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Medicine and an Island Way of Life

John Commins, for HealthLeaders Media, October 15, 2012
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This article appears in the October 2012 issue of HealthLeaders magazine.

Since 1983 Timothy Lepore, MD, has been the general surgeon for Nantucket Island, 30 miles off the coast of Massachusetts. The population of the famous resort island swells from about 10,000 in the winter to 50,000 in the summer. Lepore (pronounced LEH-pree) has treated everything from tick-borne diseases to stab wounds to the heart and everyone from singer Jimmy Buffett and Sen. John Kerry to weathered lobstermen. The doctor's many hobbies include marathons, falconry, and knapping obsidian scalpels, which he once used on an obliging Nepalese shaman. Lepore is the island's medical examiner. He's been on the school board for 22 years. He travels off island with the high school football team. Lepore's life, stories, and quirks are the subject of the book Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor, which is under development as a TV series.

On the seasons of Nantucket: The island in the summer is a very upscale, wealthy, opulent place to live. Nantucket in the winter is a very small town. You know everybody. The joke is that people even know if you haven't been taking your medication.

On island limitations: When the weather socks in, probably one-third of the time we can't get transportation out of here. Then you have to do what you have to do. I've had a stab wound to the heart that was not going to wait for a helicopter. A patient with a ruptured spleen wasn't going to wait. We had a bus roll over out here and all of a sudden there were 17 people in the emergency room.

On fee-for-service, Nantucket style: Somebody gave me some smoked bluefish because I saw them on a Sunday. If my patient can pay me, great. If they can't, my concern is getting the patient happy and out of there. Physicians are going to make money. But how much do you want to have? If someone wants to pay me with lobsters, there are worse things.

On the perils of celebrity: I am 67. I have a pretty good sense of myself. I understand what is real and what is hype. I'm not going Hollywood. I live on Nantucket. I've got a great house and four dogs and a wife of 36 years who reminds me every day of my failings.


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This article appears in the October 2012 issue of HealthLeaders magazine.


John Commins is a senior editor with HealthLeaders Media.