Q&A with Dr. Chuck Vega

Charles Vega, M.D., FAAFP

Title:  Residency Program Director
Organization:  UC Irvine Department of Family Medicine
Years in Medical Practice: 14
MLP Affiliation:  MedLaw Project, Santa Ana, CA
How were you introduced to MLP?  One of the Vice-Chancellors at UC Irvine is very involved with the Legal Aid Society of Orange County.  He also knew of our mission for social justice in the School of Medicine and put us together on this project”

Q: What are the benefits for your residents of getting exposed to the MedLaw Project medical-legal partnership?

A: One of our missions at UCI and the family medicine department particularly is to train doctors to be strong advocates.   We have the term “Physician-activist,” and MedLaw is a big part of that.  We really believe in team-based care, and treating the whole patient, and if you believe in those things then a medical-legal partnership makes a lot of sense.  I don’t believe physicians can do it by themselves.

Being exposed to the kind of legal issues that come up with patients helps our residents learn to be those strong advocates. They get a strong sense of the injustice that some of our patients have to bear. Seeing how lawyers work by sitting in our MedLaw clinics also gives them a whole different perspective about what actually can be done.   It takes it to another level where they're not just identifying problems but they're helping to form the solutions for them.

Q: Describe an example that sticks out in your memory.

A: One of our most successful cases was with a family that was constantly coming in.  We're family doctors, so it wasn't just the kids, but it was the parents too and the aunts and the uncles, that were constantly coming in with these rashes.  It was due to a chronic infestation in their low-income housing unit, which the landlord really wasn't doing anything about.  Yet this whole large community, hundreds of individuals in this housing complex were really suffering.

With a simple letter to the landlord from a lawyer, it got cleared up.

It was interesting for the residents to see that on a micro scale from the kids and to think about how it affected the macro. If you think about all the complications— all the doctors' visits, all the spending on medications, all the asthma that can be incurred—it really affected lives in terms of both quality and dollars.

The idea with a case like that is connecting the dots. When you've got a very full schedule of seeing patients and you see a rash, the temptation is just treat the rash. The challenge is to peel back layers and look at the underlying cause of that rash. The ability to think more broadly in that context is a very valuable skill moving forward.

Q: You worked as a family medicine doctor for 10 years before joining MedLaw. How does being part of a medical-legal partnership change your work?

A: Take the rash as an example. Before, I might have been able to put two and two together, but then I might have sent them to legal aid or to a lawyer down the street who I knew. I felt like I was just giving people a phone number and an address and pushing them out into the ether. The patient might not back for two months, and I’d have no idea what happened.

This is a way where we can actually take care of it in-house, and it just feels a lot more secure. I’m not afraid to go out and look for these issues and look for the social determinants of health, because I know I can do something more proactively about it. Rather than commiserate and gnash our teeth, we can actually make a difference and make positive change for individuals and families.