Make Law Better by Looking Outside of Law—A Medical and Dental Examination

February 13, 2020

By Bob Glaves | CBF Executive Director

A trip to the doctor or dentist is not something most of us look forward to. But there is much we in law can learn from the evolution of those professions, and that is the next stop in my 2020 Resolution for the Legal Profession journey.

While there is still room for further progress, three ways these professions have improved access include: a continuum of care options with many different entry points, a range of professionals who assist and are known by who they are rather than being called “non-doctors” or “non-dentists,” and a variety of business models for their practices to best meet the needs of both the professionals and their patients.

A Variety of Business Models

The fundamental starting point for these advancements is that medical and dental practices can choose from a variety of different business models to deliver services to their patients.

These models range from small neighborhood or specialty practices to broader care networks to large corporate entities with national presence, and ownership can take many different forms. Doctors and dentists don’t check their professional ethics at the door when they choose different practice models, but they do have a lot more flexibility to connect to necessary marketing, business, and technology expertise and to determine the form of business that best suits their needs.

If a doctor or dentist is in a community or specialty where they are well-known and can attract enough patients to be successful, they may value the independence of running their own practice above other considerations and stick with that traditional model. Indeed, many still choose to do just that.

They also might prefer that their smaller practice is part of a broader regional or national network that connects them to a menu of other potential resources and services to help them succeed and better meet the needs of their patients. Or they may want to just focus on being good doctors or dentists, choosing to be part of a corporate structure that handles all of the marketing and business functions for a set price or a share of their fees or profits.

All three of these models are integral parts of the medical and dental services ecosystems, and all doctors and dentists benefit from having these options. Patients benefit at the same time, getting access to trusted brands, flexibility, and a range of service options they can choose from. The starting point for most people is still going to be word of mouth, but when that doesn’t work, having access to these other resources and options makes a huge difference.

Whatever the business model, patients generally have no idea and don’t care what type of business entity the practice is or how the professionals are divvying up their income. What they do care about is that the doctor or dentist—and the other affiliated professionals—provide good services and are reasonably accessible.

A Range of Professionals and Continuum of Options for Patients

When we go to the doctor or dentist’s office or to a hospital, we don’t always even see the doctor or dentist. And even when we do, it’s usually a smaller part of the visit.

There are a whole range of other professionals providing services. And we don’t call them “non-doctors or “non-dentists”, we call them by who they are: dental hygienists, nurses or nurse practitioners, physical therapists, and so many others.

We generally take access to this continuum of options for granted , and for a flu shot, teeth cleaning, or physical therapy (to name just a few), most of us are perfectly comfortable and even prefer working with these other professionals. We certainly like having the choice.

The ability to connect with these other professionals also plays an integral role for the doctors and dentists, allowing them to focus on the higher value services only they can provide and enabling them to provide additional expertise and services for their patients in a more affordable and accessible manner.

Multiple Entry Points for Patients

The last piece to highlight is that people have multiple entry points to get services, particularly for medical care.

In addition to setting up an appointment at the doctor’s office or visiting the hospital, a typical person in the Chicago area might get a flu shot or strep test at a clinic based in a Walgreens or CVS, do physical therapy at a place like Athletico, or make an evening visit to an urgent care clinic near their neighborhood. And all of these services are increasingly connected to their primary care doctor through a health care network or insurance plan.

Flexible hours, convenient community locations, and multiple points of entry make the services much more accessible for patients, and these trends are only increasing in the medical and dental professions.

Turning to Law

It is not news to anyone that we don’t see similar trends in law, but why?

The biggest overarching reason is that our Rules of Professional Conduct governing the business of law have not kept up with the changing times. These rules were literally written for another era of practice, before technology became such a prevalent part of our lives, and they are not serving the public, our profession, or our justice system well.

We need to modernize the Rules so the legal profession can adapt like the medical and dental professions. The CBA/CBF Task Force on the Sustainable Practice of Law & Innovation is seeking to do just that.

Opening the Door to New and More Flexible Business Models

Lawyers and bar leaders tend to get overly hung up on what happens to fees paid by clients, in a way that becomes counterproductive to the interests of the public and to moving the profession into the future.

We essentially expect solo and small firm lawyers to not just be good lawyers, but to be good CEOs, CFOs, CTOs, and CMOs all in one. Only a fraction of our profession is equipped to pull that off, and it is no wonder that lawyers trying to serve the consumer legal market increasingly are struggling to compete at the same time that more people in the middle class than ever before are unable to find affordable legal help. Larger firms typically have the means to bring in these other professional specialists and do so, but that is not a realistic option for solo and small firm lawyers.

We of course want to protect clients from paying for inferior or conflicted services or from being exploited. But the way that plays out in the Rules is in unduly restrictive boundaries for how lawyers can split fees with the other professionals and entities who are increasingly critical to a successful law practice today.

The result is we don’t see in law the network structures like Aspen Dental and Heartland Dental that would give lawyers (1) new and better ways to connect with the consumers who need them, and (2) the means to provide more efficient, effective and affordable services.

We don’t necessarily need to open up law firms to private equity ownership to do this, as they have in the medical and dental professions. But so long as we take steps to protect the professional independence of lawyers and reasonably ensure the public gets good services, we need to enable lawyers to work in modern business networks where the fees paid by the client may go through the business or network and then be split reasonably between the entity and the lawyer.

That is an eminently achievable goal if we put our collective minds to it. And it will make for a better profession and provide more flexible and accessible legal options for the public.

Better Incorporating Other Professionals into the Legal Services Continuum

The first sign that we have a long way to go on this front is what most of us still call anyone who is not a lawyer: a nonlawyer. This binary universe does not exist in the real world, and the narrow mentality it betrays is hampering our profession’s ability to engage the other professionals who are key to increasing access to our services.

Along with recognizing the valuable contributions that other marketing, business, and technology professionals make to a successful law practice, other professionals like domestic violence advocates, community and court navigators, and paralegals can and should have an integral place on the legal services continuum.

We should start by mapping out the journey of what it looks like for someone who has a legal problem (and may not know it), to when and how they first might seek legal help, to the final resolution of their matter. Even for more complex and higher-stakes issues where the lawyer should play a prominent role in that journey, other professionals can provide high value and often more effective services along the way. And that is even more true for legal issues where the stakes are not as high, or the legal issue is not as complicated.

Our medical and dental colleagues are setting a good example for how we can better incorporate these other services.

Meet People Where They Are

The last big lesson we can take from our medical and dental colleagues is to think about how we can better connect to people where they are—in their communities, online, and with multiple points of entry where possible.

Opening up new business models and incorporating other professionals in the legal services continuum is the starting point for doing better on this front. It might not be realistic to have a legal equivalent of an urgent care facility in every community, but if we can better connect through trusted community partners and offer more flexible services and online options, we will be on our way to a more accessible system.