How does this sound? - 24/7 access to your doctor, same day office visits, no waiting, more face time, and house calls. Like a nostalgic picture of medicine practiced in small town America 50 years ago? Nope. It exists today for some Americans willing and able to pay. It's called Concierge Medicine.

A new sitcom called Royal Pains, on the USA Network, will expose the medical concierge concept to the masses. Royal Pains' central character is Dr. Hank Lawson, a fictional ER doc who loses his job in a prominent New York hospital because he breaks rules to try to save a patient. While attending a ritzy party in the Hamptons, Hank brilliantly diagnoses the medical condition of one of the wealthy guests and provides lifesaving treatment on the spot. Overnight, he becomes the most sought after doc in the Hamptons social set.

Unheard of 10 years ago, concierge medical practices have grown to about 5,000 practitioners nationwide. Concierge practices are generally for the affluent but run the gamut in terms of what they charge for the privilege of membership. Perhaps the most obvious market for concierge medicine is the affluent elderly. But not necessarily, take Steven Knope, MD, for example. Dr Knope is a sports medicine internist. He's a four-time Ironman triathelete. His Tucson, AZ practice focuses on preventive medicine including a two-hour physical, nutritional analysis with a staff nutritionist, and fitness analysis with a personal trainer in his in-office gym. Dr. Knope's concierge patients pay an annual retainer of $6000 each.

The Concierge Medicine / LA practice in the Brentwood section of Los Angeles serves a wealthy clientele similar to that depicted in Royal Pains. Medical Director, Raphael Darvish MD, says that not all of his patients are wealthy. Some are just very health conscious. The practice has two other doctors in addition to Dr. Darvish serving about 1,000 patients. Memberships range from $2,000 to $10,000 annually depending on age and other factors. Concierge Medicine / LA features the presidential physical which is similar to the comprehensive physical Obama receives each year.

Concierge doctors say this style of medical practice is very rewarding to them in ways other than financial. The pace is relaxed and they get to build relationships with their patients.