Direct practice medicine. Co-founded Qliance Medical in 2006, but was one of the earliest physicians to convert to the direct practice model, with Seattle Medical Associates in 1997. Qliance eschews insurance, trading the reimbursement hamster-wheel for pre-paid subscriptions. But where other direct practices charge extra for office visits or house calls ( Shlain), Qliance charges a $99 initiation fee, and then at most $129 a month for unrestricted access to its physicians and nurses. All direct practice models give physicians more time with their patients, and patients seem to feel they are getting higher-quality care. Dr. Bliss also says that Qliance saves individuals up to 50 percent and employers 35 percent, on their healthcare costs. But the jury is still out on a few points: does direct practice actually improve outcomes? And, while the business model works in boutique situations, can it scale? We'll find out: this month Qliance raised $4 million in venture to fund expansion.

To Pharma Knowledge:  "I love insurance - I own plenty of it. But if we don't move away from our current system, we're going to bankrupt the country."