The impact of a pediatric Medical-Legal Partnership on pediatric providers

Objective: Medical-Legal Partnerships (MLP) integrate medical and legal care to address prevalent health-harming legal needs (HHLN) among socioeconomically marginalized populations. MLPs address a diverse array of social determinants of health (SDOH) and have been shown to positively impact children's health. Less is known, however, about how MLPs affect health care providers. MLPs may affect child health by changing clinical practice and provider behavior, and transforming providers’ relationships with their patients and patients’ families. Examining and understanding how MLPs affect providers is thus critical to elucidating how MLPs may ultimately impact child health. Methods: We examined one pediatric MLP at an academic medical center in New Haven, CT. We conducted semi-structured interviews with 20 pediatric providers who had engaged with the MLP and 20 parents/guardians who had interacted with the MLP. We analyzed the qualitative data using inductive coding, primarily drawing upon provider interviews. Results: The MLP affected providers in five major ways. The MLP (1) improved provider awareness of SDOH and HHLN, (2) expanded provider perceptions of their role and responsibilities as clinicians, (3) improved provider efficacy in addressing SDOH and HHLN, (4) empowered providers to engage in systemic advocacy, and (5) improved providers’ relationships with patients’ families. Conclusion: Our study identifies multiple ways that a pediatric MLP affects providers. Our findings suggest that MLPs can improve patient and population health by equipping providers with the knowledge and tools needed to assist patients with HHLN and SDOH, improving provider-family relationships, and encouraging providers to engage in systemic and institutional advocacy.