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“Prescribing Inertia” and “Medication Reconciliation.” Familiar Terms?
The “Interesting Article of the Week” is: Knowing how to stop: ceasing prescribing when the medicine is no longer required. J Manag Care Pharm. 2012 Jan-Feb;18(1):68-72. Ostini R, Hegney D, Jackson C,...
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The F-Word. “Formulary!”
Back when I worked in the Emergency Department of a large hospital, my medical staff assignment for many years was to the Pharmacy and Therapeutics Committee. The P&T committee’s assignment was to...
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Interesting Articles of the Week: Prescriber’s Letter and Medical Letter
The saying goes that just half of what we were taught in medical school is wrong. Also half of what we think we know about medicine now is wrong. The problem is that we don’t know which half! But...
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What Do You Think of The 10 Point Pain Scale?
I was asked via email what I thought of the 10 Point Pain Scale. I have never been a big fan of the 10 Point Pain Scale, but I think that it is a particularly poor fit for Correctional Medicine and I...
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Understanding Pharmacy Prices. Can It Be Done?
There are several good reasons to know what your pharmacy is charging you for each of the drugs you order. You need to know actual prices in order to assess the value of similar drugs, like two...
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What Makes a Good Medical Scoring System?
My good friend Al Cichon wrote the following comments to me about my article on the 10 Point Pain Scale. Use of a ‘scale’ to measure subjective factors is a true oxymoron (heavy on the moron part). The...
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Nursing Clinics and Scope of Practice. What Do You Think?
At the last Essentials of Correctional Medicine conference, Dr. Marc Stern gave a thought-provoking lecture about the proper use of nurses in the correctional setting. I have to admit that his talk was...
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Nurses and Chronic Care Clinics. What Do You Think?
In my last post, I discussed the differences between how nurses are used in Acute Care Clinics in the community versus how they are used in corrections. Today, I would like to discuss the differences...
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Chemical Sedation is Safer than Prolonged Physical Restraint
Here is the clinical scenario: You have an inmate in your facility who is running his head into wall, bull-like, at full speed. He then backs up and does it again. He may be suicidal. He may be...
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Judges Practicing Medicine–The Right Response
I received a court order last week, ordering me to provide a certain inmate with several medications (some of them misspelled) during her six month incarceration. Upon investigation, it turned out...
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Antibiotic Over-prescribing and The Looming Threat of Resistance
I ran across a couple of interesting articles about antibiotics recently. In the first article, entitled We Will Soon Be in a Post-Antibiotic Era, CDC researchers predict that the end of the antibiotic...
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Book Review. Maximum Insecurity: A Doctor in the Supermax
Quick! Name a book that describes the experience of being a medical professional in a jail or prison! . . . Can’t do it, can you? There are lots of books that talk about the life of a lawyer or a...
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Help a Brother Out! Outcome Studies
Hi Dr. Keller, I was hoping I could pick your brain (and those of your readers) for ideas regarding Outcome studies. We are an NCCHC accredited facility with a population of less than 500 inmates. We...
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The Bright Side of Metabolic Syndrome!
I have been doing yearly wellness exams for the local fire fighters for many years now. I quite enjoy it. Many of them are in such good physical shape that I pronounce them to be “Mary Poppins” fire...
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Understanding Breast Cancer Screening Recommendations
Who knew that setting up a breast cancer screening program for corrections could be such a big deal? Fortunately, I don’t have to deal with screening mammograms much in my jails. But we have been...
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Top Posts from 2103 and New Year Resolutions
Thanks to everyone who has read JailMedicine this past year! I have to admit that when I started writing JailMedicine, I never thought it would be as successful as it has been. Total readership should...
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Do Not Use Hydroxyzine for Alcohol Withdrawal!
We correctional practitioners get to see a wide range of medical practice as we review the medical histories of inmates arriving at our facilities. I myself have seen many prescribing practices that...
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Essentials of Correctional Medicine . . . Final Agenda
I am excited to be part of the Essentials of Correctional Medicine conference! It is only five weeks away, February 19, 20 and 21. Click here for more information! As it was last year, Essentials will...
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Reader Question: Xanax Withdrawal
I am looking for a withdrawal protocol for benzos. I have patients that have been on Xanax 2mg for 3-5 years and now I need to detox them. We all know how difficult this is with people in the community...
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Introducing C.F.O.A.M. (and Other Changes)
It is June, 2012 at a pub in Dublin, Ireland. During a break in an international Emergency Medicine conference, and over a pint of Guinness stout (what else?), several doctors were discussing how much...
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