Rail Work Was Once So Dangerous They Needed Their Own Surgeons

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For what it's worth, railroad employment is still extremely dangerous. Railroads in the US still maintain medical departments, (Usually under the auspices of the Risk Management Department), to screen prospective employees, provide regulatory compliance, and to make determination of qualification for retention and re-entry. Much of this is contracted to specialty medical practices, and local surgeons / hospitals in cities along the right of way.

Railroads also pioneered employee health care, in the form of "Hospital Associations" which provided care instead of health insurance. These organizations were more common on western railroads. There are / were also employee relief organizations which provided assistance to sick and injured employees. These were organized on local, regional and system levels, and by craft, separate and apart from the carrier provided benefit.

Railroad work was so dangerous, that Railroad workers were unable to obtain (life) insurance protection due to the high risk, (real and perceived), involved with railroad employment. This is how the various railroad labor organizations became insurance carriers, with their own risk assessment and under writing departments and sales forces. At least one major union still operates their own insurance department, while others maintain close affiliations with well known life insurers.



Well-Known Member
Staff member
As a youngster, I lived within earshot of a yard in NZ, where shunting was carried out frequently. There were reports of injuries and a death from those activities. It was no wonder when you consider the type of coupling used that had to be manually connected by someone stepping between the cars to do the literal hook up.

Iron Horseman

Well-Known Member
For what it's worth, railroad employment is still extremely dangerous.
Yup, that is what I was going to say. The only reason they no longer have their our own surgeons/EMT is because of the number of readily available providers of medical facilities, transport (flight for life), etc. near to the right of ways who are contracted or just generally available.

I sometimes have the duty of pulling "on duty" records of those involved in accidents. In one case a fellow was impaled by the couplers between two cars. They knew he was going to die as soon as they pulled the cars apart. A gruesome sight for his wife who was called down to the location so they could speak to one another before they separated the cars.


Active Member
There was a fire in Grand Central Station back in the early 70's. A lot of employee's suffered smoke inhalation. I was one of them. Our train was in the tunnel at the time. I remember cutting the fuel supply and then abandoning the engines. I also remember going to a RR doctor in Grand Central.

In one case a fellow was impaled by the couplers
We had a similar incident at a chemical plant, but the fellow was much more fortunate, and survived, but never returned to work. The curves were so tight and visibility so limited that two additional brakemen were assigned to the crew on a permanent basis. A result of the incident, the chemical company consented to permit use of radios by the crew. Ultimately, the crew was replaced with chemical workers using a track mobile.

I also remember going to a RR doctor in Grand Central.
There were RR doctors in the stations in Baltimore, MD; Wilmington, DE; Philadelphia, PA and Harrisburg, PA. Washington Terminal Company, had their own company surgeon, in the Terminal. In the PC era, as these doctors retired, these positions were not filled.

Back in the early 1970's when I worked for PFE all medical services were provided through the SP Hospital/Medical system. If you needed to see a doctor, you went to the SP Hospital (SP, then known as Harkness Hospital on Fell Street in San Francisco was the main one and was a fairly large hospital building.) Unions kept the system from being used by the RR company to totally manage employees. This all broke down and went away in the 1970's as many economic, political and social changes took place in the US. Some might call it corporate paternalism, others considered it cost management and containment.

The closest I came later in life to a similar situation was my final employer, The Permanente Medical Group of Kaiser Permanente. Medical coverage was of course part of employment.

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