I am often asked by my non-correctional colleagues what it is like to work in a jail. I tell them that practicing correctional medicine is different in many ways than medicine in the “free” world. Many of them scoff at this. How could the practice of medicine be different in a jail than it is anywhere else? “Medicine is medicine,” they say.
But correctional medicine is different. In my experience, if you just throw a practitioner into a jail or prison clinic without any training, he likely will not do well. It took me two full years before I was comfortable in my sick call clinics and I am still learning things as I go. Experience matters in Corrections!
This is obvious to those of us who have experience working in jails and prisons. But how do you explain the intricacies of a jail medical clinic to an outside physician? I have thought about this a lot over the many years I have practiced correctional medicine and I have come up with several concrete examples of how correctional medicine is different from medicine “on the outs.” The first, and perhaps the most important, difference is the Principle of Fairness.Continue reading →
I recently read my friend Lorry Schoenley’s excellent article on Correctional Nursing is Different–Research Report which is about the differences between correctional medicine and traditional community medicine. Coincidentally, I also found myself at about the same time hiring a new full-time Physician Assistant with no correctional experience and having to explain how important these differences are. If you do not recognize and embrace these differences, you can get yourself and your patients into serious trouble. In this article, I am going to point out some of the important differences between correctional medicine and what I am going to call “Outside Medicine.” Continue reading →