One physician in Virginia has devoted his practice to truck drivers, who spend all of their days on the interstate and often cannot get routine medical care.
Physicians aren't what you would call a happy bunch these days. I know two who have quit their practices and retired because of all the headaches of filling out paperwork and grappling with insurance companies over how to treat patients. "To me, healthcare has become a mess and I just don't want to go through all the agony anymore," one told me. 
Though these docs are no doubt voicing an opinion shared by others in the field, there are many more who are staying the course. Many have sold their practices and are working for hospitals, feeling that as employees they have more security.
Still others have decided that in spite of all the changes under way in the practice of medicine, there are opportunities to explore new options on where and how they work, keeping the spirit of the community doctor alive.
I am about to tell you the story of one of them and if you haven't heard this tale of good old American ingenuity, I think you will find it inspiring. It first appeared in the Washington Post.
Dr. Rob Marsh, 58, operates a medical office in a tiny town called Middlebrook, Va., about 50 miles west of Charlottesville. He makes house calls, some late at night, and checks on patients who are hospitalized. "He knows which tough, leathery farmers will blanche as soon as they spot a needle," the article states. In other words, until about two and a half years ago Dr. Marsh was practicing medicine just as other primary care physicians had done for generations all over the country.
The difference is Dr. Marsh's decision to reach out to a neglected population: truck drivers, who spend all of their days on the interstate and often cannot get routine medical care. In July 2012, he opened a unique medical clinic at the TA Petro truck stop in Raphine, Va., about 15 miles from Middlebrook. There, he provides federally required physicals and cares for the many conditions arising from the stress, diet and sedentary nature of long-haul trucking.
Raphine has truck stops where as many as 20,000 drivers pass through every day, and roughly 1,000 stop to sleep each night. For instance, at the TA Petro truck stop, the article states: "Drivers wander the stores killing time, looking at chrome for their trucks, hunting gear and fried strawberry-rhubarb pies in wax-paper packets. They can get an oil change, work out, take a shower. And now they can get a U.S. Department of Transportation-mandated physical, a flu shot or treatment for a sore back."
Robert Berkstresser, a self-made businessman, owns TA Petro and is intent on turning it into a destination. He is adding a laundromat that will page drivers when their clothes are clean, a movie theater, a barbershop and what he says will be the country's first truck-stop pharmacy. So far the clinic is doing quite well and giving truck drivers the opportunity to get the medical care they need.
Dr. Marsh is planning on expanding his clinic, adding staff and space so he can treat more patients. Furthermore, he will see locals by appointment only but allows truck drivers to walk in and sometime soon hopes to adjust his hours to serve them more efficiently. How's that for true convenience and great customer service?
The article states: "It seems the drivers like to get on the road first thing in the morning, he said, and take care of medical needs at the end of the day. So Dr. Marsh, who already spends most nights making house calls and hospital rounds, often finds himself treating patients at the truck stop at 8 p.m., long after the clinic has technically closed. He is thinking of whether on some nights he can keep it open even later."
A key element of the value of this service is that Dr. Marsh puts exam results into an EMR so drivers can get medication or follow-up care farther along on their routes.
I love this story because it involves taking care of an underserved population, making it convenient for them to get medical care. In all too many cases in healthcare, getting to see the right physician conveniently can be ridiculously difficult.
Take the case of driver Terry Jenkins, who came into Dr. Marsh's office for his employer's random drug test, which took minutes to complete.Mr. Jenkins says that getting his test had been onerous in the past. Once, a dispatcher contacted him to order a test, and Mr. Jenkins had to park his truck in the lot of a big box store, take a taxi to a hospital 20 miles away, wait a couple of hours there for test results, then take another taxi back to his truck.
Dr. Marsh is no ordinary primary care physician. He is a decorated U.S. Special Forces medic, who just barely survived the disastrous firefight involving U.S forces in Somalia made famous by the book and movie 'Black Hawk Down." According to the Post, he returned to his hometown of Middlebrook for his next call to service: caring for his friends, the farmer down the road, the people sitting in the pews alongside his family.
Last month, an industry group named Dr. Marsh the 2014 Country Doctor of the Year. In 2014, the percentage of doctors who work alone fell by 17 percent. Walker Ray, the vice president of the Physicians Foundation, which surveys doctors each year, stated that 60 percent of physicians worked independently less than a decade ago. Now only a third do so, with the remainder employed by hospitals and large medical groups.
One thing that Dr. Marsh misses in his trucker clinic is the intimacy he has with his other patients. Truckers are loners who just pass through. But the drivers get doses of the doctor's warm personal approach. And he has hopes that, in the long term, the clinic will provide enough of a financial cushion for him to keep treating patients the way he thinks is right. "I'm a survivor — I'll make this work," Dr. Marsh told the Post. "I'm willing to make those adaptations because I love what I do so much."
I wish Dr. Marsh great success!