As more doctors charge up-front fees, patients find better care comes at a cost

When Judy Taggart's doctor told her she'd have to start paying an annual fee for care, she decided to give it a try.

In 2013, the 69-year-old Severn resident, who was overweight and on medication for diabetes, cholesterol and high blood pressure, began paying $1,650 a year to Dr. Peter Ramirez's Glen Burnie primary care practice. In return, she received a two-hour annual exam that included mental health and sleep dysfunction screenings, body composition analysis and in-depth lab, EKG, vision, hearing and lung function tests.