Date: January 12, 2012
Let’s face it. If someone mentions the words “medical” and “legal” in the same sentence, the next thing we imagine we’ll hear about is a lawsuit. Picture this instead: empowered, proactive social workers, collaborating with health care providers, lawyers, and legal experts, to ensure that the health of indigent patients isn’t undermined by unsafe housing, lack of food, or lack of access to benefits and entitlements. Some people refer to this type of outreach as “preventive law” because it’s directly related to preventive health measures we now recognize are crucial to help people head off disease or better manage chronic conditions.
Doctors and nurses on the front lines have understood for years the role that social conditions play in improving or worsening health. Also, what happens when problems brewing at home, such as domestic abuse, don’t rise to the surface during a routine medical visit? Fifteen years ago, Dr. Barry Zuckerman founded a program at Boston Medical Center to address a swarm of issues affecting the health of low-income children. Six years ago, this initiative became the National Center for Medical–Legal Partnership, focusing on anyone, at any age, in need of the combined power of medical and legal intervention. The effort and the framing caught on and there are now over 200 programs like Zuckerman’s across the US, one of them in Cincinnati.
WIHI host Madge Kaplan welcomes Dr. Zuckerman and Dr. Robert Kahn of Cincinnati Children’s Hospital Medical Center to explain and explore the ingredients of an effective medical-legal partnership and how the efforts to date are making a difference in patients’ health and their lives. At Cincinnati Children’s, key prompts to get at social determinants of health are built right into the electronic health record. This helps screen for health-undermining circumstances — for instance, a landlord’s lack of attention to a faulty refrigerator — that might benefit from legal attention. This is just the type of thing Carol Beasley is keeping an eye on as she continues to help spearhead the work of the IHI Triple Aim initiative. When the goals are improving the experience of care, improving the health of populations, and reducing per capita costs, it’s increasingly essential to form coalitions and partnerships that integrate legal and social service expertise with health care expertise.