to look like. They're knocking on my door, and I think in such a vulnerable time when you have a new-born in your arms, you want to feel like the person coming over is just warm, friendly person, and I think we can really portray that in what we put out. But it's important to put your face out there. I think that's probably harder for a lot of us because we're like, I don't want to put myself out there. I don't want to do a live video. I don't want people to see me. I don't know what to say. But it's so important and your clients will really appreciate it in the long run. So be bold. Put your face out there.
Annie: That's a great tip. I think I'm communicating that you're a safe person begins the first point of contact that any family has with you. You want to just put that vibe out there because that's what we're supposed to do for people. We're going to care for you and we want you to know it. So we can segue into the actual content of the episode, which is all about safety, and as we said at the top of the episode, we're not just talking about keeping ourselves safe during a home visit. We're also talking about helping our clients feel safe because there's two sides of it. We're going to a place we've never been before and they're inviting someone in their home who they've never met before. Leah, what was it like for you the very first time you did a home visit way back when?
Leah: Oh my goodness. I remember I was terrified. I had never done anything like this because even with my work with La Leche League, I didn't ever do home visits, or at least not for anybody I didn't know. It was more like a friend of a friend needed me to do a home visit or something like this, but this was going to a complete stranger's house, so that was really, really intimidating, and of course, that was eight years ago before I knew Annie and knew all the things that I could do ahead of time that you've taught us over the years, but it was definitely really intimidating, and a big leap for myself, I think. The good news is, at the time I had a partner working with me and we actually did like the first, I don't even know, maybe 10 or 15 visits together, which was kind of nice. We kind of held each other's hand like, okay, we're going to go do this together so at least if it's really shady, scary or something we're together and it wasn't. It was all wonderful, and it turned my eyes around. I was so intimidated and then it wasn't as bad as I thought it was going to be so that was good news. How about for you?
Annie: Yeah, you know, I feel like I can't remember feeling nervous. I was just like, okay, people do this, so I'll do it. I'm sure it's going to be fine, which is a little bit how I approached my professional life, which is completely fine to do this. I can do this. This will be fine. And my husband is more of the safety person. He's like, I would really like for you to tell me where you're going. Text me when you get there. I was like, Oh, right. I moved to New York City in 1995 and I feel like I have a pretty highly developed personal safety radar, so sometimes when my husband would say things to me about just make sure you don't park in a dark spot, I was like, who do you think I am? Like I am a woman in New York City. Don't mansplain me how to keep myself safe in a strange environment. I got myself home from the club in the late '90s multiple times and I was okay mostly, you know, so I think looking back, my cavalier attitude is not one that I would recommend to anyone these days, but at the same time I felt from the very beginning that it was important for me to set some expectations on both sides so that I felt like we're real people who are going to do something real together. This is not a fake thing.
So we can start by giving some ways that you can protect everyone's safety in advance of the visit and that are really specific to lactation. So I think we all know, you are told if you're going to buy something off of Craigslist, for example, they say always meet them at a separate location. Don't ever go to somebody's house to pick them up or don't tell them where you live. So that's obviously not something that applies to this situation. So let's go through some ways that you and I have come up with and through talking with each other in our own practice and hearing from other people doing private practice, we're getting safety taken care of in advance of the visit.
Leah: I really like the idea of making sure that the client fills out some kind of information about themselves prior. Now, you know, I know some people send their complete forms and the client has to have all of that information filled out ahead of time, but we use Acuity and we have very specific questions that you have to answer to create the appointment letter. You have to answer these questions or the appointment won't be created, and that's been really helpful. One of them is our consent is on there. We always get the birth dates and we ask for the paediatrician and I think that's really helpful because somebody could make up a bunch of stuff but it's going to take more effort to just find a paediatrician name and then be able to put their name. It's just some extra questions like why they want the visit and who referred them. So questions like that that might filter out anybody that was maybe trying to do something more shady. We have never had anything like that happen so thank goodness. But I definitely think it's wise to stay kind of on guard a little bit and have some filtering questions that you get ahead of time, and we send out our full forms as well, but just to book the appointment, we have some filtering questions that we have. What about you Annie? What do you do?
