Should Law and Medical Schools Urge Students to Help the Poor?

Based on personal experience, it seems to me that only a small portion of people who decide to go to law school or to med school are doing it so that one day they can work on behalf of indigent populations. The rest of them, if not going into the profession expressly for the fat paycheck, certainly don't mind the prospect. It's easier to spend years in school, and nights in the library, when there's a literal pot of gold on the horizon.

Lawyers and doctors are needed badly by poor people, though. The recession has only increased the need while decreasing the access. When President Obama's health care reforms kick in by 2014, for example, the Medicaid rolls will be greatly expanded as 32 million more Americans suddenly get health insurance. But with the pool of primary care physicians shrinking, will those people be able to get doctor's appointments? States and doctors have been cutting off access to Medicaid patients because the reimbursement rates don't make it worth their time — at least, not when they could service wealthier individuals.

Will the family members of those patients be able to get legal representation? Though poor people in Tennessee are denied legal representation they are entitled to, and New York defendants are stuck with incompetent public defenders, and many prisoners are there simply because they can't afford bail, just one half of one percent of the legal industry is devoted to the 40 or so million poor people in America.

The problem probably isn't with the students, but with their medical schools and law schools, which aren't incentivizing aid work. In addition to heaping debt on their students, they're nudging them toward high-dollar specialties so they can pay that debt back.

U.S. News & World Report considers prominent law firm placements in its rankings of law schools, so deans feel they have no choice but to prioritize corporate work. "As a consequence, legal education has been designed to make students attractive for firm jobs, the cost of education has risen to match law firm salaries and the shrinking law firm job pipeline has law schools in a panic," writes Jonathan Smith, the executive director of the socially-minded Legal Aid Society of the District of Columbia. Smith believes that schools should be teaching students to serve where they are needed most, and should adjust tuition accordingly so that's possible for students.

A new survey published in the Archives of Internal Medicine rejected the U.S. News rankings and instead evaluated medical schools based on their "social mission." Suddenly, Harvard wasn't at the top. When it comes to producing minority doctors, primary care physicians and doctors who work in underserved communities, state schools and historically black colleges rise to the top. Could it have to do with the fact that their students and professors are more closely aligned with low-income populations?

Photo credit: a.drian