PROFESSIONAL ISSUES

Reputation rehabilitation: Prison medicine

Increased standards of care are making it more respectable to practice medicine for patients behind bars. And there are even some perks in scheduling, practice management and safety.

By Damon Adams, AMNews staff. Nov. 22/29, 2004.

Clanging metal chains and handcuffs can't distract Joachin Okafor, MD, from caring for his patient.

The 44-year-old man has come to Dr. Okafor, complaining of chest pain. He rests on a gurney. An IV is started. Paramedics soon arrive, and Dr. Okafor tells them what medications the man takes.

The patient has a history of heart problems. He has a criminal history, too.

As a prison guard unravels chains attached to handcuffs and shackles the patient's ankles, Dr. Okafor continues to explain the man's condition to paramedics. The guard pulls more chains through the gurney's steel frame, cuffing the ill inmate's hands to his side. As paramedics wheel the man out of the room, he thanks Dr. Okafor, adding, "Have a good day."

This is routine treatment for prisoners at Westville Correctional Facility, a medium-security prison of about 2,800 inmates nestled among corn fields and wide open spaces in northwestern Indiana. Anytime a medical problem requires a trip to a hospital emergency department in town, inmates must be cuffed before leaving. It's also routine for Dr. Okafor to treat the inmates with the same level of compassion he would provide to patients on the outside.

Dr. Okafor practices medicine behind bars because the regular work schedule gives him more time to spend with his wife and four children. There are no HMO hassles, no Medicare issues. He doesn't worry about patients missing follow-up visits. It's a more secure and satisfying job than most outsiders realize, he said.

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