68 | Finding and designing your dream office with Katy Linda, IBCLC

Leah: Well, hi there, Annie.

Annie: Hey there, Leah, how are you?

Leah: I'm doing great. How about you?

Annie: I am doing great. I am super excited because we are getting ready. Tomorrow we're going to be joined by Shondra Mattos, IBCLC for our deeper dive into marketing, business strategy, and SEO and all the things that are inside Shondra’s amazing brain that I can't wait for her to drop upon us. Then our next deeper dive is coming up really soon after that on May 11th. We've got Rachael O'Brien coming in to do a deeper dive on educating families about bottles. I am also super excited about that because that will be kicking off the Clinical Complexities and Supplementing Babies Conference that is happening live in May and June and our special awesome guests today, Katie Linda, IBCLC is one of our speakers for that conference on supporting second-time families when supplementation is indicated. So we have her here today. Leah, what are we here to talk to Katie about.

Leah: I'm excited to have Katie because I know that she worked really hard to create an office space that she loves and it was a big journey. I know Annie and I both know Katie and kind of got to see her through this journey a little bit with posts and questions and things on our kind of social network. So it's really fun to have you here today, Katie, welcome to the podcast.

Katy: Thanks. Thanks for having me. I'm super excited.

Annie: When I was in Baltimore in February visiting my parents and I like to see what I'm down there, which it had been a while because I hadn't been down there much because of COVID. I was like, I want to see your office, Katie, have gotta see your office. Then I met you down there and my jaw was on the floor. It was a magnificent space, just being in there. It had such a great energy and a great vibe and all your people were there. It was just, I was like Katie is living the dream. We would love to start out by asking you, Katie, what led you to seek out getting an office space in the first place?

Katy: Years and years ago, I remember being at a conference and someone was talking about the breastfeeding center in DC. I didn't know that existed even though it was only an hour from me. But I was a brand new IBCLC and I was like, oh, this is really cool to have a breastfeeding center where there are people and classes and community. I thought that was a great concept. At that point decided that I was going to have something like that in Baltimore. My first step was to register a bunch of domain names so that I was ready when I was ready. But that was about as far as I got at that point because I was still building my practice and I was still having babies. It was just more of an undertaking than I was ready for it that time. Years later, I went to a different conference and came home like on fire. I have to do all these things and help all these babies and help all these parents and I need a space. So I set myself out a timeline of when that would happen and what it would look like, where would it be? So I kind of picked the side of town I wanted on, I set the timeline up, and as that time approached, everything was really going fine with home visits, and I wasn't sure I really wanted to add on that extra expense of having an office. Because rent is a lot and internet and electricity and all the supplies, I mean it's a lot. So kind of backburner that for a couple more months and then COVID hit. Then I realized that COVID wasn't going anywhere. But I always was uncomfortable with flu season and germs and I remember even talking to my dentist at one point being like, I don't know how you guys even do this with people being sick. I have a hard time going from house to house during flu season. I'm holding these babies, do I change my clothes? How do I keep these families safe from all these germs that come from other homes? Then COVID just made that exponential and I realized by August of 2020, that this was just not sustainable. I could not see multiple families in a day and take germs from one house to the next and everybody had different levels of concern. So after being at one home visit where I realized that like, this was it. I went home that night and started looking for office spaces.

Leah: Oh, wow. It's like all the things that have come out of COVID. Katie wanted this amazing office space was pushed forward because have COVID.

Katy: It really was, I mean, it was always my dream. I just didn't have the kick in the butt to spend the money on it.

Leah: And COVID knows how to kick people in the butt, let me just tell you. That's its specialty.

Katy: So I went home that night and searched Craigslist. Then I found a space I thought was gonna be amazing and I sent it to all my friends, like, look at this, look at this. I went and I saw it, and I really liked it. I was ready to sign the lease, my husband was like, you should see some other offices. And I was like, but this one's perfect. He was like, you should see some other offices too. There's not a lack of real estate out there, especially right now. And I was like, but I can afford this one. He was like, Katie. So I reached out about another office and the response back was, well, that place is leased but I have another space I'd like to show you. I was like, I cannot afford that other space. He's like, let me just show you the space and so that's how I found our office.

