Phyllis Scher, 75, of Boca Raton, Fla., receives personalized service from her internist.

Within hours after she calls him, Scher is whisked through the waiting room and is seen by Dr. Bernard Kaminetsky, who examines her at a leisurely pace. He also makes sure that nothing falls through the cracks when she sees a specialist or is hospitalized. "I'm extremely well-taken care of," says Scher, a two-time cancer survivor.

Kaminetsky and his patient are part of a fledgling movement called concierge medicine, where patients pay a fee for personalized medical attention.

"I'm old enough to remember how doctor-patient relationships were in the 1950s, when doctors made house calls," says Ken Marinace, 61, a certified financial planner in Burbank, Calif., who sees a concierge physician in Sherman Oaks. "I can return to old-fashioned medicine, if you will, for a small premium."

Marinace pays an annual membership fee of $1,800 (Scher pays $1,650) to MDVIP, a Boca Raton firm that has enlisted physicians to provide individualized care. The fee is on top of health insurance, Medicare and other medical-related costs.

About 100,000 patients receive concierge care, which is practiced by more than 250 physicians, according to the Society for Innovative Medical Practice Design, a Seattle-based organization of health care providers. Most concierge patients pay between $1,500 and $2,000 annually.

Membership fees typically cover high-end preventive and wellness services not covered by Medicare or most insurance plans. Concierge care commonly covers same- or next-day appointments for nonurgent care, 24-hour telephone access to a doctor, nutritional planning and preventive care exams. When patients require extensive care, many concierge doctors help deal with specialists.

Kaminetsky cares for 600 patients, far fewer than the 2,600 patients he saw before he became affiliated with MDVIP in 2001. MDVIP pays Kaminetsky $1,150 per patient. All of his patients are in concierge care.

Although Kaminetsky accepts insurance, some other doctors don't. Seattle Medical Associates, a three-physician practice, charges patients $95 a month to meet all their primary care needs, says Dr. Garrison Bliss. That covers some concierge amenities, such as immediate access.

For a participating doctor, check the Society for Innovative Medical Practice Design (www.simpd.org). The MDVIP Web site (www.mdvip.com) lists its doctors. Other groups include Simple Care (www.simplecare.com), MD Squared (www.md2.com) and Concierge Choice Physicians (www.choice.md).

Interview the doctor and get a list of provided services. Ask if the physician participates with your insurer. Call your state's insurance commissioner to see whether the regulators have approved the fee model practiced by the doctor.