Trying to figure out a career path is difficult, especially when the one you have chosen doesn’t even exist yet.
It was an interest in social justice and the rights of disadvantaged groups that led Evans down this path. The Hospital for Sick Children, or SickKids, is affiliated with the University of Toronto, and is Canada’s most research-intensive hospital and largest centre dedicated to improving children’s health in the country, integrating care, research, and teaching. The staff includes professionals from all disciplines of health care and research.
Most people think of not-for-profit organizations as small, locally focused organizations. But SickKids has an annual budget of more than $600 million and does more than $100-million worth of research on an annual basis. So when Evans made the transition from private practice, she was blazing a new trail.
“There are very few hospitals in Ontario that have their own in-house legal department,” she says. “The big Toronto hospitals tend to have at least one lawyer on staff, but that’s a relatively new phenomenon.”
SickKids had a few lawyers on staff responsible reviewing contracts when research was being contemplated — if, for example, a pharmaceutical company wanted to partner with a doctor at the hospital to conduct research. The amount of research being done by hospitals has grown exponentially over the past 10 years, and the health-care sector itself is complex.
It is also a regulated industry and, as such, there’s a ton of legislation and government policy to navigate. So SickKids decided to bring on in-house counsel at a more senior level to lead the group of lawyers already there, but also to analyze and assess what was more broadly required across the organization in terms of legal services.
As a lawyer in the health law group of the Toronto office of Cassels Brock & Blackwell LLP, Evans volunteered with SickKids by sitting on its research ethics board. Once every few months, she’d attend meetings to review proposals for medical research on human subjects to decide whether they met all the ethical standards for research. That was her introduction to SickKids.
“I had a great deal of respect for SickKids from what I had seen sitting on the research ethics board, and thought it would be a huge challenge to come into an organization that hadn’t looked at a holistic approach to legal services from an in-house perspective, to help them envision that,” says Evans.
Now, as the director of the legal services program, Evans supervises a team of three lawyers and a law clerk, on the research front as well as the general commercial operations of the hospital — from new programs to partnerships to contracts with third parties.
“When you’re coming into an organization that doesn’t have an established legal function, you have to be a diplomat,” she says. “There are people who can’t wait for the lawyers to show up — they can’t understand how such a sophisticated organization has operated as long as it has without in-house counsel.”
There are those at the other end of the spectrum who feel lawyers are going to slow things down and generally make their lives more difficult. “So you have to be mindful of that and show the value you add from the minute you walk in the door, and get people to see that you’re there to facilitate them, not to act as a roadblock.”
SickKids already had a department of quality and risk management, which had developed sophisticated procedures to deal with patient care claims made against the hospital.
So Evans had to find a way to work within the existing set-up of the organization, rather than starting from scratch.
Now, she spends her days helping those around her — but no two days are ever alike, and that keeps her on her toes.
Evans was recently asked to sit on a task force examining the issue of allowing male children, about to undergo chemotherapy, to bank sperm since they would likely not be able to have children later in life.
This brings up several ethical issues, such as how old a child has to be to consent to the process and if the child dies of cancer whether his parents can then take possession of the sperm.
It’s those types of ethical issues Evans finds fascinating. She has a background in advocacy and dispute resolution and it is why she loves her job, even during those tough days.
“At times it can be stressful, but at the end of the day when you feel like the work you’re doing is supporting an organization like SickKids achieve its mission of healthier children, it’s a good feeling,” she says.
“You feel like you’re giving back in a meaningful way that’s directly affecting the lives of kids.”
This extends beyond Canada’s borders. Last year Evans went to the Middle East as part of SickKids International, which shares its knowledge of running a world class pediatric hospital to parts of the world that don’t have that expertise, from India to Africa.
“We have a ton of information and know-how,” she says. “If we share it with others who don’t have that kind of infrastructure built up, it’ll be a lot faster and easier for them to build it up.”
While she doesn’t do the consulting work on how to run a pediatric hospital, she works with the SickKids team to
negotiate the terms upon which they’re agree to go to foreign countries.
In the health-care sector, there’s a philosophy of consultation in the decision-making process that is quite different from for-profit environments, so she’s found people skills essential to the job.
“Inclusiveness and collaboration are important in the hospital environment, and making the right decision is really only half the battle. Who you involve and how you implement a decision are critical.”
But blazing a trail through unknown territory doesn’t seem to faze Evans. “We’re at a stage right now where we’re building a platform for the comprehensive legal services that need to be provided across the organization,” she says.
Her next challenge is to move that forward and operationalize a full-service legal department within the hospital — and she intends to be a vital part of that strategic direction.