I'm going to highlight key points. I'm not sure how it was titled, but I'm going to talk mostly about ancillaries and building verticals in your practice and different practice organizational structures. Who's going to leave at 8.30? It's not rude. I just want to know who's going to leave, how many people have to leave. I'll try to do this in less than 15 minutes. You guys are good? Okay. Great. I think the biggest challenge that we all recognize in your hearing today is that we're not just doctors. We're seeing patients running clinic and doing surgery. We're trying to strike this balance with business. That still holds true with most of orthopedics as more than 70% of us are still not employed physicians, but in practices that we have to pay close attention to all of these issues of running a business. We're actually entrepreneurs. If you look at the MGMA data, salaries right now are somewhere between 700 and 800. This is some old data, but it hasn't changed that much. Some are in the neighborhood of a three to four year out physician, some around the neighborhood of 700 to 800,000 in total compensation. That's not an uncommon number that you see. We're still doing pretty well from a compensation point of view. These are all the things you hear about, and these are all the buzzwords. I think most of them are pretty relevant. We've been talking about value-based care forever, and we're finally now starting to see some of these vehicles that really embody the concept of value-based care. As Kevin said, it's not really outcomes over cost anymore. That's a fallacy, but it's still relevant to talk about because that's the narrative we have with insurance companies. These are the things that are really important. I think the key ones are the consolidation issue and the formation of these supergroups and this shift to the outpatient setting, as Lou just talked about. The relevance of this graph is that the healthcare spend still is largely in the hospital system. This push to the outpatient setting is important because hospitals are really high-cost providers. There's a tremendous amount of cost shifting that goes on in the hospital setting. Frankly, in the past, the ASCs, the outpatient segment, was not really that interesting to insurance companies. Now, that's all they're interested in because they finally get it. It's amazing how long it took them to recognize that there's actually real savings to be had by pushing things to the outpatient setting. That includes spine and arthroplasty, which I can tell you in Chicago, 70% of our spine and arthroplasty is done as an outpatient, and we're just waiting for more codes to get approved in that setting. We'll probably see a jump to 80%. This is the crux of the problem for all of us. Reimbursement never goes up, right? Even when we get a new CPT code, all it does is eat into the pie. Really, what we're dealing with is declining reimbursement or staying the same. I have had a couple of patients recently from New York. They have this product there that basically pays Medicaid rates. These are people who have jobs, real jobs. I don't know if it's an exchange or what it is, but their reimburses are no better than Medicaid. They have very limited access, 10, 20 physical therapy visits. This is a product that's commoditized, and that's in some ways being generalized around the country. Narrow networks, it can lead to reductions in professional revenues. It can be a race to the bottom. That's something to think about because they corner you into, look, you're going to participate, and if you don't participate, you're not going to have access to these patients. Controlling that narrative in our positions, as Kevin alluded to, is particularly important. Then this concept of reduced benefits, we employ now 750. Now, we're up to about 700 employees, including our therapists. Every year, we shrink their benefits. Every year, their access and benefits in the healthcare setting gets narrower and narrower. Just to drive it home, when we follow our professional revenues in our group and in the OrthoForum data, there just is a general decline in professional revenues. You can barely keep the lights on anymore in professional revenues. If you and I were just to get paid based upon the work you do in the office and in the operating room, that would generally just offset maybe up to about 80 to 90 percent of what it takes to keep the lights on, pay your insurance, pay your employees, all your directs and indirects. It really has become impossible to manage this based upon professional revenues only in terms of driving a living and compensation. The other thing you keep hearing about is consolidation and formation of supergroups and things of that nature. There are a lot of benefits to consolidation. Not just the efficiencies, but having your footprint solidified, creating sustainability, a growth model, sharing resources, the ability to have a narrative with an insurance company, third-party payers and so forth, bundles. This value-based proposition becomes a real possibility if you have a broad enough geographic swatch. That's some of the advantages of consolidation. It's not new. Everyone else around us is consolidating. Why wouldn't it be a natural for a business in healthcare? That's clearly what's happening. Orthopedics is just a little bit slow. You've already heard about the outpatient shift. That's real. It's very real. There's some geographic differences. I can't stand this value because quality over payment because it's never really been leveraged that I've seen on the payer side. Where the quality matters is that if you're going to have a discussion with an insurance company and do some risk sharing, then quality does matter because then the buck is on you. Warranties and guarantees are becoming more and more common. Assuring the episode of care where you're saying, look, I'm fully responsible for what happens 30 days before surgery and 90 days