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Healthcare Behind Bars: Inside the Doctor's Office on the Inside

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DOCTORS WITH CLEARLY DEFINED BORDERS
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Prisoners, like everyone else, get sick.

Sometimes it's something commonly seen on the outside, like the flu. Other times, a convict might be suffering from something a little bit less common, like a wound from the shiv his cellie just opened up his abdomen with.

Someone's got to provide medical care to the incarcerated--and there's no shortage of companies that are more than happy to do it. Just think: guaranteed contracts with state, municipal, and federal agencies, a steady stream of patients, and minimal contact with Upper East Side matrons who gossip on cellphones during their physicals.

One of these companies is called Correctional Medical Services. According to the CMS website, "CMS is an integrated, full-service provider, offering medical and dental care, nursing, mental health, pharmacy and electronic medical records services. Since 1979, we have provided talented physicians, nurses and other healthcare professionals with rewarding, growth-oriented alternatives to traditional healthcare careers."

CMS is "the contracted healthcare provider for 10 state correctional healthcare systems," it provides "pharmacy services for 17 states, including three stand alone pharmaceutical contracts," and serves "more than 250,000 inmates in 19 states."

Naturally, most peoples' first question is, "Who goes to work as a prison doctor?"

The answer isn't so cut-and-dried. There are psychologists and psychiatrists who are truly interested in the criminal mind. There are doctors who probably enjoy the ER-type of environment, with unusual cases to gain real-life experience in treating things your average doctor never even gets to see. And then, there are the more pragmatic reasons:

Doctor? CMS says: "The unique working environment of correctional medicine offers more regular, convenient hours, which enables physicians to practice their healing art while balancing their professional and their personal lives."



It also says that "Many of our patients have had limited prior access to healthcare services, so our physicians see a wide variety of medical conditions – everything from relatively simple, routine patient presentations to unusual cases often referenced only in medical textbooks or journals."

Wow.

As Dr. Mary Morehouse, Medical Director at Moberly Correctional Center in Moberly, Missouri says, she "particularly enjoys the stimulating pathology a correctional physician sees."

"Many of the inmate patients we have didn't seek medical care prior to coming here, so their healthcare needs have been neglected," she explains. "I see a lot of cases you normally don't see in private practice in terms of conditions that have gone untreated and even unusual cases, like a patient with lung cancer in his 20s or another one about the same age with a carotid tumor. It keeps you on your toes, but it's exciting, challenging work."

Dentist? CMS says: "The correctional model takes the pain out of dentistry."

How?

* The unique working environment of correctional medicine offers dentists the opportunity for maintaining a steady practice with little or no economic burdens.

* You enjoy a steady patient load and stable work—with no concern about the patient’s ability to pay.

* No administrative headaches, such as collecting insurance payments, so you can focus on dentistry.

* Regular office hours, without being on call or providing the after-hours emergency responses often required in private practice.

CMS also points out that:

* Because of prior limited dental care, many patients present with a wide range of dental health challenges, offering opportunity to review unique states of pathologic oral condition.

* For dentists closer to the end of their careers, correctional dentistry can allow you to simplify your service offerings, and focus on essential services such as trauma and emergency dentistry.

* For recent dental graduates in particular, correctional dentistry affords you the opportunity to develop your professional skills.

WHOA--hold the phone there, Hoss. "Developing professional skills" means "practicing," doesn't it? And I don't mean "practicing" like, a doctor's practice. I mean, "practicing" the way a kid practices piano.

OW! OWWWWWWWWWWWWWW!!!!!!!!!!!!!! OH MY F---ING GOD!!!!!!!!!!!!!!!!!!!!! DOC!!!!!!!!! YOU'RE KILLING ME!!!!! AAAAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

CMS does point out that correctional dentistry isn't all peaches and cream.

"Despite all the positives, we all know that no job is perfect. Correctional dentists often find that one quality they may need to exhibit more of in their environment is good communication skills," the CMS site says.

I can see it now:

"Open wide."

A smoldering glare from the examination chair.

"Last person put his hand inside my mouth, doc, I shot the motherf----r. That's why I'm here."

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