Doctor/lawyer synergy improves healthcare outcomes
Partnerships help avoid interruptions in services
Across the nation, healthcare organizations are discovering that collaborative care transcends the medical discipline. Patients often experience “upstream” legal problems that can later adversely affect their health. That’s why there’s a dramatic increase in the number of medical-legal partnerships (MLPs), where legal professionals work closely with providers to identify and resolve these issues.
“The legal partners come from the ranks of legal aid organizations, law clinics and bar associations – and the medical partners are often academic hospitals, community health centers and even public health departments,” said Megan Sandel, MD, interim executive director of the National Center for Medical Legal Partnership in Boston, a nonprofit group that helps MLPs get launched. “An MLP is not just a referral system; it’s an integrated partnership. Most MLPs have a memo of understanding between the two parties, such as pursuing only civil matters and avoiding criminal issues. The focus is different in each MLP. For example, some concentrate on pro bono partnerships while others mainly do policy work.”
The Medical-Legal Partnership for Children/Dallas has two main goals: to train future providers while offering a wide array of early-intervention legal services. “Our office is onsite at Children’s Medical Center in Dallas, a private nonprofit pediatric hospital,” said Susan Schoppa, the MLP’s supervising attorney. “Being onsite makes it much easier to train providers in how to identify patients’ legal needs upstream. Otherwise, legal aid gets involved much later with the emergency room cases. By being affiliated with a teaching facility, we get the opportunity to train 100 future doctors, who can then take that knowledge with them all over the country.
Most of Schoppa’s training efforts revolve around patient income support and education.
“The majority of our cases involve wrongful termination of benefits and denial of coverage,” she said. “For example, if a physician is seeing a child with cerebral palsy, and the mother says that Medicaid has terminated physical therapy, the doctor knows to get us involved right away. Without intervention at this point, precious time is lost by having the patient go through financial counseling and re-applying for coverage. On the educational side, let’s say a mom tells the pediatrician that her child is falling behind in school. The physician requests some educational testing, but the school takes no action. So we contact the school district’s legal services division, and suddenly they decide to test that child after all.”
Schoppa adds that it’s rare for one of her cases to ever wind up in court. “If I’m providing early intervention, it’s usually not going to reach the crisis or litigation level,” she said.
So far, MLPs have been most successful in populous states like Massachusetts, New York, California and Texas. “But we’re seeing activity in just about every state,” said Leanne Ta, project coordinator at the national center. “There are strong leaders at the state and regional level who are working toward the common goal of improving the lives of vulnerable patients and families.”
