Advancing Health Equity Through Issue Spotting in Primary Care: A Case for Medical-legal Partnerships.

Social and legal determinants of health have been shown to have substantial impacts on the health outcomes of individual patients and the population as a whole. This case report highlights the importance of screening for social needs as well as having appropriate interventions to address their impact. One intervention is medical-legal partnerships. The case presented describes the use of social screening tools and medical-legal partnerships to address health concerns, reduce health care spending, and promote optimal health outcomes. The case provided is a patient who was evaluated for bilateral lower extremity swelling in a primary care setting.

Novel perinatal medical-legal partnership development and pilot implementation to address health-harming legal needs.

Medical-Legal Partnerships (MLPs) are evidence-based, interdisciplinary collaborations between health systems and legal service organizations designed to address health-harming legal needs among low-income patients and their families. MLPs provide civil legal services and advocacy around health-harming needs, such as substandard housing, food insecurity, benefit denials, education and employment barriers, legal status, custody, and child support. Widely implemented in pediatric health settings, research supports MLPs ability to positively impact the health trajectories of children and their families. This manuscript describes our health system's innovative development and pilot implementation of the first MLP in a neonatal intensive care unit (NICU). We share our MLP integration strategies, scope of practice, screening processes, workflow, and challenges. We conclude with anticipated areas of growth and future direction for this program, which we believe will address health-harming legal needs for our patients in their earliest weeks of life.

Seeking a Second Opinion on Social Media.

Social media pervades all aspects of our lives. In medicine, it has changed the ways that patients and parents get health information, advocate for particular treatments for themselves and their children, and raise money for expensive treatments. In this Ethics Rounds, we present a case in which the use of social media seemed to cross the boundaries of acceptable professionalism. What should the ground rules be for doctors who are tempted to give medical opinions online about patients whom they have never seen?