A View From Inside the California Prisons by a Doctor Who Treats Prisoners
Moss David Posner M.D.
September 13, 2006
This article appeared first in "California Progress Reports" within the past week. It is reproduced herein verbatum.
My name is Moss David Posner. I am a staff physician for the California Department of Corrections and Rehabilitation—at least for the time being. Let me explain:
While working in the prison, two years ago, I found on my desk in my office a very ominous drawing. It consisted of a sketch of two daggers plunged through two hearts, and with the exiting dagger tips dripping blood onto a drawing of two Jewish Stars, respectively. Thinking perhaps an inmate had drawn this, I took it to the custody captain, who immediately said, “My God, Doctor, this is a death threat, “ and took the drawing back to my nurse, who—incredibly--admitted having drawn it herself,. Immediately, she snatched the drawing, and ran out into the hall. A search of her purse and through the area failed to turn up the evidence.
Here’s a little background: At that time I was being considered for a position as Chief Physician for Corcoran State Prison. Previously, I had been the acting Chief Physician for Salinas Valley prison; and after that, I had transferred to Substance Abuse Treatment Facility (SATF,) another prison, also in Corcoran, where I had been appointed the acting Chief Medical Officer for several months. SATF, by the way, is the largest prison in the free world, housing about 7500 prisoners. So I had a bright future as a medical leader.
As you might expect, I filed charges against the nurse; but as you wouldn’t expect, she was promoted, yet I was removed for consideration for a position as Chief Physician at Corcoran, a position, by the way, for which the Chief Medical Officer at Corcoran had personally asked me to apply, and to which I was entitled. By a strange coincidence, this occurred right after I complained to the Warden about the incident I described above. Actually, it was no coincidence: the Chief Medical Officer told me to my face that my complaint was why I was removed from consideration.
This was done to scare me off. You see, I have been a champion of inmates' rights to adequate care, and with that, a vociferous critic of the Department. I have written articles about the Department’s neglect. I am a writer, and have spared no modesty in pointing out the foibles of the CDCR to the public. You can review some of my stuff here.
I also kept detailed notes of wrongdoing in my office.
One year ago, a custody official removed my notes from my office, even though they were under lock and key. I was accused of a violation of patient confidentiality, and was threatened with disciplinary action. This accusation was—and is--patent nonsense. My notes were in a folder, behind a locked door, in a clinic that is either always monitored or locked up.
They had to know that if the information in my notes ever got out, there would be hell to pay. Recently, I asked that this accusation be removed from my file, as allowed by regulation. To date I have received no response. I also have never got my papers back.
Shortly after my notes were confiscated, I was accused of giving inadequate care to three inmates and put me out on leave pending resolution of the matter. At that time, the Medical Department made no specific accusations. What they did was to say that a custody official made the accusations. Despite numerous demands, the custody department has never produced any charges.
Months after I was put on leave, with no explanation whatever; and in order to give some semblance of legitimacy to their claims, the Medical Department in Sacramento sent some of my charts to some doctor of their choosing in San Diego, someone associated with the University of California at San Diego. The only problem with this is that, not only is this is not standard procedure, but also, these reviews were done two and three months after—I was put on leave. I’ll have more to say about this reviewer later. To make the farce complete, the Department actually gave me the chance to rebut the reviewer’s charges—not to physicians, but to custody officials, who know nothing about medicine, by their own admission.
In 43 years of medical practice I have never been similarly accused. I’ve never been sued for malpractice. I’ve never had to appear in front of the Medical Board. So far the medical board has seen fit to stay out of this until the dust clears, which I appreciate.
