When Dr. Thomas Murphy talks about the moment correctional medicine clicked for him, he points to a single sentence from a patient he counseled about his chronic conditions.
“You realize that when they’re in the community, on the streets, their medical care and their health needs are not a priority,” he says. “Their priority is, ‘What’s my next meal? Where am I going to sleep?’”
“We are not only continuing care. We are saving lives.”
“This is something you just need to follow up on with your primary care physician,” Dr. Murphy told him. The patient looked back at him and said, “Well, doc, you’re my primary care physician.”
It was early in Dr. Murphy’s tenure as Medical Director at the Hamilton County Justice Center, and he describes it as a light-bulb moment.
“You realize that when they’re in the community, on the streets, their medical care and their health needs are not a priority,” he says. “Their priority is, ‘What’s my next meal? Where am I going to sleep?’”
“We are not only continuing care. We are saving lives.”
From the Hospital to Corrections
Dr. Murphy’s route to NaphCare ran through some of the most demanding settings in medicine. He earned his medical degree at Indiana University in Indianapolis and completed his residency at Wright State University in Dayton, Ohio, training at Miami Valley Hospital, where he served as Chief Resident. He stayed on with Wright State as a Hospitalist in internal medicine, practicing at Miami Valley Hospital, Kettering Medical Center, and the Dayton VA, while also serving as an associate professor.
The hospitalist lifestyle, with its intense seven-on, seven-off rotations, eventually took a toll.
“Anytime you’re in the hospital, that’s very intense work. It was draining,” he recalls.
Looking for a role with more room to lead, something that felt out of reach inside government bureaucracy, he began exploring opportunities on LinkedIn and joined NaphCare in 2024.
Corrections was a new environment, but the patients felt familiar. Across his career, Dr. Murphy had gravitated toward the most vulnerable and at-risk populations, including veterans and underserved neighborhoods in Dayton.
“As the Medical Director here, a lot of my role is administrative, but I also see a lot of patients. Part of my role is clinical, and that's what I love about it, taking care of these patients and this patient population.”
Finding Meaning in the Mission
As Medical Director, Dr. Murphy balances administrative leadership with clinical work, but he feels most connected to the mission when he’s working with patients. The patients who pass through the Justice Center often arrive with chronic conditions that have gone unmanaged for years, because survival itself has crowded out everything else.
“We’re helping these guys really focus on their chronic illnesses. It’s hard, and it’s also rewarding.”
For Dr. Murphy, continuing a patient’s care within the facility is rarely routine. It is, in his words, a chance to catch what the outside world missed, and to send people back into the community in better shape than they arrived.
Why He Stays
Ask Dr. Murphy if there are any other reasons why he continues to work in corrections, and he answers with characteristic candor. “Part of it is the clinical opportunity and the leadership and administrative opportunity — so that’s more of the selfish reasons,” he says with a smile. “This is where I want to be, where I think I can improve my skills as a leader.”
The variety keeps him engaged. Beyond his role at the jail, Dr. Murphy runs telemedicine clinics for NaphCare facilities across the country on Mondays and Thursdays, giving him exposure to both jail and prison medicine. “Every day is different,” he says. “I’m able to practice at different facilities, and I see different patient populations.”
Leadership and Teamwork in HealthCare
Dr. Murphy is quick to point out that excellence at the Justice Center is a team achievement, and one of his primary responsibilities is supporting the team’s performance. He says the hardest part of correctional medicine is piecing together histories for patients who often arrive knowing only that they were “on some meds,” unsure of the names, doses, or when they last took them.
Doing additional research to discover the patient’s medical history is challenging. But the easy path isn’t usually the right path. He admires the way his teammates live out NaphCare’s value, “We go above and beyond,” refusing to defer responsibility just because it’s a busy day.
“Going above and beyond is looking up their medical history, using the resources we have,” he says, including access to University of Cincinnati healthcare records.
On more than one occasion, that extra step revealed a patient with a history of severe heart failure who needed to restart life-sustaining medications immediately.
