Remaking Rural Health: A KET Special Report

Providing Health Care On-site: Alliance Coal Health Care Clinics

After treating miners in his private primary care practice in Inez, Ky., for 42 years, Raymond D. Wells, MD, recognized that miners need a specialized health-care delivery system due to the unique nature of their occupation.

“If you’re down in the mines, it can take half an hour to get to the face. Miners can’t leave to go to the doctor to have their blood sugar and blood pressure checked or to get a prescription refilled,” Wells says.

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Management at Alliance Resource Partners, L.P. had also begun to recognize the impact this lack of preventive care had on health-care costs and the health of employees, many of whom were experiencing major heart events. After analyzing data related to employees who had heart attacks and strokes, they realized many of those employees were not taking medication for cholesterol or high blood pressure. There was a lot of undiagnosed, untreated disease at the company, but the remedy was simple: help employees identify health risks to help prevent catastrophic events.

What began with one van and one nurse practitioner traveling from mine to mine has grown to on-site clinics in each of Alliance Coal’s seven mine sites across six states. Each clinic is supervised by Dr. Wells and staffed with nurse practitioners and registered nurses who are available during all three shifts. While miners can still choose to visit outside health-care providers, most choose the on-site clinics. Services do not require co-pays or co-insurance, and easy access to a medical professional provides caregivers and patients time to discuss diet and exercise.

The availability and intimacy of one-to-one consultations give the miners and clinic staff a sense of family and community. One participant described the clinic as “a small town with a country doctor.” Part of the clinic’s outreach strategy is a social marketing campaign called Built to Last, which encourages miners to take care of themselves in order to enjoy long lives with those they love.

Once a year, the company offers “health checks,” which measure key health indicators such as cholesterol, blood sugar, and blood pressure. The printed results provide the miners with a “heart age.” The health checks also help company epidemiologists evaluate the success of their health services.

“If we have a 36-year-old smoker with high cholesterol and high blood pressure, it may show their actual heart age is 54, and that gets their attention,” according to Kimberly French, a nurse practitioner at the River View mine site.

The River View mine, which is featured in the program, is an underground mining complex located in Western Kentucky near Morganfield in Union County. Producing high-sulfur coal through continuous mining since 2009, it employs approximately 440 people.

 

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Remaking Rural Health: A KET Special Report is a KET production, Laura Krueger, producer, and is funded, in part, by a grant from the Foundation for a Healthy Kentucky.