It was so tight that I thought I would need a jar of Vaseline to make payroll on Monday.  I needed $500 more . . . got $1200 in today. A good night’s sleep is due.

I am often asked, “Are you glad you did it?” I’ll get to my answer in just a minute. A year ago at this time, I was fighting with the bank for a loan. It was painful. They were telling me that any day I would hear . . . then they would never call. I was also trying to get malpractice insurance and there were delays after delays. But enough of that . . . all water under the bridge now. But it is a year later now. Here is how I answer the question. Imagine you were a man you fell in love with a strange, yet beautiful woman. She is this hybrid of genius and  lunacy, of tenderness and uncontrolled mania. She wrecks your life, crashes your car, takes your money, destroys your nerves, but loves you intensely while she eats your heart like a carnivore. She soothes your pain but smears your face with total chaos. When its all over, a friend asks you, “Don’t you regret ever meeting her?”  Then you just stare off into space . . . speechless.  That’s what’s been like. It has been a year of more continuous stress than any time I can remember.  In the last 365 nights, I’ve had trouble sleeping at least 300 of them.  I’ve been on the edge of bankruptcy several times and yet, here I am ten months after opening my doors, at that point again. So people ask, “Don’t you wish you had never done this?” I just stare out the window in silence. It is a crazy world, this world of medical business. Up one minute, crashing the second.  Just a few week ago I was trying to decide what I should do with my extra money. Pay my loan off early? Give myself a raise?  Hire that third provider? The winds of February blew in a perfect storm my way that sucked the financial blood out of me and my bank account. Right now I’m back at that point of counting tens of dollars to see if the money is there to pay the next bill.  I can’t cash my own paycheck right now and for the foreseeable future. We had to shop and shop to find the cheapest toner cartridge we could today. So what happened?  The first wind of the perfect storm came in the form of my supervising physician being out of the country for two weeks. The state required us to close.  Not a big deal. We do need a vacation sometimes, pus I spent one of those weeks in the office doing non patient seeing activities.  But it also meant two weeks of no revenue generation at all. The second great wind gave in the form of a HITECH (Obama Care EHR money) incentive gone a muck.  It is a long story, but we had spent over a hundred hours working on receiving a grant from the HITECH bill. They assured us that the second week of February, about the time our two week hiatus was ending, we would get a check for $18,000 . . . which was more than enough to make up for the loss revenue. We got back from our trip and there was no check. We had worked with the HITECH people for several days, then they finally figured out that because the PA (I think that means me) saw more Medicare patients than the SP, that they couldn’t give us 18K after all. No, we would be getting about $800 dollars instead . . . an it won’t come until March. The next whammy also involves the Feds. Because Congress is so incompetent, the national budget has had delayed and delayed. So, Medicare is technically broke. All Medicare money is being frozen right now. That hurts. Lastly, several insurance companies have decided that they would immediately stop sending checks to PO Boxes.  I’ve fought tooth and nail with the Post Office and our landlords for almost a year to get mail delivered to our office. To make a long story short, tomorrow our mailbox arrives, and we should be getting mail at our office by next week. But you would think that we were living in the Third World. So, I require $900 per day income to stay afloat. In the last four weeks we have suddenly averaged about $200 per day.  The cushion is gone . . . being replace by cold stone of reality. Are we going to make it?  I’m so confident that it will, that I had a phone conference early this morning with the custodians of my retirement fund. I am poised to liquidate.  So here is the great irony.  With my fears about the coming loss of money, I did some strategic things to increase our marketing.  It was like throwing a rock on the side of a mountain . . . creating a huge avalanche.  We are completely overwhelmed with patients right now. It is as nutty as the day the latest Air Jordans shoes were released.  There is a riot at our door wanting to get in.  We are %120 booked through the third week of March and the demand is growing. I think we have hit critical mass. So, don’t I regret walking into this valley of constant terror and turmoil? Don’t I wish this was a year ago before I made a commitment? I sit and I stare out the window of my office.  I sigh. I look at my clock and it is 7 PM once again . . . and I want to go home.  But I sit in silence. I look out over the acres of sailboats moored just outside my door. The lights flicker in a few of their portholes. I sigh as the question is asked again as if I hadn’t heard, “Man if only this were a year ago . . . if only.  If it were . . . yes, I WOULD do the whole thing all over again.” What’s wrong with me!?  Why do I like to tango with the torturous?