Correctional Medicine

[New World... Symphony!]

So I had some questions about practicing for the correctional system.

1. Do most prisons have their own dedicated hospitals, or do most prisoners get care at their closest community/teaching hospital?

2. I guess it kind of goes along with the first question in a way, but are all specialties needed for correctional medicine. For instance, I really love anesthesiology, but would love to provide care for inmates, is this a thing that happens?

3. If this is a thing that happens, how does it happen?

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[Sublimazing]

There are usually primary physicians that work at prisons that can manage the day to day and low level urgent care cases. Depending on the size of the prison they may have one chief medical person and then a handful of part timers.

When a prisoner's malady falls outside the scope of the primary (surgery, imaging, chemo) then the prisoner is taken to the county hospital (or whichever hospital enrolls in the program).

If the hospital sees a lot of inmates they may have a section of the ED that houses prisoners and then usually a whole unit that serves prisoners. Once there, they will have to stay in the detention unit (only leaving for intensive care) and the covering physicians will round/treat them along with their other patients.

I have never personally seen a prison with more than a handful of primary physicians and a psychiatrist...but i'm sure there are exceptions.

 

[tennisguitar]

Talk about a lucrative career... http://www.huffingtonpost.com/2012/10/19/california-prison-doctors_n_1990847.html

 

[Mad Jack]

Talk about a lucrative career... http://www.huffingtonpost.com/2012/10/19/california-prison-doctors_n_1990847.html

My god, a prison psychiatrist made 800k? 😱 Sign me up!

 

[RJGOP]

So I had some questions about practicing for the correctional system.

1. Do most prisons have their own dedicated hospitals, or do most prisoners get care at their closest community/teaching hospital?

2. I guess it kind of goes along with the first question in a way, but are all specialties needed for correctional medicine. For instance, I really love anesthesiology, but would love to provide care for inmates, is this a thing that happens?

3. If this is a thing that happens, how does it happen?

1. I believe most prisons have a cycle of internists who care for the inmates, not positive though.

2. I don't think anesthesiology is one, but you might see family physicians there, again I'm not positive.

3. I think my first answer could answer this, I'm not exactly sure what you mean though.

 

[touchpause13]

My god, a prison psychiatrist made 800k? 😱 Sign me up!

Yup. Plus you get a really nice pension. But most people don't want to do it. Idk if I could. My dad was actually a prison psychologist for a long time

 

[RJGOP]

Yup. Plus you get a really nice pension. But most people don't want to do it. Idk if I could. My dad was actually a prison psychologist for a long time

I would never want to work in a prison- doctor or not.

 

[Mad Jack]

Yup. Plus you get a really nice pension. But most people don't want to do it. Idk if I could. My dad was actually a prison psychologist for a long time

There's not many things I wouldn't do for 800k a year. Regardless of the hours, if I just did it for a couple years I could be set for life, slow down, and do something a little less crazy.

 

[Temperature101]

So I had some questions about practicing for the correctional system.

1. Do most prisons have their own dedicated hospitals, or do most prisoners get care at their closest community/teaching hospital?

2. I guess it kind of goes along with the first question in a way, but are all specialties needed for correctional medicine. For instance, I really love anesthesiology, but would love to provide care for inmates, is this a thing that happens?