Leah: Oh, wow. It's so funny how you look back and you're like, you see how the pieces are falling together but you're like, why did it have to be so much push and shove and pull? Like I had to be persuaded to do this. It's like, wouldn't life be so much easier if we let the river just take us down the road? But no, we have to bump into all the rocks along the way. So if you were going to be kind of coaching a new LC, maybe in a similar situation that's like, yeah, I think I want to think about an office space, what's something now that you can look back and say like, what would be a first step, like the first first first thing to consider before you are out there looking for office spaces? I mean, because I hear you saying like, I can't afford that. I mean, that might be something to consider. But what do you think looking back would like I should have considered X first.

Katy: Because I have been thinking about this for so many years I think the biggest thing to consider that I've seen other people make mistakes with is accessibility. Are there stairs? Is there a handicapped entrance? What is parking like? How close is it to the highway or other major thoroughfares? If you live in a major city where's the closest mass transit? Who is your ideal clientele and how is it gonna get to you?

Leah: Those are so many good questions to ask and consider because I feel like accessibility and ease of getting to you is a huge marketing piece. If parents think, oh my gosh, I've got a drive around town to this unfamiliar area and roads I've never heard of and the parking is three blocks away. Then I've got to pay for it. I mean, there's so many things that we really have to think about, especially in big cities, where like you said, people might not have a car and they might need to take public transportation to get to you. I think that's such a smart thing to think about because I think probably a lot of people's first thing you think about is like, the space is pretty and the lighting is nice. I could put a couch right here and people could do laidback breastfeeding on this one. It's like that might be the first things are pr like, oh, it has space I could teach a class or something like that. But before all that can happen, people gotta get to you. They gotta get in the door. I love that you brought that up because I think that's something that we just don't think about as much because we're looking at the actual physical space that we're in.

Annie: That's definitely something that I thought about because I just started in an office. I'm like it is steps away from the train and I know there are parking garages because that is like the whole point is like, for me, it wasn't so much about the COVID stuff and not wanting, it was more like I want to make it easy for people to choose the office. I was lucky that the office that I'm in it's on the ground floor, you walk right in. It had been a doctor's office previously, so they already had this full filtration system built into the HBC, it was amazing. They're like yeah, it is just all a filter, this whole thing, so that was really cool. I'm sub renting from homebirth midwives who are renting from a massage acupuncture place, which is a very cool synergy. I mean, I definitely was like and it's so pretty, but like not as pretty as Katie's office because I don't know that anything could be. I want to have Katie describe for us what her office looks like, what the layout is. I can tell you like from driving up like I drove up. She gave me parking directions. She had a great little automated text that was like if you're in this lot, you're gonna go this way and if you're in this lot, you're gonna go this way. You're gonna take this elevator, walk to the end of the hallway, like it was all step by step. Honestly, I needed that because it's one of those office complexes that has like, you can maybe not even find the door sometimes.

Katy: It all looks the same.

Annie: It was a little intimidating and there's not like a main door person, front desk reception area for the whole building. So I got in the elevator, I walked up and I opened the door and I was like, there's a waiting room. There's the little place where the person is. So tell us about you've got the waiting room, and you've got the reception area, tell us about the different treatment rooms that you have, and also that common space. Then I have a follow-up question for you about, I want to hear who's in the space with you.

