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Health care law

Hey all, Are there many small shops that specialize in he hunter147708/09/18
There are not many small shops that specialize in health car 3lol08/09/18
I've been doing health law for most of my career. Health ca quillan08/09/18
Lol I felt much better about myself before reading this. lolwutjobs08/15/18
Haha, me too even though I knew some of that stuff. And my c 3lol08/15/18
So there's "health law" in the sense of considerations that onehell08/15/18
I practice health law. Most firms are big-mid law firms. Sm lolwutjobs08/15/18
hunter1477 (Aug 9, 2018 - 10:04 am)

Hey all,

Are there many small shops that specialize in health care law? It seems like a good portion of the health care market is occupied by biglaw shops.

What is the money like as an experienced associate and partner in health care law? Obviously it's going to vary from firm to firm. i'm looking for a general range.

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3lol (Aug 9, 2018 - 1:20 pm)

There are not many small shops that specialize in health care law, though some do exist, and I work for one. They mostly operate on the practice/individual physician side of health care. Think medical conduct proceedings, audits and investigations, credentialing, employment contracts, corporate work (i.e. practice formation and divorce), M&A (i.e. practice groups absorbed into hospitals or other practices), compliance, etc. Salary is small-firm typical.

My impression is that most health care law is done in big firms with large institutional clients, such as hospitals, medical device/biotech companies, etc. I imagine salary is what's to be expected in any biglaw environment.

The other place you'll find healthcare lawyers (obviously) in in-house at hospitals and large practice groups.

It's a good practice area, but not easy to get your foot in the door, especially if you're not bound for biglaw. I can only think of two other healthcare lawyers in my graduating class, and one of them is in biglaw and the other works for a local midlaw firm.

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quillan (Aug 9, 2018 - 5:05 pm)

I've been doing health law for most of my career. Health care remains a growth area, though there is more risk now than at any point in the past 20 years. The Stark Law was a huge money-maker for large, medium-sized, and small firms - even solos. However, there is a real chance that it gets repealed or significantly pared in the current Congress. Drug and device companies were a boon for large firms for years, but they have massively increased in-house numbers and with threats of price cutting (so far only rhetoric) that gravy train may slow down. The need to paper all agreements due to fraud and abuse laws has been key for smaller firms - their clients are typically docs, small hospitals, physician practice groups, ASCs, etc. Consolidation has reduced the number of these entities that operate independently, so more of the work is now done by larger firms that have the system relationship or is done in-house - nobody wants to pay firm rates to do a physician compensation agreement or a HIPAA business associate agreement. Also, large companies like Optum are increasingly buying up physician practices and operating them as an integrated network, so that work all moves in-house and to large firms. The demographics are still favorable for elder law, which is a species of health law. Again though, lots of consolidation in the long-term care and hospice spaces. Finally, there are several large (sprawling even) firms that have followed the Jackson Lewis employment law model and offer national or regional health law services at relatively low rates - Polsinelli, Hall Render, Nelson Mullins, Kutak Rock. In sum, it's still a great specialty, but the salad days of the 90s and 00s are long gone and it gets more competitive every year. The money is probably the same as any other specialty regulatory area - good but not great. Finally, if I were a brand new lawyer I might think twice, as the US is eventually going to have to go to a single payer system like everyone else and that will result in a massive amount of legal work in the short term, but much less in the long term.

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lolwutjobs (Aug 15, 2018 - 3:41 pm)

Lol I felt much better about myself before reading this.

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3lol (Aug 15, 2018 - 5:17 pm)

Haha, me too even though I knew some of that stuff. And my compensation isn't even that great.

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onehell (Aug 15, 2018 - 1:43 pm)

So there's "health law" in the sense of considerations that are fairly unique to healthcare orgs, like stark and anti-kickback stuff, credentialing and privileging issues, privacy issues, research compliance, and so forth, and then there's "health law" in the sense that you're handling issues healthcare organizations have because of everything else that they are or may be: Large employers, owners of large amounts of real estate, nonprofits with special tax considerations, and so forth.

We use both biglaw and small law, and when we use the latter it's usually for these related, but not uniquely "health law,", sorts of things. On the small firm and solo side, there's an ERISA guy, a nonprofits guy, and a real estate guy, just to use the examples that come immediately to mind. They aren't necessarily firms that focus specially or exclusively on "health law," but they do focus on issues healthcare orgs happen to have. I found 'em because I liked a presentation they made at some conference, or because they had useful blogs on their website that gave me starting points for some issue I needed help with, but I wasn't searching specifically for a health lawyer so much as someone more specialized in something we needed in the day-to-day.

For really big, bet the farm type of issues it's going to be biglaw. But for day-to-day legal needs, there is room for small firms. I can control costs with them, they pick up the phone when I call, etc etc.

Idk what they pay but my point is, you might want to look for firms that happen to have healthcare clients as opposed to firms that practice "health law" specifically or exclusively, and you might want to find a focus in a practice area that interests you that is something that healthcare clients happen to encounter, as opposed to something that's exclusive to healthcare.

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lolwutjobs (Aug 15, 2018 - 3:38 pm)

I practice health law. Most firms are big-mid law firms. Smallest firm I deal with is ~20 attorneys. Most health law attorneys appear comparatively better compensated in part because hospitals, physicians, etc. tend to be able to do so

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