Middlebrook Physician Honored as Country Doctor of Year - WBOC-TV 16, Delmarvas News Leader, FOX 21 -

Middlebrook Physician Honored as Country Doctor of Year

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RICHMOND, Va. (AP) - Dr. John Otho "Rob" Marsh III has tended to soldiers wounded in battle but finds that practicing medicine in a rural area has its own challenges.

His dedication to his patients in the small town of Middlebrook in the Shenandoah Valley has earned him an award as "country doctor of the year" by a national physician staffing firm.

"It's a great honor and I'm really happy about it, not just for me, but I think it's a great reflection on my staff, who work so hard, and my family, (which) sacrifices a lot, and then also the patients, who wait for hours to see me," said Marsh, deflecting some of the attention from himself.

Staff Care, a division of Texas-based staffing firm AMN Healthcare, has given the award since 1992, recognizing a primary care physician in a community with fewer than 30,000 people who "exemplifies the spirit, skill and dedication of America's rural medical practitioners."

A Virginian has won the prize previously. In 2006, Dr. David Nichols of White Stone was honored. For more than 30 years Nichols made weekly trips to tiny Tangier Island in the middle of the Chesapeake Bay, piloting a small plane or helicopter to get there, to provide care to the island's 500 or so residents. He died in 2010.

The winning doctor gets a plaque and time off - if he or she wants it. The staffing company pays for a physician to fill in for the doctor for two weeks, an award valued at about $10,000.

Marsh, 59, was nominated by colleagues.

"I guess the word 'extraordinary' comes to mind," said Mary Mannix, chief executive officer of Augusta Health, a 255-bed community hospital that serves the region where Marsh practices. Marsh is on the hospital's board of directors.

"His extraordinary dedication. His performance standards. His willingness to do things that you don't really see happen in practice any more," Mannix said.

"He is one of the few primary care physicians in our community that still admits (patients) to the hospital, meaning he follows his patients from their home setting, to his physician office practice, to the hospital, back home or to the nursing facility."

Marsh set up practice in Middlebrook, a town of about 300 people in Augusta County, about two decades ago. His patients come from across the region.

His ties to the area go deep. His father, former Army Secretary John O. Marsh Jr., served as a congressman from the Shenandoah Valley from 1963 to 1971.

Marsh's return to the area came after he'd seen the world and suffered through one of the nation's most deadly combat episodes in recent times.

He was 38 years old and a physician with U.S. Army special forces on a mission in Mogadishu, Somalia. The attacks known as the Black Hawk Down incident, because of the Black Hawk helicopters shot down, resulted in 18 deaths and 80 wounded among U.S. forces, along with hundreds of Somali casualties.

Marsh was among those tending to the U.S. wounded when he himself got hit. He was at a Somali airport when it came under mortar attack. He and three others with serious injuries were transported to a hospital in Germany.

He later retired from the military and came back home to practice medicine.

"When I got out of the military I thought I was a good doctor, but I knew I didn't know how to run a private practice," Marsh said.

He went to work for the University of Virginia Health System in the mid-1990s, a time when hospitals were expanding their practices, he said.

He asked his bosses at U.Va. about setting up a practice in Middlebrook, and got the go-ahead. For 12 years, he was on staff at U.Va. Then he decided he would rather practice independently.

"It was sort of the square-peg, round-hole sort of thing," he said, explaining why.

"For example, I always wanted to open my practice on the day after Thanksgiving to see acute emergencies. Because it's a long period between Thursday . and Monday." He said the university's policy then was to close clinics on that Friday.

"They also didn't feel comfortable with me opening the practice at night, to come there by myself, to sew somebody up or seeing people there on Saturday or Sunday."

Those sort of things are just part and parcel for a small-town family doctor.

"I work longer hours. I have more responsibility. I make less money. I'm happier," Marsh said, laughing. "It's worked out well."

He is a busy man. Middlebrook is located between Staunton and Lexington on state Route 252. He starts the day doing rounds at Augusta Health if he has patients there. Usually, he has three or four.

Then it's back to Middlebrook to see patients at the office, where a staff of nurses, nurse practitioners and a physician assistant help keep things running smoothly. He said his set-up is unique.

"For a day I'll have at least three nurses working with me," Marsh said, explaining how he manages to get though the typical 25 to 30 patients per day.

"What I try to do is have each nurse linked to a patient, so there is good continuity," he said.

He knows patients may not always retain what he says, so the nurses go over that information again. If the patient calls back, often the nurse can help.

"If it's something that I need to handle, I'll handle it, but a lot of the times my nurses can take care of the problems for me," Marsh said.

After that, he may do house calls or go back to the hospital to check on patients who have been admitted. Some evenings, he checks on patients at a local nursing home.

His wife, Barbara, has been by his side throughout. They met when Marsh was in medical school.

"She went on to nursing school. She went in the Army with me as a nurse. She moved around when I moved around," he said.

They have four children, two in college, one a senior in high school and the youngest a high school sophomore.

"The glue is the family," he said. "I think they have the wrong name on the award. It should be the country physician's wife of the year award."

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