Prison Doctors 

Prison doctors facing review
Judge orders action after many are found to be deficient.
By Clea Benson -- Bee Capitol Bureau - (Published September 23, 2004)

A federal judge has ordered all California state prison doctors to undergo competence evaluations before the end of next year in response to a study that found widespread problems with prison medical staffs.

U.S. District Judge Thelton Henderson issued the order Friday to enforce a legal settlement in which the state pledged to improve inmate health care.

In a report released last month, experts who visited prison health units said they found many poorly trained doctors who were often practicing outside of their areas of expertise. At some prisons, between a third and half of the staff physicians had faced disciplinary, mental-health or substance-abuse problems. Some had faced criminal charges.

The investigation found that at least one doctor in charge of internal medicine cases "makes serious life-threatening mistakes on a continuing basis."

The Department of Corrections agreed with the findings and helped draft the terms of the court order.

Prisoner advocates on Wednesday hailed it as a step forward.

"The Department of Corrections recognized that there was a significant problem with patient care," said Alison Hardy of the Prison Law Office, the legal organization that sued the state on behalf of prisoners who received poor health care. "To their credit, they came up with a plan that we think should ensure that the physician-quality issues are addressed."

The evaluations will place doctors in three categories: those who are fit for duty, those who need more training, and those who should not be treating patients or supervising other physicians at all.

Training will be provided. Margot Bach, a spokeswoman for the Department of Corrections, said it was unclear whether civil service rules would allow the department to fire the doctors who were deemed completely unqualified or whether those doctors would have to be moved to other jobs within the Department of Corrections.

Henderson also directed the department to overhaul its hiring practices, job classifications and salaries.

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 treat the high-risk patients until the prison system hires enough of its own doctors to treat them.

Bach said the prison system would create a program to bring medical residents in to treat inmates at clinics and would try to offer more preventive health services to inmates. Currently, to receive health care, inmates must fill out a form requesting treatment for an existing illness. Each medical consultation costs the inmates $5.

"The department is moving toward a primary care model for inmate health care," Bach said. "We're going to move forward to make sure all of our physicians are qualified."

The Bee's Clea Benson can be reached at (916) 326-5533 or

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