David Nichols: Primary Care Doc, Pilot Puts Patients First

Anna Webster, for HealthLeaders Media , December 2, 2010

"Giving up too much time for others; that's how it was in those days. It was the norm for medicine."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is David B. Nichols' story.

"Aviation" and "medicine" were the two highest scores from his high school career aptitude test. And for the past 31 years, David B. Nichols, MD, has been commuting once a week to Tangier Island, piloting his own plane or helicopter. The 15-minute flight takes Nichols to an area where the residents have triple the rate of diseases he has seen any place else.

Islanders with major injuries like fractures and even heart attacks sometimes wait days for Nichols to arrive to provide them with care, due to difficulty traveling to the mainland.

"We have people here dying in their 20s and 30s of heart attacks; it's a big, big issue," he says.

Nichols is currently facing his own mortality—cancer is this superhero's kryptonite.

Six years ago he survived melanoma in the back of his left eye, only to learn that this year the cancer had spread to his liver, giving him only a few months left to live. The family physician, 62, knows his kind is a dying breed. Seventy hour workweeks and after-hour appointments are not as common as when he started his practice.

"Giving up too much time for others; that's how it was in those days. It was the norm for medicine," he says. "I can understand why today younger doctors don't want to work the long hours; they want to go home to their families."

Compared to other areas of Virginia, Tangier Island families often fall below the norm in some areas, making healthcare accessibility a challenge. For example, the island falls below the state averages for median household income, employment, and house values.

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