Monthly Archives: May 2015

Removing Microdermal Implants, A Photographic Tutorial

A couple of years ago, I first started to see microdermal implants in my jail patients.  This is, of course, jewelry that is implanted in the skin.  These have become so popular as to be almost universal.  If you work in a jail or prison (or even if you have looked around at your local grocery store), you certainly have seen these.  Microdermal implants can be problematic in correctional settings, because they cannot be easily removed like the older bolts and rings.  Microdermal implants are imbedded in the skin, and removal requires making an incision to extract them.

But in corrections, even though it is difficult, microdermal implants often must be removed, either as a security issue or because the patient requests that they be removed.  Nowadays, these implants are so common that all correctional practitioners really should know how to deal with microdermal jewelry.  But most of us were never taught how to do this in our training!  I certainly never learned about these in my residency training.  Such a thing would have been inconceivable back then.   Cutting edge fashion in those days was long hair and grungy jeans!

So I was grateful when an opportunity for education presented itself recently.   A friend of mine asked me if I would remove two of her micro dermal implants and kindly consented to have the procedure photographed.  Todays JailMedicine post is a photographic tutorial on how to remove microdermal implants.IMG_0793 Continue reading

How Does Jail Medicine Differ From Prison Medicine?

I was talking to a physician colleague of mine the other day and he was quite interested in what I was doing and in correctional medicine in general. Like most people (it seems), he had no idea what the difference was between jails and prisons and what the practice of medicine is like in the two settings. While the term “Correctional Medicine” encompasses medicine practiced in both jails and prisons, the actual practice of medicine in the two settings can be as different as that of an emergency department and a nursing home.

A good way to illustrate the difference between jails and prisons and between jail medicine and prison medicine is by using patients as models. To this end, let’s consider the cases of two patients entering the correctional system for the first time, a homeless alcoholic and a successful middle aged business man who sees his primary care physician regularly.BonnJail Continue reading