'Concierge care' offers medicine with personal touch

“When I finally did find a doctor here in North Carolina that I liked, they left and went to a different practice or whatever,” Santillana said.

She's thankful to have found Dr. Gaither, but even he is dealing with problems on the business side of his practice.

“Our costs are going up. Our reimbursements are dropping. We're required to see more patients in a day,” he said. “I want to decompress my day.”

Many doctors are choosing partnerships with hospitals, but Gaither has chosen to keep his private status by changing to a "membership care" model, also known as concierge care.

Concierge care isn't new, but it's growing dramatically. Older plans required patients to pay an annual fee in addition to their insurance co-pays. Those fees can be as high as $1,500 to $1,800 a year, an amount that only the well-to-do can afford.

But now there are packages that offer tiered pricing.

Skip Brickley, president and founder of Choice Care Advantage MD, says his tiered pricing starts at $300 a year.

Higher fees guarantee no wait times or even 24-hour, 365-day access to the doctor by phone or email.

The company takes care of the business end of the practice, while Dr. Gaither does what he got into medicine to do - spend more time with patients.

“Patients want to be heard. They want to be listened to,” he said.

Those who choose not to pay the annual fee can remain on their current insurance payments, but they may not see Dr. Gaither.

“We try and use extenders: nurse practitioners and physician assistants in non-critical instances,” Brickley said.

Santillana says she may be willing to pay an annual fee if it means more personalized care.

“You have one person looking at you as a whole,” she said.