Interpersonal Medicine in the Jail
John was placed on a regimen for his diabetes by a board-certified specialist working with the county jail. His treatment plan included multiple insulin shots per day based on John’s ability to count the number of carbohydrates he ate. The plan was driven by evidence-based medicine, but since the specialist but did not consider the jail environment, John’s diabetes remained uncontrolled. He was not able to count his carbohydrates accurately and was sent to the ER multiple times.
Partner with your practitioner
The latest industry buzzword in health care delivery is “evidence-based.” Evidence-based care, or evidence-based medicine, refers to a clinical approach that relies on data to standardize care. However, this evidence-based mindset has, in some cases, shifted care away from a consideration to specific patient circumstances and capabilities.
What John should’ve received was an “interpersonal approach” to his diabetes. Practitioners are medical experts, not jail experts. A practitioner should partner with jail staff and take the time to understand both the patient and the jail environment when designing a treatment plan. Each jail may function entirely different from one county to the next. Partner with your practitioner.
Put patients over protocols
Evidence-based guidelines are built for every specialty, which tends to standardize treatment protocols. The problem is that the standard chronic diseases like obesity, diabetes, and heart disease are not what kills most individuals in the jail environment. Incarcerated individuals are at a higher risk for death due to suicide and withdrawal. Influential factors may not be strictly physical, but social and behaviorally developed prior to incarceration. A strict evidence-based approach to these problems may not be successful. Avoid treatment protocols and standing orders. Put patients over protocols.
Connect with community professionals
Interpersonal techniques include learning the challenges that detainees face outside of jail and working with the medical team to create a treatment plan that the person can follow in jail and upon release. Detainees released from jail may not have the resources to continue treatment provided during incarceration. If a detainee experiencing substance use disorder is released with no follow up to a health care professional, they may not continue that treatment plan and end up back in jail. The revolving door of recidivism is expensive and wastes valuable resources in your jail. Connect with community professionals.
For more information, please contact training@sparktraining.us.
Disclaimer
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. When in doubt, send them out!®