Some wonder if Smith will ever retire, and if he does, how will the community find such a dedicated replacement.
Fishermen's Hospital Administrator Kim Bassett doesn't want to think about that. "He's going to be one of those physicians who will work until he can't do it any longer. I don't see him stopping; there are very few people like him left in the world," she says. "But if, for some reason, he can't continue at this pace or must cut back, it will take two surgeons and an internist to replace him."
And finding that many doctors for a small community like this is a tall order, especially physician specialists willing to work the long hours.
Smith agrees. "A lot of (doctors) who come out of training today don't have the work ethic of people who came out of training when I did. Their residency programs require them to work only a certain number of hours, and they have different priorities. Not that it's bad, but it's different," he says.
"They've tried in the past to offer doctors reasonably good salaries to work here. And they come, but they don't necessarily work very hard for their salaries. For someone to want to live in this area, they have to be willing to work a lot, and give up cultural aspects of life in the big city and entertainment," Smith says.
Smith recently was named the 2009 Country Doctor of the Year, the first surgeon to be named for an award traditionally given to family doctors by Staff Care, a physician staffing service. His prize: a two-week of respite with a paid locum tenens to cover his practice so he could take some well-earned time off.
But he didn't even consider it.
Instead, he asked that the amount of money they'd spend on the locum tenens–$5,000–be donated to a fund for indigent cancer patients. Then he matched it with another $5,000 for medical care for victims of the earthquake in Haiti.
"We paid it forward three times, and it worked out really neat," he says.
Smith has no intentions now of slowing down. The next day, he would get up at 7 a.m., drive to Tavernier for another full day of surgery and patient visits.
"I really enjoy what I'm doing, as long as my health holds up," Smith tells me. "I'm not sure what I'd do if I retired."