It may be a little corny, if not melodramatic, to be talking about giving thanks at Thanksgiving.  But there is a point to all of this. You know the saying that you don’t know what you had until it is gone.  Well, it works both ways. You don’t know how bad things were . . . until they are better. I’ve shared openly about the uphill battle to get this ship upright and at sea. I can say, now six months later, that it is full steam ahead. I had lived through about 8 months of extreme stress.  I got to a point where I literally felt sweaty palms each time I opened an e-mail or a real letter. Over and over it was bad news.

Today we closed the books on our ninth payroll with no help from the bank. This time our margin was about $5,000 in the black.  That is much better than the $35. just a month or so ago.  We are not out of the woods but my bills are paid and the schedule remains mostly full. My sleep tonight should be sweet.

So, I’m sitting in Mesa, Az waiting for my flight back home. We were just told that it will be another hour wait so  have time to chat. I was here for the Scottsdale Headache Symposium.  We finished early this morning (10 AM) so my wife and I hiked from the hotel to the top of Camelback Mountain (pictured). It was a 5 mile round trip hike.  The climb up the mountain is 2.5 miles of that. It is steep. Very Steep in places and 50% of the “hike” is bouldering. They have these strange metal rails up the steepest parts, which do help. So, I’m a bit tired. But this is also a respite from clinic climbing. My mind has been able to get away from the grind for time to reflect.  On Thursday night I did a presentation to a group of NPs and PAs about my process.  I was almost moved to tears when so many came up and said dumb things like “you’re my hero.”  I was moved to tears because I feel like for the past year I’ve been one of those adventurers who is skiing, solo, across Antarctica. It is nice to be with PAs and NPs who understand what I am talking about when I struggled with banks who would not loan to a PA who is trying to start a clinic, or malpractice insurers who couldn’t get their heads around the idea. I had some quality visits with my SP, whom I brought to the conference. I got to rub shoulders with many old colleagues.  It has been a good time. I’m going back feeling refreshed, and with a new zeal.  I see things I need to fix in the way we do business. I have some new dreams of expanding into different cities and into SE Alaska. It has been good indeed.

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.

 Okay, I know that Wall Street has been on every minds of late.  It is completely crazy. I don’t have any time to worry about it, after all, I have no money left to loose. But I was looking at my balance sheet and the ride there has been about as turbulent, however, still in a positive direction.  Since I’ve posted last or income as been as following (collections per day) $60, $135, $265, $2688.  So, for the first time in the history of the universe, our clinic WILL make payroll next week with no help from the bank. Our training wheels are about to come off! My malpractice is paid up for the next quarter as well.  But . . . we are still not out of the woods. It has been a very trying week as our high end computers, our EHR have all been failing us. Even our very expensive phone system wasn’t doing simple tasks. We found ourselves in the middle of major battles with each of those vendors. That can be emotionally draining when you are trying to run a busy practice.  My office manager has done most of the fighting as I’m always with patients. One last frustration with Physicians Insurance.  To remind you, they treated me, the practice owner, like crap because I am a PA. It is like I’m totally invisible to them. I call them, and they return the call to my SP in another town. They sent him the bill, which I paid out of my personal checking account. In our three months, before I fired them, they never once sent me a piece of mail but sent my SP lots of stuff.  The last shot was they sent my refund, payable only to my SP. He didn’t pay a dime for the policy. I wrote them a check out of my own bank account. I told them, called and told them, wrote and told them MAKE THE CHECK OUT OT MY COMPANY!!!!  Yet, today I heard that my SP got paid my refund. They are a very bigoted company when it comes to PAs being clinic owners. Medical Protective has treated me much better. Have a great week and don’t sweat the stock market too much.