Co-authored by Anne M. Ryan, JD, Assistant Professor of Family and Community Medicine at the University of Arizona and Randa M. Kutob, MD, MPH, Associate Professor of Family and Community Medicine at the University of Arizona
Can a visit to see a lawyer actually reduce stress rather than cause it? Ask patients at the University of Arizona Medical Center Alvernon Family Medicine Clinic, and they will tell you "yes."
Nine years ago, the Department of Family and Community Medicine hired an attorney, not to represent the clinic, but to work as the "patients' lawyer" to address housing, hunger and insurance needs contributing to the poor health of its patients. It was a gamble on an approach to health care that prioritizes access to healthy housing right alongside access to medications, but one that has succeeded in reducing the stress of its patients. A study conducted by the university showed that reported stress levels among patients went down an average of 30 percent and their sense of well-being increased by almost 41 percent after they received care from an attorney.
This week NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health released a report, "The Burden of Stress in America," that highlights the seemingly endless cycle of how stress causes poor health and how in turn poor health leads to more stress. The most commonly reported sources of stress among the more than 2,500 people interviewed were health-related. That stress comes from the obvious fear and fatigue caused by being ill or taking care of an ill loved one. But that stress also comes from the circumstances created by illness -- the loss of one's job because of too many missed days of work, the loss of income that threatens food and housing, and the increased need for child care a patient faces when admitted to the hospital.
These kinds of social stressors are exactly the type that attorneys are equipped to address. Health care providers at the University of Arizona Family Medicine clinic are trained to screen patients for them, and when they detect a problem, they send the patient to see a lawyer at their medical-legal partnership, the Tucson Family Advocacy Program. While a doctor focuses on a cancer patient's chemotherapy, an attorney working with health care providers can ensure that disability benefits are in place to help the family afford food if illness interferes with employment and ensure that advanced directives are created. It is precisely these types of interventions that led to patients' reported reduction in stress. Chemotherapy may be the single most important factor in treating a patient's cancer, but worrying about where her family will live can be an even bigger source of stress and can even cause the patient to skip her surgery.
We cannot ask health care providers to address all the factors that make people sick, nor is there a fix to every source of stress. But we can recognize the broader impact of illness on a person's life and the outside factors that interfere with their medical care and recovery. This means rethinking who is on the health care team and how we coordinate care across professions, and yes, maybe even looking to lawyers to reduce stress.