Abstract
Introduction
Medical-legal partnerships (MLPs) bring together medical professionals and lawyers to address social causes of health disparities, including access to adequate food, housing and income.
Setting
Eighty-one MLPs offer legal services for patients whose basic needs are not being met.
Program Description
Besides providing legal help to patients and working on policy advocacy, MLPs educate residents (29 residency programs), health care providers (160 clinics and hospitals) and medical students (25 medical schools) about how social conditions affect health and screening for unmet basic needs, and how these needs can often be impacted by enforcing federal and state laws. These curricula include medical school courses, noon conferences, advocacy electives and CME courses.
Program Evaluation
Four example programs are described in this paper. Established MLPs have changed knowledge (MLP | Boston—97% reported screening for two unmet needs), attitudes (Stanford reported reduced concern about making patients “nervous” with legal questions from 38% to 21%) and behavior (NY LegalHealth reported increasing resident referrals from 15% to 54%) after trainings. One developing MLP found doctors experienced difficulty addressing social issues (NJ LAMP—67% of residents felt uncomfortable).
Discussion
MLPs train residents, students and other health care providers to tackle socially caused health disparities.
Similar content being viewed by others
References
Zuckerman B, Sandel M, Lawton E, Morton S. Medical-legal partnerships: transforming health care. Lancet. 2008;372:1615–7.
National Center for Medical-Legal Partnership. Available at: http://www.medical-legalpartnership.org/. Accessed June 30, 2009.
Zuckerman B, Lawton E, Morton S. From principles to practice: moving from human rights to legal rights to ensure child health. Arch Dis Child. 2007;92(2):100–1.
Zuckerman B, Sandel M, Smith L, Lawton E. Why pediatricians need lawyers to keep children healthy. Pediatrics. 2004;114(1):224–8.
Legal Services Corporation, Documenting the Justice Gap in America. 2005 Available at: http://www.lsc.gov/justicegap.pdf. Accessed December 15, 2009.
Williams DR, Sternthal M, Wright RJ. Social determinants: taking the social context of asthma seriously. Pediatrics. 2009;123:S174–84.
Robert Wood Johnson Foundation Commission to Build a Healthier America. 2009. Beyond Health Care: New Directions for a Healthier America: 108. Available at: http://www.commissiononhealth.org/Report.aspx?Publication=64498. Accessed December 15, 2009.
Wise M, Marple K, De Vos E, Sandel M, Lawton E. Medical-Legal Partnership Network Annual Partnership Site Survey. Boston, Medical Legal Partnership Boston. 2009. Available at: http://www.medical-legalpartnership.org/sites/default/files/page/2009%20MLP%20Site%20Survey%20Report.pdf. Accessed December 15, 2009.
Kenyon C, Sandel M, Silverstein M, Shakir A, Zuckerman B. Revisiting the social history for child health. Pediatrics. 2007;120(3):e734–8.
LegalHealth. Available at http://www.legalhealth.org/. Accessed December 15, 2009.
Fleishman SB, Retkin R, Brandfield J, Braun V. The attorney as the newest member of the cancer treatment team. J Clin Oncol. 2006;24(13):2123–6.
Medical-Legal Partnership | Boston. Available at: http://www.mlpboston.org/. Accessed December 15, 2009.
Missouri Association for Community Action. “Community Action Poverty Simulation ”. Available at: http://www.communityaction.org/Poverty%20Simulation.aspx. Accessed December 15, 2009.
ACGME Outcome Project. 2007. “Common Program Requirements: General Competencies”. Available at: http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf. Accessed December 15, 2009.
Fleishman SB, Retkin R, Brandfield J, Braun V. The attorney as the newest member of the cancer treatment team. J Clin Oncol. 2006;24(13):2123–6.
Acknowledgments
Megan Sandel and Pamela Tames would like to acknowledge funding from the W.K. Kellogg Foundation and Atlantic Philanthropies. Funding for the creation of LegalHealth’s curriculum was from the Jacob and Varleria Langeloth Foundation. Funding for the LAMP program is from the Healthcare Foundation of New Jersey, Robert Wood Tohusan Foundation and the Merck Foundation. FAP is supported by Lucile Packard Children’s Hospital at Stanford, Bernard A. Newcomb Foundation, The California Endowment, First Five San Mateo County, Philanthropic Ventures Foundation, Equal Justice Works, United Health Foundation and the National Center for Medical-Legal Partnership.
Conflicts of Interest
The authors have indicated they have no financial relationships relevant to this article to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cohen, E., Fullerton, D.F., Retkin, R. et al. Medical-Legal Partnership: Collaborating with Lawyers to Identify and Address Health Disparities. J GEN INTERN MED 25 (Suppl 2), 136–139 (2010). https://doi.org/10.1007/s11606-009-1239-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-009-1239-7