A day in the life of a Correctional Managed Care physician

Sep 15, 2014, 15:07 PM by India Ogazi

Carole Young Medical FacilityWe’ve all seen horror stories of prison life through overly dramatic films and television shows. But what is life really like in prison? Our fellow UTMB correctional managed care employees, who work within the Texas Department of Criminal Justice system, have an idea.

To learn more about their experience and work life in a prison, I recently visited Dr. Joe Taylor, practicing physician and medical director of the Carole Young Medical Facility prison in Dickinson.

While Hollywood prison stories are set in filthy facilities filled with anguish and violence, the Carole Young unit and Taylor paint quite a different picture of prison life.

Carole Young is a minimum security prison for inmates with ambulatory and inpatient care needs. While it is not a fair comparison to the high-security prisons usually featured in film and TV, the unit did dispel some myths about the prison system. I expected to encounter gruff guards and unpleasant facilities –instead, I was pleasantly surprised by friendly yet stern guards and clean surroundings.

While the majority of Carole Young inmates’ are female patients, it is a co-ed facility with 300 outpatient beds for females and 153 in-patient beds for males and females. As Medical Director, Taylor is ultimately responsible for the care of each patient. He supervises three other physicians, one nurse practitioner, one physician assistant and one psychiatric nurse practitioner, while treating patients as well. In addition to the physician and practitioner staff, UTMB provides a nursing staff of 90 at the facility.

Taylor1Taylor begins his work day at 6:30 a.m. by checking his email for admission information on patients who came into the facility after hours and for patient status updates. “Patients come to us from all over the state,” he explains. “Some patients are transferred from ‘free world’ hospitals like Ben Taub, Clear Lake Regional or any county hospital.”

When an offender becomes ill with an emergency, they are often transferred to the nearest hospital for stabilization. If more care is needed once they are stabilized, they are then discharged and transferred to one of TDCJ’s medical facilities like Carole Young, where they receive medical attention from UTMB employees.
“We are the only female hospice facility in the state,” said Taylor. “We are also an Americans with Disabilities Act facility, so we are equipped for patients who are wheel-chair bound or have special needs.”

Approximately 25 percent of Carole Young’s female patients are pregnant. They come to the facility when their pregnancy is from 16 to 24 weeks or high risk, and remain there until time for their delivery, when they are transferred to the TDCJ Hospital at Galveston. Carole Young is a multi-disciplinary medical facility that provides a range of care, from physical and occupational therapy, to dialysis and cancer treatment, and even dental care.  

After Taylor reviews the patients’ records, he begins his rounds through the medical units, assessing patients’ needs.

One of the major differences in delivering health care in the prison system is the morbidity of the patients explained Taylor. “Many of the inmates neglected their health care before becoming imprisoned,” he said. “They couldn’t afford it health care or weren’t compliant and didn’t know how to access care.” 

Taylor said it is common to have a patient with multiple health issues including diabetes, hypertension, high cholesterol, cirrhosis of the liver and maybe even HIV.

The complexities of these cases provide a remarkable learning experience. The physician assistant students who train at Carole Young often comment that it has been their best rotation, because they are able to learn so much from just one patient. “We have things here that they may see once in a blue moon,” said Taylor.

Prior to joining UTMB, Taylor was chief medical director in the Air Force for the Department of Defense Tricare Gulf South region. During his 24-year career in the Air Force, he served as flight surgeon, hospital commander and chief of medical staffs.

Taylor brings the same vigor and personal responsibility for care to his treatment of patients at Carole Young. Regardless of the individual’s history, Taylor explains that they do what is medically necessary and clinically appropriate for each patient. “As a physician, in every job I’ve had, you accept that responsibility and do your best for every patient under your care,” he said.

Taylor and his team embody the UTMB values, to demonstrate compassion for all and  show respect to everyone we meet. And that’s a day in the life of a CMC physician.