Annie: I do the exact same thing. They have to give me some basic information. So before I was using online scheduling because it didn't really exist back when I started my private practice, I was talking to people on the phone and just getting that basic information and yeah, I mean I feel like it would take a lot of effort to develop a con so specific. This con will start with getting a lactation consultant to think she's coming to my house to help me with my baby.
Leah: And I think also we as IBCLCs are super savvy detectives. I always tell my clients that I'm doing lactation detective work right now. That's why I'm asking you 40,000 questions and I think we would pick up on it. We'd be like, really? That happened? Okay. I think we would pick up on it pretty quick if somebody was trying to con us.
Annie: And because I think a lot of us too, at least in the volunteer worlds from being a LA Leche League leader, we definitely got creeper texts. You are so not a real person. You're not asking me a real question. And then when we really got going in Facebook groups and you'd find out, Oh yeah. That same creeper texted the same gross question to 50 different leaders across the country. Just don't answer calls from that phone number, that gross creeper. And I think that's really my experience has been you either have the gross creeper that you identify right away or legitimate people who need breastfeeding help.
Leah: I definitely think so.
Annie: I do think it sets a good expectation to take the consent in advance and it helps you learn something about your clients. I like to ask, tell me a little bit why you want the visit today to just get a little narrative and it helps me not only prepare clinically, but also just established with them that we're going to be preparing to do something together. I want them to have a sense of what to expect. I don't want them to think, what's going to happen when she comes? Is she going to come in and just start berating me that I'm not doing it right? And I think a lot of people do have that fear. They're not sure that they're safe with us and I think it does hold a lot of people back from even consulting, reaching out to a lactation consultant, let alone having them come into their home.
Leah: Yeah, I definitely agree. And one of the things that we do in our confirmation email, we send a link to our how to prepare for your visit, which the verbiage in there, we try to be really establishing some trust and caring and non-judgment. We talk a lot about you don't even have to get dressed and please, please, please do not even think about anything in your house. We're not looking at your dishes or what laundry needs to be done. We're focused on you and your baby, your family, and what help you need, and so I think that can be really helpful if you have something to help them get a sense of how the visit might run and their expectations. So speaking of other safety concerns, so pets. I never was worried about pets until I was bitten. And then one of my newer LCs that came on, she was bitten by a cat. You usually don't think of a cat attacking you, but it totally bit her.
Annie: Oh my gosh!
Leah: And so now, you know, over the years I've developed actually more and more firm boundaries on that because I've just had so many dogs. And I think in the Facebook groups you hear a lot too. Like, Oh my gosh, this dog bit me or came after me or whatever. So we actually have that in our confirmation email to you just saying your pets will be secured or put away. We still have people leave them out, but I'll ask, oh, do you mind putting them away? I just know that some can be a little bit more protective of baby. So that's another way to keep yourself safe and don't be afraid to put that boundary out there. I know that sometimes it's hard. It's even hard for me sometimes, especially when the dog is really clearly super sweet and happy, but I still know that I'm going to feel on edge the whole time just because I've been bitten twice.
Annie: And I've never been bitten by a dog, but I have had a dog lock me and the client in the hallway of their apartment, the front entryway of their apartment ... with the baby still in the apartment,
Leah: Oh no! Because the dog was growling?
Annie: No, no. When I finally met the dog, I was like, are you kidding me? It was the tiniest little dog and she would open her apartment door and then lean out and she could open the front entryway without letting the door close. She didn't have to let her apartment door close behind her. And she's like, my dog has never done anything like this ever. They lived there for years with that dog and she stepped out and the door was sort of cracked open behind her and the dog jumped up and pushed the door closed and it locked.
Leah: Oh my gosh!
