Tim O’Connor tries to keep himself active in retirement, teaching English as a second language to adults in New York City, and staying fit to ward off health problems.

“I don't have a great cardiac family history in my family,” the retired attorney explained.

When his longtime doctor converted to a concierge medicine practice with a $2,100 annual fee per person, Tim and his wife decided they’d pay to keep their doctor. It was a decision they weighed carefully, now that they’re on a fixed income.

“Is money a consideration? I don't want to say it's not a consideration. But I do believe in preventive medicine,” O’Connor said.

For the O’Connors, the fee provides them with unlimited access for same-day appointments, longer visits and a comprehensive annual physical. For their doctor, converting his practice has meant being able to provide more personalized care to about 500 patients — about a quarter of the size of his old practice.

“If someone has three, four, five (health) conditions, it's impossible to see them in a 10-minute period,” said Dr. Peter Zeale, a cardiologist with the MDVIP concierge medical group. “So, you have the time to … sit down with them, go through each problem and try and direct them in the right direction. And I don't know how you can do that in the traditional model.”

While concierge medicine and other fee-based primary care practices have been around for decades, they make up less than 10 percent of physician practices, nationally according to a number of health industry surveys. Cost is a big deterrent for a lot of patients, especially since they still need to pay for health insurance on top of the concierge fee.

But now the Trump administration could give some fee-based practices a boost. Earlier this year, the Centers for Medicare and Medicaid Services put out a request for information to health-care providers, asking how the administration could help fund access to some fee-based practices for Medicare patients.