I always regret posting when I feel emotional. But when things are going well, I don’t get in the mood to write. I just came off my first vacation since starting this clinic. It was to celebrate my mother’s 90th birthday. It was a great trip and I got to spend quality time with all my kids and my siblings. But this morning I returned exhausted. It started yesterday morning with a 275 mile van ride at 3 AM (our time) then a flight from Nashville to Minneapolis, then a flight to Seattle arriving home at 11 PM. During the vacation I had on average five calls per day from the office, asking me to help with problems.

I’ve been open for four months and today . . . I had to let my second person go. But this time it was different. This time the employee was a friend. Last time it was a biller, whom I had spoken to many times, but hardly ever saw her face to face. This time it is a biller that I’ve worked with since we opened. I saw her often. She was a friend. But she was chronically under preforming.  As a businessman, I felt I had no choice.  As a friend, I feel like a trader. I can’t think of a more horrible feeling of telling someone that I’m letting them go, and watching them squirm trying to hang on to their job the best they can.  The thing I can relate it to the most is when I shot a robin with my bee bee gun at age 12.  I carried the wounded bird around and was in tears. I begged it not to die. I put a bandaid on its chest. I force-fed it worms . . . but it died anyway.  That’s how it feels to fire someone you like.  God have mercy on my soul.

I  think it was the late Ronald Reagan who defined an optimist as a kid who steps in a pile of horse shit . . . smiles big and says, “Hey, there must be a pony around here somewhere!” I’m in the middle of a pile of manure right now with the clinic and my wife is perplexed while I seem to feel so positive about things. After all, I’ve struggled for months in frustration. Here’s the horse shit.  

T he photo is a thousand words for what kind of day its been. One of the most difficult in my thirty-year career. I hate to always come here and post when I’m frustrated or exhausted, but maybe that is my therapy. But I will try to end in some rightful praise. My mental marathon began a couple of days ago.  It is too complicated to explain here but, once again, has to do with our billing problems. I will just summarize and say that I was disappointed in our billing performance.  As an owner, such disappointments always creates an inward tension.  How am I to act to be a good boss?  

I had a long post I was working on but honestly, I feel exhausted. I will simply post that tomorrow at 1 PM I meet with Group Health Cooperative, the major insurer in our region, who has decided to boycott our clinic apparently because it is PA-owned.  I walk in to meet the VP as a David against Goliath. I will keep you posted.  I’m nervous a bit.   I am disappointed that neither the AAPA, the previous state PA chapter president (who was on the board with Group Health) nor my own attorney has shown any interest in this case. So, I’m on my own.  On days like this, I wish I were an NP where I would have a crowd of supporters at my back.