Fifteen years ago, I went to prison — voluntarily. Jobs were in short supply after I graduated from my NP program, so I took a locum tenens position in our state prison system. Like most clinicians, I had never heard of correctional medicine, nor given much thought to how prisoners might receive care. Not long after experiencing practice behind bars, I began to realize that correctional healthcare could be not only a viable career option, but also a very rewarding one.
The most common question I am asked is, “Why would anyone ever want to work in a jail?” Most clinicians have never considered working behind bars because they have a negative image of correctional medicine.
In response, here are five good reasons to consider a career in corrections:
1. It’s Really Not Boring
If you thrive on variety and challenges, you will find them in correctional healthcare. Clinicians are often surprised at the number of rare or severe conditions that are treated inside a jail. As a colleague of mine once said, “Anyone can get arrested.”
In the course of my career, I have taken care of paraplegics, heart failure, and terminal cancer in addition to more common conditions. While I don’t see pediatric patients (thank goodness!), I have cared for inmates in their 80s and 90s. I have become proficient in TB and MRSA, and somewhat of an expert in drug and alcohol withdrawal syndromes.
Many inmates sustain injuries such as gunshot wounds, stabbings, and car crashes during the course of committing their crimes. Once they are released from the hospital, it’s up to us inside the jail to manage their care.
2. You Work With a Truly Underserved Population
Many inmates led chaotic lifestyles prior to incarceration. These people enter jail in very poor health; not only have drugs and alcohol taken a toll on their bodies, but they are often malnourished and have multiple untreated medical conditions. It’s not unusual for medical staff to discover dangerously high blood pressures or out-of-control diabetes at booking.
Unfortunately, jails are also home to the full spectrum of mental health conditions. Barriers to access in the mental health system in the “free world” mean that many of my patients only receive psychiatric care when they come to jail.
3. Providing Quality Care to Inmates Benefits Your Community
The majority of people who are incarcerated will eventually be released. The care we provide to inmates in the course of stabilizing their physical and mental health means they will leave jail in much better condition than when they arrived. A newly released inmate will have more success in reintegrating into society if his or her health problems are under good control.
4. You Get to Be a Positive Role Model to People Who Lack Role Models
Most of my patients grew up in broken homes. I often see several generations from the same family in my jail. Like my family practice counterparts in the community, I see siblings, uncles, fathers, mothers, and assorted other relatives in my practice.
Many of my inmates have never been taught healthy habits. They grew up watching those around them cope with stress in the unhealthiest of ways, and seeking care in the emergency room was their norm rather than the exception. We have the opportunity to teach and encourage these inmates to take more responsibility for their own health.
5. You Don’t Have to Deal With Insurance Companies
Jails and prisons are responsible for providing and paying for their inmates’ healthcare needs. It’s common for jails to have formularies and guidelines for prescribing and referrals, but unlike our counterparts in the community, we only deal with one set of guidelines. This means we spend our time delivering care rather than coding and billing.
Providing medical care in a jail is not glamorous, but it is essential. While working with this population can be challenging, the rewards are usually great for both clinicians and the people affected by incarceration.
And if that isn’t enough, you will certainly have some great stories of life on the “inside” to share with your friends and family!