Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

Paul, Edward; Fullerton, Danya Fortess; Cohen, Ellen; Lawton, Ellen; Ryan, Anne; Sandel, Megan

doi:10.4300/jgme-d-09-00016.1

Cited by 33 publications

(21 citation statements)

References 6 publications

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“…26 30 Child HeLP aims to resolve legal issues common among families living in poverty (eg, substandard housing, denial of public benefits, intimate partner violence). 31 Attorneys with expertise in poverty law are natural allies for pediatricians caring for lowincome patient families with multiple legal needs found at the bottom of Maslow's Hierarchy. 32 Our collaborative began with a shared vision of child and family well-being and the recognition that the 2 organizations served many of the same families (phases 1 and 2).…”

Section: Figurementioning

confidence: 99%

A Road Map to Address the Social Determinants of Health Through Community Collaboration

Henize¹,

Beck

Klein

et al. 2015

Pediatrics

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Economic, environmental, and psychosocial needs are common and wideranging among families cared for in primary care settings. Still, pediatric care delivery models are not set up to systematically address these fundamental risks to health. We offer a roadmap to help structure primary care approaches to these needs through the development of comprehensive and effective collaborations between the primary care setting and community partners. We use Maslow's Hierarchy of Needs as a well-recognized conceptual model to organize, prioritize, and determine appropriate interventions that can be adapted to both small and large practices. Specifically, collaborations with community organizations expert in addressing issues commonly encountered in primary care centers can be designed and executed in a phased manner: (1) build the case for action through a family-centered risk assessment, (2) organize and prioritize risks and interventions, (3) develop and sustain interventions, and (4) operationalize interventions in the clinical setting. This phased approach to collaboration also includes shared vision, codeveloped plans for implementation and evaluation, resource alignment, joint reflection and adaptation, and shared decisions regarding next steps. Training, electronic health record integration, refinement by using quality improvement methods, and innovative use of clinical space are important components that may be useful in a variety of clinical settings. Successful examples highlight how clinical-community partnerships can help to systematically address a hierarchy of needs for children and families. Pediatricians and community partners can collaborate to improve the well-being of at-risk children by leveraging their respective strengths and shared vision for healthy families.Pediatricians and primary care centers embrace the importance of identifying and acting on the economic, environmental, and psychosocial needs faced by their patients and families. Early recognition and action on these social determinants of health (SDH) are increasingly seen as critical, given their known impact on morbidity and mortality. [1][2][3] The related toxic stress model suggests that adverse childhood events often rooted in the SDH disrupt physiologic processes and cause such experiences to "get under the skin."This places children at risk for adverse health and developmental outcomes that can persist into adulthood. 4,5 Defining, identifying, and mitigating these toxic stressors could therefore promote childhood resilience, positive development, and health later in life.There are increasing calls to reshape pediatric care to better address the SDH. The American Academy of Pediatrics has outlined principles of patient-and family-centered care that include supporting and empowering children and families across the life

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Section: Figurementioning

confidence: 99%

A Road Map to Address the Social Determinants of Health Through Community Collaboration

Henize¹,

Beck

Klein

et al. 2015

Pediatrics

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“…Only one specialty supports ''intensive'' resident legal education: obstetrics and gynecology, and reports of the adequacy of this training come from program directors, not program participants. 2 There is one report of medical and legal partnerships for patient care, 7 suggesting a case-by-case education for health care practitioners as it applies to their patients, but the work by Kollas to develop a curriculum for education continues to stand as a model in relative isolation, with little evidence that there have been any significant changes to nationwide training requirements.…”

Section: Introductionmentioning

confidence: 99%

Medico-Legal Education: A Pilot Curriculum to Fill the Identified Knowledge Gap

Evans¹,

Refrow-Rutala²

2010

Journal of Graduate Medical Education

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Purpose We sought to determine if a medico-legal educational curriculum designed to increase physicians' familiarity with the legal system in a nonthreatening environment—a didactic and interactive educational seminar—would positively influence learners' knowledge base and self-awareness. Methods Because neither the Accreditation Council for Graduate Medical Education nor its Residency Review Committees specifically addresses medico-legal liability education, we designed a 2-day intensive medico-legal educational curriculum and piloted it in 2007 and 2008 at a large academic tertiary-referral medical center. Postcurriculum evaluations and precurriculum and postcurriculum testing were used to identify areas of common and/or persisting knowledge deficit. Results A total of 50 graduating residents, fellows, and community practitioners participated in the course. Common areas of knowledge deficit were “privilege,” “discovery,” statutes of limitations, and basic legal procedure. Discordance in physician interpretation of patient perspective and misunderstanding among physicians of the impact of the legal suit were evident. Conclusions Concentrated legal education at selected times during medical training may support physicians' motivations to improve the assurance of quality and continuity of care. We continue to revise the curriculum to address issues of lecturer style, lecture content, and overall attitudinal values related to clinical practice, legal education, long-term impact on practice patterns, job satisfaction and its effect on attention to quality and continuity-of-care issues, and health care provider attitudes about the provider's role within the legal system and the community. We plan to conduct follow-up of participants to assess retention and subsequent use of this knowledge.

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“…31 Most notably, MLP training and experience helps to meet the ACGME competency in systems-based practice, training residents to identify larger systems-based barriers that affect their patients' health and locate the appropriate resources to address those barriers.…”

Section: Mlp In Graduate Medical Educationmentioning

confidence: 99%

Training the 21st-Century Health Care Team: Maximizing Interprofessional Education Through Medical–Legal Partnership

Tobin-Tyler

Teitelbaum

2016

Academic Medicine

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For too long, many stakeholders in the health care delivery system have ignored the extent to which social determinants of health (SDH) are inextricably woven into and affect individual and population health. The health care system is undergoing a relatively rapid transformation, which has included in part an increasing recognition of SDH's effects. This recognition, in turn, has led to renewed calls for changing the way that physicians are trained and has accelerated medical education curricular reforms. This Perspective focuses on one such innovative method of team-based care and the opportunities for its integration into medical education: medical-legal partnership, a health care delivery model that embeds civil legal services into the spectrum of health care services provided to low-income or otherwise vulnerable patients and communities.

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Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

Cited by 33 publications

References 6 publications

A Road Map to Address the Social Determinants of Health Through Community Collaboration

A Road Map to Address the Social Determinants of Health Through Community Collaboration

Medico-Legal Education: A Pilot Curriculum to Fill the Identified Knowledge Gap

Training the 21st-Century Health Care Team: Maximizing Interprofessional Education Through Medical–Legal Partnership

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