Abstract

Medical–legal partnerships (MLPs) allow providers to address patients’ health-harming legal needs through partnerships with lawyers. MLPs are most successful in addressing the complex needs of vulnerable populations when clinicians, social workers, and other care team members regularly communicate with the MLP lawyer. Privacy laws and professional rules of conduct governing patient/client confidentiality, however, potentially hinder this exchange of patient-client information. MLP attorneys may be reluctant to share relevant information about a client with the medical partner for fear that doing so would breach client confidentiality or result in an ill-advised waiver of attorney–client privilege. Similarly, privacy concerns may lead providers to limit MLP attorneys’ access to patients’ medical information.

Drawing on the real-world experiences of MLP professionals, this article explores whether legal and ethical obligations impede the sharing of patient-client information between MLPs’ medical and legal partners. Our research indicates that at present patient/client confidentiality rules generally do not pose a significant barrier to doing so. However, current legal and professional standards may frustrate emerging advanced care coordination models that pair MLPs with care teams that comprehensively address a broad range of social, economic, and behavioral health needs. We therefore recommend continued monitoring and discussion of the issue.

摘要

医疗法律伙伴关系 (MLP) 允许提供者通过与律师的伙伴关系来解决损害患者健康的法律需求。当临床医生、社会工作者和其他护理团队成员定期与 MLP 律师沟通时，MLP 在解决弱势群体的复杂需求方面最为成功。然而，管理患者/客户保密性的隐私法和专业行为规则可能会阻碍患者-客户信息的这种交换。MLP 律师可能不愿与医疗合作伙伴分享有关客户的相关信息，因为担心这样做会违反客户机密或导致不明智地放弃律师-客户特权。同样，隐私问题可能会导致提供商限制 MLP 律师对患者医疗信息的访问。

本文借鉴 MLP 专业人员的实际经验，探讨了法律和道德义务是否会阻碍 MLP 的医疗和法律合作伙伴之间共享患者-客户信息。我们的研究表明，目前患者/客户保密规则通常不会对这样做构成重大障碍。然而，当前的法律和专业标准可能会阻碍新兴的高级护理协调模型，这些模型将 MLP 与全面解决广泛的社会、经济和行为健康需求的护理团队配对。因此，我们建议继续监测和讨论该问题。