Katy: Alright, so we have our waiting room, which we honestly don't use very much at this point because I don't want there to be a ton of people sitting around and waiting for us. But we did make some changes to the layout of the space, it had been a nephrologist's office years ago. So the way that they set up the office was very much small exam rooms and big doctor's offices. A lot of building space that we just didn't need. So we hadn't actually tear out all the desks in their administrative billing area and made that a nice big open room. We hung a TV on the wall in there so that we could do classes and support groups in that space, which I hope we're gonna bring back this summer. I hope that we are on the back end of this pandemic. I mean, it might be a safe choice again, fingers crossed on that one. We use that space as our weighing the babies, changing the babies, and doing the infant exam because I'd really love to get moms up and moving and change pace a little bit. It's really cool when moms see each other and can say, oh, I remember that stage, look at that itty bitty little brand new baby, here's where we are now. It's like that nod back to my Le Leche roots getting those connections of parents in different stages, where they can connect and support each other. We've even had people that ran into friends who didn't know they're both there. Then they're like, oh hey, how are you? Oh, you had the baby, congratulations. They had no idea they were going to run into someone they actually knew but it's super helpful. So I just love getting that movement into the visit. So we weigh the babies, we changed the babies and we do the exam out in the big common space. Then we have three smaller rooms. They're not small rooms. They are what the doctors previously had used as their offices and those are our main exam rooms. One we sublet out to somebody else who I guess we'll get to in a little bit. Rhen the other two are lactation rooms and those have couches that are nice and deep so you can do a sideline nursing position. They're also six feet long, so you can lay down on them. They are from IKEA. So they pull out into a futon if you needed to make them a bed, which I mean realistically. We have a little side table with some affirmations that I found on Etsy to encourage parents and we keep nursing pillows in each room, regular bed pillows we keep out underneath the scale, and we pull those as needed as well. We've got tissues and sanitizer and plants in each room. That was me on Google searching what plants were best for cleaning the air as we were setting up before vaccines were available for most people. Then the air purifiers because again, like pandemic and also babies and I don't think we'll ever get rid of the air purifiers even when we don't technically need them anymore. We have a rolling desk that can be used that we used to chart on. Some of my team likes to put it across like a real desk. I just use the corners of my laptop on because I don't like a barrier between me and the family. We'll pull in chairs as needed for another parent or their support person or our interns. If it looks a little cart full of like teaching tools and items that we might just need to quickly grab during the visit. So we keep the rooms fairly well stocked but we do have all the other supplies out in like the main storage areas. Then we have one bigger room that has just some chairs and a massage table set up in there that gets used for a variety of purposes, not mostly lactation, but others things that we provide for parents and we use it for lactation if we need to. It has like a nice double, one half times wide rocking chair that a lot of parents really love but doesn't quite fit two people on that chair so then it comes like a little awkward with the seating. So yeah, we've got a storage room and a bathroom because the bathroom was kind of a really important thing for me.

Leah: Yeah, you gotta have a good bathroom that moms feel comfortable. They're already uncomfortable in so many ways, it's nice to have a good space that they can go and use and feel comfortable in.

Katy: Obviously, we need to sink to wash our hands. We ended up with three of those, thankfully.

Leah: Are they in the rooms or are they in your common space?

Katy: There's one obvious in the bathroom and then one is in our biggest exam room, which realistically, that had been two rooms. We knocked down a wall to make it a big exam room. It had been like a lunchroom and an office for the old providers but we decided that we really needed at least one room with a sink in it for long-term growth. Then because it already was a physician's office before we got there, there is like, what I call the lab area, where you process urinalysis and things like that and there's a sink in that area as well.

Leah: Nice. Sounds like a great setup.

Katy: It really is. When when we were looking at spaces within this building, the realtor was like, we can put a sink in anywhere but a bathroom cost $20,000. I was like, well, find me a bathroom because I'm not having parents walk who knows how far to the bathroom.

Leah: Yeah, outside of your space?

Katy: What does that even look like? Certainly, not everyone's going to be as fortunate and luck into a space that has a toilet. We had some problems with the toilet when we first moved in and the maintenance guy was like what least the bathrooms are right outside. I was like, yeah, but like you have parents who just gave birth, and are they going to hold it and risk a UTI or something? Are they going to leave their newborn with a stranger?

Leah: Yes!

Katy: Or are they going to take their baby into a gross public restroom? I know the bathrooms the building are clean and they're well cared for but it's still a public restroom and it's still your brand new baby.

Leah: Yeah, I'm so grateful in our office space, like literally, you open the door, and the bathroom is right across the hall. So parents are often like, can leave their baby right there and literally could hear everything. So it's super nice. I am so grateful that we have that bathroom kind of closed off in our little space right next to our exam rooms. Because I do feel so bad for parents, like, what do I do? It's like, those first times I know I did this like you're out at the doctor's office, you're like, I've got my baby, and I gotta go to the bathroom. What do you do? How do you make it through that? Especially because I used to baby were so that I'm like, oh, I got the baby on my body, can I go to the bathroom? I have to work that out. So that's awesome that you were able to look upon a space like that like that's a real value to it. Are there other like, and I know we're gonna get into other providers that you have in your space, but I was just curious as you've worked through and had people come through and been in the space for a while, like some kind of high-level design tips to consider. Obviously, we talked about the bathroom is a great design tip. Is there anything else that kind of stands out, like yeah, we actually change this because it works so much better to do it this way, or something that you put into place that you really like that feels like a good design tip? You're gonna give it to somebody else.