Annie: She was in her pyjamas. She had nothing. She didn't have her phone. And so this was a great example I'm going to help you feel safe now because I'm personally terrified. Your baby is sleeping in there, right on the other side of the door. The baby was right there but the baby was alone in the apartment with the dog and so I said, okay, here's what we're going to do. Here's my phone. You're going to call your husband and you're going to tell him what happened. And she said he'll come back. He'll bring keys, but he works in the city. That's 40 minutes by train. I was like, great, do that. So she texts her husband. She gets him to come. The texts were hilarious between her and her husband. Later when I went back to look at them and we ended up doing a bunch of visits together and were able to get to a point where we could laugh about it, but it was terrifying in the moment. And so then I said, is there someone else you want to call to come and be with you while you wait for your husband, because it doesn't have to be me? I'm good with whatever you feel comfortable with. And she was like, no, no, no, it's okay. Do you mind waiting? I said, no, not at all. Absolutely. And what I realized I was I need to keep talking so she doesn't panic because this is scary. This is not okay. Her baby could wake up at any minute. Thank goodness he slept. And so then I said to her, we could do whatever you want to do right now. We can just sit here and talk, or whatever, or we could start the visit. I do have a lot of questions that I like to ask at the beginning, but it's really up to you. What's going to help you feel calm and keep your mind off things? She's like, oh, that's a great idea. So I just started taking the history.
Leah: Out in the hallway.
Annie: In the hallway, while somebody upstairs was having a party and was getting pizza delivered every 15 minutes. Not helpful for us because they couldn't get into the apartment. And she just kept answering the questions and she told me her whole birth story in the hallway. Her baby woke up and started to fuss, and three minutes later her husband walked in and let us into the apartment and it was so relieving. But ever since then I'm actually scared 'm going to get bit, but then I really think about animals are really unpredictable.
Leah: They're going to do something crazy like lock us out of the house.
Annie: Lock us out of the house.
Leah: That's an amazing story. I definitely have never been locked out of the house with the family before, but you handled that beautifully and how beautiful how you kept her feeling safe and kept your mind off of things and stayed with her. That's just another example of how we can keep our families feeling comfortable and trusting and safe with us. I think one of the other things, and you were kind of talking to this is giving location information to somebody else, especially if you are on your own private practice and maybe you have a support person that you just communicate like, Hey, today's where I'm going to be or if it's your partner, somebody that you feel trusted and maybe have some agreement with that they are just watching out for you and I like the idea of having like a 9-1-1 or something. So if I'm ever going to an area that I'm just not familiar with, like I've never been to this part of town or something new. I'll let my husband know like, Hey, I'm going to this new area. Hopefully I don't get lost. A lot of times, because Houston's growing so fast, our GPS won't identify the location so you're kind of on the fly so I'll always tell my husband, I'm going to a non-existent place right now. It'll be a new neighbourhood that's in the suburbs. And so I'll tell him, okay, I'm just following, literally turn by turn directions, which is terrifying to me now. I'm so dependent on my GPS to tell me what to do and when it won't pull up, then I have to ask the family, Hey, can you give me directions? And it's so hard. You've no idea how hard that is when you have not used somebody's directions. You've only ever used GPS for the last eight years of my life. What does this mean? Why won't something tell me when the street is coming up? So you're that person that's driving all slow and looking at all the signs and everything, but it's important. I think if you have some concerns, somebody that's watching out for you. You had talked about having something like a warning. Hey, this doesn't feel like it's going well. Some kind of way to communicate I don't feel safe right now to your support person. Do you do anything like that or have you thought through what would you do if you got to a consult and didn't feel safe or felt like maybe your safety was a concern there?
Annie: You know, it's weird because it's just never happened.
Leah: It hasn't happened to me either, but I always think about what would I do?
Annie: Things I do are I have in my consent for care that I'm going to be sharing their address with my support person, and I provide his name, my husband and if anybody came to me and said, I'm not comfortable with that, I would say that I'm not the lactation consultant for you, and you're totally allowed to do that. It's a case where informed consent means they have the right to refuse, but you also have the right to not take them on as a client if you're not feeling like that falls into your safety protocol. I've never had anybody have a problem with that. Other things I do is I always make sure my cell phone is charged and I do carry a backup battery.
