Why do the ca state prison jobs pay high and are always available ? Whats the catch?

[the5thelement]

I have never worked for a prison. Recruiters consistently tell me that the work load is very low, and its a dream job . Yet the jobs are consistently being advertised so I would guess its high turnover (for psychiatrists). Making $300/hr in a stress free low patient load job sounds tempting but literally anyone I have spoken to has nothing but discouraging words to say. The cons range from "not being able to check your phone, feeling locked in like you are in a prison too, the ever present potential for violence, prisoners having nothing but time on their hands so all they do is strategize on how to fool the doctor, etc.." One of these was from a psychiatrist who worked in a federal prison for 12.5 years. Another was a RN who recently was working at the state prison. I am on the verge of starting a small telepsych private practice but the constant temptation makes me think the prison route would be better. Anyone here with a similar dilemma?

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[splik]

Most of the prisons are in undesirable areas. The volume of patients to be seen will vary on the prison and the level of staffing. However, the slowness of the custody staff is a rate limiting factor in how many patients you can see so it usually is much lower volume than say outpatient. Since you are have to stay there to whole time, won't have your phone with you, the computers are limited in what you can access, it could be quite boring if you don't have much to do. You could also be stuck there if there's a lockdown due to a prison riot etc. It can also be a depressing environment for some people to work in. You can't just come and go as you like. $300/hr+ would be for locums positions typical for inpatient not an outpatient or employed prison position.

There is a lot of politics and there have been concerns about the outsized power that psychologists wield in the system and the negative effects of that. There have been several psychiatrist filed lawsuits and whistleblowers over the years. As a contractor you probably wouldn't be too bothered about that.

California prisons are generally much safer than working in an ER or inpatient unit. Most inmates are grateful for psychiatric care, even the antisocial/psychopathic ones and will be nice to people they want something from. It is a potentially interesting job if you are interested in the systems based aspects and sociological dimensions of corrections and working in a total institution. Some people find it especially rewarding caring for some of the most marginalized patients.

 

[B52slinger]

One of my attendings in residency worked in a CA prison for 8 years. During this time he was assaulted 6 times by patients, the last time very seriously and causing him to quit and switch to a non-prison job. He could have been killed had the guards not intervened in a timely manner.

Most people only do short-term contracts, work 6 months at a prison and then say that it's safe because nothing happened to them. I have spoken with other former CA prison attendings who have been gassed (feces squirted out of a bottle), slapped, had their hair pulled and otherwise assaulted over the course of working at a prison for several years. A female attending I worked with quit her prison locums job after less than 1 month because of inmates repeatedly pulling out and showing their genitalia to her without her consent and making sexual remarks.

Safety does vary by location but at certain locations if you are small female psychiatrist I would absolutely not recommend working there. If you're a 6'5 250 pound male then this might be less of an issue.

 

[TexasPhysician]

Let’s ignore the threat of assault - quite possible.

I do different jobs to keep entertained. My rate varies based on what I do. With such a job, you are asking me to be in an environment with likely no windows, no decor, disgruntled patients, support staff with no incentive to be efficient or helpful, prevent total access to my phone, and allow myself almost no forms of entertainment between patients. This is almost worst case scenario. In Texas, many of the prisons don’t have air conditioning, so that would be worse. I’m not sure I could be paid enough to take this job.

 

[vanfanal]

Seems ripe for virtual care. I wonder why that’s not more available.

 

[TexasPhysician]

Seems ripe for virtual care. I wonder why that’s not more available.

This is a better discussion for its own thread, but virtual care is clearly deficient when compared to in-person. It is hard to evaluate tremors, cogwheeling, EPS, and non-verbal cues on current technology cameras. Legal minds agreed which often results in facilities/organizations needing to have quotas for in-person access like exists publicly.

I have discussed virtual with a similar population, and the entity essentially said that such a thing is impossible, even if I provided all of the equipment free of charge. I have to be on-site for them to be in legal compliance.

 

[jbomba]

I work corrections and love it. I have my phone, I come and go as I please. My colleagues and the staff who work there are great. I do consider myself lucky to have this position and I can't say all corrections is the same.

 

[ObsequiousAplomb]

I work corrections and love it. I have my phone, I come and go as I please. My colleagues and the staff who work there are great. I do consider myself lucky to have this position and I can't say all corrections is the same.

The more you describe your job the more I'm certain it's the Beverly Hills jail that Eddie Murphy orders a pizza in.

