Horizon Expansion 101.5: Nonprofits (Cont.)–Hospitals, Land Trusts et al.

Hospitals

Just over 50 percent of the almost 6,000 U.S. hospitals are nonprofit corporations (the rest are either for-profit corporations or federal, state or local government hospitals). Like academic institutions, hospital functions and activities have become increasingly “legalized.”

Hospitals‘ response has also been similar to that of academe. The 21st century has witnessed the rise of hospital in-house counsel offices and the subsequent creation of separate legal and quasi-legal offices to manage responsibilities that have grown too large to be handled by the central legal staff. You can often find attorneys working in many of these offices. The key difference is that hospitals are much smaller employers than colleges and universities.

The “200-Bed Rule”

The major employers that hire for hospital law-related positions are those hospitals with 200 or more beds. There are 1,750+ such facilities, of which approximately 1,200 are nonprofits. As a rough rule of thumb, the greater the number of beds, the more likely that the institution will have a variety of law-related positions. The number of hospitals meeting this threshold is growing.

See the American Hospital Directory for a list of hospitals and their number of beds.

Why the Growth in Legal Jobs?

The variety of law-related positions in hospitals is diverse and growing, thanks to the following developments:

An Aging Population. Almost 80 million Baby Boomers becoming senior citizens are putting a tremendous strain on the healthcare system. More than 10,000 Boomers turn 65 each day and this will continue until 2029.

A Broken System. Talk to physicians, nurses, other healthcare professionals, politicians on both sides of the aisle, academics and consumers. All agree that American healthcare is broken. We rank 45th among nations in life expectancy and 37th in the performance of our national health system. Seventy-five cents of every healthcare dollar are spent on chronic disease treatment (four out of every five chronic diseases could be prevented because they result from smoking, consuming alcohol to excess, obesity, and lack of exercise).  We only spend 5 percent of each healthcare dollar on prevention.

Skyrocketing Healthcare Costs. Americans spend over $3.3 trillion a year on healthcare – almost 18 percent of U.S. Gross Domestic Product, twice as much as any other nation.

New Technologies. Telemedicine, e-prescribing, treatment breakthroughs and new drugs and therapies are fraught with legal, regulatory, ethical, business and other issues.

Corruption. One major reason why healthcare costs are exploding is the corruption endemic to the system. Providers are tempted by both the third-party payment systems and legal liability exposure to overprescribe and over-test. Fraud accounts for an estimated $200 billion per year in unnecessary healthcare costs.

The Opiod Epidemic. More than 72,000 Americans died last year from drug overdoses, more than from gun violence and traffic accidents combined.

The Most Prevalent Hospital JD Advantage Positions

The most hospital law-related jobs are in the following disciplines:

  • Regulatory Compliance
  • Risk Management
  • Ethics and Bioethics
  • Government Relations
  • Research Integrity
  • Patient Rights.
  • Privacy/Cybersecurity
  • Ombudsman/Mediation
  • Contracts and Procurement
  • Labor Relations
  • Technology Commercialization

Land Trusts

Land trusts are nonprofits that work to conserve land, natural habitats and endangered and threatened species of flora and fauna. Their mission is to acquire land and/or conservation easements, and to preserve land or easements owned by or under control of individuals, governments or private organizations. They solicit donations of land, conservation easements or money to purchase land.  Currently, 1,363 land trusts operate in the U.S., including national, regional and local organizations.

Selected Major Land Trusts

The most prominent national land trusts include the following:

Legal and JD Advantage Positions

You will find typically find attorneys in the following positions (note: job titles vary from trust to trust):

  • General Counsel
  • Staff Attorney
  • Director of Land Preservation
  • Director of Project Review
  • Executive Director
  • Land Conservation Coordinator
  • Acquisition Manager
  • Land Steward
  • Stewardship Coordinator
  • Land Protection Specialist
  • Real Property Specialist

More Information

Land Trust Alliance

Next: Horizon Expansion 101.6: International Organizations