(CNN) Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They’re expecting patients to pony up with cash.

Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.

In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. (“Cash-only” is a loose description. Nunamaker accepts payment by debit or credit card too.)

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