They Might Be Faking

It was great to gather again for the Minnesota Sheriffs’ Association’s annual Correctional Health Division conference. This year, I presented on non-psychiatric (“medical”) malingering. Here’s my PowerPoint:

We could perhaps tackle psychiatric malingering next year (hint, hint). In some ways, this is easier to deal with as presentations seldom require urgent off-site transport. Standardized tests also make determinations more secure.

Many thanks to Holly Compo, Tom Wells and Randy Willis for inviting me to participate, and for onsite support. ✸

Vital Signs Are Truly Vital

I’m looking forward to presenting at the Minnesota Sheriffs’ Association’s Correctional Health Division Conference on October 13th. I’ll be discussing the use of clinical decision rules in assessing inmates for chest pain, head injuries and other high-risk presentations. You can find my PowerPoint here.

My title is a riff on the National Early Warning Score (NEWS), which has good negative predictive for really bad stuff like cardiac arrest, ICU admissions and death. I previously wrote about it for Today’s Hospitalist (and PDF version here).

Many thanks to Heather Qunell and the other conference organizers for inviting me to participate! ✸

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Postscript [10/18/2021]. Here’s a PDF of the final program.

Top Doctor 2021

I was recently notified that I’ve been named to Minnesota Monthly’s annual Top Doctors listing. I appreciate the ongoing recognition from my peers.

I consider awards like this professional capital—they allow me to do more for my patients and our community. And spend it I will! Some examples are virtual addiction care at Allina Health and CentraCare Health, and various media appearances

The Top Doctors listing will appear in the September/October issue of Minnesota Monthly, which hits the newsstands on August 26th. Minnesota Monthly also maintains an online provider directory. ✸

Doubleheader

The Twins were eliminated by the Astros yesterday, however, it’s still baseball season! In that spirit, I’m “pitching” a split doubleheader today in two different ballparks through the wonders of Zoom.

The first presentation is for the Minnesota Sheriff’s Association at its Correction Care Division’s Annual Conference. The subject is identification and management of substance withdrawal syndromes (I’m the medical director for two county jails).

CentraCare Health; St. Cloud, Minn.

The second outing is for CentraCare Health at its Opioid and Controlled Substances Prescribing Training. I’m the middle reliever in a line-up that includes Drs. Michael Massey (pain medicine) and Lynn McFarling (medical informatics). The two-hour event is designed to fulfill Minnesota’s new(ish) legislative mandate for provider education. My contribution deals with unhealthy substance use with special attention to patients with chronic pain syndromes.

CentraCare Health; St. Cloud, Minn.

Just click on the above images or hyperlinked text to access my PowerPoints. ✸

Suboxone Treatment in Jail

The Saint Cloud Times recently featured CentraCare Health’s correctional care (“jail medicine”) program. This unique public-private partnership is designed to identify and treat mental illness and addiction while inmates are in custody. We then link them to a special clinic following release to the community for ongoing management. (I serve as the medical director for the program.)

Captain Mark Maslonkowski. Photo: Jason Wachter

We launched in the Benton County Jail on October 1st, 2017, and in the Stearns County Jail on January 1st, 2o18. As outlined in the article, the early signals are promising: fewer ambulance trips between the jail and hospital, fewer detox admissions and decreased total cost of care.

As far as we know, we’re the only Minnesota counties starting inmates on Suboxone, the medication to treat opioid addiction, while in custody. And, one needs to look far and wide to find other examples nationally.

Our ever-growing provider team includes:

Providers see inmates in jail and following release to the community. This continuity of care is unprecedented. Health authorities (a statutory term) have historically focused on inmates’ immediate medical needs in jail without regard for the bigger picture. This penny-wise but pound-foolish approach doesn’t resolve some big reasons—mental illness and addiction— for criminal recidivism. Thus the revolving door.

Special thanks to my partners in crime (sorry! couldn’t stop myself):

  • Captain Susan Johnson (Benton)
  • Katy Kirchner, director
  • Captain Mark Maslonkowski (Stearns)
  • Kenzie Moehle, supervisor
  • Heather Qunell, manager

Jail Medicine

This week, we paused from life’s bustle to celebrate a remarkable public-private partnership. CentraCare Health, based in St. Cloud, Minn., began discussing correctional health care (“jail medicine”) with its host counties about three years ago. This ultimately resulted in CentraCare being named as the health authority (a statutory term) for the Benton County Jail and Stearns County Jail.

I’m fortunate to be part of the team that spun up the program. Originally, it was just Katy Kirchner, Heather Qunell, Cindy Henze and me squatting in a vacant office. There were only two desks, so I typically sat on the floor with my laptop.

The program and team quickly grew to include infirmaries in the jails and a clinic to serve inmates following release to the community. Our providers—all stellar people and clinicians—are Zach DorholtBri Eriksson, Lori Korte, Julie Moriak and Cat Standfuss.

The program also owes its success to incredible nurses and support staff, and unwavering executive support. On the CentraCare side, Kelly Macken-Marble and Kathy Parsons have championed the partnership. And from the counties, Captains Susan Johnson (Benton) and Mark Maslonkowski (Stearns), the jail administrators, have been fantastic colleagues.

Many thanks to CentraCare for involving me in this deeply rewarding opportunity! §