Thinking Outside the Silos: Information Sharing in Medical–Legal Partnerships

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.