“That’s what I notice my team doing a lot,” he says. “Doing the due diligence, taking that extra step.”
To keep that standard from depending on any one person, Dr. Murphy works closely with Hamilton County Justice Center’s healthcare leadership. Weekly leadership meetings and continual communication bring together the people closest to each area of care: Sam Oney, MAT Nurse, on the medication-assisted treatment program; Angel McCarthy, Infectious Disease RN, on HIV and infectious disease; Sarah Jackson, Director of Nursing; Kenya Lewis, Health Services Administrator (HSA); and the mental health team.
“I can’t be everywhere,” he says. “I can’t see all the MAT patients. I can’t be with all the nurses while they’re doing med pass. So, it’s important to have the leadership come together and find ways to improve.”
Proactive Healthcare Improves Outcomes
Dr. Murphy describes a clinical philosophy built on anticipating problems. “Medicine in general is very reactive,” he says. “If you can create an organization that promotes proactivity, trying to catch something before it happens, that’s very important.”
The team focuses relentlessly on two things: early recognition of chronic disease, mental health, and substance-use needs, and early, effective action. “We always say we don’t like surprises here.”
One early win addressing the cost and access challenges that affect HIV medications shows what that looks like in practice. Dr. Murphy collaborated with HSA Kenya Lewis, infectious disease RN Angel McCarthy, and community partners at UC Health to identify opportunities to improve the process to access lifesaving HIV medications. They were able to decrease the time it takes for patients to get access to 24 to 48 hours. They also connected with an infectious disease clinic to help patients continue care after release.
The effects of this process improvement extend far beyond the Hamilton County Justice Center. Maintaining access to HIV medications plays an essential role in limiting the spread of HIV, a major concern in the Cincinnati area. This commitment to proactive care is bearing fruit in the community and beyond.
Innovation in Action: The George 100
Nothing illustrates NaphCare’s commitment to innovation better than the project Dr. Murphy took on with the custody leadership. The facility uses a rapid-response protocol called a “George 100,” a call for medical help initiated by correctional staff. Curious about how officers decided when to make that call, Dr. Murphy engaged with custody leadership to assess the criteria they relied on.
Dr. Murphy recognized that custody staff aren’t clinical experts, and that can make it challenging to assess when medical care is necessary.
“They would call a George 100 when they thought something was wrong,” he explained. “But it was kind of a gut feeling.”
Rather than accept that, he saw an opportunity to innovate.
“The correctional officers are our eyes and ears. They’re looking at the cameras. They’re with the patients. We don’t expect them to diagnose, but we’d like to improve their awareness of when something doesn’t seem right.”
“We came up with a medical reference guide that improves that gut feeling.”
Working alongside the facility's captains, Dr. Murphy developed an easy-to-follow medical reference guide that helps custody staff at all levels make informed, clinically sound decisions about requesting healthcare support. The guide has been emailed to all cadets and correctional officers and placed in the tanks for quick reference, helping staff recognize the early signs that something is wrong.
Dr. Murphy is building on this project’s success by working with custody leadership to include the healthcare team in cadet training to further develop officer awareness and understanding of what to watch for. It is one of the many process improvements the team has driven, demonstrating that innovation in Hamilton County is a daily habit.
Underlying every process and protocol is a simple commitment to treating every patient, no matter the circumstances of their incarceration, with humanity.
“You can understand that when we see these patients, they may not be in the best head space,” Dr. Murphy says. “But there is a baseline of empathy and compassion that you have to have.”
On Working for NaphCare
For all the demands of the work, Dr. Murphy is clear that he values the support he’s received in this role. The difference, he says, is the company behind the facility.
“It’s really NaphCare,” he says. “If I have an issue and I’ve emailed leadership, they’ve responded pretty quickly. It’s the willingness to listen.”
Many of the process changes that have taken root at Hamilton County, he notes, began with a concern that corporate leadership, regional doctors, corporate physicians, and others across departments took seriously and helped move forward.
“You can really feel the motivation to improve with NaphCare. That’s one of the reasons I stayed here.”
