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To the Editor: Drs Grumbach and Bodenheimer¹ discussed the importance of reestablishing a "primary care home" for patients. As a newly graduated resident in family medicine, I too have recognized the urgent need for reprioritizing the primary care home. In response, a colleague and I created a modified version of the "boutique" style medical practice.

Our new-generation membership practice expanded upon the positive qualities exemplified in the original boutique practices and excluded some of the less desirable features. In general, this model is supported by the annual retainer fee paid by each patient member. Services rendered are the financial responsibility of the patient or insurance provider (excluding HMOs). This allows us to focus our attention on only 800 patients and provide more personalized care.

This low-volume format allows us to enhance physician access by offering same day appointments regardless of need, minimal or no wait before seeing the physician, office . . . [Full Text of this Article]

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