As with other institutional settings, physicians should request a written description of their duties before accepting a position. For example, some jurisdictions have specific arrangements in the jail health system or with the county hospital system to take blood samples and other specimens from criminal suspects. Physicians accepting a position in prison health should know whether they will be called upon to obtain such biologic evidence and to provide court-ordered medical testing and involuntary treatment.

Independent contractor physicians do not enjoy governmental immunity from suit in the way that governmental employee prison officials do. Such physicians should be particularly careful not to compromise their professional standards when caring for prisoners. Care that would be protected from suit if performed by an employee of the prison system may be actionable if performed by an independent physician. Contract physicians should also ask the prison authorities to indemnify them for legal expenses and lost time if they are named as parties in civil rights litigation against the prison medical care system. Such actions may not be covered by medical malpractice insurance. Without such an agreement, a private physician may have to spend tens of thousands of dollars and hundreds of hours of uncompensated time defending actions taken on behalf of the prison.