Correctional medicine

Practicing in correctional facilities can offer a predictable schedule and the ability to care for patients long-term.

By Marcia Travelstead | Career Move | Spring 2012

 

NAME: Patrick Arnold, M.D.
TITLE: Regional Medical Director
EMPLOYER: Corizon, Albuquerque, N.M.
EDUCATION: Attended medical school at Alabama School of Medicine; post-graduate education at Oklahoma University Health Sciences Center in Internal Medicine.

What do you like best about being a correctional medicine physician?
I’ve been able to address common and uncommon medical conditions in a captive population. That affords me the opportunity to follow patients long-term. I like the support that I get from my colleagues and superiors…the opportunity to practice in what I think is an interesting field.

Is there anything you don’t like about it?
No, but I think for an individual on the outside looking in, the possible experience of practicing within a correctional environment could be somewhat daunting. For me, when I initially entered correctional medicine in 2004, I was somewhat apprehensive. I entered a correctional facility, and the doors were securely closed behind me. I was oriented to the clinical area; it was just like practicing ambulatory medicine in any routine outpatient clinic.

Why did you choose to practice correctional medicine?
I worked in a community-based clinic in rural Mississippi and was looking for a change from that environment. A recruiter contacted me about working in one of the correctional centers. I interviewed as a temporary replacement to earn extra income and ended up working in that facility from 2004 to 2006.

Today, I’m the regional medical director at a New Mexico contract for Corizon, but I do have some clinical duties to perform patient care.

I think correctional medicine is an excellent opportunity for practitioners to practice autonomously and to take care of patients. They have excellent support from the company to practice evidence-based medicine and to develop experience in a managed care setting.

What is a correctional medicine physician’s schedule like?
Typically, our schedule is an 8 a.m.-to-5 p.m. day. In most of our correctional facilities, we provide ambulatory care services and chronic care management. We do stabilization of emergency situations. We typically transport these people to tertiary care sites where they can be managed by emergency room staff and be admitted to a community hospital.

Would correctional medicine physicians work an evening shift?
In New Mexico, 80 percent of our facilities are 24 hours, but we have around-the-clock nursing services and our providers are not required to be on site, but take telephone calls.

What about weekends and holidays?
In New Mexico, we have a step-down unit. It is a 24-hour facility where nursing services are present 24 hours a day and physicians are on call but are not at the site. Ambulatory care clinics are available at 100 percent of our sites and are Monday-through-Friday, 8 a.m.-to-5 p.m. clinics.

Is that pretty common for other states as well?
Some states have licensed hospitals, which require they have physicians and mid-levels available to return to the site 24 hours a day. That varies from state to state.

Do you have any advice for physicians who are interested in correctional medicine?
I think they need to give it grave consideration. They need to give themselves the opportunity to go out and visit a correctional facility, especially the medical units, to see how they compare to community-based practices versus private practice. I think they’ll find it comparable.

If they take the time to invest time and energy into the patient population and health services provided, I think they’ll be impressed. I feel as though we provide care that is above the standards of the community. We provide our patients care that they cannot access in the community because of economic strains, and health care in the correctional settings is only health care. Incarcerated individuals are the only individuals in this country that are guaranteed health care by the U.S. Constitution.

Was there anything that surprised you about correctional medicine?
One of the things that surprised me the most—in addition to how well the clinics operate in facilities—is how appreciative inmate patients are with the services we provide. I’m surprised at how well correctional facilities operate even outside of the medical facility and how organized they are.

How would a physician get started on the path to becoming a correctional medicine physician?
We have recruiters that operate for Corizon. I would contact the recruiting department and corporate headquarters. We have a website with a list of positions available. We have contracts in more than 30 states, and we have both part-time and full-time positions available.

Do you have any other words of wisdom for new physicians?
I think many of the challenges that face physicians coming out of residency and the opportunities for private practices and hospital-based practices are overwhelming at this time. I think correctional health care gives you an opportunity to practice, to take excellent care of your patients, have a flexible schedule and yet have adequate time for yourself and your family.

—By Marcia Travelstead

 

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