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Price, Supply and Demand: Why Can’t I Earn More?

By Cathey Horsfall

iStock_000015593024XSmallIBCLCs are often under-recognised for their skills within the multi-disciplinary neonatal setting.  Where this is the case, IBCLCs report that they face reduced work opportunities and lower earning potential.

The way to reverse this trend is to increase demand for the qualification through establishing a sound commercial understanding of what the profession can offer and increasing brand awareness worldwide.

When speaking to IBCLCs online, I have regularly found the conversation drifting towards discussions around the “fairness” of IBCLC pay and the perceived lack of understanding of the IBCLC qualification, both from other health care professionals and by mothers in the community.  Recently, one such thread prompted me to think about the situation in more detail.

As a 100% breastfeeding supporter, I understand at least some of the frustrations.  I want heath care systems to understand that we need experts in this field and to pay for it appropriately. In short, I want to be out of a “job”, replaced by somebody with way more expertise, who gets paid.

The only way to achieve high-quality paid support is to increase demand for the best.  It is not through breastfeeding professionals arguing that their pay is poor or that less well qualified supporters charge too much, as all too often happens on the threads.

Why does demand matter?

It is worth taking a brief look at the economic “price-supply-demand” model.  Basically, it says that, in a market economy, price can only be high if demand outstrips supply. You cannot increase demand by increasing price BUT you can increase price if you increase demand (relative to supply).

This clearly doesn’t work when mothers are paying out of pocket (nor would we want it to) however, we have the scope here to move away from “patient payment” and into a situation where support is a “covered service”. This has potential to work however your health service is funded.

How can demand be generated?

The only way to make the medical profession sit up and listen and start demanding your services is to hit them in their pockets – or, in this case, to demonstrate how NOT using you is hitting their pockets.

At the end of the day, purchasing and pricing are commercial decisions. Customers (insurance companies/governments etc) are unlikely to buy your services if they can’t see the value to them of doing so.  Perception of value is as important here as value itself.  If a product is not marketed well, then it will not be perceived as having high value irrespective of the numbers.

You, as IBCLCs, along with the organizations that surround your profession, are the only ones who can market you and your skills. This may seem uncomfortable but it is the way the world works.

What can be done?

So far, we have established that IBCLCs need to market themselves better in order to increase demand and to be able to demonstrate the financial value of their service.

If members are really serious about improving pay and respect for the profession, it is time to increase the expectation placed on the International Board of Lactation Consultant Examiners (IBLCE) etc., in terms what they do for the profession and how they market it.

IBLCE is key to this situation as they have the greatest interest in making “Brand IBCLC” a success.  They are financially invested in it and need to see service growth in order to support that investment. In addition, they have a commercial interest in maintaining the standing of the qualification – If they don’t, then you might not renew.

So, what might you ask of IBCLE?

There are some basic questions that it would be worth asking IBCLE that focus specifically on marketing and brand awareness. These may include:

What are they doing to improve perceptions of the brand?
How are they affecting purchasing decisions within your health system?
How do they plan to do this in the future?
What is their plan for expansion for the next 10-20 years?
What do they see the long term aim for the organization to be?
Are those long term aims centered around increasing appreciation and use of the specialism?
Are the aims based “on the ground” or are they wooly?
What information are IBLCE giving you so that you are able to better market yourself locally?

Looking locally

Perhaps it is also time to take a look at what you are doing locally to demand greater respect for the profession, and what you are doing to earn that respect. Are you lobbying your local hospitals? Are you actively campaigning for recognition or carrying out research? Are you demonstrating your worth at every possible occasion?

All feeling too commercial?

A lot of this is fairly basic business sense and I think this makes many IBCLCs shy away from discussing it.  There is a strong cultural feeling that kind and caring people shouldn’t like talking about commerce, however, the business aspects of this really do need discussing for everyone’s benefit.

Many people working in similar caring professions have managed to find a way to do this.  Indeed, some time ago I worked for an examination board (educational) where we routinely asked similar questions in order to try and increase the uptake of our service. Just because we spent some time thinking commercially, it didn’t mean we didn’t care.

We work within commercial health care systems. We have to play the game or we will be out competed.

Cathey Horsfall is a trainee Breastfeeding Counsellor with the Association of Breastfeeding Mothers, UK.  She has two children under four and holds an eclectic set of qualifications including a B.ed (Hons) and a post graduate business qualification from Cambridge University, UK. She has spent the last ten years working in commercial organisations where the importance of good marketing and brand awareness were felt very keenly.  Most recently, she has written for a large UK public relations company, giving her a strong understanding of just how important it is to actively lobby and constantly ensure that potential customers are exposed the skill and strengths possessed.


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