The concierge model has produced ideas that have migrated into traditional medical practices. Concierge practices serve as a learning laboratory where clinic operations such as patient flows and enhanced communication are refined. In the HealthTexas Provider Network (HTPN), when concierge models develop, other practices often adopt many of the techniques. For example, e-mail access to a physician is standard in concierge practices and is now more common in all practices. Office schedules in traditional office practices that minimize wait times are being emphasized. Attention to preventive services and immunizations, between office visits, is becoming more common. The teamwork philosophy using multiple members of the team has been refined in progressive concierge practices and then spread to our other practices.