 

[TexasPhysician]

I work corrections and love it. I have my phone, I come and go as I please. My colleagues and the staff who work there are great. I do consider myself lucky to have this position and I can't say all corrections is the same.

Wow. My buddy works corrections. The building has no air conditioning. He shows up in essentially Under Armour gear and prepares to sweat profusely in the summer. 100+ degrees outside is common in the summer. Part of the job is weeding through malingering as inpatient psych has a/c.

 

[comp1]

So sticking to California corrections in specific, which does have air conditioning throughout as far as I'm aware, I think it's mostly the phone thing to be quite honest. By phone thing, I mean the security that you have to go through. Not only are you cut off from the rest of the world yourself, but also it adds on at least half an hour to your commute each way. And yes, you are a salaried government employee, so even inpatient, this is not a job you're going to leave when you're done or pop out for lunch. Now telework, I think it's absolutely appropriate for corrections and so does CDCR. Sure, something MIGHT be lost in the video, but it would seriously be a minimal. I mean how often do you all do cogwheeling exams on even your inpatients, much less OUTPATIENTS. That said, CDCR has a kind of weird telework setup where you still have to drive in to an unsecured facility (not a prison) to do it. Then you see patients throughout the state. I know one is in Elk Grove (Sacramento). It'd be a nice area to live and I know several people who have done this. I think there might be another site somewhere in the state, but that is the main one for telework. Anyways, here's the pretty much always open listing: SENIOR PSYCHIATRIST (SPECIALIST)

 

[Roxas]

I'm moonlighting in corrections at a large county jail on the weekends while doing CAP fellowship and my experience doesn't seem to match anyone else's here except apparently @jbomba (however I'm not in CA). I get that jail may be different from prison, but corrections environment nonetheless. I get to have my phone. I don't have to go through any security when I get there, and can come and go as I please. The other moonlighting gig offered to me was at a high-acuity psych ED with high volume for significantly less money. I figured my chance of getting assaulted was equivocal or lower in the corrections setting. It doesn't hurt that I'm a pretty large dude, although I worry that may come across as a challenge to some in that setting. The support staff and custody here has been phenomenal, but I'm told by a lot of the people here that this is a uniquely good environment. I can see not wanting to make a career out of corrections, but either as PRN gig or doing it for a few years to pay off loans doesn't seem to be the worst option either. And it's a hell of a lot more stimulating than outpatient where it'd be 15-20 patients a day of titrating Prozac and telling 40 yo adults they didn't just suddenly develop ADHD and ASD.

 

[splik]

One of my attendings in residency worked in a CA prison for 8 years. During this time he was assaulted 6 times by patients, the last time very seriously and causing him to quit and switch to a non-prison job. He could have been killed had the guards not intervened in a timely manner.

This probably says more about him than it does working in a prison. It's always the same people who get assaulted again and again. There are some scary people in prison but in general CDCR prisons are much safer to work in for psychiatrists than acute hospitals.

 

[comp1]

I don't think safety is generally the issue in prisons or jails. They are safer than pretty much any other setting. State mental hospitals might be a bit different in terms of risk, but that's more technically psych inpatient as opposed to corrections. On site corrections where you got to keep your phone and didn't have to go through major security could indeed be nice. I've never seen it, but it appears to exist per the poster above. I definitely wouldn't count on it at CDCR. Some sort of podunk Mayberry type jail somewhere? I just don't know where they could dispense with the security and allow phones free floating around.

 

[splik]

I don't think safety is generally the issue in prisons or jails. They are safer than pretty much any other setting. State mental hospitals might be a bit different in terms of risk, but that's more technically psych inpatient as opposed to corrections. On site corrections where you got to keep your phone and didn't have to go through major security could indeed be nice. I've never seen it, but it appears to exist per the poster above. I definitely wouldn't count on it at CDCR. Some sort of podunk Mayberry type jail somewhere? I just don't know where they could dispense with the security and allow phones free floating around.

Usually county jails aren't so restrictive so you can usually bring your phone in (or sneak it in if not officially allowed), but prisons tend to be more restrictive.

 

[jbomba]

I'll also add, there is currently a lawsuit pending that would allow outside phones into facilities. A couple of the attorneys I bump into coming to and from the non contact rooms told me about that.

 

[Stagg737]

I mean how often do you all do cogwheeling exams on even your inpatients, much less OUTPATIENTS.

Just want to point out that if you're meeting standard of care then at least yearly for any patient on an antipsychotic. This is even more relevant for outpatient docs chronically prescribing patients antipsychotics...