Katy: The flooring was really important to me. They were like, what carpet do you want? I was like, no, no, no carpet, please. We have breast milk and we have spit-up. I told the story a couple of times now, we had a family who the new dad put the diaper on and it wasn't quite on well. So mom finished nursing the baby and he's like, what is that on your, oh my god, and there was poop coming out of the diaper all over mom. He picks up the baby and he carries the baby to the changing table and it's like poop dripping the whole way. I am dying like this is hilarious. I am cracking up, dad is mortified, and mom is mortified. It's a wipeable floor, no big deal. Let me grab a cabbie wipe and a tissue and I'll get the dirt up and then I'll get the germs up and this is totally fine. I can only imagine if we had had carpet.

Leah: How much cleaning would have been involved? I know one of the things that we searched long and hard for was wipeable couches so they're faux leather. But that has saved us from all the things poop, milk, spit-up, everything has been on that couch.

Katy: The ones that my husband really liked, were also faux leather because I was at IKEA. I knew what I needed but they had buttons. He's like but they're so attractive and I was like, that's gonna gather spit-up and poop, no.

Leah: That is such a good, good thing. I think your design tip, I just want to point out about like maybe creating some kind of common space, maybe beyond a waiting room, but some common space that people might be passing each other or having some interactions, I think that was something else to highlight that you have found to be really valuable.

Katy: That movement helps with the learning. I mean, it was one of the things that I learned years ago, when I was working on my prenatal breastfeeding class and even my pumping class, I actually had someone reach out to me after they had a not so great prenatal class that they took, and they were education designer at a college. They were like, let me talk to you about how to make your classes better because I was really disappointed with the class I took elsewhere. One of the things that she really talked about was the amount of movement that helps you learn and retain information. If you're just sitting and it's monotonous, you're not going to retain all of that. So moving around, helps people retain the information.

Leah: That's really interesting, that's a really good tip for all of us, not just about building the space out, but like even when you do your classes, don't forget about this piece of adult learning that is just so valuable. We have a similar setup in that, like, we have our scale and everything outside of the exam rooms and I do love it. Again, it kind of breaks up the visit. So we're moving and I don't know, it just feels better than if it was all kind of we're sitting in this enclosed space, which they're big, but they're not huge rooms for such a long time. It's like that in and out and get everybody up and moving. It's nice, I can pull the partner in to be like, okay, take a break parent, we're gonna go and weigh the baby. I've really found it to be such a valuable way to set up those rooms where you don't have the scale in the room with you. I'm sure there's plenty of pros about that as well but that communal space feels really nice. Our waiting space, we get a lot of cross-traffic because we're in a pediatric office and the amount of like, I walk in there, and they're all like communing over, like oh my gosh, we were just there, like you're gonna make it everything's fine. I just love it so much because I'm like, thank you for showing this parent-to-parent support just feels so good. I love that you're also seeing that in your space, too.

Katy: It's so important.

Leah: Yes, it is and we forget about that. During the pandemic, for a long time, we didn't have anybody in waiting rooms, but we're just now getting that back and it's just been warming my heart. Almost every time I go to pick up my client, they're having a sweet conversation with the parent next to them, encouraging them.

Annie: You also did something design-wise that was really about that sense of community that both of you are talking about, you have a very special piece of art in your main area. Can you tell us about it?

