|The Specialty of Correctional Medicine|
|By Jeffrey E. Keller MD|
I just returned from this year’s NCCHC convention. It was excellent, as always. A very important announcement was made at the Society of Correctional Physicians’ meeting on Sunday that deserves more publicity than it is getting.
The American Osteopathic Association (AOA) has officially recognized Correctional Medicine as a Medical Specialty. This is a huge step for those of us who practice the Specialty of Correctional Medicine. This is the first step in getting our specialty fully recognized and legitimized within the bigger world of medical practice.
We do not now have the recognition and respect that we deserve. As an example, if you are registering to join the physician community at Medscape, you are asked to list your specialty and you are given a drop-down list of sixty-nine (69!) possibilities including “Nutrition” and “Genomics” (what the heck is that?) but not Correctional Medicine. What is the closest alternative? Internal Medicine? That’s not right. General Practice? Doesn’t fit. In fact, there is no other comparable specialty. And Correctional Medicine is, in fact, a specialty practice of its own.
I learned this the hard way when I segued into correctional medicine from my original specialty of emergency medicine. It took me several years until I really felt comfortable with the practice of medicine in my jails. And I am still learning! I am making changes to several of my protocols based on things I learned at the SCP conference and the NCCHC conference this last week. A couple of them were real head-slappers, “How could I have never thought of this?” Those I will write about eventually.
Correctional Medicine’s tentative acceptance as a recognized specialty reminds me of the early days of emergency medicine. “Back in the day,” meaning the 1940s and 1950s, emergency rooms (nobody called them “Emergency Departments” back then. They were literally rooms.) were staffed by various members of the medical staff as part of their obligation to the hospital. There would be an orthopedist there one day, a pediatrician the next day and an anesthesiologist the next. If you worked in the ER full-time, other doctors looked at you askance. They were thinking, “What’s wrong with you that you’re not working as a ‘real’ doctor, with a ‘real’ practice?”
That began to change in the 1960’s as full-time emergency physicians began to get organized and set the standards of their fledgling specialty. The American College of Emergency Physicians was established in 1968. The Journal of the American College of Emergency Physicians (now the Annals of Emergency Medicine) was first published in 1972. Later the same year, the first emergency medicine residency program was established. Emergency Medicine was finally officially recognized as an independent medical specialty in 1978 by the American Medical Association. The first official certification exam was given by the American Board of Emergency Medicine in 1980.
When I entered my Emergency Medicine residency in 1985, there was still a little of the old attitude still around: “If you work in the ER, there must be something wrong with you.” But I believe that attitude nowadays is finally gone. Emergency Medicine nowadays is a fully integrated, well-respected specialty.
Correctional Medicine is well on the way along the same path. We have the NCCHC, established in the 1980s. We have The Society of Correctional Physicians, established in 1992. The first issue of the Journal of Correctional Health Care was published in 1994. And now we have the American Osteopathic Association recognizing our discipline.
There are two other organizations besides the AOA that certify medical specialties in the United States. The first is, of course, the AMA. The other is the American Association of Physician Specialists. But since the AOA has already recognized Correctional Medicine, there is momentum for recognition by the other two organizations.
Note that the first Emergency Medicine residency program was established in Cincinnati a full six years before Emergency Medicine became an official specialty. Where in the country will the first Correctional Medicine residency program be established? It’s coming!
Corrections.com author, Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of practice experience before moving full time into the practice of Correctional Medicine. He is the Chief Medical Officer of Centurion. He is also the author of the "Jail Medicine" blog
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