About
Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of emergency medicine practice experience before moving full time into his “true calling” of Correctional Medicine. He is the Medical Director of Badger Medical, which provides medical services to several jails and juvenile facilities in Idaho. Dr. Keller is available for consultation on any aspect of Correctional Medicine, including legal cases, program development, and system analysis.
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Dr. Keller; could you consider an article on a particular type of offender manipulation – offenders who use medication / treatments etc. to leverage an issue.
Here are some examples:
#1
We typically provide a calculated calorie diet (based upon ideal weight) for all diabetics and have a food restricted commissary. Items that have little to no caloric / carbohydrate value are allowed.
A diabetic patient will complain, file a grievance and finally ‘refuse’ treatment (medication, testing) if the first few efforts fail.
NOTE: offenders are fed by trays delivered to their rooms not in a ‘chow hall’ setting so they cannot ‘select’ their diet – if we used a ‘chow hall’ it would be an education issue.
#2
An inmate cannot work – on disability in the community – after exam and health history a medical profile and activity restriction is accomplished. The jail has no work position available that fits the profile. The offender is refusing all medications.
NOTE: Of interest; the diabetic / hypertensive / COPD patient has better glucometer readings, plod pressures and activity level than in community.
My concerns are:
First that the patient-offender will cause themselves (medical) harm
Second the facility will be open to some level of liability
Third that the offender is turning this into a ‘contest’ (and I’m falling for it).
Finally, they often say (offenders) that they are ‘willing’ to sign a ‘release’ that frees the jail of any responsibility for their (offenders) choices [Not worth the paper used to write it]
PS the notes are my personal comments and probably add nothing to the post.
I would love to see your opinions on the Hep C treatments being mandated across the country for the inmate populations. I want to see people get treated, but budgets are not infinite, and say cost is not an excuse but how can we afford to treat hep c when in some cases its more than triple an entire states pharmacy budget.