Opportunities in Health Law for Nursing Degree Holders

By Joseph L. Fink III

Looking for a challenging position that draws upon your nursing knowledge, skills and insights and has the potential for broad impact? A career that applies your education, training and experience as a nurse to legal issues may be just what you’re looking for as a way to contribute. The career opportunities in health law are many and varied.

Overview of Health Law

Health law involves working on issues at the interface of legal principles and systems with issues rooted in the health care system in its broadest sense. In recent years it has been considered one of the two “hottest” areas of the law. The other is intellectual property law that deals with issues related to patents, copyright, trademarks and trade secrets. Health law includes a wide variety of issues arising from the patient-practitioner relationship, the ties between practitioners-insurers or managed care firms, or operation of health care facilities such as hospitals, long-term care facilities or ambulatory surgical centers.

The phrase “health law” is much more expansive and inclusive than the traditionally high profile area of the law dealing with professional liability or malpractice claims. During 2007 the American Health Lawyers Association conducted a survey of its members on two topics – which types of entities were their most significant clients, and what health law issues were of the greatest significance to their clients. For the first question the top five ranked responses were: 

1.                  Hospitals

2.                  Health systems

3.                  Physician practices

4.                  Physicians

5.                  Academic medical centers

For the second question the top five responses were:

1.                  Federal and state regulatory compliance

2.                  Fraud and abuse enforcement

3.                  Medicare or Medicaid reimbursement

4.                  Business transactions

5.                  Physician-hospital relations

Knowledge and skills of the nurse that are relevant and valuable for activities at the intersection of health care and the law include familiarity with  the lingo or jargon used by health professionals, knowing how to navigate through and understand patient records, and  having a practical understanding how health care services are actually delivered to patients.

Nurse-Attorney

It certainly is possible for the nursing graduate to attend law school and become admitted to the practice of law. In fact, some who have done so have formed the American Association of Nurse Attorneys (TAANA) which has a website at www.taana.org. TAANA has identified members practicing in private law practice, in academia, as plaintiff and defense litigation attorneys, as legal counsel for healthcare entities, and in health care compliance roles among others.

Contrary to popular belief, there is no official “pre-law” major required for admission to an accredited law school. Students come to the study of law with a wide variety of educational backgrounds. In fact, law school admissions committees seek to assemble an academically talented and diverse student body. Laws schools seek students who have well honed analytical and writing skills.

One need not go to law school directly upon completion nursing school. Actually, several years experience can be invaluable and pay large dividends later in terms of the expertise and insights gained from that period of practice.

Some law schools offer part-time programs where the three year curriculum is spread over four years with most courses available on an evening or weekend schedule. This may enable the law student to continue to practice nursing while attending law school. A list of accredited law schools is available at www.abanet.org/legaled/approved lawschools/approved.html.

Legal Nurse Consultant

Legal nurse consultants can find themselves in a wide variety of roles but the typical assignments will include reviewing patient records, conducting research regarding the patient’s disorders or treatments, and preparing reports describing their findings. Often the focus of this work will be around clarifying or describing the applicable standard of care. This could include scrutinizing policy and procedure statements of an institution or exploring professional standards of care guidelines. In addition to compiling reports the legal nurse consultant may assist an attorney with preparing for depositions (interviews of parties to the lawsuit or witnesses conducted under oath) or formulating questions for use during trial. Locating appropriate expert witnesses to participate in the case can also be a role for this professional. The mix of cases can be quite varied – professional liability claims, personal injury cases arising from accidents or defective products, or criminal cases involving a health dimension. They may work with attorneys on either side of the case – plaintiff or defendant – or may work for a liability insurance company.  

Risk Manager

A person undertaking risk management activities works to identify and then control or manage threats to the smooth operation of the organization, threats that may even have the potential to terminate the business operation. Originating with responsibility for assuring that the enterprise had appropriate and adequate insurance coverage, the role has now assumed a more activist posture of seeking out potential threats and working to manage them along with responding to hazards when they do materialize.

Threats to the organization may come from myriad sources – governmental rules and regulations, accreditation standards, deviations from internal policies and procedures, or patient or employee lawsuits. Moreover, they can involve all aspects of the organization’s operation -- patient care activities, convenience services such as patient parking areas, or operations tied to the business activities of the institution.

Conclusion

A degree in nursing may well admit the nurse to one of the professions with the greatest range of opportunities to serve. Exploring opportunities at the interface of nursing and the law may well be a good match for your interests and abilities. If you are a person who likes challenges and enjoy researching and digging into issues, then investigating the many and varied opportunities in health law or nursing law may represent a very good investment of your time.

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Joseph L. Fink III, BSPharm, JD, is Professor of Pharmacy, Health Administration, and Public Health at the University of Kentucky, Lexington, KY. He is also the Public Member of the Council on Recertification of Nurse Anesthetists, Park Ridge, IL.