after. If there's a reoperation, I'm responsible. I'm responsible for the facility fee. You can have some underwriting and protection for hospital-based problems and so forth, but a more common product is where that you and I will share and gain share with an insurance company to say, we're going to be really responsible for what goes on. That's where quality plays in. I have yet to see any insurance company pay for an outcome. Outcomes are super important for a variety of reasons. We'll just refer to that. The quality aspect relates to how you will bear the burden if you decide to have some of these value-based arrangements. The other thing I'll just comment on is that this BCPI has been very, very profitable for a number of groups, but it's really shrinking. I sense that that opportunity is going to dwindle away over the next year or two. That's also been a race to the bottom. We got all the gains sharing out of BCPI that we could possibly get, and now I think the opportunity has shrunk. You have to have some form of outcomes. In the past, we'd say, outcomes is just a luxury, and we don't really get anything economically from outcomes. Maybe you're interested in research, so you have a platform, but I'll tell you the outcomes is important because even if not from a marketing perspective as another, but I have yet to see very strong vehicles where outcomes are leveraged when it relates to how we get paid. I will just tell you that there are some things that are demanded with MIPS and things like that. Those are basic things, but from true outcomes perspective, we need this to integrate with our EHR. It has to be economically responsible. It's got to be easy. It's awesome and absolutely needed for research, but I've yet to see it play, and I'll be interested in the panel's thoughts in terms of how I get paid. It's just something that's been in some ways aspirational, but it's not irrelevant. I'll just cover a couple of models and brief about physician employment. In general, orthopedics remains about 70 percent private practice, if you will, and that could be single specialty, multi-specialty orthopedics, or multi-specialty in a group that does everything, internal medicine, cardiology, and then there's orthopedics and has access to patients. It could be, as you know, this hospital health system employee. You can have that, and that could be either academic or a privatized version. In an employed physician compensation model, one common thing you'll see is the salary plus bonus. You get an income guarantee and then some defined metrics that give you your bonus. That's very common. Most of the employed contracts that I'm seeing recently are these three-year runs where you sign a contract and you're RVU based, and the ranges are in the neighborhood of 70 to 85 bucks. That's what I see around the country. I rarely see anything that's collection based. This is an interesting model if you're an employee of a healthcare system. What you heard in the first talk on coding, 100 percent, 50 percent, 25 percent, nothing, or just 100 percent if the shoulder is being seen as its own joint with nothing else, but the hospitals often are agnostic to that, and they're paying all the procedures. You think you're walking away with a home run, and you're getting 75 bucks in RVU, and you do an interarticular bereavement, 29823, you do a subacromial decompression, you do a cuff, and you're actually getting recognized for all those services, but keep in mind the trade-off is that they're getting all your downstream revenues. They're willing to cough up a little bit more for procedures because they're walking away with all the facility fees, MRI, PTOT, DME, pharmacy, and everything else. They're not stupid, but it's also not as profitable as you might think in some instances for the hospital. There's other ways to garner incremental compensation as an employed physician. There's call pay, and the typical numbers that I see around the country are about 500 to 1,000 a day. There's academic and leadership appointments. That's something that we do in our group. We try to incentivize service and leadership involvement, and then there's service line agreements where you can come in and say, look, I'm an arthroplasty surgeon. I'm going to come in, and I'd like to oversee the quality, the metrics, the outcomes, the operating room schedule, all of those things, and I want a stipend for doing that, and that's usually a fair market-based stipend. It's never extraordinary, but it's some way to supplement your income in addition to your day job when you're in these employed models. Then there's this group compensation formulas based upon an LLC, if you will. What's very common is this full distribution revenue-based LLC. You have a company, you pay off your expenses, and you just pay everything else out to the partners. It can be a need-what-you-kill model, which I don't advocate for, where there's direct allocation of all overhead, direct and indirects, and fixed and marginals. In other words, everything that's applied to me as a doctor, I get assigned that cost. That's my burden, so I can decide to lean up or not. All the indirects that they can parse out, how many light bulbs do I pay for, how many seats do I pay over here, it's very difficult to parse out indirect overhead equally or fairly. The problem is this, in my experience, and we have a pretty good-sized group I'm the managing partner of, we have 50 providers. As I said, about 750 employees. It destroys a group mentality if you have multi-specialties. Another way as far as this equal distribution is, really, I think you can do it for smaller groups, but it doesn't necessarily incentivize work. If you have no metrics and bonuses and so forth, it gets very tough, especially as the ages get more disparate between the young and the old, and people are just taking home, for example, an ancillary share, and there's a lot of resentment that gets developed along the