Conceptualizing interprofessional working – when a lawyer joins the healthcare mix

ABSTRACT

Research, policy and practice in the field of interprofessional collaboration have focused on how medical, nursing, allied health and social care practitioners work together to positively impact patient care. This paper extends conceptual thinking about interprofessional practice by focusing on lawyers as part of the interprofessional mix. This attention is prompted by medical–legal partnerships (MLPs), a service model by which lawyers join health care settings to assist patients with unmet, and often health-harming, legal needs. MLPs are present in around 450 hospitals and other health care sites across the United States and the model has spread to other countries, including Australia, the United Kingdom and Canada. However, enthusiasm for the MLP model is not yet matched by good evidence on how, when and for whom the model works. Interprofessional scholars contend that imprecise terminology and poor conceptualization of interprofessional arrangements hinder high-quality research and evaluation. In response to their critiques, this paper formulates a stepwise conceptual framework to guide the design, implementation and study of interprofessional arrangements that connect health, social care and legal practitioners. This framework draws on findings from national surveys of MLP initiatives in several countries and adapts several key conceptual frameworks that have been developed from systematic reviews of interprofessional working in primary health care. These conceptual frameworks are valuable because they promote clarity about different modes of interprofessional working and characterize the factors at macro (policy, funding), meso (organizational) and micro (practitioner, patient) levels that help or hinder professionals from different disciplines in working together. The paper considers factors at these three levels that require particular attention when lawyers join health care settings and proposes questions for future research in this emerging area.

KEYWORDS:

• Interprofessional collaboration
• medical-legal partnership
• conceptual framework
• inter-organizational collaboration

Acknowledgments

This paper was prepared during the author’s 2019 research fellowship with Health Justice Australia (HJA), a national charity and centre of excellence in health justice partnerships, supporting collaborations between services to achieve better health and justice outcomes for vulnerable communities. The author thanks the following people whose expert insights shaped the ideas developed in this paper: Tessa Boyd-Caine, Chief Executive Officer, HJA; Suzie Forell, Research Director, HJA; Lottie Turner, Partnerships Director, HJA; Elizabeth Tobin-Tyler, Associate Professor of Family Medicine and Medical Science, The Warren Alpert Medical School of Brown University and Associate Professor of Health Services, Policy and Practice, Brown University School of Public Health; participants at the 2017 HJA National Conference who participated in the Working in Partnership stream that generated initial ideas for this paper; and the co-organizer of the conference stream, Peter Noble, Executive Director, Services and Innovation, Victoria Legal Aid.

Disclosure statement

The author reports no conflicts of interest. The author alone is responsible for the content and writing of this article.

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