Law schools start firms in order to employ their graduates

The New York Times reports that law schools in the US, smarting from the collapse of the job market for lawyers, are establishing law firms so they can hire their graduates and give them something to do.

Regarding such a scheme in Arizona, the article says, "Over the next few years, 30 graduates will work under seasoned lawyers and be paid for a wide range of services provided at relatively low cost. The school-based firms will be something like teaching hospitals for law school graduates."

Several schools have bought in to the idea to solve two "seemingly contradictory problems: heavily indebted law graduates with no clients and a vast number of Americans unable to afford a lawyer."

For a minute there, I thought the legal profession was actually going to break precedent and do some real charity work. [Please don't tell me lawyers do pro bono work. Very few do, and when they do, it is a paltry amount of time. A judge had the audacity to recommend that new lawyers do 50 hours of pro bono work before being allowed to take the bar exam in New York. That's about 6 days of work per year. A law blog called it "indentured servitude."]

But the article mentioned that the legal services provided will not be free. in fact, the plan for the Arizona project "is to charge $125 an hour in an area where the going hourly rate is $250." That's not exactly analogous to the way a teaching hospital works.

By what criterion is $125 per hour "relatively low cost"? Oh, I think I've got it. That's relatively low cost for legal fees. Of course, lawyers know how make up for low hourly fees. According to another New York Times piece, it called padding the bill or "churning." One expert commented that "churning, while not endemic, is an insidious problem in the legal profession."

A lawyer for a firm that is being sued for overbilling of hours allegedly worked said in an email to a colleague, “Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” Mr. Thomson wrote. “That bill shall know no limits.”

So the idea of law schools setting up graduates in business reminds me of a joke.

Back in the late 19th century, a lawyer moved to one of the many new towns springing up in the West. He was the first and only lawyer. For a year, he had nothing to do and nearly starved to death.

Then another lawyer came to town.

Pap smears, guidelines and churning

A friend called me the other day to say that his wife had just received a rather concerning message after a visit to her gynecologist. They had been away over the holidays and returned to find this registered letter.

Dear Patient,

We have previously contacted you or attempted to contact you regarding follow-up of your abnormal test results. As we have not heard from you, we are writing to urge you to seek medical attention if you have not already done so.

It is very important that you contact us at your earliest convenience. If you have any questions or would like an appointment, please call between the hours of 8:00 AM through 5:00 PM.

Very truly yours,

They were not too upset because many years ago she had a false positive Pap smear (a test done to detect cancer of the cervix) and received a similar letter. On that occasion, the repeat test was normal.

They made the appointment. During a three-minute visit with the gynecologist, they were informed that the Pap smear was normal.

My friend asked the doctor why the letter was worded in such an ominous way. He was told that was their standard letter and that the doctor “would look into it.”

My friend wondered why the normal result couldn't have been been simply told to them by phone. I replied that the purpose of the registered letter was to generate an office visit.

During the phone call, my friend told me that his wife was having Pap smears every 6 months. He asked if that was routine. I said I had never heard of anyone doing it that often, especially with no history of abnormal Pap smears in the past.

Did I mention that his wife was 71 years old?

All guidelines say that women over 65 without risk factors don’t need a Pap smear at all, so every 6 months seems a bit excessive.

Regarding the office visit and the too frequent Pap smears, the stockbrokers have a word for this sort of thing. It’s called “churning.” To boost his income from commissions, a broker will churn by unnecessarily buying and selling a lot of stocks for his clients.

It’s not unique to this gynecologist. According to an article about a CDC report, 60% of women who have undergone a total hysterectomy, a procedure which involves removal of the cervix, continue to have Pap smears done. In case you aren’t familiar with this topic, cervical cancer is not going to occur when the cervix is in a jar in the pathology department.

And even more amazing is that the article says in 2010, “About two-thirds of women 65 and older who hadn't had a hysterectomy reported having a recent Pap test. That's down from nearly three-quarters in 2000, but it's not a huge improvement.”

“It’s not a huge improvement”? That’s quite an understatement.

It's Medicare, so we're all paying for it.

Things like this make me really worry about the future healthcare of my children and grandchildren.