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Performance Pediatrics is a primary-care practice in Plymouth, Massachusetts. Our objective is to optimize the provider/patient relationship through long appointments: 45 minutes for a well exam and 15 minutes for each acute exam. All of the clinical contact (history, physical exam, procedures and education) is led by the provider increasing trust, knowledge and impact upon the patient’s health. Minimal staffing and smart use of technology keeps overhead low enough for the practice to be profitable without having to charge patients a membership “concierge” fee. Our providers see about half the number of patients a day than a typical provider would. In addition, we utilize a secure patient portal for electronic communication to relay lab results, answer questions, and even provide some follow up if no exam is medically required. We are not a concierge practice and take standard insurance payments; in fact nearly 35 percent of our patients are enrolled in Medicaid.