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California prisons pay big bucks for questionable medical care!
Prison doctor gets paid for doing little or nothing By Jack Dolan, Los Angeles Times July 13, 2011 Reporting from Sacramento -- The highest-paid state employee in California last year, a prison surgeon who took home $777,423, has a history of mental illness, was fired once for alleged incompetence and has not been allowed to treat an inmate for six years because medical supervisors don't trust his clinical skills. Since July 2005, Dr. Jeffrey Rohlfing has mostly been locked out of his job — on paid leave or fired or fighting his termination — at High Desert State Prison in Susanville, state records show. When he has been allowed inside the facility, he has been relegated to reviewing paper medical histories, what prison doctors call "mailroom" duty. Rohlfing's $235,740 base pay, typical in California's corrections system, accounted for about a third of his income last year. The rest of the money was back pay for more than two years when he did no work for the state while appealing his termination. A supervisor had determined that Rohlfing provided substandard care for two patients, according to state Personnel Board records. Rohlfing won that case before the board and was rehired and assigned to "mailroom" work in late 2009. "We want taxpayers to know we had no choice in this," said Nancy Kincaid, spokeswoman for the court-appointed receiver in charge of California's inmate healthcare. "If you are ordered to bring somebody back to work, and you can't trust them with patients, you have to find something for them to do." Rohlfing, 65, could not be reached for comment. His attorney, Joseph Polockow, said his assignment is an attempt by prison officials to get him to quit. "If you stick a doctor in a room for eight hours a day with no patients, you're making it very hard on him and trying to drive him away," Polockow said. Rohlfing isn't the only doctor in California's cash-strapped prisons earning big money to shuffle paper. Dozens have been relegated to the chore in recent years, according to Kincaid, who said it's the standard assignment given to physicians when questions arise about their clinical ability. Some eventually return to treating patients, some quit and others are ultimately fired, she added. Last year, a prison doctor who was fired for letting his license expire and was later reinstated by the Personnel Board received $313,610 in back pay, records show. Another, fired for "extreme departure from the medically accepted standard of care," was reinstated and collected $298,787 in lost wages. And a surgeon who had been fired, then put on three years' probation, for missed diagnoses that led to the deaths of two inmates and treatment that robbed another inmate of vision, collected $193,779 in back pay. California's corrections system has a history of employing troubled doctors. When a federal court installed the receiver in 2006, judges noted that "20-50% of physicians at the prisons provided poor quality of care," and 20% had a black mark on their record when hired. Their shortcomings contributed significantly to the fact that a prisoner died "needlessly" every six to seven days in a state lockup, the judges said. Rohlfing's difficulties date to at least 1996, when he suffered a psychiatric crisis while working at a hospital in Fresno, according to Medical Board of California records. After he engaged in "bizarre, irrational and delusional communications," co-workers called police. Rohlfing fled when they arrived, led a car chase through the streets and was caught at his house. Two involuntary 72-hour commitments to psychiatric wards followed. The medical board, which licenses all doctors in California, placed Rohlfing on probation for five years, the board's records show. In August 2000, while still on probation, Rohlfing began working on a limited basis for High Desert State Prison in Lassen County in northeastern California. The state hired him full time in May 2003. Two years later, after the death of an inmate in his care, Rohlfing's clinical privileges were revoked, effectively removing him from the practice of medicine. A review of his cases by a supervisor noted that two patients with histories of heart trouble, who had gone to Rohlfing with chest pains and other signs of cardiac distress, had not been sent to an outside emergency room. The supervisor determined that they should have been transferred because the prison clinic lacked the equipment to perform necessary tests, according to Personnel Board records. Neither patient died or suffered permanent injury. But the supervisor, Dr. Robert Chapnick, determined in both cases that Rohlfing's care had been "significantly substandard." Rohlfing was put on paid leave for 18 months. In 2007, he was fired. Rohlfing appealed his termination to the state Personnel Board. It ruled that his examinations "may not have been textbook perfect," but they did not amount to the inexcusable neglect of duty needed to fire a prison doctor. Rohlfing got his job back in November 2009, but medical supervisors decided he still was not ready to treat patients. Instead, he was put on records duty. He also participates in a retraining program designed to "evaluate clinical skills and provide feedback to the physician and the employer," Kincaid said. The receiver believed that decisions by the Personnel Board were being based on an overly strict reading of state service rules, not on what might be best for patients, and successfully petitioned the court to order the board to hire outside medical experts for help with future cases. jack.dolan@latimes.com |