Jack and John are identical twins but have varying interests in life. One day Jack, 43 years old, decides he has had enough of these headaches and calls his family doctor and asks what he should do. He is told that his doctor can see him in 4 days and to take some over-the-counter ibuprofen. And to go to the ER if the headaches worsen.

John, who has also been having similar headaches, emails his doctor and asks what he should do. His doctor responds within two hours of the email and asks him many questions. John and his doctor go back and forth on email for a little while before John takes his doctor’s advice and takes some OTC medicine in combination with natural supplements and exercise.

Two days later, Jack’s headaches worsen, and he calls his doctor’s office again and asks to be seen that day. Someone at the office tells him to come in around 2 p.m. and his doctor would “fit him in.”

Meanwhile, John’s headaches are getting worse, and he emails his doctor and asks to be seen. His doctor, already knowing what is happening with John, tells John to come in immediately.

Jack arrives at his appointment on time, but there are many, many people in the waiting room, and Jack has to wait for over an hour. When he inquires how long he will have to wait to be seen, he is told that since he was a “walk-in,” he will have to continue to wait until there is room in the doctor’s schedule.

Earlier that same morning, John was seen by his doctor promptly at 8:30 a.m. There was no waiting for him; his doctor could see him, order a CT scan for later that day, and get John back to his day within 30 minutes.

Jack waits and is finally taken back to an exam room at 3:30 p.m. and then waits for another 30 minutes before his doctor arrives. His doctor, seeming rushed, asks Jack what is happening. His doctor takes notes on his computer, examines John, and tells him he needs a CT scan. John waits another 20-30 minutes while his doctor’s staff set up the CT scan for two days later.

Meanwhile, John completed his CT scan and had the report of a normal CT scan before 3:30 p.m. even arrived.

Jack finished his visit by paying his co-pay of $15 and walked out, still with headaches.

John did not have to pay his doctor for his visit today as he is on a “service plan” that pays him $25 monthly for service, including email and texting support.

John has his CT scan two days later but does not hear about the normal results until one more day after. His doctor apologizes for the delay stating that he is very busy with his patients.

One week later, both Jack’s and John’s headaches are resolving, and both are feeling better.

One week later, John’s doctor is swamped with paperwork and 38 patients to see that day. He does not make it home until 6:30 p.m. or so.

One week later, Jack’s doctor is busy emailing his patients and connecting with them on Facebook and through his blog. He will see eight patients that day. And get home before 3 p.m.

Identical twins have a similar path in life. But each can choose what they prioritize about how they want to spend their time and money.

Jack and John’s doctors also choose how they want to spend their day seeing patients. Jack’s doctor chooses the health insurance model, while John’s doctor chooses a direct-pay model outside the health insurance industry.

Both choose to connect with their patients very differently.

What do you choose? Because it is a choice. Yes, we had grown up and were trained at a time when private-practice, outpatient medicine worked alongside the health insurance industry. But patients are making other choices about how they want to be treated. Some will continue to choose the model that has been around for decades. While others will choose newer models, models that are evolving as we speak.

You get my point; everything is a choice.

The author is an anonymous physician.