Why I use Spruce as my phone service for my lactation practice

Hi I got your number from our hospital, we just had a baby on Tuesday and I don’t have enough milk, we are supplementing with formula. Can you come to my house today?
Desperate New Parent, 2:39am

If you’re a lactation consultant, you’ve totally gotten this text.

How about this one?

Hi Annie, I thought things were going really well since our visit but now she’s started biting me again. What should I do?
Current client, sent at 9pm

The tyranny of text messaging

I’m old enough to remember when you didn’t call anyone after 9pm unless someone was heading to the hospital. And when my husband started texting me because he got a smartphone, I used to find it super annoying because I only had the keypad and writing replies took a hundred years.

That feels like ancient history to me. Now, texting has replaced phone and even email, especially among new parents and even more especially among millennials.

Along with this technology has come a breakdown in communication etiquette. It used to be that we all had a hold to a community standard for when it was OK to make a phone call. You didn’t call someone late at night because you didn’t want to be woken up by the loud noise of your own phone ringing unless it was an actual emergency. Or you had made prior plans to call your best friend at 11:01 as soon as the long distance rates went down.

Now, however, the expectation has shifted from community standard to personal responsibility. Don’t want to be woken up by a phone call or text or breaking news from Yahoo news or an alert from your calendar? Put your phone on silent, or activate Do Not Disturb, or turn the dang thing off. Because we have control over how we receive notifications, the tide has shifted and it’s now become generally acceptable that you can send texts at any hour of the day or night. If the recipient didn’t want to be woken up, they should’ve turned their phone off.

(By the way, you might want to reconsider sleeping with your phone.)

Setting limits with a second line

You could, theoretically, run all of your communications, personal and business, through one phone number. If you’re just starting out and have a low volume of clients, you may not yet see why this can be a problem. Once you start carrying a larger client load, you’ll feel a lot more organized if you have a second business line.

The simplest way to do this is to get a second phone with its own cell phone carrier plan, that you can turn off after hours. This is truly best practices but can be an expensive option.

With a smartphone, you have access to services that use VoIP technology. That stands for Voice over Internet Protocol, meaning communications do not travel over the traditional telecom network, but rather travel over the internet.

VoIP is often a much less expensive option than a traditional phone service plan, and many of these services can be accessed by an app on your phone. This enables you to distinguish between personal and business communications quickly and easily, because they are being handled by different apps on your phone.

You can also set your business phone to go straight to voicemail, a workflow hack I strongly recommend. That way, if your phone actually rings, it’s either a personal call or one of those SCAM LIKELY calls I get seven times a day despite being on the Do Not Call list.

Once you have yourself organized, you can document all of your boundaries and decisions in your Policies and Procedures manual.

Privacy concerns with client communications

If someone is not your client, you probably don’t have to worry about privacy concerns. In the US, HIPAA only applies to your actual clients.

For client communications, however, we do want to make sure that we’re keeping our privacy act together. I love this article as a great starting point, and I also offer a guide to Secure Messaging so you can understand why not all second line services are appropriate for clinical use.

It’s imperative that we be mindful of how our technology protects our client privacy, as that’s one of the tenets of the IBLCE Code of Professional Conduct. Your obligation to privacy may even supersede what’s legally allowable in the country where you’re practicing.

Why I love Spruce

I’ve been using Spruce for the better part of a year now and I have been extremely pleased with how well it’s performed for me and met my specific practice needs.

  • I was able to port my business number over from my old service with very little downtime

  • I can set calls coming in to my business number to go straight to voicemail

  • I can access my texts and voicemails from my desktop computer

  • I can set up a vacation auto-responder

  • Nobody needs to have the Spruce app to send me regular, non-secure texts to my business number. On the client and potential client side, they are just using their regular texting app to reach me

  • If clients want to use secure messaging through Spruce, they can download the free Spruce app, which takes up very little space on their phone

  • The app opens with thumb ID, no need to remember the crazy complicated unique password I set for it

  • I can maintain my own contact list inside Spruce that does not connect to my regular, personal (and highly non-secure) address book

  • Spruce can pull from my address book if I want to use Spruce to text or call someone that I’ve stored there

  • Customer service is easily accessed directly from the app, and I’ve found them to be responsive and helpful

  • If I were in a group practice, I could set up a team

  • You can send PDFs and images easily through Spruce

  • Spruce lets you offer video consults through their secure platform

What I wish Spruce did better

  • Spruce keeps contact info with conversations, rather than in an address book, so it takes some extra steps to find a client you’ve archived. I keep the conversations with my active clients sitting in my Spruce inbox so they’re easily accessible

  • I wish the app would switch to landscape mode on my iPad. At least I’ve gotten good at typing sideways

  • While I’m glad that the Spruce app does not display message text on my lock screen (huge privacy feature), I do wish that it would give me message text if I unlock my phone (like Inbox does). That way I can see if someone is responding “OK” to an “I’m not available, try this person” text or if it’s a current client whose message I’d want to see right away

I do offer a communications services comparison chart that shows you the pros and cons of a bunch of different services. As for me, Spruce has been a winner and worth the monthly fee for the way it protects privacy and makes my work life easier. Mention me and we’ll both get a free month. And here’s me on the Spruce blog talking more about how I use Spruce in my clinical practice.



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About the Author

Annie Frisbie, MA, IBCLC is the creator of the IBCLC Private Practice Essential Toolkit, a collection of books, resources, legal forms, training manuals, and workbooks aimed at helping private practice lactation consultants build a private practice that’s ethical, profitable, sustainable, and enjoyable.