A renowned HIV specialist in Houston has given his 1,500 patients a proposition: pay $1,500 within two months, or look for another doctor. This sudden price hike has shocked—and outraged—some of his patients.

Dr. Shannon Ray Schrader is charging patients $1,500 per year, on top of the cost of regular care, to remain patients in his practice. He is now working with a company called MD-VIP, which specializes in premium “concierge care,” for patients wealthy enough to afford it. Only 600 of his current HIV patients will remain after the two-month deadline.

Schrader’s “a greedy jerk.... You do the math: 600 times $1,500 equals $900,000 for Schrader without even depressing one tongue,” says one activist, who worries about whether Houston’s AIDS-treatment facilities can handle a sudden influx of patients.

Schrader attributes the change in service to an inability to handle the pace of a larger practice, which was affecting his personal life.