Why doctors should prescribe legal aid for their patients

medical-legal-partnerships

Dr. Alicia Turlington with attorney Randy Compton at the Kokua Kahili Valley health center in Hawaii. Credit: Robert Wood Johnson Foundation.

Ask doctors who’ve practiced in underserved communities and they can testify that what happens to their patients can hinge on the social and economic circumstances to which they return—not just the medical treatment they get at the hospital. Many of these problems bedeviling people and compromising their recovery involve legal issues in particular, whether it’s insurance red tape that bars follow-up care, substandard housing that worsens health conditions, or employers that won’t allow time off to take a sick partner or child back to the doctor.

That’s why some medical and legal professionals are teaming up in medical-legal partnerships, which integrate civil legal aid into the patient care process. There are only about 300 partnerships across the country, but they are likely to increase in number as more recognize the holistic approach demanded by the actual lived experiences of patients.

The benefits of doctors prescribing legal aid? Healthier patients and wiser use of our health care dollars. Vivid examples highlighted by the Robert Wood Johnson Foundation illustrate just how significant the impact of these cross-sector partnerships can be:

Lancaster General introduced an attorney into its care team for high-need, high-cost patients. The lawyer helps identify legal problems, supports and extends the work of the case management team, and represents patients with housing, insurance, disability, safety, and employment-related legal needs. Once legal problems were resolved, hospital admissions for these patients dropped dramatically, and costs fell 45 percent per patient.

For example, at Cincinnati Children’s Hospital Medical Center three patients were being threatened with eviction for asking their landlords to improve substandard housing conditions. Doctors there sent the patients to an on-site attorney from Legal Aid Society of Greater Cincinnati. The lawyer discovered that all three lived in buildings owned by the same landlord. By sharing data about asthma admissions and housing code violations, they were able to “hotspot” substandard housing clusters, and together helped get 19 buildings rehabbed and under new management. The reconditioned buildings did not just help those three families; they stocked the healthy housing pharmacy for more people in the community.

As one hospital administrator summed up to PBS, if done well these partnerships are a win-win for everyone:

If we can take some of these issues and reduce the number of visits to a physician, reduce the number of times that they’re going to end up in the emergency room, reduce the number of times that they’re going to have to be admitted to the hospital, that in itself will help from a standpoint of using the dollars that are going to be allocated going forward in a much more conscientious and wiser manner.

For more information, see “What’s Law Got to Do With It? How Medical-Legal Partnerships Reduce Barriers to Health,” Robert Wood Johnson Foundation (2015); “Why doctors are prescribing legal aid for patients in need,” WETA (2015); “Civil legal assistance saves money and helps people escape poverty,” Talk Poverty (2015); “Medical-Legal Partnership Helps Children East of the River,” Washington Council of Lawyers (2015); and “Medical-Legal Partnerships Pro Bono Project,” American Bar Association.