BRINGING MEDICAL, LEGAL BACKGROUNDS TO INFORM HIS STUDENTS
“I decided this is the thing I want to do next in my career in health care and health care law: Teaching about the issues that I am interested in and know quite a bit about, having worked in both the provider and legal sides of the health care industry.”
That’s putting it quite mildly. Professor R. Gregory “Gregg” Cochran, originally of Atlanta, brings his extensive experience as an E.R. doctor and law-firm partner to the classroom, providing valuable cross-disciplinary insights and real-world examples to illuminate the curriculum. After receiving his B.A. in Anthropology from Emory University, Cochran began his health care career by attending the Georgetown University School of Medicine on an Air Force scholarship and then completing two years of a residency program in general surgery, also at Georgetown. Stationed thereafter in rural northern Maine, Cochran spent his early post-training years treating patients in military and civilian emergency departments. But the call to live in a more urban environment for this urbanite and to get back to a normal sleep pattern were too loud to ignore. With not enough training to work as an E.R. doctor in a more populous area, and with a growing interest in health law and policy, Cochran turned inward to find what his next move would be—attending law school.
What drew you to attending law school?
I became interested in the law during my medical training and practice days, during which I witnessed the myriad laws and regulations that impacted how physicians, hospitals and other providers take care of patients. I also saw that health care providers generally were woefully under-informed about so many health laws, from how Medicare works to what constitutes proper informed consent to what the possible consequences are for a hospital that violates any number of federal and state laws and regulations that govern how they operate. So the idea of going to law school started to make sense.
I saw that health care providers generally were woefully under-informed about so many health laws.
I went to University of Pennsylvania law school with the intent of using my medical background in the practice of some type of health care law. An obvious choice for many M.D.-J.D.s is to specialize in medical malpractice law, either on the plaintiff side or the defense side, but that felt too specialized for me. I was also interested in the regulatory and transactional side of health care, including peer review and fraud and abuse. I sought out high-quality training by starting my legal career at larger firms, first with Foley & Lardner LLP and later with Latham & Watkins LLP. And I ultimately found my best fit for practicing law at a medium-sized firm, Nossaman LLP.
And now you’re moving into an educator role.
About a year ago, I started thinking about making another shift to get into health law teaching and research. I had done some teaching in both medical school and law school, and I was fortunate to have learned several areas of health care law during my 15 years as a practicing attorney. But the market for law school professors is extremely competitive, and I hadn’t done enough scholarship over the years to be able to qualify for a tenure-track position.
But as luck would have it, a mutual friend introduced me to Jaime King, health law professor at Hastings and co-director of the UCSF/UC Hastings Consortium on Law, Science and Health Policy, which was in the process of developing a new Masters of Science program in Health Policy and Law (HPL), which will begin in August 2016. Jamie and I agreed that the position as Associate Director for HPL was really suited for me because of my broad experience in health care and in health law practice. After the HPL is up and running, I would like to get some more research and scholarship under my belt and perhaps move into a more traditional position down the road.
There are so many changes happening in health care law, how does this degree fit in with the current landscape?
The HPL is an excellent new alternative that can meet the needs of a certain group of people interested in health law and policy. Health care is and will continue to be at the forefront of our American political discussion for some time to come. Particularly in this election year—with so much going on in health care and potential huge shifts in policy that could result, depending on election outcomes. And even without substantial changes to the current system, so much more needs to be done in making our system safer, more cost effective and available to more of our citizens. Plus, there are so many more new laws all the time in health care that some degree of legal training can be invaluable for those who want to be involved in the business or politics of health care, whether as a health care administrator, consultant, legislative policy expert or clinical leader in a health facility, particularly in cases where obtaining a formal law degree is not necessary.
Health care is and will continue to be at the forefront of our American political discussion for some time to come.
For example, the HPL could be a perfect opportunity for nurses, physicians and other health care providers who are moving into more administrative roles and helping their institutions with compliance efforts or in developing new policies and approaches to solving legal issues. This background will inform folks like that in a more focused and efficient way and in a much shorter time than attending law school. The HPL would give those folks an opportunity to get involved in making things work better at their institutions by teaching them the gamut of health law topics that impact providers and other health care professionals, such as how Medicare, Medicaid and commercial insurance work, or how regulators expect institutions to comply with applicable statutes and regulations.
HPL could be a perfect opportunity for nurses, physicians and other health care providers who are moving into more administrative roles and helping their institutions with compliance efforts or in developing new policies and approaches to solving legal issues.
Another example might be legislative policy analysts who are lobbying for a candidate or legislator. You need to understand health care legislation to draft laws. This degree will fit the bill for such people. They will learn enough about a large body of federal and some state health laws—which are so broad, voluminous and frequently complex—to be able to do their jobs from a more solidly informed position. In short, the HPL is filling a niche for people interested in health care law and policy, but who don’t want to be lawyers, but also to lawyers and law students who may want to move into health care law but who may not have had the opportunity to be get such experience in law school or in legal practice.
Teaching the HPL courses in California provides a uniquely valuable opportunity for students because California is a much more highly regulated state regarding health care providers and payors than most others. Many new ideas in health care happen in California first. For example, managed care, both the industry and the laws, were really born and pioneered here, and the Knox-Keene Health Care Service Plan Act is an important state law that has served as the model for many other states who came later to the business of regulating managed care business.
How do the two ideologies—medicine and law—fit together?
That’s really one of the substantial challenges for the HPL because the two disciplines don’t meld together naturally very well. Medicine is more black and white and subject to the scientific method; we look at numbers and outcomes, and we make a diagnosis or treatment recommendation based on the objective facts. But in the law, words in statutes, regulations and case law are not always entirely clear. A given rule may be interpreted in a number of ways.
HPL students will gain a solid understanding of the American health law system and how policy issues drive health laws so that they will be better qualified to work in certain areas that might not previously have been available to them, in either their current or future roles.
Because of that difference, health care law is a difficult area to study and learn, particularly for students who may not have had any law school training. So we’ll present the material so that students from all different backgrounds will understand and benefit. For those students with some legal training under their belt, we will hopefully expose them to at least some novel areas of study and will welcome their insights in teaching the courses. The ultimate goal will be to provide HPL students with a solid understanding of the American health law system and how policy issues drive health laws so that they will be better qualified to work in certain areas that might not previously have been available to them, in either their current or future roles. Also another important goal from my perspective will be teaching HPL students how to better spot and recognize legal issues, which they may either be able to address themselves or refer to more specialized compliance personnel or regulatory counsel. I believe that my experience in medicine and in working out health care legal problems will help me to shed more light on the courses I teach.