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

supervising the work.
A more fundamental problem is that law has only limited formal specialty
certification boards and no formal specialty training analogous to medical residency
training. Attorneys are deemed specialists because they have worked in the area for
some time, or because they happen to work for a law firm that has the reputation of
having expertise in a given area of law. There is no credentialing process by legal
institutions in the way physicians have to be credentialed to ensure their competence.
This makes it difficult for a client to ensure that an attorney is really expert in an area
such as health law.
3. Choosing an Attorney
There are law firms that do a lot of medical care work, who have expert attorneys on
staff, and who only have those attorneys work on medical care matters. There are
also law firms who do a lot of health law work that have limited expert staff and who
allow unskilled attorneys to work on complex health law matters, sometimes with
little effective supervision. There are even law firms that claim to do health law
work, who have no expertise and plan to learn as they go along, on the client’s tab.
Size is no guide. If anything, the conflicts of interest in a large firm representing
many medical care competitors can be more problematic than the lack of expertise in
a smaller firm.
Personal friendships, club memberships, and financial success are no better (or
worse) a measure of attorney competence than they are of physician competence.
Physician clients must try to determine their attorneys’ general competence, as well
as their expertise in the specific legal problem at issue. Clients should inquire into the
attorney’s experience in the problem area. They should pay attention to how
effectively the attorney questions them about their legal affairs. If the attorney does
not appear knowledgeable, the client must question the attorney’s experience in the
area. For example, if the problem involves a medical joint venture, it is important
that the attorney ask about the impact of this venture on professional decision making
and referrals. If the arrangement might create a conflict of interest with certain
patients, the specific constraints that the state imposes on the physician–patient
relationship should be discussed in the interview.
D. How to Approach the Law and Lawyers
Where law once had little day-to-day impact on medical practice, law now permeates
every corner of medical care and affects all medical care practitioners. The penalties
have also changed. Not long ago most medical legal issues just involved a medical
malpractice claim. Now providers can face huge, uninsured civil fines and even jail
time. Medical care practitioners now accept that patients should learn about their
diseases and treatments. This facilitates more effective informed consent and makes
patients more effective partners in their own care. It is common to find patients with
chronic conditions who know more about their diseases than most physicians. Medical
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