n Alaska’s isolated North Slope—more than 650 miles from Anchorage via airplane—thousands of individuals work in the oil and gas industry. While many of those employees have their medical needs covered by their employers, what happens if someone gets hurt or sick? How do the nearly 10,000 people who reside within the North Slope Borough’s boundaries receive medical care?

Beacon Occupational Health and Safety Services has ten remote medical locations across the North Slope; six are accessible by car and three are situated on islands, accessed by ice roads in the winter and marine vessels in the summer. The tenth location is only accessible by plane.

“To put it into perspective, our closest location is about fifteen minutes away from the airport where a medevac would take place, so Guardian support, LifeMed, et cetera, would be there to support getting a patient off the slope,” says Amanda Johnson, Beacon’s vice president of medical and training services. “Then, the furthest from that location is about two hours away… And then there are others that are within about twenty to thirty minutes of each other.”

Johnson says very few patients who visit Beacon’s clinics are year-round North Slope residents. Some are transient or visitors to the state, tourists, or otherwise—but the majority are there for work, generally on behalf of an oil field operator or contractor.

Johnson says their clinics receive upward of 12,000 visits a year. “Even though there could be days without a major traumatic event, when that event takes place, our team’s ability to respond is really key to our success,” Johnson adds.

Dr. John Hall, medical director at Beacon, has been working in the medical field on the North Slope for nearly forty years. “We’ve always had good, quality PAs [physician assistants], and Beacon makes sure that all of our PAs have good, emergency medicine experience,” he says. “Then we teach them occupational medicine if they don’t already have it.”

In addition to his role at Beacon, Hall also works in the emergency department at Providence Alaska Medical Center, so he sees first hand some of the differences of working in an urban center versus remote oil field. He says Beacon’s remote medical professionals—emergency medical technicians, paramedics, physicians, physician assistants, nurses, and nurse practitioners—have smaller teams than those based in urban areas. For example, if a patient suffers from an acute heart attack, Hall says he typically has eight people assisting him in Anchorage, but on the North Slope it may be just a handful.

And more than just staffing levels, what each healthcare professional actually does is different. “[Beacon’s remote medical professionals] have to start IVs, they have to mix medicines, they have to do all that stuff while making arrangements to get the person transferred out,” Hall says. “Logistically, they have problems and they can’t just stand at the head of the bed and say, ‘You start an IV, you mix up the medicine, you do this, you do that, you take vital signs, you put on the oxygen.’ They have to do a lot of that stuff themselves and with a few people that they’ve trained to help them.”

Beacon’s remote medical facilities aren’t equipped with the same tools or technology as a major health center in a populous area, but they are able to stabilize patients and expedite their care to another location when necessary.

“If somebody has a heart attack up there, we don’t keep them there,” Hall says. “We can give them medicine that dissolves the clot, and we can start an IV, and if we have to we can breathe for them—we can do all that stuff—but none of those patients that have something serious like that end up staying there; they all go off-Slope.”

There are a number of illnesses—such as high fever—that Fairweather can treat on-site to minimize turnover in the workforce. But if a patient needs to be transported, Fairweather helps coordinate medevacs for the patient with medical air ambulance providers.

“When we provide services for our clients, one of the first steps is to create an emergency response plan which outlines what to do in the event of an emergency that results in a medevac; we identify the points of contact, chain of command, potential backup options, and the order in which notifications are sent out,” Majors says.

Patients are often flown to facilities that can provide a higher level of care, primarily in Fairbanks or Anchorage, but a number of factors are considered when deciding which facility in what city, such as if the injury is work-related, the condition of the patient, insurance, and weather conditions.

Hall says they will fly out any patient they think will medically deteriorate if they wait. Patients who have diabetes or have suffered a heart attack are common, but Hall says they recently flew out an individual with a hernia trapped outside of the body.

If the individual’s symptoms are less severe and/or non-life threatening, like dental pain, a physician assistant can start them on antibiotics and patients can see a dentist when they have time off.

When it is necessary to move someone, “patients are medevaced off in several different ways,” Hall says. “They can go on a charter: so if somebody has a simple problem, let’s say they fell and broke their wrist, then we can put it in a splint and send them on the charter. If they’re a little bit sicker and we think they might need some medicine on the charter, we send them with an escort.”

“There are few cases where a lesser fracture may be flown via commercial airline instead of medevac—either accompanied or unaccompanied by medical staff—to Fairbanks or Anchorage,” Majors says.

While employee health and safety is obviously important to employees and their families, it’s vital to employers on the North Slope, as well.

“Companies really pay attention to that because they, too, want to ensure that their individuals are safe on and off the job,” Johnson says. “They’re up there for fourteen or twenty-one days at a time and this is their only medical care within hours. All operators have an interest in preventative care as well… infectious disease for the most part, and how are we preventing things from spreading across the geographic space, especially in a controlled environment.”

“Up on the North Slope, our providers are some of the finest that I’ve ever known… those patients that come in with an acute heart attack, they get state-of-the-art care—they just are three to four hours away from a cath lab,” Hall adds. “So they have to not only treat them initially, but they have to continue to treat them until they turn them over to the air ambulance… they get the same kind of excellent care up there, and I think mainly because of the providers that we’re able to put up there.”