In previous posts I have addressed the similarities between the legal business and the medical business, and briefly described the Patient Centered Medical Home approach that the medical community has taken to address some of their issues. In the next few posts, I would like to imagine what a similarly designed Client Centered Legal Practice might look like.
I think the four general areas that the PCMH addresses, can be copied and pasted almost wholesale into our CCLP. The CCLP should seek to establish 1) Team-based Legal Support, 2) Active Client Involvement, 3) Evidence-based Practice Improvement, and 4) Comprehensive Legal Payment Reform.
Team-based Legal SupportThe primary relationship in any legal services transaction is necessarily between the partner and the client, just as a medical transaction is primarily between a doctor and patient. However, in both cases, there are entire teams necessary to maintain and support these relationships. Those teams must have direct and regular access to the client. In a law firm that would mean, not only the associates and staff immediately involved in a particular matter, but also fellow partners who could step in when the primary partner is not immediately available. If the client's satisfaction and well-being is to be the central focus of a legal practice, then legal partnerships must become actual partnerships and not loosely affiliated solos sharing expenses and resources.
Active Client Involvement
In many ways, this is much easier in a legal context than it is in medicine. Clients usually know exactly what their problem is before they contact their attorney. Many matters are managed with regular and comprehensive input from the client, but lawyers rarely keep their clients up to date on all aspects of a matter's progress. In the CCLP context, active client involvement would include keeping the client "in the loop" at all times. Giving them web access to track the team progress throughout the management of the matter. Clients should be constantly aware of hours spent and tasks completed, when and by whom. They should have education resources available through the firm to answer basic legal questions without racking up charges for speaking to a partner. Clients should never be surprised by the content of a bill, unless they've chosen to actively avoid firm resources.
Evidence-based Practice Improvement
This one is much trickier in legal than in medicine. In medicine, there is a constant metric for progress, the health of the patient. If the patient's health deteriorates, stop what you're doing and try something else. If it gets better, then try what you just did on the next patient. (Of course, I'm grossly oversimplifying, but the concept is sound.) There is not an immediately obvious equivalent metric to patient health in a legal context. In fact, there are very few metrics in the law firm. And those that exist are virtually meaningless. (Profits per Equity Partner, tell's you what exactly about a firm.) This is what we must change. An old adage says, "You can't improve what you don't measure." We need to begin to measure efficiency, productivity, and profitability at the task, matter, and firm levels, so that we can begin to adjust our practices to improve all three. Until we accurately measure these things, any changes we make are just guesses as to what might be better.
Comprehensive Legal Payment Reform
Notice, I didn't say billing reform. This is not about adopting alternative fee structures, or non-hourly billing schemes, this is about aligning the financial incentives for the attorneys and the firm to the needs of the client. In medicine that means ending the practice of fee for service, where doctors get paid based on the total number of procedures they perform instead of for maintaining the health of their patients. In legal, we need a similar realignment from meeting hourly targets to maintaining client satisfaction. How we should do that is a huge topic of conversation, beyond what can possibly be summarized in this paragraph. This change will be a difficult adjustment for attorneys and firms, but is absolutely key to putting the client at the center of legal services.
In the final installment, I'll look at some specific elements of the PCMH and imagine how the regulatory aspect of a CCLP might work.