We recently published an article about physicians assistants (PAs) pretending to be doctors and performing surgery on prisoners in unclean environments. We naively believed that the Pennsylvania Department of Corrections (DOC) would like to know about the violations of the law. We reasoned that the DOC would want to correct the abuses before more prisoners die. Boy, were we wrong! We sent a copy of our article to Jeff Beard, the Secretary of Corrections, along with a letter explaining that, if asked, we would provide the names of the prisoners who are mentioned in the article and the names of the PAs. Eventually we were favored with a response from one: Catherine McVey Director, Bureau of Health Care Services Department of Corrections 1110 Fernwood Avenue Camp Hill, PA 17001 cmcvey@state.pa.us Ms McVey expressed no interest in correcting the problems, rather, she excused the abuses with boiler plate pap: "The Pennsylvania Department of Corrections, through contracts with PHS and Wexford as our health care providers, provides quality care to the inmate population, which is consistent with the applicable standards of care and with statutory medical practice requirements, to include the responsibilities carried out by the contract physician assistants." Ms McVey went to great length to cite the Medical Practice Act of 1985. That law makes it clear that the conduct of the PA that we had complained about, is illegal. A PA is a kind of medical "go-for," one who may only act under the close supervision of a real doctor. A PA is authorized to do such things as: Screen patients for medical need Review patient records Take medical histories Perform physical examinations And other such trivial matters. The law doesn't authorize a physicians assistant to perform surgery, to use the title doctor or to hack on a prisoner in a dirty environment. A good bureaucrat, Ms McVey spouted the official line of tripe. Standard practice is for the bureaucrat to shift responsibility. No state worker is ever responsible for anything. It's always someone else, usually the injured citizen who's at fault. It "is the ultimate prerogative of the patient to either refuse or permit treatment by a physician assistant ... The inmates should be encouraged to exercise their right to file grievances if they believe that they have been medically mistreated." The problem with the pap is that most prisoners believe it when a PA calls himself a doctor. Worse yet, in prison, the prisoner is completely at the whim of the PA. Whatever he does or doesn't do is final. In life-threatening situations, the prisoner has been made to realize that the PA has to "like" him in order to be assured of proper and adequate care. Dissatisfied with Ms McVey's brush off of the serious abuses by the PAs, we are taking the issue to enforcement authorities and the legislature. Lets try to prevent any more needless prisoner deaths.