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MEDICAL SCHOOL
EVALUATION & GRADUATION

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 in a complex and often contradictory body of overlapping laws, regu-
joke. It is not a joke. At least I hope it is not. That is because I am the lations and rules. The requirements these authorities impose and the
lawyer, and the medical school I walked into is the University of the limits they set are in the exam room with a physician and patient, just
Incarnate Word School of Osteopathic Medicine. I joined the SOM like a stethoscope, tongue depressor or sharps disposal. Yet, medical
full-time in September 2020 as the inaugural Assistant Professor of education does not necessarily prepare learners for the realities and
Medical Jurisprudence and Health Policy. My position gives me the demands of the system in which they will deliver care.
privilege of working with learners across all four years of the medical The SOM is changing that. By threading legal topics into the four
school curriculum and beyond into residency. years of study – a pinch of informed consent here, a touch of HIPAA
Why would a medical school hire a lawyer? You might think that there – and creating meaningful opportunities for deeper exploration
mixing an attorney into a faculty of physicians is like asking dogs and of real-world issues that arise in the practice, business and regulatory
cats to live together in harmony. But the combination is not quite so oversight of medicine, the SOM is equipping learners to be physicians
outlandish. To obtain a license to practice medicine in Texas, each in a holistic sense. This approach carries over beyond graduation and
graduate must pass the Texas Medical Jurisprudence Examination. The into residency when topics such as the basics of medical malpractice
JP exam, as it is known, is an online, multiple choice test that covers a insurance and physician contracting are addressed. This fulsome com-
range of topics drawn from Texas law, administrative regulations and mitment to education is perhaps to be expected at an osteopathic med-
medical board rules. What information does a physician have to report ical school. Osteopathic medicine focuses on the whole person, a sum
if she suspects elder abuse? Which immunizations must children re- of more than the genes, cells, organs and systems that comprise the
ceive to attend school in Texas? When is a person incapacitated to body. The SOM applies the holistic osteopathic philosophy to medical
make medical decisions? These are the sort of questions the JP exam education itself. By adding legal and policy elements to the curriculum
poses, and they are not the traditional fare of medical school curricula. and doing so in a way that supplements rather than disrupts the learn-
Integrating the law into pre-clinical and clinical education helps learn- ing experience, the SOM is educating the whole learner. Graduates
ers develop skill spotting legal issues and prepares them more effec- will emerge from the SOM with the expertise they need not just to be
tively than cramming does for the JP exam. physicians, but to thrive as professionals in a complicated and some-
At the SOM, however, incorporating the law and policy is about times bewildering health care system.
much more than a licensure examination. It is about preparing learners So, now that I have laid out my case for lawyers in medical schools,
to practice medicine, to become effective and fulfilled professionals perhaps my point can best be made with a lawyer joke after all. What
and to become responsible stewards of the public’s trust. A common do you call a lawyer on a medical school’s faculty? A good start.*
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 John J. LoCurto, JD is Assistant Professor of Medical Ju-
functions, law and policy provide structure that influences how the risprudence and Health Policy at the UIW School of Osteo-
health care system functions. The practice of medicine is embedded pathic Medicine.

This joke is a riff on one I have heard many times in many ways: What do you call 100 lawyers in front of a firing squad? A good start.

28 SAN ANTONIO MEDICINE • June 2021