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Prison Medicine: Now for Something Completely Different

It is no secret that both doctors and nurses leave traditional employment in favor of locum tenens work simply because they want to try something different. They have been doing the same thing for years, and locum tenens offers them the chance at a new way of practicing. Within the locum tenens arena there are lots of different opportunities for doing something different. One of them is practicing medicine in a correctional facility.

A recent Medpage Today article written by Jeffrey E. Keller, M.D. offers some interesting food for thought in this regard. Dr. Keller practices in a correctional facility. He often finds himself explaining to other doctors just how different prison medicine can be. Though he only mentioned a couple of things in his piece, there is actually a lot to think about.

Firing Your Patients Isn’t Possible

Doctors in private practice have the opportunity to ‘fire’ patients who make a habit of being difficult. In the same way, patients can fire their doctors if they are not satisfied with the service they receive. In a correctional institution, neither is possible. Inmates are forced to use whatever doctor and nurse the facility provides. Doctors must continue seeing difficult patients whether they like it or not.

As Dr. Keller put it, inmates and the physicians who provide treatment are stuck with one another for better or worse. To practice in a correctional facility, the doctor has to be willing to put up with the most difficult patients made even more so by less-than-ideal conditions.

Inmates Are Still People

A similar article published many years ago discussed something that doctors in private practice don’t necessarily have to deal with. The point of the article was to say that inmates are still people. Its writer wrote about the fact that practicing medicine in a correctional environment requires the doctor to set aside his or her own visceral reactions to the crimes their patients have committed. They must still provide high quality care to human beings who deserve at least that much respect.

This is a lot easier said than done. Why? Because there are some truly horrendous crimes being committed every day. Doctors are human beings like anyone else, human beings with their own reactions to said crimes. They must always remember that the Hippocratic oath makes no distinction between civilian and convict; no allowances for certain crimes. All patients are human beings deserving of the same level of treatment.

Self-Inflicted Harm

Another thing that doctors have to remember is that patients often have to be seen as a result of self-inflicted harm. In other words, prison is a dangerous place in which inmates routinely injure themselves and one another. Sometimes those injuries are quite serious. Doctors have to set aside what they know is going on within the facility and still provide quality care.

Doctors are, by nature, compassionate people. They want to reach out to patients in ways that help change circumstances so that further visits to the office are unnecessary. But there is little a prison doctor can do to change what happens inside the walls of the institution. It is what it is, for better or worse. The doctor has to just put on blinders and provide the best possible care.

Locum tenens medicine is certainly unique in a lot of ways. For something completely different, try combining locum tenens with prison medicine. There may be no other combination quite like it. If nothing else, the doctor would come away with a new appreciation of how difficult it is to practice medicine in a correctional environment.

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