A Little Less Conversation, A Little More Action

Several weeks ago I was approached by a couple of my in-house colleagues who were formulating a response to a patient’s complaint after their application was denied for our hospital’s charity care program.

By way of brief background, non-profit hospitals are governed by a federal regulation known colloquially as 501(r) which dictates how a hospital must administer its charity care or financial assistance program. Like most good-intentioned federal regulations, what started out as an honest attempt to ensure hospitals are providing sufficient charity care to earn their tax-free status, has turned into a regulatory nightmare.

Several revisions and updates to the regulation have done little to provide clarity and have left many aspects of the regulation open to divergent interpretations amongst experienced attorneys.

Which brings me back to my colleagues who approached me a few weeks ago for a second opinion on the patient’s complaint. Sure enough, their question was a good one as it fell into one of the many grey areas of the regulation that was open to interpretation.

After review, I gave them my opinion, we discussed the matter for several minutes, and off they went. Foolishly, I assumed this would be the last time I heard of the matter as such conferences amongst in-house colleagues are rather routine.

However, a few days later the same colleagues returned with the same question on the same patient complaint. In the time since we had last met, they had circled with two of our other colleagues who introduced yet another interpretation into the mix. As we had done previously, we discussed the validity of the various interpretations, and off they went.

And since my colleagues apparently had access to a flux capacitor, they arrived back in my door a few days later with the exact same question on the exact same patient complaint. This time I was far less collegial as I began to grow frustrated their delay was harmful to our patient and beginning to damage our hospital’s reputation.

Generally, while patients may not always agree with a decision we make, they can at least expect a decision in short order. It is often the waiting that can do the most harm.

I politely reminded my colleagues as much and encouraged them to make a decision with haste. Given the current ambiguities in the regulation, whatever they decided would at least be defensible and I would imagine our patient would appreciate knowing the outcome of their complaint rather than assuming it fell into a bureaucratic black hole.

Unfortunately scenarios like this are all too common in the world of in-house. Although I know my colleagues in Biglaw are faced with decision points for their client each day, they are removed a layer from the process. Whereas in most corporate offices, when legal signs-off on a particular matter, the decision is likely final and implemented within hours.

Although this sort of power is what a many law student may crave during their time in school, when the spotlight is on you, analysis paralysis can set it.
Even though my mother tells me I’m perfect, I know I am not and I know I will make a wrong call from time to time. What is important is to make the best decision you can in the time you have without delaying the day to day operations of your respective company.

After all, a many of a corporate in-house legal department was created for precisely that reason. The ability to get decisive legal advice in a timely fashion.

If they had wanted nuanced memos that took days to craft, they could have just stuck with Biglaw.