In October 2009, the NCCHC board of directors chose Peter Ober, JD, MSEd, PA-C, CCHP, as chair-elect. However, early in 2010 he stepped up into the chairman role when the sitting chair had to resign. Now, as he enters his second year of directing the board, he shares tidbits about his career, his views on correctional health care, and his focus for his term as chair.

First, some background. After completing his freshman year of college, Ober joined the U.S. Air Force when he learned that it offered both paid tuition and a paycheck. He trained as a medical technician and worked three years in a hospital emergency room, where he “became enthralled by the medical profession.” That led to a degree in the relatively new career of physician assistant. “It opened up a new world to me as I worked in family medicine and the emergency room at several USAF bases all over the country and in Japan.” In the mid-80s, he became chief of a primary care clinic and medical laboratory with responsibility for medical care of senior Air Force officers and Department of Defense officials.

During his 20 years in the Air Force, however, Ober’s educational and professional paths both expanded far beyond health care. He attained a master’s degree in education and later a doctorate in law and, related to his Air Force work, he trained in special investigations and counterintelligence. In the final few years of his Air Force career, he commanded investigations in the United States and Saudi Arabia, and supervised training at the USAF Special Investigations Academy, where he also taught criminal law to new agents.

A Career Shift
So how did that career path lead to corrections? Ober calls himself an “accidental correctional health professional.” As Air Force retirement approached, he felt called to return to medicine and patient care. In May 1992, a physician assistant job at the Washington, DC, Department of Corrections provided the flexibility he needed to manage both roles.

His introduction to correctional health care shocked him, however. “Unlicensed practitioners, poor or no standards, too few health professionals for too many patients with very poor health,” Ober recalls. “I did the best I could under that system, but it was clear to me that it needed to be changed.”

He spent four years at that facility while simultaneously (upon retirement from the Air Force) working as chief physician assistant at Fredericksburg (VA) Emergency Medical Associates, a position he still holds.

In 1996, Ober took an opportunity to start a partnership with an emergency medicine physician and provide contract services to a new regional jail in Stafford County, VA. His goal was to create a health care system far better than what he experienced in DC. While researching jail medical operations he discovered NCCHC and used its standards and other information to develop the new system.

As he and his business partner began to attend NCCHC conferences and meet its staff, including vice president Scott Chavez, PhD, MPA, CCHP-A—also a physician assistant—he wanted to become involved with the Commission. He became certified through the CCHP program, took surveyor training and in 1999 sought, and attained, appointment to the board of directors representing the American Academy of Physician Assistants. “I believe that is when my real education about correctional medicine began,” he notes.

Today, Ober is still managing partner at Rappahannock Creative Health Care, based in Fredericksburg, VA, with a client roster of six county and regional jails and a weekly patient care workload of 20 to 30 hours. He also puts in 35 to 40 hours in the ER of a local hospital. Combined with management time for both roles, his workweeks sometimes reach 80 hours. 

Challenges and Rewards
Pondering correctional health care, Ober notes the stark differences between his highly educated, generally healthy Air Force patients and the complex illnesses of inmate-patients. “The contrast hooked me pretty quickly,” he says. But these challenges are also the source of job satisafaction: “It is particularly rewarding to have a resistant and difficult patient with complex chronic disease see the light and make remarkable strides to recovery. That’s hard to match in any other area of medicine.” He credits NCCHC’s chronic disease guidelines for helping with this care.

The most difficult part of correctional medicine, Ober says, comes from the need to create and maintain good, trusting relationships with the facility’s senior administrators. “I do not mean playing golf or going to dinner,” he explains. “I mean developing an understanding of the way they think and helping them understand how and why you make your decisions. I find I have to communicate frequently with superintendents to avoid unpleasant surprises. Financial issues are in the forefront of most administrators’ minds, but with a full understanding of a patients’ needs we can find a way to make the right decision.”

With his entrepreneurial successes in correctional health care and his long history with NCCHC, including service on many committees and projects, Ober understands well that obstacles remain in this field and that new ones are continually emerging. At present, for instance, the economy is forcing budget cuts that are proving very difficult for correctional health services. The growing population of aging inmates with more serious health needs is also a concern.

At the same time, he appreciates the great strides that have been made in recent decades and believes the field is on the right path, even finding creative ways to manage these challenges. He says it is important to recognize those who are taking that path.

“NCCHC is an extremely well-run and focused organization. There isn’t much I can do to improve it. But as good as our standards and programs are, they are only as good as the people who use them every day. I want to place emphasis on the people who do great work with patients or make decisions that affect their care. We need to recognize correctional health care as the remarkable field it has become.”