Leah: That's a good idea.
Annie: Something else that has happened to me is I have been stuck in an elevator and so wanting to make sure that I have a way to like... I'm not stuck somewhere that I can't get service. That's a big reason for people to know who I am. And so speaking of that, I go to apartments that are these big high rise buildings where I'm so high up, I don't have cell phone service, or there are pockets of New York city where I don't have cell phone service or have really spotty service or you're just so deep inside. And so having someone who knows where I am because I can't text them if I'm stuck in an elevator or my location services aren't working, and thankfully you get stuck in an elevator, you get out of the elevator. I'm going to get out of the elevator. But it's things like that why it's important to not just rely up on ... I have Find my Friend turned on on my phone and my husband and my kids can see where I am, but if I'm not in cell phone service, they can't see where I am. But always getting that permission and making sure people understand that. I also ask about parking if I'm going to somewhere new. I mean in New York City, that's more about convenience than it is about safety, but if you're in a rural area, you might want to know am I going to have to park my car and then walk for a quarter of a mile and what is that walk like? And maybe I don't want to do that walk at night. I would not personally feel comfortable in doing ... I don't do night visits in general more because I have difficulty seeing and driving at night. I just don't like doing it, which I guess is also about safety, but going to a brand new place that I've never been to where it might be in a part of Queens or Brooklyn where it's more industrial still and so where I might not be able to park. Can I park right in front of your building or do you have a parking spot?
Because there are areas where I just don't want to be walking. I might be by myself in an industrial area where there isn't a lot of foot traffic. I'm personally not comfortable with that. So I could imagine a case where I would come to a client's address and they are living in one of these neighbourhoods, and I can't park close enough and the only place to park I don't feel comfortable with my surroundings and feeling vulnerable on the walk to their house. That might be a reason where I might say I don't know, I might not do the visit or I might say, can we reschedule for another time when there's parking available or say I'm not going to drive my own car. I'm going to take a car service there or have someone drop me off and pick me up.
Leah: Oh yeah, that's a good idea.
Annie: So I've been in New York City almost 25 years. I've been very safe thankfully here, but I do know that those deserted areas, the empty subway cars. Those are the things I tell my daughters that you just don't want to be the only person on the street and you don't want to be the only person in a subway car because that does make you vulnerable.
Leah: Yeah. Those are definitely big things to think about, not so much here in my area, but I know in some of the big cities where they're expanding but not out like Houston expands out and I think a lot of these big cities, some expand inward, so you're getting all these new growth in areas that didn't have people living there like you're saying, industrial areas and it can be hard to navigate because they are different than your typical areas that you're used to going to. But once you get to the visit, I think there's things that we do on both ends for us to feel comfortable there.
Like we were talking about the dog and the pet safety and stuff like that, but beyond that, I know as a mom, I have more tended towards the germaphobia side, definitely and so I definitely would be more aware of like the person's cleanliness. Are they washing their hands? Are they cleaning their scale in front of me? Does it seem like they've taken some time? I think that can help most moms. I think most new moms with new-borns are a little bit more conscientious of hand-washing, especially the time of year. If you've got that winter baby, they're really cautious of it and I think we can help them feel safe by doing that before they even ask. I know you have the 'take your shoes off' thing, which I love. You are always taking your shoes off. I ask every time. I think things like that that show that we're thinking of their comfort level helps a lot for them to feel safe with us. To be comfortable to say, hey, please don't put your stuff there or take your shoes off, being comfortable to ask us those types of things if we start out by asking them what are your preferences, and showing them that we're thinking of their needs in this area too. So I think that's definitely really helpful as well. How about you? Have you had any in-home things that you think about to help you feel more comfortable once you're in the home?
Annie: One thing that I'm aware of is that my clients are going to have Alexa or Google Home, and so here in New York State, they don't have to tell you if they're recording you.
Leah: Oh wow.
Annie: So every state is different.
Leah: Yeah, I've heard of that before.
