Public Health Law Map - Beta 5 - Medical and Public Health Law Site

and a smattering of classroom-based “clinical education.” They get almost no
intensive, problem-oriented clinical experience. The parallel would be licensing
physicians and putting them into unsupervised practice after the basic science phase
of medical school. Even law schools with extensive clinical education programs
expose law students to clients with only simple legal problems.
This model of education is based on the assumption that law school graduates will go
to work for large law firms who will train the new lawyers and supervise their work.
It is not clear that this was ever valid for the majority of law school graduates, but it
is certainly not true now. Even the big firms no longer have significant, supervised
in- house training. While law schools are aware of the problem and are seeking ways
to correct it, any changes will take years to implement. This is partially due to the
inertia that affects all higher education, and partly due to the lack of incentives from
the community to profoundly change legal education.
2. Pitfalls in On-the-Job Legal Education
Medical care practitioners, especially physicians, must learn their skills on their
patients. The first several years of this training are done in formal education
programs where the hospital or other institution pays the student as an employee to
take care of patients as part of their training. The patients are supposed to be notified
that they are being examined and treated by students, and most programs do inform
them. The care is supervised and signed off by staff physicians who are expert in the
area. The federal government pays most of the costs of this training. The patients, or
the government on their behalf, pay the costs for the care, but this is generally limited
to the work performed by the attending physicians, not the student. If the resident
does not know how to do a procedure, the patient is not charged extra for time
needed to train the resident. After formal clinical training, physicians and other
medical care practitioners, like all professionals, must continue learning on the job.
The cost of this training is amortized over all the patients treated. No individual
patient is charged extra because the physician spends an hour reading a journal
article about his or her disease, or bought a new reference text. There may even be a
duty to inform the patient if the practitioner is trying a new technique in which he or
she is not skilled.
Attorneys, however, charge each client for the time the attorney spends learning
about the law governing the client’s problem. Attorneys working in an area of law
new to them not only have no duty to warn the client; they may be paid extra for the
additional time needed to research this unfamiliar area. Attorneys working in an
unfamiliar area spend time researching irrelevant issues, miss important issues, and
have difficulty in translating legal research into useful legal advice. Once it is
accepted that clients should pay for educating senior attorneys, then it is a logical
extension to expect clients to pay for educating junior attorneys. Thus, the client’s
financial advantage of hiring an attorney expert in a particular problem often
evaporates. The client may get the advantage of the senior attorney’s judgment but
have to pay junior attorneys to duplicate this knowledge. In the worst case, the client
pays the junior attorneys to learn judgment and there is no expert senior attorney
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