Katy: Yeah. So as I was dreaming of my space years ago, I actually applied for a program in different parts of town where they were giving you the first year free rent to kind of revitalize his neighborhood. So I started like really drawing out my thoughts and dreams at that point of what the space would look like. One of my foundational pieces was the arts. Lauren Turner is a local doula birth advocate and artists and so I knew that I really wanted Lauren's art in our waiting room to really kind of showcase black maternal health to help moms feel like they were welcome in our space. It's really been a conversation point for a lot of families as they come in, and they see the bodies that look like theirs. They feel welcome and accepted. It's really powerful and meaningful to me that we're able to support a local artists and a local mom, but also have art that depicts what we're about in the space. So there's like some pregnant bellies. There's a person using an SNS, there's a nursing mom, and like this beautiful pink gown. There's five pieces of main art in the waiting room that all kind of depict that piece of art but from a woman of color perspective. Then I just commissioned a new piece that I have yet to hang but it's going to be, it is amazing. I'm super duper excited about that is people from all kinds of backgrounds, and different ways of feeding their babies and babywearing and bottle feeding and breastfeeding and music and SNS. There is a masculine presenting parent chestfeeding the baby. There are moms with head coverings, and there is a parent in a wheelchair and just really trying to encompass the foundation of what we're about is supporting all families and meeting families where they are and not having an, I don't want to say open bias, but trying to work within our biases to serve all the families that need us because we all have some biases, but trying to kind of backburner that to make sure that we are being the best that we can be for the families who need our support.

Annie: I love that. If you're listening may have be familiar with Lauren Turner's artwork, and you just don't know it. It's being featured on the cover of USLCA's journal this year, all their covers are artwork by Lauren Turner. So I think you will see it and this piece, I've seen your pictures of this piece, and we'll try to get it for people watching to see how it's really beautiful and can tell the love that went into it not just from like, it wasn't commissioned just to be like a piece of corporate art. There was a dream behind it and it was a dream that you incubated so many years ago. I also love that it's a local artist, that's somebody from your community. There's so much meaning and so many layers there and back to the other providers that are in your office because that is how you have this dream of not just providing lactation, but really supporting the birthing families in Baltimore. So tell us about who else is working with you.

Katy: I knew that when we had an office, I was gonna need to have something, some reason to come to us, instead of us going to families. I felt like there needs to be some big difference. So at the point, we were in the office, there were two of us., We were two IBCLCs and we needed a bigger space, obviously the two of us doing visits, but I needed to also bring in some other team members. So at the time, there was a birth center that had unfortunately just closed. I knew that several other midwives were not working anywhere else yet so I reached out to one and I was like, listen, I've got this dream. I'm about to sign this lease, I'm looking for spaces. Here's what I'm thinking, will you walk this journey with me and kind of figure out what this is going to end up being. She said I love your passion. I love your ideas. I don't know, this is a long-term plan for me because I do want to go back to doing births. But I would love to help you get this started and figure out what the job really looks like. So, Melissa join me and we went through the path of figuring out how to set up a clinic where we had a nurse-midwife as our medical director, so to speak. I live in a state where an NP of any sort whether it's a CNM, a family nurse practitioner, or any other of the specialized nurse practitioner roles are independent providers. They do not need a physician's oversight to operate. So with our nurse-midwife, we are able to be a network with all the major insurances. That allows us to bill for our lactation visits. We can also use her skills to better support the community. So Melissa had a passion for helping support families through family planning, through postpartum and just kind of helping moms get a handle on how to handle postpartum. When it was time for her to transition, we hired a midwife who has her postpartum mental health certification and is actually finishing up her clinical for her psych NP as well. So Helen is able to talk to families, talk to parents, kind of help them manage how they're feeling postpartum, prescribe meds if that's acceptable or not acceptable if that's the right choice for that situation. She can also order labs, if we need to order labs from a milk supply standpoint or from a mental health standpoint, we do a lot of like, how is your vitamin D and how was your thyroid? If those are off you're not going to feel good. So it really gives us this well-rounded ability to order labs, to prescribe medications when that's the right answer for the family, and to be able to bill insurance in that setting for the lactation as well as the mental health and some breastfeeding medicine stuff as well.

Leah: That's so awesome. I love that you really saw this need and you figured out how to fill it and pulled in the right people to make that happen. I think that's so neat and it's really great to hear how that allowed you to reach more families and also became a draw to have families come to you. Because I know it's always a little scary going into the office because you're thinking, everybody's not going to, they want to keep the home visits. They're not gonna want to come see me. I feel like I need to coax them in like, I promise you'll love my office, just give it a try. But you figured out a way that like, hey, it just makes sense to come to the office, it just makes sense. This is why from many different aspects of that but I think that's really neat that you kind of figured out a way that's what we always do. We're figuring out a way around, work around the situation. So our last kind of wrap-up question we can do really quickly is just, if you could go back in time, and maybe whisper something in the ear of past Katie, just some piece of wisdom or advice or like, hey, just chill out, it's fine. What would be like, if you went back and looked back, what would be the thing that you would whisper in past Katie's ear?

