“I still want to be in a helping profession.
[Being a lawyer is] a very personal service, and to
relieve fear and to relieve burdens and to have a
client say, ‘I’m not afraid anymore,’ is just fantastic.”
the people working through that issue are having to deal with it and
what the realities are as far as having access to information: who can
legally access it, who they can control and who they can’t.
A hospital’s like any other business except it’s got this group
of highly educated professionals that work in that setting yet
typically are not employees and are not controlled by hospital
administration—and that’s the physicians, because in many
instances, they are members of the medical staff only. They have
privileges to provide services in the facility, but they own their own
medical practices and have their own employees in a business setting
separate from the hospital. Recognizing how you would have to deal
with that type of professional in responding to issues, it’s helpful to
have been there.
Q: What’s your favorite part about practicing in health care?
A: I think interacting with the clients is my favorite part of my
daily job because they’re bright, they’re educated, they know their
business, they appreciate it that I understand their business—and
just that interaction of helping them work through complex problems
is my favorite part of the day. Of course, I also do trial work and so
having a jury come back with a verdict in your client’s favor is the
most fulfilling success for a lawyer.
Q: Do you have a preference between litigation and
nonlitigation matters?
A: I like all of it. I’m one of those few admittedly happy lawyers. I was on a
cruise with my husband in Alaska a few summers ago and had gotten to
know this other couple. It came out several days into the friendship that
I’m a lawyer and they were shocked because I seemed to be genuinely
happy and to like my work. And I was like, yes, actually, I’m a happy lawyer.
As far as between litigation and nonlitigation, it’s really hard
to say because I enjoy both of them so much. Working through
compliance issues and helping get a whole privacy infrastructure in
place for a health information exchange in northeast Oklahoma is
a nonlitigation matter that’s been challenging and fun for me this
year. But, also, getting out there and taking depositions and digging
into the facts when there’s allegations against your client and finding
ways to poke holes in the plaintiff’s argument—because they’re
usually suing us—that’s a lot of fun, too.
Q: Do you have a most memorable case?
A: The last one’s always the most memorable. [Laughs] I just had
an excellent jury verdict in a credentialing dispute in a state court
action. An interventional cardiologist had sued for a significant sum,
believing he shouldn’t have been terminated from the medical staff
of a community hospital I have worked with for years. Winning that
case was really nice.
When the jury knocks on the door and their question is, “We can’t
find the form to award punitive damages in favor of the hospital and
against the doctor,” there’s nothing happier for a lawyer to hear when
you’re representing the hospital in that case. And the judge laughed,
saying, “I’ve never had that happen before!”
Q: Have you ever had anything funny happen in the courtroom?
A: Well, in that particular case, I was trying it with one of my law
partners who handles all kinds of litigation matters, not just health
care, and he was cross-examining a physician who was explaining
that he had—I’m going to start laughing—packed a wound with
4-by-4s. Those of us in health care wouldn’t blink at that because
we all know a 4-by- 4 is a sterile bandage, but my law partner
thought that the doctor had propped this patient up on boards in
his home and left him there. He was having a very hard time trying
to picture how that was helpful to the patient and asked in disbelief
if that was sanitary. [Laughs] When the doctor got that the lawyer
cross-examining him didn’t understand what a 4-by- 4 was … I’ve
been giggling about that ever since. [Laughs] You know, I guess
courtrooms are pretty serious places and we didn’t laugh there, but
we sure got a howling good time about that afterwards.
Q: Now that the health care reform bill passed, what kinds of
changes have you seen in your practice?
A: The biggest change for the areas I work in is the concept of
“accountable care organization,” or ACO. Advising clients as to how
to form an accountable care organization—how that is likely to affect
their reimbursement rates and the quality requirements that go
into that—is a real challenge. I’ve had a number of clients who’ve
expressed concern because ACOs will come in and assign members
after they’ve already provided the care. There’s a lot of concern in the
health care community: “Well, how do we even know what risk we’re
dealing with, or how we’re going to manage the care for these people
when they’re assigned to us after we’ve already provided the care?”
The response to that is that providers should be providing high-quality services that are evidence-based, that have the patient at
the center of it, for every patient. It shouldn’t matter who’s assigned
later, because you shouldn’t treat those in the accountable care
organization any differently than you would any other patient.
Then, also working on this new health information exchange. Tulsa
is one of the 15 Beacon Grant Communities in the country [which are
pilot program communities to see how health information technology
can improve local health systems]. What we’re setting up is the
health information exchange and part of our challenge is helping
people understand [that the] information stored and shared on the
health information exchange is just your medical record, and [that]
the new way it is being shared among your health care providers is
not anything to be afraid of. We’re moving towards electronic medical
records for every patient. This is going to be a centralized place where
all providers, all labs, all radiology services can access the patient’s
information and know if they’ve already had an MRI this month and
know that they already had a CBC [complete blood count] done
last week so they don’t need another one. It should really help us
eliminate duplication of services and drive quality indicators for the
community. Oklahoma, I’m sad to admit, is one of the poorest health
states in the nation. Oklahoma is the only state in the nation where
people die at a younger age each year. If trends in our state continue,
children today will die at younger ages than their parents will.