Annie: For what they allow, so in some States, both parties have to consent to be recorded, but in New York State, only one party has to consent to record something. I guess for me, I don't really care about being recorded, but sometimes, I do recommend, first of all, if you're not comfortable being recorded, know what your state laws are and have a policy that you're communicating to your clients, but also as a safety issue for them, to let them know that when Alexa and Google Home listen to you, even having them turned on and not recording, they're collecting data about you and Google in particular might serve up some ads to you for nipple butter. Do you want that?
Leah: Oh my gosh! That is so crazy!
Annie: So that's sort of a new safety concern is the devices that are listening to us that are so convenient and help us out so much, but also where is that data going? Is that data secure? I mean, if I were in an office, I would not have any of these devices turned on because that is a violation of HIPAA for my client's privacy, but they're allowed to do what they want to do, and I'm also really concerned about making sure I'm getting out on time and helping the clients feel safe that way. I'm not here to be there all day. I don't want them to ever feel like I'm a guest or expect anything from them. They don't have to give me water. I've actually realized recently that I had this hard-core policy that I would only ever say yes to water if it was offered to me by a non-lactating person.
Leah: Yes, we've talked about that before. I love that.
Annie: I have changed my tune on that because I've realized that people like to extend some kind of hospitality when you come into their home, so I have revised my policy. I'm not going to ask for water. I'm not going to come in and be like, I would love some water. I'm so thirsty, but if I'm offered, I will say that would be wonderful. Thank you so much, and then sometimes I get seltzer. Whole new worlds of getting seltzer from my clients. It's amazing.
Leah: It's so funny. I have this one client that I guess in one consult with her I, they had seltzer and I was like, Oh my gosh, I have that. I love that one too. The grapefruit is so amazing. And I ended up seeing them several times and it was so funny because every time I would come in, she would have it like sitting on the table on a little coaster, ready for me and she's like, there's your seltzer. I'm like, Oh my gosh, I love coming to your house.
Annie: I totally had that same client. The same thing - look, we have your seltzer for you. It's so cute.
Leah: It's so cute. I love that. I love when they're thinking of us too.
Annie: So have you ever had a situation where you walked in and you felt like the baby or the mom or the family was in trouble and they weren't safe? Not where you didn't feel safe, not where they didn't feel safe with you, but where you felt like they were not safe or something was not going well for them, not going right?
Leah: I luckily have never had like something really scary. I've had a couple of clinical situations where I've sent them right out the door to the emergency room. So yes, safety concerns as far as clinical goes. Luckily I have not had any situations where I felt mom or baby were not safe in a non-clinical but physical way or mental way, but I'm sure that that could come up because you're really coming into somebody's personal space. You're going to see things that might not have been seen if you'd seen them outside of their home environment. So I think it's an important thing for us all to think through what would we do. Have you ever had an experience like that?
Annie: I have not. I have after the fact had clients share with me certain things that I didn't know were happening at the time, just in terms of stress in their relationships, so it was a wakeup call for how these things can go undetected and things like especially domestic violence can be very hidden. People work very hard to cover them up and I would not even presume to be any kind of expert on how to manage that. We did have a great session of last year's LC and PP conference that was too short. It could have been a lot longer about working with abuse victims and survivors, people who are currently experiencing abuse or people that had experienced abuse and how to talk to them and how to show care for them and create a safe space, and I would really love personally to get more training on that. I did implement some of the recommendations. It was an IBCLC named Rachel Blumberg gave the talk and it was great, and I hope she's planning to do more education on the topic.
Leah: Yes, so important.
