By Erinn Hutkin, Special to U-T San Diego 6 a.m.Jan. 21, 2014

Dr. Gary Levinson has practiced internal and sleep medicine in the San Diego area for years, but he practices in an unusual way.

Some of his patients have his cellphone number and the number for a separate phone line into the office. They are also promised same or next-day appointments. And in the office, hes able to spend more time with them, build relationships and get to know patients and their health issues.

Hes able to do all of that under the concierge or boutique medicine model.

Its a model thats emerged in recent years in which some doctors offer patients the option of paying an annual fee or a retainer, which varies from physician to physician, in exchange for more access and time with their doctors.

Patients typically keep their private insurance, which pays for office visits and services, but the annual fee gives them perks such as being able to reach their doctor after-hours via email or phone, securing appointments within 24 hours and more one-on-one time with their doctor.

In turn, the fee allows doctors to lighten their patient roster, see fewer people each day and spend more time with patients in the office.

Some doctors have switched to the model full time, while physicians such as Levinson offer concierge service to 5 percent of his patients now with the hope of eventually offering the model to 10 to 15 percent.

Its not only advantageous to his patients, its often advantageous to him.

Its unrushed, said Levinson. Patients get what they want and we get more satisfaction without feeling like a cog in the health care wheel.

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Some doctors practice 'boutique' medicine