Physician's Life a Reminder that Medicine Can Be Noble

If 2011 is anything like 2010, it will be another mean year for the business of healthcare.

The healthcare reform debate in Congress undoubtedly will reach new heights of vituperation this year as Republicans regain control of the U.S. House with what they claim is a mandate to repeal "Obamacare." Democrats are already firing back at the GOP, calling them liars and hypocrites for misrepresenting the effects of the reforms while failing come up with fiscally viable alternatives. Both sides will sow fear, confusion, and angst. The "death panel" rhetoric—perhaps the single most unfortunate rumor to arise from the healthcare reform debates in 2009 and 2010—apparently has been rekindled.

Lobbyists for doctors, hospitals, drug makers and the health insurance industry will cruise the halls of Congress to ensure that any changes made to the healthcare reforms will come at someone else's expense—more than likely, the consumer.

And we'll hear more in the coming months about how hospitals and the healthcare system continue to kill tens of thousands of Americans each year through HAIs and medication errors, other preventable mistakes—and frankly, incompetence.

On the healthcare business front, Community Health System's very public hostile takeover attempt of rival Tenet Healthcare Corp. provides us with a fascinating glimpse of C-Suite fisticuffs.

There will be more questions about conflict of interest for physicians who take money from drug makers or medical device companies. There will be turf wars between rival hospitals and healthcare systems.  There will be more strikes, or threats to strike. Unions and management will try to discredit one another in the media. And, rival unions will try to discredit one another.

With our attention so focused on these divisive issues, it's easy to forget that healthcare is supposed to be about the noble science healing. So, before the mud starts flying, let's take a moment to remember the example of David Nichols, MD, who died Thursday after a months-long battle with liver cancer. He was 62.

Most regular readers know about Doc Nichols, who in December was named one of HealthLeaders Media's 20 People Who Make Medicine Better—2010. A primary care physician, Nichols for more than three decades served as the only healthcare provider for about 525 people on remote Tangier Island in Chesapeake Bay. Once a week for 31 years Nichols would fly himself out to the island from his coastal Virginia home. He didn't have to. He could undoubtedly have found other far less inconvenient ways to make money. In fact, Nichols told HealthLeaders Media that his White Stone Family Practice in Hampton Roads, VA helped to subsidize much of the unreimbursed or low-cost care he provided on the island, which is inhabited by fishing families.

Nichols chose to make those predawn flights ever year for half of his life because he saw a need. He put the welfare of his patients above all else. He saw himself as a dying breed, a self-described "Dinosaur Doc," but he didn't resent what he saw as a different set of priorities for younger physicians.

"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."

In August, the whole town and a slew of visiting dignitaries from across Virginia honored Nichols at a dedication ceremony for a new $1.5 million health clinic on the island, which was named the David B. Nichols Health Center.

"I've received way more than what I've given," Nichols told HealthLeaders Media, of his legacy on the island. "I hope people will remember, Dr. David Nichols tried his best to help people."

If Hollywood made a movie about Nichols' life—how in his final months the whole town turns out to shower him with love, to tell him how he changed their lives, to shake hands and embrace the babies he helped grow into adults—nobody would believe it really happened. But, it did.