Merging law and medicine: Patient attitudes about and experiences with social needs screening and medical-legal partnerships in primary care

BACKGROUND: Collecting patients' social determinants of health data allows primary care providers to identify needed services that can address patients' social needs and improve their overall health. Patients' social needs may also be addressed through collaborations between legal and primary care teams, known as medical-legal partnerships (MLPs). We sought to understand patients' experiences with social needs screening (SNS) and MLPs in primary care. 

METHODS: In 2024, we conducted a web-based survey with a national sample of 502 U.S. adults who had visited a primary care provider in the prior year. The survey assessed patients' experiences with SNS, preferences of SNS delivery and referrals, and perceptions of MLPs. Analyses used multivariable logistic regression models to assess correlates of willingness to use MLPs. 

RESULTS: Thirty-eight percent of participants (n = 194) reported having completed a SNS. Of those who completed a SNS, 51% were offered a referral to address their social needs, including 19% who were referred to legal assistance. Approximately 53% of all participants said they were willing to use MLPs. Participants were more willing to use MLPs if they live in rural communities (Odds Ratio [OR] = 1.79, 95% Confidence Interval [CI]: 1.07-3.01) and were aware of SNS (OR = 1.47, 95% CI: 1.05-2.06) and receive public benefits (OR = 0.67, 95% CI: 0.48-0.93). 

CONCLUSION: MLPs are perceived favorably among patients. Establishing MLPs in rural areas may help address social determinants of health in these communities. Next steps in this research include understanding how to build trust in legal representatives in communities with negative experiences with the justice system.