Over the last 30 years, the role of prison physicians has changed dramatically.
Being the doctor for the county jail used to be a relatively easy job. The
position was frequently filled by a physician who had retired from private
practice. Prisoners were viewed as having little right to medical care, and there
was not much concern about its quality. Even incompetent physicians were
usually immune from suits for medical malpractice because, as governmental
employees, they enjoyed immunity for many of their actions.
Prisons are now highly regulated. (This section will use
prison as a generic term
for all correctional and detention facilities.) State and federal court cases,
combined with legislation, set minimum standards for medical care in prisons
and jails. The first effect of these standards was to end most medical
experiments on prisoners. In addition, the standards ensure that inmates
receive adequate medical care and make it easier to sue physicians and others
involved in improperly run prison medical programs. Despite these regulations,
prison conditions are deteriorating in many parts of the country. Prisons are
overcrowded, and inmates are increasingly HIV infected secondary to the drug
abuse that may have led to their incarceration.