A growing number of primary care physicians are opting out of Medicare because of concerns that the federal program does not adequately reimburse doctors for their services and that the amount of paperwork involved to get reimbursed is overly burdensome. Some physicians have chosen to enroll in concierge medicine practices, where patients are required to pay an upfront fee to retain the services of physicians. Primary care doctors practicing in concierge medicine are predominantly found in private practice, are more prevalent in wealthier communities, and are still a very small percentage of the overall number of family medicine physicians practicing in the United States - but their numbers are growing each year. While the vast majority of patients can find a new doctor that accepts Medicare patients with ease, the loss of a physician can have a negative effect on older patients with multiple medical conditions. These patients may have trouble establishing trust with a new doctor, or information about their medication history could be lost as they transition to a new provider which can lead to health complications.