Two months ago the State Personnel Board ruled in my favor on my claim that I had been illegally removed from consideration as Chief Physician on the basis of “Retaliation,” and the Department was ordered to desist from any other intimidation. By another astonishing coincidence, shortly after I won my case, the Department decided to take me off the staff—permanently. Rather than confront me in the appellate process, the Department has referred the matter to an Administrative Law Judge. To date I have yet to speak with any doctor about any allegations; but as bad as this is, what I am about to tell you next, staggers belief:
You’ve read in the papers about all of the criticism of the inmates’ medical care. To cover itself, the Department hired on what we were told was an independent testing service, based at UC San Diego to do testing to evaluate the doctors’ competence. This is to have been done even if they haven’t been accused of any wrongdoing. The legitimacy of this is now being fought in the courts because doctors already are required to take ongoing medical education courses. This testing service is the same one that independently evaluates doctors referred by the California Medical Board--doctors who have already face some specific charges. If there are specific accusations against doctors, it’s only fair to all parties to do this.
Let’s go back to the chart reviews. Because of the implications in his reviews, I wrote and asked this reviewer if the Department had hired him personally. He never answered. Instead I got a letter from his superior.
Guess what? The reviewer’s boss is the same guy in charge of the “independent testing.” I had to dig for this info because this boss’ name appears nowhere on the documents—yet the reviewers work for him. Two separate paths to hang the doctors out to dry, both from the same source.
If the doctors ever could tell you folks the truth of what goes on in the Department of Corrections and Rehabilitation, they would blow the lid off what the Department doesn’t want you to know—that their orders are cancelled, that consults they desperately need are denied, that medications they have ordered are refused—that they are being set up as the fall guys, and so far it is working.
The doctors will survive, wherever they end up working. It’s the inmates and their families that will pay the price. In all sincerity, I’m known to the inmates as a good and caring doctor and have been told as much on numerous occasions. These guys are getting a very bad deal and I've stuck up for them, and I'd do it again tomorrow morning.
You folks have to make a decision: Do you just want someone to take the rap, or do you want the truth? Think of it this way: If these people can treat the inmates unfairly and get away with it this long, what makes you think that they can’t do the same to anyone else under their control, people who threaten their authority? They love nothing better than to have you and the medical staff at loggerheads. Then they can just walk away whistling.
If I could go back tomorrow morning to my patients, I’d do it in a heartbeat. Do you really want to help the inmates? Okay then, hear our story.
My name is Moss David Posner. I am a staff physician for the California Department of Corrections and Rehabilitation—at least for the time being. Let me explain:
While working in the prison, two years ago, I found on my desk in my office a very ominous drawing. It consisted of a sketch of two daggers plunged through two hearts, and with the exiting dagger tips dripping blood onto a drawing of two Jewish Stars, respectively. Thinking perhaps an inmate had drawn this, I took it to the custody captain, who immediately said, “My God, Doctor, this is a death threat, “ and took the drawing back to my nurse, who—incredibly--admitted having drawn it herself,. Immediately, she snatched the drawing, and ran out into the hall. A search of her purse and through the area failed to turn up the evidence.
Here’s a little background: At that time I was being considered for a position as Chief Physician for Corcoran State Prison. Previously, I had been the acting Chief Physician for Salinas Valley prison; and after that, I had transferred to Substance Abuse Treatment Facility (SATF,) another prison, also in Corcoran, where I had been appointed the acting Chief Medical Officer for several months. SATF, by the way, is the largest prison in the free world, housing about 7500 prisoners. So I had a bright future as a medical leader.
As you might expect, I filed charges against the nurse; but as you wouldn’t expect, she was promoted, yet I was removed for consideration for a position as Chief Physician at Corcoran, a position, by the way, for which the Chief Medical Officer at Corcoran had personally asked me to apply, and to which I was entitled. By a strange coincidence, this occurred right after I complained to the Warden about the incident I described above. Actually, it was no coincidence: the Chief Medical Officer told me to my face that my complaint was why I was removed from consideration.
This was done to scare me off. You see, I have been a champion of inmates' rights to adequate care, and with that, a vociferous critic of the Department. I have written articles about the Department’s neglect. I am a writer, and have spared no modesty in pointing out the foibles of the CDCR to the public. You can review some of my stuff here.
