Spending precious time struggling with patients' drug formularies. Fitting in same-day appointments for sick patients, even on crazy days. This kind of flexibility can make a huge financial difference for patients, says Dr. Benjamin Brewer, a physician in primary care practice. While insurance doesn't pay for the time he spends helping patients avoid extra medication expenses or costly ER visits, it's just part of his job, Brewer contends. Column (WSJ sub. req.)