Conceptualizing interprofessional working – when a lawyer joins the healthcare mix

Abstract

Research, policy and practice in the field of interprofessional collaboration have focused on how medical, nursing, allied health and social care practitioners work together to positively impact patient care. This paper extends conceptual thinking about interprofessional practice by focusing on lawyers as part of the interprofessional mix. This attention is prompted by medical-legal partnerships (MLPs), a service model by which lawyers join health care settings to assist patients with unmet, and often health-harming, legal needs. MLPs are present in around 450 hospitals and other health care sites across the United States and the model has spread to other countries, including Australia, the United Kingdom and Canada. However, enthusiasm for the MLP model is not yet matched by good evidence on how, when and for whom the model works. Interprofessional scholars contend that imprecise terminology and poor conceptualization of interprofessional arrangements hinder high-quality research and evaluation. In response to their critiques, this paper formulates a stepwise conceptual framework to guide the design, implementation and study of interprofessional arrangements that connect health, social care and legal practitioners. This framework draws on findings from national surveys of MLP initiatives in several countries and adapts several key conceptual frameworks that have been developed from systematic reviews of interprofessional working in primary health care. These conceptual frameworks are valuable because they promote clarity about different modes of interprofessional working and characterize the factors at macro (policy, funding), meso (organizational) and micro (practitioner, patient) levels that help or hinder professionals from different disciplines in working together. The paper considers factors at these three levels that require particular attention when lawyers join health care settings and proposes questions for future research in this emerging area.

Medical-Legal Partnerships Facilitate Patient-Provider Cost of Care Conversations: A Multisite Qualitative Study in the U.S.

“…Barriers for clinicians engaging in CoC conversations identified in our study included lack of time, knowledge, and confidence, which are commonly cited barriers in CoC conversation literature ( Alexander et al, 2004 ; de Kort et al, 2007 ; Rubinstein et al, 2019 ; Schrag & Hanger, 2007 ). Potential solutions to these barriers include ongoing training and co-located interprofessional care models, which were both associated with enhanced CoC conversations in this and other studies ( Ries, 2021 ). In particular, social workers were identified as key members of the healthcare team in conducting psychosocial screenings to assess for health-harming legal needs, adding to the growing evidence on the use of social workers in enhancing MLPs ( Colvin et al, 2012 ).…”

Fostering guardians for frontline medical disputes: a government-led medical dispute mediator training program in Taiwan

“…It not only provides practical information for legal mediation committees in understanding the complexity, high risk, and unpredictability of medical disputes [ 25 ] but also enhances medical staff’s capacity for addressing conflicts in terms of legality. Participants can stimulate cognition from multiple perspectives through knowledge-sharing and collaboration across disciplines by working with each other [ 26 , 27 ].…”

Inter-Disciplinary Work in the Context of Integrated Care – a Theoretical and Methodological Framework

“…This definition implies that inter-professional collaboration is a social process that does not require formal structures to be enacted. Studies have focused on conceptualising the different levels and dimensions of interprofessional collaboration [20][21][22], contextual factors that influence interprofessional collaboration [15,[23][24][25], the competencies required to engage in interprofessional collaboration [7] and the effects of interprofessional collaboration on teams and on patients [19,26].…”