way, and it doesn't really incentivize work to just distribute everything equally. This is the model that we do, and I've spent... Mike McCaslin from Somerset, who is a consulting firm that works with the Ortho Forum, has always said, if you've seen one compensation formula, you've seen one compensation formula. I mean, it is amazing when we all talk amongst ourselves about how we determine our comp formulas, but I'll just tell you, this is what we do, and I'm extremely happy with it, and I think it's very fair. We are a multi-specialty orthopedic group, so we have primary care sports, we have physiatry, we have chiropractor, we don't have any podiatry. The group we're merging with has rheumatology and infusion therapy. We are really a multi-specialty musculoskeletal group, so taken in this context, we share our indirect overhead, okay? The stuff that you can't really parse out, we just share equally. We assign all direct overhead to the physicians, so they're responsible for that. We have a formula-based professional comp distribution, which means that once you get to certain thresholds, you start to get to eat what you kill, but there's always a little bit of a tax for a socialized portion of it, which is the partner share. So it ends up being an average of about a 15% tax once you meet this minimum threshold, and the minimum threshold is your partner share. It should cover your partner share, your ancillary share. It's what you take out is the minimum threshold, so that's the minimum income threshold that we have in our group. In our group, you have to sort of pull in revenue-wise about a million to a million two before the group is made whole, and then everything above that is taxed at some rate, and that delivers a partner share that gets shared equally, redistributed to the group in the end. That's important because we have pediatrics, which doesn't obviously revenue well. We have trauma. We have oncology. Those things don't do as well, but you kind of need it if you have a group mentality. So that's the socialistic aspect that we have, and then in order to keep people incentivized, there's a lot of tricks to distributing ancillary revenues. Most common model is you do it equally, but we now do it by MGMA RVUs because what we've learned is if you want to find all the things that are indirectly related to delivery to your ancillary opportunities, a lot of it is based on new patients. It's based on the number of surgeries, and it's based upon the total RVUs you do. So we've created metrics so that people are incentivized to work, and they don't just take an equal share of the ancillaries. You cannot do it by saying, I delivered five MRIs. I get five MRIs worth back of money. That doesn't work like that. That's not compliant, but there are ways to keep people incentivized and make it fair. Because ancillaries are becoming so important, you have to think about, and that's sometimes 25 to 50 percent of people's revenue compensation and sometimes more when you bring in the ASCs. You have to figure out some way that people feel like it's fair, but at the same time maintain the group mentality. And then the final issue is as people are winding down in their practice, how do you prevent your senior partners from not feeling like criminals when they're done? The most common model now is these guys wind down, their costs exceed their revenues. The young people start, they don't remember the legacy and all the things that they've contributed. There's a lot of bad blood. People leave in the worst years of their life, the last couple of years of practice, because they're made to feel awful because they're not contributing anymore and they're irrelevant. So I've spent a lot of time trying to figure that riddle out so people don't basically feel like shit at the end of the day after their entire career because they get treated badly because they're not revenueing. So the common paradigm in our world is that you walk away, the day you stop operating or seeing patients, you walk away with nothing. And I have a real problem with that tenant because these individuals have been given their blood for 30, 40 years in some instances, created the goodwill, the value, contributed, built the platforms, funded through debt all of the ancillaries, and then they walk away, they get nothing. There's not very many businesses that actually function like that. So that's something that we're working to change. So then beyond the professional revenue, I think this really gets in the crux of sort of, for those of you who have the opportunities to build ancillaries and verticals around what you do and I do every day, we've learned that the patient, him or herself that comes in the office, represents about $2,000 to $3,000 of incremental revenue even if you don't operate on them, okay? So if a patient's captured into your system, non-surgical or surgical, the average is about $2,000 to $3,000 in terms of what they contribute to our verticals, so every patient matters. So when a guy says, well, I don't wanna really see that patient because it's not convenient for me, that's a real problem if you don't have that group mentality, they don't understand how important getting a patient in the door is to deliver to verticals and subsequent revenues because as I said, it's not about professional revenues, it's about the patients that walk in the door in our practices. So the driving philosophy is that private practice will always be able to provide higher quality, I believe, higher level of customer satisfaction and doing it at a lower cost. Hospitals are just huge cost-shifting machines and you're responsible for all their lines of business, not just what they do in orthopedics. So private practice are smaller and nimble, they respond to the needs of the customers, they have lower overhead and direct control over really all aspects of patient care. So these are the pros and cons of verticals and I'll just tell you that