Nov. 4, 2014 – Working in-house at a large, non-profit like Texas Children’s Hospital is a lot like practicing at a small law firm -- a close-knit team handling a broad range of issues, but with clients who work right down the hall.
“If we give them bad advice, we see them the next day,” Lance A. Lightfoot, Texas Children’s vice-president and general counsel, told students Monday during a lunch hour panel discussion hosted by the Health Law Organization at the University of Houston Law Center.
Lightfoot ’99 led a panel of UHLC alums, Melissa Murrah ’93 and Afsheen Davis ’06, in providing insight to legal operations at the nation’s largest children’s hospital as well as the practice of law in-house.
Each of the three took a different path to their careers in the Medical Center. Lightfoot was “very lucky” and started in institutional health law right out of law school, rising through the ranks. Murrah, director of Risk Management, Environmental Health & Safety, and Emergency, clerked for an appeals court, practiced with a law firm, and then started her own. Davis, director of Compliance Services & Privacy, brought a master’s degree in public health to the job.
Their varied backgrounds complement their legal skills in dealing with such disparate issues as privacy concerns, hospital policies, bioethics, religious beliefs, contracts, insurance, finances, personnel, and a host of others.
“We focus on things that are health law centric,” Lightfoot said, “but we also deal with issues across the spectrum.” Those issues are not always clear cut.
“There’s a lot of gray out there,” he said, referring to laws, regulations, and case law. “Our primary goal is to help the decision makers so they are on the lighter side of gray.”
He advised students interested in practicing in-house to know the business inside and out, where the money comes in, and where it goes out, whether it is a giant corporation or a small non-profit. “You have to get into the executives’ heads when you’re making a recommendation. Know how they are going to receive it.”
“You have to have that hat on as a problem-solver,” Murrah added; “that you are going to come in with a business solution to a problem.”
In answer to a question about gaining experience for those students already convinced they want to practice in-house, Lightfoot suggested doing everything possible -- internships, clerkships -- to “learn the language” of the particular industry or public service. Employers are looking for knowledge and experience, he said. While corporations have the means to “cultivate” talent, non-profits “need” experienced hires, he said. That’s why non-profits generally don’t hire graduates right out of law school.
As to future trends in health care, Davis said the biggest issue by far will be privacy under HIPAA, involving issues such as safeguarding data, technical controls, and limiting access to protected health information found in records ranging from diagnoses and medications to billing.
Lightfoot said consolidation of health care providers is a concern to many. While it is beneficial for many practical and professional reasons, he doesn’t foresee the nation’s health care system evolving into a small number of mega-providers.