Cristy Beckman, who suffers from chronic pain in her spine and osteoarthritis, spent six hours in a doctor's crowded waiting room in severe pain. That was enough, she decided. It was time to make a drastic change in how she was treated. At about the same time, Dr. Christina Bovelsky opened Peachtree Family Medicine in downtown Middletown, Del., with a unique approach to medicine. Instead of dealing with traditional insurance, co-pays and deductibles, her patients pay a one-year membership fee that includes an annual physical exam and between two and four office visits. Small procedures such as nebulizer treatments, strep tests and electrocardiograms are included.