I also kept detailed notes of wrongdoing in my office.
One year ago, a custody official removed my notes from my office, even though they were under lock and key. I was accused of a violation of patient confidentiality, and was threatened with disciplinary action. This accusation was—and is--patent nonsense. My notes were in a folder, behind a locked door, in a clinic that is either always monitored or locked up.
They had to know that if the information in my notes ever got out, there would be hell to pay. Recently, I asked that this accusation be removed from my file, as allowed by regulation. To date I have received no response. I also have never got my papers back.
Shortly after my notes were confiscated, I was accused of giving inadequate care to three inmates and put me out on leave pending resolution of the matter. At that time, the Medical Department made no specific accusations. What they did was to say that a custody official made the accusations. Despite numerous demands, the custody department has never produced any charges.
Months after I was put on leave, with no explanation whatever; and in order to give some semblance of legitimacy to their claims, the Medical Department in Sacramento sent some of my charts to some doctor of their choosing in San Diego, someone associated with the University of California at San Diego. The only problem with this is that, not only is this is not standard procedure, but also, these reviews were done two and three months after—I was put on leave. I’ll have more to say about this reviewer later. To make the farce complete, the Department actually gave me the chance to rebut the reviewer’s charges—not to physicians, but to custody officials, who know nothing about medicine, by their own admission.
In 43 years of medical practice I have never been similarly accused. I’ve never been sued for malpractice. I’ve never had to appear in front of the Medical Board. So far the medical board has seen fit to stay out of this until the dust clears, which I appreciate.
Two months ago the State Personnel Board ruled in my favor on my claim that I had been illegally removed from consideration as Chief Physician on the basis of “Retaliation,” and the Department was ordered to desist from any other intimidation. By another astonishing coincidence, shortly after I won my case, the Department decided to take me off the staff—permanently. Rather than confront me in the appellate process, the Department has referred the matter to an Administrative Law Judge. To date I have yet to speak with any doctor about any allegations; but as bad as this is, what I am about to tell you next, staggers belief:
You’ve read in the papers about all of the criticism of the inmates’ medical care. To cover itself, the Department hired on what we were told was an independent testing service, based at UC San Diego to do testing to evaluate the doctors’ competence. This is to have been done even if they haven’t been accused of any wrongdoing. The legitimacy of this is now being fought in the courts because doctors already are required to take ongoing medical education courses. This testing service is the same one that independently evaluates doctors referred by the California Medical Board--doctors who have already face some specific charges. If there are specific accusations against doctors, it’s only fair to all parties to do this.
Let’s go back to the chart reviews. Because of the implications in his reviews, I wrote and asked this reviewer if the Department had hired him personally. He never answered. Instead I got a letter from his superior.
Guess what? The reviewer’s boss is the same guy in charge of the “independent testing.” I had to dig for this info because this boss’ name appears nowhere on the documents—yet the reviewers work for him. Two separate paths to hang the doctors out to dry, both from the same source.
If the doctors ever could tell you folks the truth of what goes on in the Department of Corrections and Rehabilitation, they would blow the lid off what the Department doesn’t want you to know—that their orders are cancelled, that consults they desperately need are denied, that medications they have ordered are refused—that they are being set up as the fall guys, and so far it is working.
The doctors will survive, wherever they end up working. It’s the inmates and their families that will pay the price. In all sincerity, I’m known to the inmates as a good and caring doctor and have been told as much on numerous occasions. These guys are getting a very bad deal and I've stuck up for them, and I'd do it again tomorrow morning.
You folks have to make a decision: Do you just want someone to take the rap, or do you want the truth? Think of it this way: If these people can treat the inmates unfairly and get away with it this long, what makes you think that they can’t do the same to anyone else under their control, people who threaten their authority? They love nothing better than to have you and the medical staff at loggerheads. Then they can just walk away whistling.
If I could go back tomorrow morning to my patients, I’d do it in a heartbeat. Do you really want to help the inmates? Okay then, hear our story.
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