What law firms can learn from the AMA: it's time for an industry standard ideal

By Ryan McClead

Five or six years after the beginning of what we have come to call The New Normal, the legal blogosphere is still vociferously debating what we should do about it. The market is flat, profits are down, and the old way of doing things is unlikely to sustain many firms into the middle of this century. Most people are convinced that the model must change and almost everyone has their own pet theory about where that change should begin.

Clients must demand greater visibility and accountability from outside counsel. Firms must adopt progressive technologies and comprehensive project management techniques to achieve greater efficiency, productivity, and profitability. There should be fewer partners and more associates, or more partners and fewer associates, or we should just replace all attorneys with software and have firms run by secretaries. Any or all of these might be true, but none of them answers the key question, what do we do first?

When it comes to change and innovation, firms tend to wait for one to set a precedent and then they all jump on the bandwagon and try to replicate their results, but each firm has its own technology, experience, capabilities, and culture. They may all be running the same direction, and overcoming the same obstacles, but they are starting at different points, and they each have their own finish lines. Even if one firm finds their way, the rest may not be able to follow.

There is another option and its precedent does not come from an AM Law 100 firm, but from the American Medical Association (AMA). In 2007, the AMA, along with several other medical professional organisations, came together to craft a set of guidelines to improve medical care, called the Patient Centered Medical Home (PCMH). The American health care system is an unholy mess of doctors, hospitals, private insurance companies, and governmental social programs. In the midst of competing interests and incentives, the American patient (ostensibly the reason for healthcare in the first place) has all but gotten lost. The PCMH is an industry-wide attempt to rectify that situation and to simultaneously improve the overall quality of medical care in this country.

The details of the PCMH will do little to help law firms, but the concept and the structure may be exactly what we need to begin to update and improve the practice of law industry-wide. The PCMH guidelines are illustrative, but not prescriptive. They tell medical practices WHAT they must do to qualify, but they do not tell them HOW to achieve those goals. PCMH qualification is achieved by combining acceptable marks on a few must-pass guidelines with a minimum score on all of the remaining points. The genius of this approach is that the lowest level PCMH qualification is relatively easy to achieve, while the higher levels will require greater effort by most medical practices. This entire system of qualification is administrated and overseen by an unaffiliated non-profit organisation.

Much of the discussion surrounding what we need to change in law firms gets bogged down in the details. Maybe we should come together and agree on the types of changes we should make, set them down as a series of detailed qualifying guidelines, and then hand them to a third-party organisation to determine which firms qualify and at what level. Chasing an industry standard ideal, with multiple pathways to get there, may be more productive for everyone than waiting for one firm to figure it out so we can all fall in line behind.

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