Kathleen M. Boozang, J.D.
Health law is a particularly challenging area in which to teach because we are preparing legal generalists. The students spend most of the semester numbed by the weekly introduction of a new substantive area of law, as if they're enrolled in BarBri for the aspiring health lawyer. But wait, that's not why it's challenging, it's because half the class enrolled because they want to kvetch about how terrible it would be to "socialize" the U.S. health care system, and the other half plans to actually work in health law. No, maybe it's the shattering disappointment of the prospective health lawyers when they realize that their future will not be filled with tension-filled days of counseling clients on whether to separate conjoined twins, offer assisted reproductive technologies to disabled clients, or improve the country's organ supply by creating a free market.
While I am not one of those professors who challenges the tax professors over which subject area is really the hardest one to teach (I actually think it's property), we are uniquely challenged by the sheer breadth of subject matter we're required to master to teach well a survey and the advanced specialty courses. Having begun teaching full-time right from practice, and having had my downs and ups for fifteen years in the classroom, I hope I have a few useful observations for the novice teacher, whether adjunct or full time.
My most important advice: have reasonable expectations. The biggest mistake a professor transitioning from practice can make is to expect too much—your J.D. students aren't going to single handedly put together a gain-sharing program the day after your exam. On the other end of the spectrum, faculty who focus exclusively on the big picture policy issues are providing terrific insights but may not be grounding the material sufficiently to enable the students to connect with it. So, the key to success is finding a middle ground between the detail of an AHLA program, and the superficiality of a presidential candidate's web page (I had the class critique them; Ralph Nader won for clarity and common sense).
Students find the health law survey course daunting because for many it is the first time they must integrate several areas of the law. The facts of many of the cases, particularly the fraud and tax cases, elude them, so, to the horror of the new teacher, many just skip them. Too much health economics is deadly so here too, yes, some just skip that part of the reading assignment. Obviously, a dedicated teacher must address that problem: neither attorneys nor policy makers can afford not to sweat the dull stuff. But there are ways to deal with student reactions to less-than-accessible material.
Remember how little the twenty-two year old who has never had a job knows. They need ways to relate to the material, and to understand its importance. A great way to convey the gaps in our health care system is to assign the students different life roles, and either give them an insurance policy (if their characters are employed) or have them find insurance, and figure out if a) they can afford it, and b) it meets their characters' families' needs.
This year, my class crunched the numbers for a senior couple with basic pharmaceutical needs so that we could understand how Medicare Parts A, B and D would work in tandem. We all learned two important lessons—it took hours to find accessible information and to do the calculations—and, surprising to the students, Medicare's not such a great deal for the senior with limited income.
Remember how much fun it was to diagram sentences in grammar school? (Or does this question itself indicate my age?) Your students can have a variation on this experience (and it'll often be the first time for them). For the more sophisticated tax and fraud cases (e.g., any Intermountain Healthcare case), I have three students draw on the whiteboard their respective understandings of the defendant's corporate organizational chart in order merely to make sure we are all on the same page factually. The students' charts resemble each other not a bit, which generates a few laughs while teaching the facts (e.g, which entity's tax-exempt status is being challenged), explaining corporate organization, and, most importantly, sending a message about the importance of understanding what you are studying.
Most students love bioethical issues-mixing a sufficient dose of bioethics in a survey course gets the students (and therefore you) through the semester. Save it for the end of the syllabus, when everyone's dragging, and coverage isn't as much of an issue if you've fallen behind. Even here, though, you can never assume too much. This year, I started the abortion discussion by asking the students to assume that President Bush would be re-elected, and that during his second term, Roe and Casey would be over-ruled. My pedagogical goal was to demonstrate the inevitability of some states' abortion statutes eventually colliding with Griswald.
I began, again, by educating the students as to basic facts—I presented a power-point presentation explaining how artificial contraceptive methods work, the different procedures used to terminate pregnancy, and when and why women seek late-term abortions. My colleagues warned me that such an approach would be insulting because, if there's one thing students think they understand, it's sex. To the contrary—the students were rapt and asked many questions (including my favorite, "what's an ova?"). The class was great—it was factual; it was neutral; it was educational. It was one of those wonderful moments of knowing you "hit one out of the park".
Teaching health law is an incomparable opportunity to be creative, and to be a great teacher. Enjoy the moments!