At the office of Lynn Ho, MD, the doctor is essentially always in. If she's with a patient, voice-mail picks up and asks you to leave a message on an in-office answering machine; she typically returns messages within the hour. Need to speak with the doctor urgently after her office has closed? No worries - her voicemail lists her cell and home numbers.

   But that's not the most startling part, at least from the perspective of this longtime medical reporter and occasional patient. Rather, it's the fact that no more than one or two patients call those numbers after hours in a given week. Why?

  Dr. Ho cites the trust that she's built over time. ''That's the paradox of really good access," she says. "People know they can get you in the office. They know you're going to return their calls."

  The Rhode Island family physician runs a micro practice, a solo physician office that strips overhead to the bare minimum, works without staff, and leverages computer software and other technology to maximize patient access and care. Dr. Ho designs her schedule so that roughly two-thirds of the available appointments on any given day are open in the morning of that day. Thus, any patient who calls in for a same-day appointment can get one. (Using an online scheduling system, patients can select the most convenient time from all remaining available appointments.) She also offers evening hours and some weekend availability. And in recent months, she's added online physician consults.

  To better address the long-standing disconnect between patient and physician needs, other primary-care doctors are starting to take similar steps, albeit typically to a lesser degree. They've been inspired by the ongoing work of numerous groups, including the American Academy of Family Physicians (AAFP) and the Institute for Healthcare Improvement (IHI). Their goal: to focus on patient-centered care and still build a financially thriving practice. Contact for complete article.