The academy is spending $8 million on consultants who visit doctors nationwide to suggest improvements in patient care. The advice is meant to "keep them from going to an in-store clinic," Ms. Denning said, while also benefiting doctors by making office procedures more efficient.

Meanwhile, the 119,000-member American College Of Physicians is promoting "patient-centric care," which it made the focus of a policy paper this year, calling for more consumer-friendly scheduling, electronic medical records and electronic prescriptions, among other measures.

In [Texas-based] Dr. [Melissa] Gerdes's office, the innovations include daily clinics at lunchtime called QuickSick, in which patients who have phoned up that morning can come in for routine problems requiring immediate attention, like an upper respiratory infection, and are guaranteed they will be examined, treated and on their way within a half-hour.

After a nurse checks the patient's temperature and blood pressure and types the symptoms into a computer, the doctor follows up with a brief exam. If medication is warranted, Dr. Gerdes can e-mail a prescription that will be ready when the patient arrives at the pharmacy.

"I can see three patients with acute needs every 15 minutes," she said.

The charge is $52 to $60, which is coverable by insurance and similar to prices at many of the new clinics springing up in places like CVS pharmacies and retail chains like Wal-Mart.

According to various polls, cost is a high priority for most patients. "People will change physicians for differentials of $10 or $15 in a co-pay," said Dr. Anne B. Francis, a pediatrician in Rochester and spokeswoman for the American Academy of Pediatrics.

But convenience also ranks high. That is one reason about 20,000 of the 59,000 actively practicing members of the American Academy of Family Physicians now use electronic health records. Being highly computerized can let doctors offer Web-based scheduling that enables patients to book their own appointments.

Many of those doctors also offer what Dr. Larry S. Fields, the academy's president, refers to as "open scheduling" — setting aside certain hours each day for seeing previously unscheduled patients.

"We try to cut down on the waiting time," Dr. Fields added. "We need to be more conscious of patients' time.". . .