Dr. Brian Forrest is a hands-on doctor, drawing blood, checking lab tests and taking patient histories. With just one staff person to support him and another physician, he has to be able to do it all. And that's the way he wants it.

Since opening Access Healthcare in Apex in 2002, he has not accepted medical insurance. It's a decision he says saves him about $250,000 a year.

"We don't have to have a billing clerk," he said. "And we don't have to have a software system to file insurance and four other people whose job it is just to make sure that we're able to stay in business."

A menu in the front lobby shows how much patients will pay. Some choose to pay a flat annual fee of $300 which guarantees cheaper office visits and coverage for lab tests that most co-pays with traditional insurance don't cover.

"I like the fact that he had set rates for everything and very good, competitive rates," said Phil Johnson, who's been a patient of Dr. Forrest for five years.

Johnson and his wife have health insurance, like about half of the patients who come to Access Healthcare. Forrest encourages his patients that can afford health insurance to get a low premium, high deductible plan in case of hospitalization or surgery. But the cash-only model can be a lifeline for people without any insurance.

"Uninsured patients tend to pay more than insured patients for care because they pay the full price, not the insurance company's negotiated price," he said. "People that come here that are uninsured save about 80 to 90 percent over what they traditionally would."

For Forrest, who spent the first few years of his career in a large practice with insurance and co-pays, practicing medicine without insurance pressures means freedom. He sees fewer patients each day and is able to spend more time with each of them, like the "Marcus Welby" ideal he always wanted to be.

"It's not a solution for everyone, but it certainly is a way to practice medicine that is more cost-effective and provides high quality care," he said.

Forrest isn't trying to keep his business model a secret. He's helped doctors all over the country set up cash-only practices. But the number is still small - about five percent of doctors are doing it.

You can find out more about Access Healthcare at its website.