Lawyers and Doctors, Together At Last
Part of the reason I decided to study social policy in college was the fact that I knew that as a doctor, I’d primarily being trying to improve the health of individuals, but I saw far too many individuals for any one me to help. So when I read about the legal aid services for children, and the fact that it’s going national, I couldn’t have been happier.
It turns out that doctors tend to work in a pretty specific realm (the medical one, surprise surprise). But health tends to be affected by multiple realms. Doctors are great advocates for their patients for their medical health–giving medications, for example–but when it comes to more systemic, structural problems, I’d give doctors as a whole an F. That’s why we work with social workers, child life specialists, home health nurses–these people have better footing in the non-medical health arena.
What the Boston legal team has been addressing is another level of advocacy–administrative and regulatory advocacy. This entails ensuring that laws are enforced and people are held responsible for their responsibilities–for example, ensuring that a landlord keeps his apartments’ habitable. Lawyers know how to push the right buttons (and have the time to do so) that often doctors don’t.
It’s possible that these lawyers are having a greater impact on health than the doctors with whom they work.
I think that you are being far too harsh on physicians. Doctors do not have the authority to deal with the”systemic,
structural problems.” It is often difficult for the physician to have “landlords”, employers, etc. to listen to and or heed what the doctor is say and do. In the workers comp. arena, for example, it is very common for a physician to give an injured worker a return to work slip with certain work restrictions. Many employers simply ignore these restrictions and until the worker’s lawyer gets involved nothing much is done.
Physicians “work” with social workers and home health nurses because these professionals have unique skills and knowledge that the physician doesn’t have. I think that an analogy that is appropriate is that of the internist who “works” with the orthopedic surgeon when the surgeon has an elderly patient with a hip fracture. Would you give the internist an “F” for not being able to do the surgical procedure necessary to treat the hip fracture? I don’t think so. Your statement, “Lawyers know how to push the right buttons(and have the time to do so) is a much fairer more realistic assessment of the situation. As far as the “lawyers” having a greater impact on health is like comparing apples and oranges. The lawyers have their role to fill and the physicians have theirs.
I’d give doctors as a whole an F.
I promise I’ll study harder next time.
Flea
Part of the reason I wanted to do- and am about to do- an MD/JD is the precise problem you’ve highlighted here. Doctors struggle to treat patients in an environment over which they have very little control- the health policy which shapes their actions is not often something they know how to- or have the time or ability to- affect.
But saying that lawyers have a greater impact on health is disingenuous. Lawyers (for the most part) aren’t doctors and don’t deal directly with patients, and thus have very little (concrete) idea on how the gears with which they work can grind and crush patients as they run. Both types of expertise are required; both inform (or should) the end policy, which encompasses its own legal applications as well the lives of patients and doctors.