Medical-legal partnership lowers costs

Jeff Tyler Apr 10, 2008

Medical-legal partnership lowers costs

Jeff Tyler Apr 10, 2008


KAI RYSSDAL: Most of the time, when you hear about problems in healthcare it’s a question of not enough money or not enough doctors. That’s usually the case in cities. They’re often short on both, and many urban hospitals are struggling to care for low-income patients. One medical center in Boston has led the search for a solution in a completely different direction. It’s hired attorneys to help fight illness and disease among the poor.

Marketplace’s Jeff Tyler has this report.

JEFF TYLER: Poor families, with no alternative, bring their sick children to the emergency room. Not only is this about the most expensive way to get healthcare, the conditions that bring impoverished kids back to the ER again and again are often preventable. Ellen Lawton is executive director of the Medical-Legal Partnership for Children at Boston Medical Center.

ELLEN LAWTON: We have families that we see, for example, who are diabetic, and when their utilities are shut off, they’re not able to keep their medicines refrigerated the way they’re supposed to, and as a result, they end up in the emergency room, instead of being able to administer some of these treatments at home.

Chairman of pediatrics Barry Zuckerman treated children with malnutrition who had been denied food stamps, and kids with ear infections who lived in homes with no heat. Treating the ear infection was easy, but there was little Zuckerman could do about the utility problem. Then he hired a lawyer.

BARRY ZUCKERMAN: And that maybe these problems of poor people that are causing illness actually has legal remedies.

Say a disadvantaged child lives in an apartment with a leaky pipe. The landlord refuses to fix it, even though the leak is causing mold, and mold can trigger respiratory problems. That’s where the medical center’s staff attorney JoHanna Flacks comes in.

JOHANNA FLACKS: There are landlords who will not respond until the matter is ratcheted up to one that is officially legal in nature.

Or economic. Doctor Zuckerman says slumlords will only make improvements if it’s more expensive not to.

ZUCKERMAN: They have a choice to make. They can either spend the $50 and fix the leaky pipe and clean it up, or they can go to court with a lawyer, and they certainly don’t want to do the latter. It’s too expensive.

In her small apartment in Northern California, Angelica, a Mexican immigrant, cooks for her three children. The three-year-old twins have Cabbage Patch dolls and plastic horses to play with. Until recently, the floor where the kids play threatened the health of her seven-year-old son. He has asthma, and suffered allergies and headaches. Angelica took him to a doctor who told her to tear out the old carpet.

ANGELICA: I asked the manager to remove the old carpet from the apartment, but the manager wouldn’t do it.

That’s when her doctor put Angelica in touch with a lawyer through Peninsula Family Advocacy Program. The lawyer contacted the apartment manager. Next thing you know, that old carpet is gone — and her son?

ANGELICA: Much better. My son no longer suffers from headaches and allergies. With the help of the lawyer, everything is good.

The concept is catching on. Across the country there are more than 80 medical-legal partnerships. In addition to helping the poor, they can help hospitals recoup insurance dollars. Again, Doctor Zuckerman at Boston Medical Center.

ZUCKERMAN: So our lawyers, by helping out the patients, actually also accrues value in dollars to the hospital, because in many cases they can find that such-and-such a condition was covered, and the hospital should be paid for the services that was provided to the patient.

The partnerships can also boost a medical facility’s reputation, says staff attorney JoHanna Flacks.

FLACKS: They are investing in being able to say we perhaps have fewer emergency room admissions for our pediatric primary care patients.

Cutting back on ER visits isn’t just for kids. Medical-legal partnerships are being expanded to help cancer victims, geriatric patients and other vulnerable groups. All confronting healthcare problems with a doctor-lawyer one-two punch.

In Los Angeles, I’m Jeff Tyler for Marketplace.

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