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Bringing medical care to remote mining camps

Dr. Tony Kos has created a medical service contract business for remote mining operations


Back in the day, when major mining properties were being discovered, workers would follow. Town sites would pop up. Think of Cobalt, Timmins, Kirkland Lake and Elliott Lake.

Merchants, engineers, bankers, lawyers, teachers and even homebuilders would arrive to set up shop. So would doctors. There was always someone getting hurt or getting sick.

Things have changed. Often as not, when new mining properties are discovered these days in a remote area it means a temporary residential camp is created. Workers are brought in on rotation with schedules of 14 days on and 14 days off for example.

One thing that hasn’t changed is the need for medical professionals. Whether it’s a small mining camp just a few hours out of town or a complete open pit mine operation situated on the remote James Bay muskeg, medical services are always in demand.

That is one of the things that inspired Timmins physician Dr. Tony Kos to provide a unique service to the mining industry – contract medical services known as Remote Emergency Medical Services Incorporated (REMSI).

Kos is a family physician in Timmins as well as being an assistant professor in family medicine for the Northern Ontario School of Medicine.

He is also the son and grandson of hardrock miners. During his university years, he spent a couple of summers working with miners in Timmins. He said he understands what miners and mining companies can be faced with.

“I got to see what it was like working underground and working in an open pit and I also saw there was a need for this type of work in remote sites,” said Kos. He added that he would not name any communities but said too many small towns in Northern Ontario, located near a mine, lack proper medical facilities for primary care.

Kos said there are small towns near some mine sites that do not have adequate medical care. He said in that case, companies have allowed REMSI doctors to provide health care to the families of mining company workers.

He said the contract medical business began more than 10 years ago when AMEC (now Wood), an engineering consulting company was working in Saskatchewan. He said the job was to provide medical services while two new mining operations were being set up.

As it turned out, AMEC was also involved in the rebuilding of the Detour Gold mine north of Cochrane, Ontario.

“We were there when they first put the shovel in the ground and we offered all the medical services,” Kos said.

From there, Kos said REMSI grew as other mining companies became aware of the convenience of outsourcing vital services. He said he still regards REMSI as a small business, however.

“We provide these services for anybody at any level. So it could be a small camp to a big mine. And what we can do is offer nursing, paramedics, physician assistants, nurse practitioners and physicians. And any kind of mix with that.”

Kos said some mining operations present unusual hazards where an employee might become seriously injured. In that case, he said REMSI can provide Physician Assistants, who have taken their medical training through several years with the Canadian Forces. He said many PAs are experienced in trauma medicine, dealing with mass casualties and triage situations.

Kos said in most instances, especially in remote situations, the law mandates that medical services must be on site and ready to respond.

“That’s important because you could have a trauma, or somebody losing a limb. You’re working with explosives. You’re working with fast-moving heavy equipment , there’s cutting blades, there’s crushing injuries and burns too,” Kos explained.

He said time is essential when a serious trauma occurs. Patients must be treated and stabilized before being airlifted out to a major medical centre.

“We also do preventive medicine and primary care. We will do inspections of the kitchens and water systems, making sure everything is clean and safe for the employees and people that visit.”

He added that REMSI also provides health and safety programs, drug screening, allergy shots, immunizations, as well as working to reduce WSIB incidents.

“We have four physicians that work for REMSI that are available 24/7,” said Kos. He added that because so many workers spend so much of their time living in mining camps, two or three weeks at a time, it is important to provide everyday medical advice for normal ailments, aches and pains.

“Two of our doctors, along with specializing in family medicine, also specialize in addiction medicine,” said Kos. He said a lot of industrial workers struggle with drug and alcohol problems and if they come forward seeking help, it can be provided.

He added that if an employee is injured or seriously ill beyond the scope of what aid can be provided at the remote site, plans are always in place to have the patient immediately transported to hospital. He said REMSI works closely with ORNGE, the provincial medivac service to facilitate this if the need arises.