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Starting Over, NOT from Scratch in lactation private practice.

Updated: Sep 8, 2023


Starting a private lactation practice and

rebranding it has been great for me personally. I've had to learn website development and search engine optimization, insurance billing, communication and counseling skills. It has kept me up at night, stretched my middle aged brain, and made me feel certain that I can do hard things.


I am writing this during the summer of 2023 when I am rebranding and building a new clientele. Having built my


practice on seeing Tricare beneficiaries for 5 years before renting space in an office, things were looking great in. 2022. Everything changed within 7 months! That sublease's business dissolved, and TriCare started a pilot program which made billing more complicated = 76 unpaid visits in 2022. If you're curious about my story, check out my bio : ABOUT ME.


I determined in 2017 that I either needed to stop practicing lactation or work for myself. I had been working for Mamas & Milk where I lead support group every other week plus saw a rare client and taught Yoga when Dawn was out of town. Once I got credentialed with TriCare in late 2016, I was seeing clients in her office more regularly. The documentation took me at least an hour after each visit. That's too much. It was partly the triple system we were using, partly my steep learning curve, and also my perfectionism. I had to face the absurdity of being the billing provider who then paid the business I work for once I filed my taxes that year. Since I was dead against renting an office and starting a business and marketing, I was considering stopping it all together. Then I realized that what TriCare reimbursed was more than I had made from any visit, ever.


That became my niche: seeing TriCare clients in their home. No one else in San Diego was doing that. Plenty of us do it for a travel fee plus the fee for service, now. I lucked out in connecting with Maria Provincher who was getting Operation Doula off the ground. Having a close friend introduce me to the head of the lactation department at the the Naval Hospital got me on their resource list. Within a few months, I was slammed with work and it was not good for my well being. Read More



Boundaries and purposeful communication: will save you time, money, headaches etc... Get in touch with your own needs and decide how you will be available to clients. Decide how much of your time will be dedicated to your business. Plan when you will offer free advice and support, and stick with it. That's impossible until you develop systems that support you. Annie Frisbie has tools to get you started with a comprehensive set of templates. They are the foundation of my systems, adapted to our needs at Tailored Lactation. My best advice is to set up a website and EHR system which can answer common questions for potential clients, and allow them to book a visit and complete the intake in the middle of the night and without your input. Invest time and attention into developing a workflow which requires less than 20 minutes of processing for the typical visit.


Develop a niche, but also diversify your business. My schedule was booked out more than a week with Tricare clients.


People looking for care move on when you aren't available soon. Being the go-to Tricare lactation consultant became part of my identity, which is why it took several months of being paid for about half of my visits before deciding to stop participating in billing. I still offer a massive discount because the population means a great deal to me. Now I'm networking and slowly building out of network and TLN clientele. It feels like starting over, but it's


not from scratch because of the experience and connections made over the past decade. Here I am doing things I didn't want to do. It's growing on me. As it turns out, birth workers are my people, and I've enjoyed myself in their company.


Develop a sense of the population, location, subject matter, etc... that you naturally enjoy. That's your niche. We are always better at tasks that we enjoy, and as you gain more experience, you continue to get better. My best advice is that you notice when you start to feel like your niche becomes tied to your identity, or that you are exclusively working within your niche. Mix it up. Consider collaborating with providers from a space outside your comfort zone.


What's in a name? I wish that I had named my business not personalized to me.  Marks Lactation Support only makes sense to a potential client who is specifically looking for Carly Marks.

Logos from 2023, 2019,2018 respectively.



Rebranding is like moving across country, whereas you declutter and update everything that matters , but it's exhausting. My best advice is that you do not accept any limitations within your business name:

My thoughts were "I never want to work for or with anyone else, and I never want to manage a brick and mortar office" Of course, that all changed and my business name didn't fit anymore.


I hope that I've offered some workable advice and if you are interested in learning some shortcuts, seriously: Annie Frisbie has all things to get started. I worked with

Marcia Wall, a career coach in May 2023 to help me sort out my goals and what had been holding me back. Not to oversell it, but 1 session brought me enough clarity to make the moves I needed and let go of ideas that would not serve me.


I offer coaching sessions, too. We can talk about using WIX website building and SEO, developing boundaries, setting up and using google workspace for communication and as EHR, etc... I'm an open book. If you like something you see, I'll explain exactly how I got it done all while taking good care of my body, mind and family.
















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