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Substandard Doctors Should Not Treat Louisiana Prisoners

September 2012

By Dr. Sidney Wolfe, Director of Public Citizen’s Health Research Group

Would you be worried and upset if someone you loved — a relative or friend — was in an institution in which the doctors caring for them had been disciplined by the state’s medical board at a rate 30 times higher than that of the average rate for physicians in that state? Examining this issue, an extraordinary investigation by New Orleans Times-Picayune reporter Cindy Chang, published in late July, had the following lead:

Of the 15 doctors working full-time at Louisiana state prisons, nearly two-thirds have been disciplined by the state medical board for issues ranging from pedophilia to substance abuse to dealing methamphetamines.

The latter physician referenced above was in jail for two years for buying $8,000 of crystal methamphetamines from an informant. His license was then restored with the condition that he practices only in an “institutional” setting.

One Louisiana physician, while serving an 18-month federal probation sentence for medical fraud, issued multiple narcotics prescriptions, violating a medical board order. Another had been arrested for illegally discharging a weapon and for criminal trespassing, and had steroid-induced psychosis, delusions and dependence on sedatives and narcotics. Still another, while on probation with the medical board for an earlier sex offense, molested yet another female patient and admitted to touching her inappropriately and engaging in a sexual relationship with her.

When contacted by the reporter to comment on these alarming findings, I stated that, in addition to being unethical, allowing these doctors to continue to practice is potentially dangerous for the inmate patients who are being taken care of by physicians with demonstrably substandard records. After being told that the prison system has claimed they would not hire such doctors if their records included “medical incompetence,” I replied that it was unreasonable to believe that the doctors’ poor judgment was limited to the areas, such as criminal behavior and inappropriate sexual activity, that had led to their being imprisoned or seriously disciplined by the medical board and that they probably had a higher likelihood of medical incompetence.

Although it is probably more difficult to find physicians willing to work full time in prisons, Dr. Don Kern, president of the Society of Correctional Physicians, told the Times-Picayune: “I don’t think it would be desirable to take a state’s lowest-quality physicians and specifically have them deal with the most vulnerable population, whether it’s corrections or the developmentally disabled. … As a whole, it would seem like there may be a concern here because that’s striking me as an unusually high proportion of people who have some kind of license problem.”

Dr. Kern mentioned the developmentally disabled because doctors restricted by the Louisiana State Board of Medical Examiners to practicing in an institutional setting are not only limited to prisions, but also can practice in mental health facilities and homes for developmentally disabled children. There is no information available regarding the percentage of physicians who serve in these latter types of facilities and have previous medical board disciplinary actions.

The National Commission on Correctional Health Care (NCCHC) has issued a position statement condemning institutional restrictions because of the implication that inmates do not deserve the same care as the general population.

The Times-Picayune also ran an editorial on Aug. 5, 2012: “Louisiana prisoners also deserve good doctors.” The editorial quoted the NCCHC president’s statement that allowing these questionable doctors to practice “gives the impression that somehow a physician is good enough to work on inmates … but not good enough to work on other patients, as if inmates are less worthy of adequate care.” The editorial concluded by saying that this “should not be the position of Louisiana’s government or the state medical board. For all these reasons, officials should work to reduce the number of sanctioned doctors working in our prisons.” We could not agree more. But are additional states also allowing doctors “not good enough” for other patients to treat inmates?

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