Prison Doctors Subject To Evaluations Under Court Agreement
Physicians working in each of the state's 32 prison facilities by 2006 must complete a series of written and oral examinations to assess their medical knowledge under an agreement made public Wednesday, the San Francisco Chronicle reports. U.S. District Judge Thelton Henderson approved the agreement between state officials and a law firm representing prison inmates (Martin, San Francisco Chronicle, 9/23).
Thelton issued the order Friday, enforcing a legal settlement in which the state promised to improve health care for prison inmates. The agreement comes after two reports released last month found that the Department of Corrections hired incompetent doctors, resulting in inadequate health care for some inmates (Benson, Sacramento Bee, 9/23).
Doctors who do not pass the exams will be retrained or banned from working with inmates (San Francisco Chronicle, 9/23). Department spokesperson Margot Bach said that it is not yet clear whether civil service rules would allow the department to fire doctors who are not found to be qualified, or whether they must be moved to another job within the department (Sacramento Bee, 9/23).
To implement the program, corrections officials are negotiating with a medical program at University of California-San Diego that specializes in physician assessments to conduct the evaluations. The state will fund the program, although no cost estimates have been released yet. The agreement also calls for the department to develop a plan to assess and train nurses and a proposal to improve doctor and nurse recruiting (San Francisco Chronicle, 9/23).
The order requires the department to compile a list of inmates with high-risk medical conditions and ensure that they receive care from qualified physicians. Independent doctors approved by the courts will then treat the high-risk patients until the prison system hires enough doctors to provide treatment.
Officials also intend to create a program under which medical residents would treat inmates at clinics and would try to offer more preventive health services to inmates, according to Bach. Inmates currently must complete a form requesting care for an existing illness to receive treatment. Each consultation costs the inmates $5 (Sacramento Bee, 9/23).
"The Department of Corrections recognized that there was a significant problem with patient care. To their credit, they came up with a plan that we think should ensure that the physician-quality issues are addressed," Alison Hardy of the Prison Law Office said (Sacramento Bee, 9/23). She added, "This is a concrete step toward getting rid of those who have been harming patients" (Gladstone, Contra Costa Times, 9/23).
Don Spector of the Prison Law Office called the agreement "a quantum leap forward." He said, "We've been suing the prison system over health care issues since 1980, and this is the most optimistic I've ever been."
"Everyone in the department knows we need to improve health care, and we think this is a very good step in the right direction,'' Bach said.
Gary Robinson, executive director of the Union of American Physicians and Dentists, which represents prison doctors, said, "Instead of spending all this money testing every doctor, what they should do is pick out the ones that have problems and give them training or replace them" (San Francisco Chronicle, 9/23).
In related news, California Journal this month examined the prison health care system following last month's reports (Howard, California Journal, Sept. 2004).
KQED's "The California Report" on Thursday will include a report on the agreement (Campbell, "The California Report," KQED, 9/23). The complete segment will be available online in RealPlayer after the broadcast.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.