Clipboard: Dr. Barry Zuckerman says medical-legal partnerships a key to meeting patient needs

By Chelsea Conaboy, Globe Staff

Doctors increasingly are being asked to address their patients’ health issues outside of exam rooms and hospitals. New models of paying for health care ask them to do more to protect the overall health of the patients they serve. For some, that may mean making sure patients have adequate housing, access to social services, and appropriate mental health care.

A key to meeting those needs may be partnerships between doctors and lawyers, says Dr. Barry Zuckerman, chairman of the Department of Pediatrics at Boston Medical Center.

Zuckerman is a leader on the development of such partnerships. He hired a lawyer in 1993 to advocate for his patients at Boston Medical Center, and created a national model.

An article published online Monday by the journal Pediatrics described the success of legal advocates in Cincinnati at improving the housing conditions of low-income children diagnosed with asthma, elevated lead levels, and developmental delays.

In an accompanying commentary, Zuckerman said medical-legal partnerships can play a key role in the success of an accountable care organization, which “will likely need to redesign its service delivery beyond social workers, nutritionists, home visitors, etc, to address upstream social factors of low income patients.”

He writes:

When community legal aid agencies and pro bono private lawyers partner with health care providers, they re-orient the delivery of legal assistance before a cascade of crises occurs from homelessness to hunger, from domestic violence to child abuse, or before mold growth causes an asthma hospitalization. This approach potentially reduces the downstream impact of legal and health crises before they occur. Preventive law becomes preventive medicine.