Annie: And it's also really important that we get trained in mental health awareness of how to deal with these situations, because this is something that I feel like has come up for me many times where feeling concerned about the parents' mental wellness and were there red flags going up for postpartum depression or postpartum anxiety and knowing how to handle that. And I mean number one, knowing that it's not in your scope of practice to address mental health situations unless you're a therapist, a licensed therapist, so if you are a lactation consultant and someone starts throwing up red flags that they are not well, that is not for you to deal with and you can make things worse by trying to deal with it. What I have been told, and again not something where I would presume to be an expert and I am still looking for more training about it and because I think it's really important that we all get it, but to say, we're going to call someone right now. We're going to call the paediatrician and to say to the client, I am not the person to help you with this. I am not equipped to help you with this. And I have had to say this actually recently to several clients that I am not the person to help you with this. And I don't know, I had this feeling of like, if I say that, what if they never get help at all? Because I'm sending them off to someone else. But in all cases when I said that, those people went and got help and it was me telling them, I am not the person to help you with this. As nice as I am and as much as I want to, for me to put up that boundary to help them, I can see that this was serious. If you've got this nice lady who came to your house and she's being all warm and fuzzy telling you I can't help you, it must be something that needs help. So I think having that training and awareness of what the signs and symptoms of postpartum depression and postpartum anxiety and postpartum psychosis are, and having prepared scripting for yourself of what to say in those situations to create that safe environment and not make the environment dangerous for them is really important.
Leah: Yeah, absolutely. Absolutely. I think those are such important topics to be aware of. And I love the idea of some scripting, to just kind of have it in your head, maybe do some role play in your mind. Okay, if this goes down, this is what I am going to say, so that you're prepared because it's really hard when you're like, Whoa, okay, this is getting way more than I expected or it's hard to put your mind around well, how do I formulate words that aren't going to make this worse, so I love the idea of thinking about that ahead of time.
Annie: And another thing to think about ahead of time is to be doing work on your own biases that come from race and culture and privilege if you're in a dominant culture, as Leah and I both are. Being aware of how you are, in some ways if you are a white lactation consultant in a country where you are the dominant and have all of those issues like we do in the US where there's a lot of racism, you're inherently unsafe to your clients of color, because of systematized racism and there's studies that come out. There was one that came out recently talking about just how even research that was designed to be blind to race turned out to be even more racist and skewed, so that white men were getting really high quality of care and black women were getting terrible care in this study that was meant to be blind to race. We have to really understand that they might not feel safe with us and they have reason to not feel safe with us because they may have been harmed by people who look like us, and so having equity training and talking about that on your website and finding ways to communicate. A lot of us have the rainbow flag on our websites that say that we're an inclusive practice to make clients who are not cisgender feel comfortable with us. So asking people in your intake form, what pronouns do you use? Not what pronouns do you prefer, what are your pronouns? What are they? because, you know, I feel like I've had a lot of good training from Stephanie Wagner, who's going on the road with USLCA to teach us all even more about this amazing stuff and how to create that safe space for our clients who are not just the typical cisgender, I look like what gender I am, and realizing that someone might come to your office presenting as a cisgender female who is actually male, and that is who they are. But if you never ask them, they're going to assume that you don't want to know, and now you're not giving them the chance to tell you who they are.
Leah: And if a client feels like they have to hide something that's going to make them less safe. So by asking ahead of time, we create this feeling of safety. I'm a safe person. You can be real. You can be your real self. We're not going to make you wear the mask. You can be your real self. And I think then we create a lot more trust and that just improves the quality of care that we can give too.
Annie: Absolutely. And we're going to make sure we have some resources in the show notes if you want to pursue additional education about postpartum wellness and perinatal mood disorders, as well as equity training and inclusivity training because I think we all need this, and as you said at the top of the episode, we want to communicate this from the get go. We want our communities to know that we are a safe space, and we're learning and we're growing and when we make mistakes, we're going to apologize and figure out how we can make ourselves better and do better for our clients. So we've talked about how to keep things safe before the visit and during the visit and we actually have to keep things safe going forward after the visit. So what are some ways that we continue to keep everybody safe after we've left their home?
Leah: So when you're communicating with the client or with other healthcare providers, making sure you're doing that in a safe way, a secure way, I think helps continue that trust, that we're not just going to be blabbing everything that happened in your visit on social media. We're actually going to keep your confidentiality and then sending your doctor's reports in a secure, safe way and giving you options for secure communication, whether they select them or not, but to just make sure that they have a way to talk to you past the time of the visit in a safe and secure way, if that helps them feel better and more open about what they're sharing, if they're having any troubles continuing on. So I think that's really important. Are there any other ways that you've thought through keeping yourself safe after?