3. If this is a thing that happens, how does it happen?

I worked at a big county jail 5 years ago and they had a medical director which was an ID doc and a couple more physicians on top of that (1 IM, 1 general practitioner, 1 part time psychiatrist)... They also had a full time NP and a PA... The PA/NP are the ones who are on call and if something was above their pay grade, they can in turn call one of the physicians. They had multiple RN/LPN... They also had a dialysis tech that came twice a week for inmates who were on dialysis... Like a poster above said, everything primary care-wise was handled in the jail. For other complicated stuff, the inmates had to be transferred to a nearby hospital... Most people might be scared working in such setting, but these people from my experience were just like any regular patient. If you treat them like you treat any patient, they won't bother you. The physicians who worked there LOVED their jobs and I know two of them who still work there. It is a Mon-Fri 8am-5pm job with no calls. When I was there, the ID doc was making around 180k/year.... I don't remember that there was an incident between inmates and any of the medical staff when I was there, but there incidents among inmates... The only thing I might say that was bad was staying on the top of the security system. They train you to keep everything/anything (pen, sharps etc... anything that can be used as a weapon) in your possession at all time. Also, it might not be a good place for some female (though there were many when I was there) to work because some of these male inmates can be very 'weird'... There were many instances when female medical staffs were making rounds and some of these male inmates pulled out their 'junk' and started 'jerking off' in front of them like nothing is happening...

 

[doctorwho9999]

okay that 800k figure is kind of an outlier and i think the psychiatrist paid 800k took some loophole. california's system is effed up and nobody, even doctors (especially doctors) should make that much money off of locking people up in extremely unhealthy conditions. for those who don't care, that's taxpayers' money (except for the fraction of private prisons).

sorry OP can't answer your question. i'd bet any physician working in a prison/jail setting could if you asked them, probably not most SDN med students.

 

[UCONN Prison Doc]

So I had some questions about practicing for the correctional system.

1. Do most prisons have their own dedicated hospitals, or do most prisoners get care at their closest community/teaching hospital?

2. I guess it kind of goes along with the first question in a way, but are all specialties needed for correctional medicine. For instance, I really love anesthesiology, but would love to provide care for inmates, is this a thing that happens?

3. If this is a thing that happens, how does it happen?

First Correctional Medicine is now a recognized specialty. Most physicians in Corrections are primary care: Internal Medicine, Family Medicine, OB/GYN, Pediatrics. However many are also trained in General Surgery, Emergency Medicine, Occupational Medicine, and Psychiatry. Jail-based versus Prison-based care are different and also varies from state to state. Some states systems do have dedicated inpatient facilities or contract with academic institutions for such services. The University of Connecticut provides global health services which includes our own seure inpatient hospital ward as well as ambulatory services at the correctional facilities.

 

[Omppu27]

First Correctional Medicine is now a recognized specialty. Most physicians in Corrections are primary care: Internal Medicine, Family Medicine, OB/GYN, Pediatrics. However many are also trained in General Surgery, Emergency Medicine, Occupational Medicine, and Psychiatry. Jail-based versus Prison-based care are different and also varies from state to state. Some states systems do have dedicated inpatient facilities or contract with academic institutions for such services. The University of Connecticut provides global health services which includes our own seure inpatient hospital ward as well as ambulatory services at the correctional facilities.

So it looks like you're a prison physician? If you don't mind me asking, how do you like it? What got you interested in correctional medicine?

I'm sure many people would be very interested in an AMA from you 🙂

 

[AM508]

There were a couple of reasonable size jails in my EMS coverage area. They seemed to have a physician medical director, but were usually staffed with NP's and RN's. They seemed to ship out quite a few prisoners with us via ambulance. It seemed that anything more than a basic malady was transported. The destination was usually the closest community hospital unless EMS determined a specialty center was required.

EDIT: grammar

 

[freemontie]

There's not many things I wouldn't do for 800k a year. Regardless of the hours, if I just did it for a couple years I could be set for life, slow down, and do something a little less crazy.

This made me lol. Just the huge dollar signs in your eyes. In reality, it was only possible through fraud. Since that story came out a couple years ago several physicians at Cali prison systems have been indicted on grand theft charges for payroll fraud. They were bilking the state while preying on a vulnerable population (the incarcerated).

 

[Mad Jack]

This made me lol. Just the huge dollar signs in your eyes. In reality, it was only possible through fraud. Since that story came out a couple years ago several physicians at Cali prison systems have been indicted on grand theft charges for payroll fraud. They were bilking the state while preying on a vulnerable population (the incarcerated).

😢 There go my dreams...