Volunteer flights keep doctor well-grounded

About once a month, John Kihm takes off from the Person County Airport in his six-seat Piper Mirage plane and lands on Ocracoke Island.

But it's not the island's charms that draw the doctor from Durham.

It's patients.

Kihm volunteers his time and his plane to make house calls to residents of the small coastal island. The island does have a health clinic, but it is often not able to meet all of the needs of Ocracoke residents.

Without his visits, many would have to travel five or six hours, by car and by ferry, to reach a doctor.

"My whole philosophy is taking care of the patient," Kihm says. "Everything else follows from there."

And take care of them he does.

Kihm also makes house calls in Durham, to patients of his internal medicine practice, Priority Medicine.

And two Wednesdays a month - technically his time off - he volunteers to see patients at the Lincoln Community Health Center clinic at the Durham Urban Ministries homeless shelter.

"For me, medicine was somewhat of a calling," Kihm says. "A lot of people go out of the country to volunteer or feel like they are giving back, but I can see a lot of room to help people just down the road."

Easy manner

Kihm is not an imposing man.

With a tanned face from all his time flying, sparkling blue eyes and a perpetual smile, he's got an ease that makes patients feel relaxed.

He's a neat dresser but often opts for the more laid back style without a tie when seeing patients.

The Michigan native talks with a soft drawl that's a cross between the speech patterns of a "Yooper" (a native of Michigan's Upper Peninsula) and a Southerner.

The son of an orthopedic surgeon, Kihm still goes home to Michigan - usually flying there himself.

But he's adopted the Tar Heel state as his home.

Kihm fell in love with the Outer Banks and specifically Ocracoke as a young man. During a two-year fellowship at Duke University, he would go camping on the beach.

He met his wife while she was working at Duke Hospital as a nurse, and he proposed to her on Ocracoke as well.

The couple tried living in Nashville, Tenn., but moved back to North Carolina after two years. They've lived in Durham for the past 20 while Kihm built his practice.

The thing that makes Kihm unique is that he's a doctor who truly listens and does not assume anything, says Julia Gamble, who oversees the Lincoln clinic for homeless residents where Kihm volunteers.

"I had a patient who kept going in and out of the hospital," she says. "No one knew what was wrong, and they were running a lot of tests. I was talking about it with [Kihm], and he had a thought that maybe the patient was allergic to a medicine that had been prescribed to him. And that's John. Instead of going to some obscure disease, he went to something simple. And he was right."

Kihm is a throwback to a time past, when doctors made house calls and knew your family's health history.

He doesn't even keep his records electronically. The wall in his office is lined with thick charts filled with hand-written notes.

"I hardly even need the chart anyway," Kihm says.

He has been flying to Ocracoke to help care for patients for 13 years total. First he worked in the island clinic, but for the past six he's been making house calls, visiting with patients, performing exams, giving shots and even doing minor procedures such as removing a cyst.

Once he completes the one-hour flight to Ocracoke, generally one of Kihm's patients picks him up from the airstrip. Whoever picks him up shuttles him around the island from house to house. Since the airstrip doesn't have lights, they have to get him back in time to take off before sunset.

"It costs me several hundred dollars each time I fly there," he admits. "And I've flown there several times just for one patient. Efficiency and profit, that's not what it's about. It's about love - loving Ocracoke and loving my patients there."

The patients love him back, many of them paying him with what they have on hand.

One woman bakes fig cakes - a local delicacy. One man takes him fishing.

For the families, Kihm has become more than a doctor.

"We have definitely adopted him," says Valerie Mason, who owns the Village Print shop.

Kihm cared for Mason's father in the time leading to his death, sometimes making the round-trip flight to Ocracoke just to see him, even once recruiting a friend who was a neurologist to make the trip with him.

"Some people when you go seem them, it's just like they don't even know you're a person," Mason says. "With him you could sit there as long as you want. It's just so different. It's hard to explain it."

Going solo

Back in Durham, Kihm tailors his practice to offer better care and also more flexibility for his own schedule.

He's been operating a solo practice for nine years, but he reached the point last year where his case load was too much. That's when he cut back from 2,000 to 500 patients.

"I was working 14 hours a day, but it was not sustainable," he says. "It's all totally do-able now."

In general, Kihm will work about 7:30 a.m. until 5 or 6 p.m., starting by making rounds with patients in the hospital and then moving on to appointments in his clinic. Then he has another hour or two of work at home in the evening taking care of business things like paying bills and processing payroll.

He subsidizes the practice by charging each patient an annual fee to belong to his clinic. That fee varies, Kihm says, depending on the income level of the person. But it's generally less than what it costs for a pack of cigarettes a day. His practice has such good word of mouth that there's now a waiting list to get in.

"Doing what's right for the patient builds patient loyalty, and then it builds momentum," he says.

In his off time, Kihm likes to spend time with his family. The father of four, Kihm never misses a game, a band show or an orchestra performance. If he's not with his kids, you'll find him jogging or flying his plane.

Even though friends describe him as calm and level-headed, he also has an adventurous side, says Gary Wilser, Kihm's friend and longtime flight instructor. And Kihm never does things halfway.

"He got his [pilot's] license in the spring, bought an airplane, decided he wanted to get some experience," Wilser says. "So he asked me if I wanted to take a trip to Alaska with him."

Kihm says that though his schedule doesn't leave him a ton of time for leisure, he would never give up his way of practicing medicine or his hunger for volunteering.

"There's nothing else I could be doing," he says. "From a human standpoint, it's a great gain for me."