Friday, March 19, 2010

Schwarzenegger Proposes UC Oversight over Prison Health System

The L.A. Times reports:

The arrangement, similar to a centralized system of managed care, would dramatically expand the use of telemedicine, a technique by which patients are seen by doctors in remote locations over a screen with an Internet connection. It would institute electronic record-keeping so providers could access medical information from anywhere.

And the plan, still being refined, could include the purchase or construction of a central hospital near several prison infirmaries for housing and treatment of the chronically sick. That would reduce the state's current -- and expensive -- practice of paying correctional officers overtime to transport and guard inmates at community hospitals around the state.



Patrick S. O'Donnell said...

i commented on this news over at The Faculty Lounge blog, where I wrote:

If the UC system can't sever its ties with Lawrence Livermore National Laboratory (LLNL) in Livermore, California, I doubt there's much hope for any successful opposition to this plan. (While the UC system no longer exclusively manages and operates LLNL, it remains a dominant part of a 'partnership team' that does so and has the most powerful role in terms of corporate governance: e.g., the University of California is entitled to appoint three Governors to the Executive Committee, including the Chair, and the University of California-appointed Chair has tie-breaking authority over most decisions of the Executive Committee.)

UC's entanglement with LLNL remains an exemplary instance of what John Ziman calls "post-academic science" and the Schwarzenegger administration's proposal appears to be yet another instance of this, among other things. There's a brief introduction to the essentials of "post-academic science" here:

Hadar Aviram said...

Well, I guess the difference would be that in the case of LLNL that aligns the university system with national security, and in the case of prisons, it could be "sold" as a semi-humanitarian enterprise that might enrich the practice in medical schools. It would be a huge headache for UC, though.

Patrick S. O'Donnell said...

The distinction you make is no doubt true: I was simply interested in the way the UC system exemplifies the practice of Big Science and that this would be yet another instance of same. This invariably creates not a few conflicts of interest as it is guided by some norms we might find troubling (as noted in John Ziman's book, Real Science: what it is, and what it means, 1992; and broached in the post I cited).

I would prefer the UC system stay out of the national security business and also believe it should not immerse itself in this form of experimentation on prisoners (i.e., with 'telemedicine,' which I think is inhumane or at least contrary to the humane practice of medicine, one that is both a science and an art, but that's another argument for another day), among other things.

Hadar Aviram said...

The concept of "telemedicine" is fascinating to me, because I get a version of that through the advice nurse at Kaiser. I would love it if any readers with medical expertise could chime in and talk a bit about what that really entails.

Patrick S. O'Donnell said...

Daniel Goldberg of the Medical Humanities blog might be someone to ask about such things:

I'll write him later and ask him what he thinks.

Patrick S. O'Donnell said...

And by way of background reading, I would recommend Kathryn Montgomery's How Doctors Think: Clinical Judgment and the Practice of Medicine (2006).

Anonymous said...

Follow the link below to see how well the University of Texas Medical Branch under Stobo's leadership did with managing inmate care in Dallas County:

And here's a news release concerning the consultant California is using.

The procedures were created at UTMB and UTMB physicians (don't know if they're still UTMB physicians) run it.