They're part of a small but growing group of people who barter for the services their insurance doesn't cover.

Tyrone Khaleel, a furniture store owner in Hollywood, has medical insurance, but no dental coverage. So when Khaleel discovered he needed a root canal, he paid his bill in barter. ''It could have cost $1,200 or $1,600 or up to $2,000,'' he says -- cash, he adds, that he didn't have to spare.

Doctors who for years have accepted small fractions of their business in barter say they have seen a spike -- in some cases a tripling -- in the number of consumers opting for alternative forms of payment.

And with their own schedules emptying as people cut back on non-essential healthcare, doctors say they're more willing to see barter patients.

''Almost everything is a fixed cost, so whether we see 50 patients in a day or 100, those costs don't change, since we're not running at max capacity,'' says Nick Savastano, an orthodontist in Longwood.

``I actually wish it were more. I'm looking at my schedule now, and I could have fit someone in for braces this morning.''

Barter has also grown more sophisticated than the tit-for-tat transactions prevalent in healthcare several decades ago.

While some providers do accept ''direct'' barter, the individuals' needs don't always align perfectly.

Locksmith Tommy Kramer was looking for regular dental check-ups, but few dentists would need locksmith work of equivalent value to the services they provide.

Such disconnects in supply and demand have given rise to an industry of bartering brokerages, whose members get taxable credit or ''barter bucks'' -- good toward services offered by any of hundreds or even thousands of brokerage clients. Thanks to the bartering firm Tradesource in Hallandale Beach, Kramer got his dental work, while his dentist, Marc Frankel, could spend the barter proceeds elsewhere.

Florida Barter, an association with 1,600 members -- about 20 percent of whom specialize in healthcare -- saw $3 million in healthcare bartering in 2008, according to its president, Scott Whitmer. This year, he expects that number will jump by 50 percent to $4.5 million.

''There's never been a time in our industry that has been like this,'' says Scott Ebberbach, who with his wife Cathy runs the Boynton Beach branch of national barter firm ITEX. ``This is unbelievable. We know the reason is the economy -- people still want to be able to get what they want, but they just don't have the cash to get it.''

But while Ebberbach says he would love to add more specialists or practitioners to the ITEX membership rolls, he says bartering remains focused in areas of medicine often viewed as less essential.

Dentists, optometrists, and plastic surgeons see the highest demand in Ebberbach's group, often, he says, because insurance often doesn't cover their services.

''A lot of people have insurance,'' Ebberbach says. ``But most people don't have dental insurance, and in order to pay for any sort of dental procedure, you've got to pay out of pocket very hard.''

Chiropractor Elana Kaplove says she has seen a decrease in her number of patients as the recession has worsened but reports a significant increase in barter business from 3 percent of her practice a year ago to 10 percent or higher today. Kaplove's specialty also sees relatively heavy barter traffic because some insurance will not pay for chiropractors, something Kaplove says she has seen affect her patients substantially over the past year.

''People change insurance to get lower premiums and higher deductibles, and often they're not covered for services anymore,'' Kaplove says. ``So if it's not an absolute necessity, they're not coming.''

An emptier schedule may not be the only reason doctors have been open to the practice. Ron Whitney, director of the International Reciprocal Trade Association, says the prospect of charging the full amount for their services in barter dollars has proved appealing when reimbursement rates from insurance companies or medicare fall below their going price.

''What we're hearing across the country is that doctors are actually calling and asking to join,'' Whitney says.

Despite the success stories, bartering is not necessarily a panacea for the uninsured -- particularly those who are unemployed.

Barter association clients tend to be small-business owners, since they are best able to trade services. But if their businesses shut down, they can often no longer barter their services.

''Those people who have lost their business, we've lost their business,'' Ebberbach says. But Whitmer, president of Florida Barter, says his organization of 1,600 has been relatively unaffected by this phenomenon, with only four of his clients going out of business. Meanwhile, he says, Florida Barter has had to recruit doctors just to meet burgeoning demand.

This surge in interest comes as no surprise to Vicki Cortina, a graphic designer who say she has bartered for 14 years. She said she would never have been able to afford the Lasik surgery that restored her eyesight without a non-cash, non-insurance option. To earn the barter dollars, she will design brochures, catalogues, logos and signage.

''Bartering is like my mad money, for things I couldn't normally afford,'' Cortina says. ''I've gotten wood flooring on barter, paint for my house, patio furniture.'' Barter has surged at her own Create One for ME graphic design firm in Sunrise, but Cortina adds she doesn't mind, as she's hoarding her barter bucks for an important upcoming expenditure.

''I'm saving up for my daughter's sweet 16 next year,'' she laughs. ``I did my other daughter's sweet 16 totally on trade . . . Even the wine.''