Annie: Yeah. So one that comes up and people ask me this all the time, what address do I have to put on my super bills when you do home visits and don't have an office? And really the safest answer to that is that's what post office boxes are for there. So you can have a mailing address without revealing your home address. And again, it's a business expense. Post office boxes are not free, but they will protect your privacy and keep that boundary safe.
I want to go back to what you said about how we talk about our clients and just using social media, and I think that is so important in terms of safety all around because those things they get out and if you are prone to just revealing too much about your clients on social media, it's going to come out and even the way you talk with your colleagues on social media, that comes out. Your reputation does precede you, and the work that we're doing is so important because our families that we're working with are in such a vulnerable time of their lives. They may be dealing with birth trauma, which also we are not equipped to help them with. That needs to be referred out. We shouldn't even really be asking them to tell us their whole birth story, as much as they might want to even. We want to get the information that we need. I learned this from Brenna Sampai last week. She talked a lot about this at the Movable Feast seminar that we really need to be asking them what we need to know about the birth, but their birth story is sacred and probably isn't for us to hear everything they went through, and I thought that was really an interesting reframing for me and very challenging reframing for me, and I've been pondering on that ever since she said it because I guess I always thought, well, it's just a birth story, but you know what? It's just like a birth story - one of the most profound experiences someone can go through, and that maybe I've been too cavalier in my own thinking about the impact of asking people to tell it.
So I mean, I've switched in the last several years. I get birth information through the intake, so I'm not typically inviting my clients to go through their whole birth story with me anyway, but it really got me thinking about if they even try to think about stopping them and saying, I'm not the person for this is the wording that Brenna gave us. So that was really interesting. I think that it's something to really be thinking about, all of the ways that we are putting our clients first and also protecting our own safety, which is good for our clients too. When they see us taking care with our own selves, they understand a self is something to be taken care of.
Leah: I like that. I like that a lot. That's a great way to think about it and it will help empower them. It gives them the opening to state their boundaries or let us know what would help them feel safe because we're sharing what's going to help us feel safe, and two safe people working together are going to make a much better outcome than anybody feeling hindered by not feeling safe, so I think that's awesome.
Annie: Absolutely.
Leah: This has been such an interesting conversation and I'm so glad we took it on, because every time we talk I'm always like, Oh, I love that thought. It's a new thought for me. As we wrap up today, I know you have a tech tip for us today, Annie. What's that?
Annie: I sure do. So I collect my client's insurance information even when they're out-of-network. So the last episode we talked about insurance and all of that crazy business and how we have an ethical responsibility to provide our clients with a super bill. So I actually have my out-of-network clients give me their insurance information as well, and I explained to them, I'm asking you this because then my system will create a super bill for you that has your information already prepopulated in it. So IntakeQ makes that very easy to grab that information.
Creating the super bill is just a few clicks. I create the invoice, I take the payment, process their credit card, and then I could click a button that's just says , and it even reminds me if I've left anything off the super bill, like if I've forgotten to put a diagnosis code on there, it won't send it to them until I make sure it's complete, and they look really nice. They are formatted and I have a disclaimer at the bottom that I loaded into IntakeQ that talks to them about how I'm not guaranteeing you're going to get anything back, but here's the link to the National Women's Law Center. So that's all there. I don't have to think about it. I find that it just gives them something really nice looking, so IntakeQ is not the only platform that does it. I have been very happy with the way IntakeQ does it.
Leah: It sounds like they are a magical unicorn, like everything I hope an EHR would do, they seem to want to do so that is super awesome and I think that is a really great way that we just continue to help our clients fight the insurance beast. It's been great talking to you today and I look forward to our next episode together.
Annie: Me too. So good to talk to you. Bye, Leah.
Leah: Bye