While this might not work for you, Jeff, it might work pretty well for a family with 2 or 3 young'uns. And isn't that sort of the way an HMO works? The dr gets paid for the # of patients on his "roster", whether he sees them or not, but still collects each month.
Many physicians have elected to implement option 1. My family physician for 25 years recently shifted to a concierge practice. Each patient pays a flat fee of $2000/year. The doctor sees them as needed with same day appointments and 24 hour accessibility. There are no other charges for his service and he does not accept any form of insurance or complete any paperwork beyond the annual bill. He reduced his practice to 300 patients generating $600,000 in billings. He employs a single part-time nurse (his wife). His office is in his house. His net income has almost doubled and he is working fewer hours per week. He has coverage agreements with other physicians with similar practices so that he can still take vacations.