My goal in life has always been is to get 100 patients to 100 years old. My mentor at Tulane, Dr George Burch, told me that with good medical care, patients should live to 100. With all our technology today, I believe that is even more possible. However, it will not occur if a doctor has only 15 to 20 minutes to see a patient, and if the doctor doesn’t do a complete evaluation and complete physical each time, including preventative health testing. Because of decreased insurance reimbursement and increased office overhead, it is impossible for a doctor to make a living, and even, at times, make payroll for his employees doing 45 to 60 minute revisits in his 12 hour work day versus your typical primary care physician who sees 35 to 40 patients a day. A Concierge fee has become a necessity nationwide for doctors that want to take time with their patients. In other states, the fee is as high as $15,000 per patient. We have tried to keep the fee as low as possible and still keep our office open.