Clients are understandably reluctant to consider endangering these long-standing, delicate working relationships. On the other side of the table, no lawyer or firm relishes the idea of relinquishing even the smallest client assignment. In-house counsel are also occasionally reluctant to turn to outside help out of concern that it somehow diminishes their value and threatens their employment.
We work very hard not to threaten those relationships. We regularly work with hospitals and health insurance companies that enjoy healthy, established working ties with their in-house attorneys, other outside counsel and health care consultants. Because of the limited scope of our work, we do not seek to invade their domains by trying to provide the broad range of services they do, like tax, litigation, employment law and corporate services. Rather, we seek to supplement the work of other professionals in our narrow pursuit of medical staff assistance. When our work is done, we leave – leaving these professionals to continue to provide the vast bulk of their services.
In-House
Counsel
Most of our work has been
performed for entities with able in-house lawyers. Why turn
to us then? The biggest reason is time. The many demands of
in-house lawyering – including compliance, corporate
governance, general risk management, licensure and business
law to name only a few – leave less time to devote to
medical staff affairs. Many medical staff matters can be
quite time consuming, making it difficult to discharge all
jobs well.
Lack of experience can also make an in-house job harder.
Without a base of experience, drafting simple medical staff
documents, for example, that take into account all federal
and state laws, regulations and accreditation body
requirements can drain in-house counsel of valuable time
and energy.
As an external resource, we are able to free in-house
counsel to perform their many other responsibilities. At
the same time, we keep in-house counsel informed throughout
our work and afford counsel regular opportunities to make
significant decisions along the way. Consistent with our
philosophy, one of our goals is to make in-house counsel
look good and smart for having hired us to help.
External
Counsel
Outside law firms, particularly
those without medical staff health care practices, have
much to gain by looking to us to help their clients with
medical staff guidance. We stand ready to help other
lawyers and firms who lack either the experience or
manpower.
Even firms with health care law practices may require
additional assistance because of an occasional conflict of
interest. In physician hearings, for example, it would be
inappropriate for hospital counsel to advise both the
hospital and the hearing panel. We have often served as
counsel to the hearing panel, to ensure fairness and
promote immunity. This frees hospital counsel to actively
pursue presentation of the hospital’s case before the
panel.
Health Care
Consulting Firms
Health care consultants that
help with strategic planning, organizational effectiveness
and survey readiness have also found us to be a valuable
adjunct resource. Consulting services often require the
creation of documents and processes that require the
services of a lawyer. We have worked closely with
consultants over the years to assist their clients in
matters such as medical staff bylaws revision,
credentialing and peer review process creation and
revision, medical staff leadership restructurings and
general legal assistance on document and process
confidentiality. This assistance, often rendered in
anticipation of Joint Commission or other accreditation
surveys, is usually part of a larger readiness effort aimed
at maximizing the entity’s compliance score.