Katy: I think there are two things. One is that the bureaucracy takes way longer than you expect so start on the paperwork side of things way earlier. I waited till I had keys in hand to work on getting malpractice insurance that covered the midwife because I thought I need the physical address first, and I really didn't. I didn't need to have that. I did not realize that that was going to be a humongous piece. That took months, it was months of us just with our lactation liability seeing families while I paid the midwife to do paperwork for us because she couldn't actually do anything. So that was like three months we wasted honestly, that we should have started earlier and gotten that taken care of. Then we also could have started on the insurance credentialing earlier. But I again thought we need a physical address for that and I thought that the malpractice insurance would take the same like 90 seconds it does for lactation. I had no idea. So it was really like six to eight months of us being in that office before we were really set up, which was definitely a financial strain. Because paying the bills when you don't have the money coming in is really, really challenging. I highly recommend doing as much of the paperwork ahead of time as you possibly can and hire an admin before you actually need one. When you wait until you are up to your eyeballs in paperwork and losing your mind, you don't have the bandwidth to make that happen. So bringing your team on, as you start to think that maybe you might need somebody else. It's a much better bet than waiting until you are at your breaking point and need somebody else. Because you'll have more time to choose the right person and you'll also have the time to get them settled in the role well, versus waiting till you're drowning and surrounding yourself with good people. Find the right team that shares your same common goals of whatever those are right. For us, it was making sure that we were providing an inclusive space. I mean, we even went as far as changing the business name, to make sure that our name was inclusive when we opened. So just make sure that you're finding people who are going to support those same common goals that you have, which is obviously easier when you have time versus scrambling.

Annie: I mean, I think that's good advice with or without an office. Things usually take longer than you think they're going to, surround yourself with the right aligned people, have a vision, and really stick to it. I love all this advice that you're giving. I'm super intrigued and inspired by just what you've done. It really is. I don't know because sometimes it's hard to see when you're on the inside of it, like the way you are doing your business every day. But from the outside, it really is incredible. It's a great thing that you're doing and I hope that people listening can be inspired by what you've done and dream those dreams and visions.

Katy: And dream big. I mean, we took a space on that realistically was bigger than I thought I needed. I was like there's no way I need this whole space. The other space I looked at originally had two exam rooms, a waiting room, a reception area, and then a bigger meeting room. Honestly, we would have already outgrown that space. But in the process of going do I really need space this big? Oh, what am I going to do with all this space? I had a physical therapist who specializes in pelvic health reached out to me and say, hey, I need an office because the clinic I'm working in is just too open. We've got to shut the whole place down if I have a pelvic PT patient, do you have anyone looking to sublet? I was like well actually, I'm about to sign the lease, let's talk. And so that really gave me the confidence that with that part of the rent taking care of because she was gonna take on that room, it was less scary for me. So think about long term, when you're signing a corporate lease that's going to be multiple, multiple years. Think about what other businesses you can bring in, what other services you can offer to really kind of make it a well-rounded space to make sure that families are getting as much support as possible in one location, which is going to then just build upon. Our PT gets referrals from us, we get referrals from her. She does ultrasound therapy for clogged ducts, which is super amazing. She knows how important it is because she sees the day in day out. So she often will squeeze them the next day for us when needed. So having those other supportive collaborative businesses on-site can be really, really powerful and making sure that families have access to the care and support they need all in one place. It's easy to get to when it's all together and it's comfortable and accessible.

Annie: So amazing. Katie, it has been awesome having you on the podcast today and I just want to invite all of you to come to our next deeper dives. Sign up for Clinical Complexities and Supplementing Babies and you'll get the deeper dive in May with Rachel O'Brien about educating families about bottles. You'll get to hear Katie talk about how to support families when they're having their next baby number two, baby number three, baby number eight. Katie is putting together a great presentation for us about that. And until next time, thank you so much, Katie and Leah. It was always great podcasting with you.

Leah: Thank you, Katie.

Katy: Thanks for having me guys.

Annie: Bye.

Leah: Bye.