By the numbers: Based on the American Academy of Private Physicians more than 1,000 doctors have opted to offer concierge care out of their practices; • Nearly 60% of physicians offering concierge care out of their offices are doing better financially than a year ago; • 29% of physicians offering this service indicated no change; • 13% indicated a decline in their practices. In Texas physicians are dropping Medicare at a rate of 100 to 200 per year; Medicare is increasing their enforcement and audits/investigations resulting in higher liability and operational costs to physicians; There is no tort reform covered under the healthcare reform; Looming threat of offering services to patients for less and less pay. Based on the above the answers are simple: Keep your options open; Minimize your reliance in Federal Programs/balance your portfolio; Consult a professional to study your options; And above all, look into possibilities to reduce your overhead.