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Kentucky Telecare





Mobile clinic takes care to miners
Doctor works with UK, coal company
By Samira Jafari
Associated Press

Dr. Raymond Wells discussed a patient's condition via videoconference with Kathryn Wellman, his nurse practitioner. Wellman drives a mobile clinic to five mines in Eastern Kentucky to offer medical care. Miners like the convenience of on-site care. Photo credit: Samira Jafari/Associated Press

PILGRIM, Ky. -- Despite his high blood pressure, Richard Wells would avoid the doctor's office. Getting a checkup and his prescription wasn't worth missing a day of work underground.

Ben Hopkins would put off getting his flu shot for the same reason, even if it meant fending off miserable coughs and sneezes while mining for coal.

The nearest doctor was nearly an hour away, and the miners' hours and isolation kept them from meeting clinic times.

"Coal mining is usually in some sort of deserted area without access to a doctor or a hospital," said Hopkins, 32, a 10-year veteran of Eastern Kentucky's coalfields. "And most of us work odd hours."

So an Appalachian doctor decided to bring medicine to them.

In a partnership with the University of Kentucky and Alliance Coal, an Oklahoma-based company, Dr. Raymond Wells has created a mobile clinic that visits each of the company's five mines in Eastern Kentucky once a week.

The van is stocked with an EKG machine, a defibrillator, a multitude of vaccines and medicines, and a camera that allows Wells to examine his patients at the mine sites from his office in Inez.

"What's unique about this problem is a group of men who were not seeking care," said Wells, a longtime physician. "But when this came, they were willing to do something for their lives."

Coal experts say the mobile clinic is a desperately needed but rare program. Especially at nonunionized mines, taking a sick day to get a physical or a vaccination is not a viable option.

"I just like to see these people get the attention they deserve," Wells said. "I found a coal company to do that, and believe me, that's not the norm."

Even industry heads had trouble coming up with other examples of coal companies that offer such a program.

National Mining Association spokesman Luke Popovich said the group commended Alliance for thinking "outside the box" and recognizing "the importance of healthy miners to productive mines."

However, others are less complimentary, saying the mobile clinic is a weak alternative to giving miners adequate compensation for taking sick days.

"It enables them to keep miners working if they're sick, instead of the miners seeing their own doctor," said Phil Smith, spokesman for the United Mine Workers of America.

But the miners who have used the clinic said they prefer the convenience of on-site care.

A grant through the University of Kentucky jump-started the $100,000 mobile clinic, while Alliance pays for Wells, his nurse practitioner and their medical supplies.

For John Small, vice president of operations for Excel Mining LLC, Alliance's subsidiary in Kentucky, offering the clinic is simply good business. He said coal companies can't afford to lose their most experienced and skilled miners to poor health: "They've earned the right to be taken care of."

The mobile clinic is available to the company's 565 Eastern Kentucky employees, and soon will open its doors to family members.

The clinic is operated by Kathryn Wellman, a nurse practitioner, who examines 10 to 20 patients a day. She drives her clinic to one site -- two in Martin County, three in Pike -- each day.

In her cramped, yet high-tech, quarters, Wellman conducts drug tests and pre-employment physicals, checks patients with chest pain, sutures minor cuts, dispenses shots and takes X-rays.

When Wellman needs a second opinion, she brings in Wells via videoconference, allowing the doctor to examine his patients at the mine sites up-close from his office miles away.

Using high-speed Internet and his video camera, Wells can receive X-rays and test results through e-mail, listen to heartbeats, check out injuries and, ultimately, make a diagnosis.

While the program makes treatment more convenient for miners, Wells also hopes to make strides in prevention.

Hopkins said he feels safer knowing the mobile clinic is close by, even if he doesn't need to use it often.

"A lot of employees here are more inclined to get healthy," he said.

"That helps because it's a job where you need to be focused at all times."

- retrieved from "Louisville Courier Journal, Sunday, December 3, 2006"

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