Psychapplicant133
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Can anyone attest to what correctional facility psychiatry is like?
Thanks!
Thanks!
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Corrections
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It's not the patients that make corrections unpleasant. They're for the most part glad someone is being nice to them and they show the doctors respect.
It's the system. Corrections institutes tend to be unpleasant by design in this country. Not having your phone makes it unpleasant. Going through security is unpleasant. All of the people who work there are choosing to be there. Somehow, you feel more trapped with them.
That being said, a corrections job in a system that isn't inherently unpleasant and has a collegial work environment can be really great. Some people speak very highly of their corrections jobs. Those people tend to be quieter than the ones who dislike it.
It's the system. Corrections institutes tend to be unpleasant by design in this country. Not having your phone makes it unpleasant. Going through security is unpleasant. All of the people who work there are choosing to be there. Somehow, you feel more trapped with them.
That being said, a corrections job in a system that isn't inherently unpleasant and has a collegial work environment can be really great. Some people speak very highly of their corrections jobs. Those people tend to be quieter than the ones who dislike it.
I just rotated through a jail in residency. It was interesting in that the pathology was so, so severe. Excellent for training. It takes really severe pathology for the police to decide to take you in to jail as opposed to the hospital for a civil commitment. that said, it wasn't fun to work in. The facility was not geared towards recovery (or even rehabilitation sadly). It was geared towards punishment as far as I could tell. Everything was drab and concrete. Further, the facility was not "managed" by physicians in the way a civil inpatient psych unit would be. It was managed by sheriff's deputies. I always felt more like we were consultants to their primary team. The formulary is obviously extraordinarily restricted (basically to the Target $10 generics), but I didn't see that as horrible thing. Not having your phone and adding an extra 15-30 minutes to your commute to get through security was indeed quite horrible.
I work corrections part time. It's amazing. It's my favorite gig of the several I have. It pays wonderfully, my work load is very manageable, and the cops who staff the jail are all professional and cordial. I have a good team of therapists and nurses who make my job easy. My colleagues are all generally good people who seem smart and have good pedigrees (for whatever that is worth).
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I think a few factors drive up correctional wages:
-Many of these facilities are in the middle of nowhere, and even if not they are constitutionally obligated to provide medical treatment (deliberate indifference is cruel and unusual punishment). Thus, they have to pay whatever it takes to get someone hired.
-Providers might feel uncomfortable or unsafe in a jail or prison.
-Some view this population as not desirable to work with, or even as less deserving of good care.
-It can feel uncomfortable to feel "locked in." For example, if your kid's school calls how quickly can you get back out of the jail/prison's security? And do you even get to keep your cell phone on you to receive that call in the first place?
I have rotated through both jails and prisons. I found they were overall good experiences. Like ObsequiousAplomb mentioned, my experience was that most inmates were quite happy to have someone who seemed to care come talk to them. No one (staff or inmates) seemed to view me negatively; the inmates didn't seem to see me as some kind of correctional officer, and the correctional officers were generally professional and not a problem to work with. I did run across some cases where people had severe personality pathology and would be pretty out of control behaviorally, but that was a relatively small portion of the caseload (and of course you have plenty of onsite security backup to respond to violent behavior, and plenty of options to set up safe interview conditions).
-Many of these facilities are in the middle of nowhere, and even if not they are constitutionally obligated to provide medical treatment (deliberate indifference is cruel and unusual punishment). Thus, they have to pay whatever it takes to get someone hired.
-Providers might feel uncomfortable or unsafe in a jail or prison.
-Some view this population as not desirable to work with, or even as less deserving of good care.
-It can feel uncomfortable to feel "locked in." For example, if your kid's school calls how quickly can you get back out of the jail/prison's security? And do you even get to keep your cell phone on you to receive that call in the first place?
I have rotated through both jails and prisons. I found they were overall good experiences. Like ObsequiousAplomb mentioned, my experience was that most inmates were quite happy to have someone who seemed to care come talk to them. No one (staff or inmates) seemed to view me negatively; the inmates didn't seem to see me as some kind of correctional officer, and the correctional officers were generally professional and not a problem to work with. I did run across some cases where people had severe personality pathology and would be pretty out of control behaviorally, but that was a relatively small portion of the caseload (and of course you have plenty of onsite security backup to respond to violent behavior, and plenty of options to set up safe interview conditions).
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In a way it seems like it would be easier if you think about it. You are likely not going to make people happy about being in prison , your job is to work with them and provide comfort. You dont have to worry about prescribing controlled medications and they typically wont ask because they know its not allowed, which is great. People sometimes are just happy to see a real psychiatrist. Sure some people suck but that happens in regular outpatient psych. Downside is probably garbage EMR or no EMR at all. In residency the prison had paper charting system which was horrendous. Also medication administration was inconsistent and poorly documented. It was ironic though, the no show rate was higher here than my current job. At my current job I generally only have 1-3 no shows per week. At the prison id have like 30% no show if they didnt feel like coming to their apt.
Ive gotten some ads for psychiatrist at a female prison with crazy pay offers, and if something were to happen at this job I think I would actually consider that. Personally I think id go for female prison, if I were to do corrections, because while most of my male patients were great, I had some that I did have concerns about physical violence.
Ive gotten some ads for psychiatrist at a female prison with crazy pay offers, and if something were to happen at this job I think I would actually consider that. Personally I think id go for female prison, if I were to do corrections, because while most of my male patients were great, I had some that I did have concerns about physical violence.
Ill also add, for what its worth, I get more respect and politeness from my corrections patients than I do my psych inpatients. I'm sure some of it might be trying to game me for whatever it is they want, but generally the negative interaction is significantly less in my correction facility than the hospital. And we use EPIC, so charting is super easy.
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how is the pay at your corrections job and patient load?
I dont want to dox myself since our pay structure and scheduling is a bit unique, but I essentially make 4k a day for 10-15 patients.
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That sounds insanely high? 4k a day? Wow
Psychapplicant133
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Is that 4 days a week? Also is it full time or locums?
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How many lawsuits have the previous psychiatrists gotten?
Zero. This is truly a unicorn position.
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I mean yes and no. For 1099, no setup needed work it's certainly great. That said, I know a number of psychiatrists who book full days at $600 hour which is almost exactly 4k after seeing 12ish patients. There is some overhead of course, but the patient population make the work sustainable to them for decades.
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im pretty surprised because a few years ago the local prison was fixated on saving money and fired all the psychiatrists in place of telehealth midlevel providers.
I didnt they would pay that much in corrections
I didnt they would pay that much in corrections
I'll say the state prisons where I live pay very average...like $285K for M-F schedule. Not sure why pay is so low. It's possible patient volume is extremely low as well but don't know for sure. I assume as a state employee you're stuck there 40 hours a week even if you're only seeing 5 people a day.
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More like 45 because lunch time is not paid.
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Nuts man. 4 days per week x 48 weeks per year and you’re looking at ~750k/yr
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Not to mention jbomba's 2 other jobs they're also working.
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Yes he is in cali so the rates are probably not that far off from similar work. Being 1099 you never know if your position is 3,6,9 months or years. Also, if there is some financial issues and new admin enter they might say hey lets hire NPs galore and we can save a bunch!!
Can you imagine if docs had blocked the whole NP movement but add that to another battle we miserly failed at.
