A Lawyer Walks into a Medical School By John J. LoCurto, JD

A Lawyer Walks Into A Medical School

By John J. LoCurto, JD

The title to this article might read like the setup to another lawyer joke. It is not a joke. At least I hope it is not. That is because I am the lawyer, and the medical school I walked into is the University of the Incarnate Word School of Osteopathic Medicine. I joined the SOM full-time in September 2020 as the inaugural Assistant Professor of Medical Jurisprudence and Health Policy. My position gives me the privilege of working with learners across all four years of the medical school curriculum and beyond into residency.

Why would a medical school hire a lawyer? You might think that mixing an attorney into a faculty of physicians is like asking dogs and cats to live together in harmony. But the combination is not quite so outlandish. To obtain a license to practice medicine in Texas, each graduate must pass the Texas Medical Jurisprudence Examination. The JP exam, as it is known, is an online, multiple choice test that covers a range of topics drawn from Texas law, administrative regulations and medical board rules. What information does a physician have to report if she suspects elder abuse? Which immunizations must children receive to attend school in Texas? When is a person incapacitated to make medical decisions? These are the sort of questions the JP exam poses, and they are not the traditional fare of medical school curricula. Integrating the law into pre-clinical and clinical education helps learners develop skill spotting legal issues and prepares them more effectively than cramming does for the JP exam.

At the SOM, however, incorporating the law and policy is about much more than a licensure examination. It is about preparing learners to practice medicine, to become effective and fulfilled professionals and to become responsible stewards of the public’s trust. A common refrain around the SOM is that structure and function are inextricably linked. Just as the structure of a cell, organ or bone influences how it functions, law and policy provide structure that influences how the health care system functions. The practice of medicine is embedded in a complex and often contradictory body of overlapping laws, regulations and rules. The requirements these authorities impose and the limits they set are in the exam room with a physician and patient, just like a stethoscope, tongue depressor or sharps disposal. Yet, medical education does not necessarily prepare learners for the realities and demands of the system in which they will deliver care.

The SOM is changing that. By threading legal topics into the four years of study – a pinch of informed consent here, a touch of HIPAA there – and creating meaningful opportunities for deeper exploration of real-world issues that arise in the practice, business and regulatory oversight of medicine, the SOM is equipping learners to be physicians in a holistic sense. This approach carries over beyond graduation and into residency when topics such as the basics of medical malpractice insurance and physician contracting are addressed. This fulsome commitment to education is perhaps to be expected at an osteopathic medical school. Osteopathic medicine focuses on the whole person, a sum of more than the genes, cells, organs and systems that comprise the body. The SOM applies the holistic osteopathic philosophy to medical education itself. By adding legal and policy elements to the curriculum and doing so in a way that supplements rather than disrupts the learning experience, the SOM is educating the whole learner. Graduates will emerge from the SOM with the expertise they need not just to be physicians, but to thrive as professionals in a complicated and sometimes bewildering health care system.

So, now that I have laid out my case for lawyers in medical schools, perhaps my point can best be made with a lawyer joke after all. What do you call a lawyer on a medical school’s faculty? A good start.*

John J. LoCurto, JD is Assistant Professor of Medical Jurisprudence and Health Policy at the UIW School of Osteopathic Medicine.