There are law firms that do a lot of medical care work, who have expert attorneys on staff, and who only have those attorneys work on medical care matters. There are also law firms who do a lot of health law work that have limited expert staff and who allow unskilled attorneys to work on complex health law matters, sometimes with little effective supervision. There are even law firms that claim to do health law work, who have no expertise and plan to learn as they go along, on the client’s tab. Size is no guide. If anything, the conflicts of interest in a large firm representing many medical care competitors can be more problematic than the lack of expertise in a smaller firm.

Personal friendships, club memberships, and financial success are no better (or worse) a measure of attorney competence than they are of physician competence. Physician clients must try to determine their attorneys’ general competence, as well as their expertise in the specific legal problem at issue. Clients should inquire into the attorney’s experience in the problem area. They should pay attention to how effectively the attorney questions them about their legal affairs. If the attorney does not appear knowledgeable, the client must question the attorney’s experience in the area. For example, if the problem involves a medical joint venture, it is important that the attorney ask about the impact of this venture on professional decision making and referrals. If the arrangement might create a conflict of interest with certain patients, the specific constraints that the state imposes on the physician–patient relationship should be discussed in the interview.