there's, in my mind, there's other than the compliance risks and that vulnerability, there's every reason in the world to be looking heavily into verticals because that really is the only way to get beyond just keeping the lights on in your practice. MRI has been an interesting one, so that's one that most of us will have in our offices and if you just look at the totality of all the answers that we're involved with, the only one that really hasn't played out well for us, if you're really an ethical person, is in-office pharmacy. If you're not a pain management person, I will tell you, in-office pharmacy can be, we've never really been able to crack that nut, so we've tried it twice and we just keep getting out of it. But this slide shows you this decrease in professional revenues on the top, the increase in ancillary revenues as a total source of compensation. I'm gonna leave this, I'll just give you high points on the ASC because Lou did a great job on that, but ASCs, it's really all about the ASCs. You see in this little diagram here, I show you all these other peripheral answers which all matter, they're all incremental, but unless you have a number of click points along the way, multiple offices with MRIs, multiple PT, OT facilities, I think we're up to 15 now, really all that matters are the ASCs and then the patient coming in the door. I'm gonna say, if you have to spend your time, spend your time like Lou said on the ASCs, but it's really nice to have this incremental EBITDA in your practice that come from all of these ancillaries. We didn't talk about Stark very much. The Stark thing is confusing because it's all designed to prevent self-referral, yet I'm allowed to refer my patients to my surgery center and to my MRIs and my PT and the OT, so it's not intuitive. The bottom line is for all the things that we own, we can only generally have about 15% outside patients that are not part of our system. So you can have a storefront physical therapy center with your practice name on it in a mall as long as 85% or more comes from your practice, okay? I haven't seen any litigation coming from this, but that's sort of the spirit of Stark. You can refer to your own. You can't have anyone else on the outside be induced to refer in, so it's a little bit strange and not intuitive. How do we get around this? We have on our website, we disclose our ownership and what alternative options are out there. It has to be supervised by the practicing physicians, but not on site. This is something that we missed out on. For the last 20 years, we've missed out on this. You can own physical therapy without a doctor of the day or being on site. You absolutely can own your own physical therapy, not in your offices. You can also not distribute ancillaries based upon your referral volume, but there's a lot of other ways you can do it, as I alluded to, based upon seniority and other predetermined measures such as RVUs and so forth, but most do ancillaries equally, and that can be very problematic and create bad blood, but the problem is if you just look at it as a box and say, well, what do you deliver in ancillaries, but you forget about the other aspects that they bring to the practice, maybe it's the ASC or other, it's a little bit nearsighted, so you gotta be very careful about looking at the individual things in a vacuum. It all matters, and you don't wanna create, you don't wanna pick these battles when it affects something else, because if a group mentality, in my mind, always wins at the end of the day. I would tell you that MRI and CT is more of a convenience than a profit center. I'll just leave it at that. There's a real cost to it. We don't do so well with Medicare or Medicaid. We're kind of cost neutral. We're comp and private payers still do okay, but it's not great. Our spinoff in our group is somewhere around 100,000 per physician. I'm being very transparent here, because this is data that's in the OrthoForum, by MRI and CT. It's good. We spend an awful lot of time and money, but I'll tell you the best part about it, patient comes in on Monday, you see them, they go down to the MRI scanner that day, they love it, and it keeps the patient in your practice. That's probably the best part of it. Our hand surgeons seem to crush it on the OT side, and I think a lot of it has to do with splinting, and these visits they get in the first day they come in for post-op, they actually go down and get splinting, so the hand guys tend to do very, very well. I'll just tell you from an ownership structure, we have always outsourced with an MSO. They offer value because they have this whole dearth of services, and they have metrics, and they can keep them trained and certified and everything else, but we've gotten so big now that we literally just took over 180 employees from a very large physical therapy chain. We brought them all in-house, and now we're overseeing all of our physical therapy, because most of these management agreements are with franchises that we compete with, and what we realize is that they just weren't that interested in helping us build our physical therapy, and we were doing a pretty damn good job, because everyone who comes in my office, I kind of tell them where to go. Nobody is in a better position to feed physical therapy than us in this room, and the years that we've been out pushing these patients to these therapy centers and losing that revenue is just crazy. We are absolutely in the best position to seed physical therapy, but it really is location-dependent, so if you're interested in this business, you basically go out and you look at where your patients are coming from, and you just plop one down. If you have enough physicians, you can feed a physical therapy center. The next thing you know, they can't get an appointment anymore, and then you gotta build another one, so it's been very, very good for us from a service point of view, a quality point of view, and it allows us to do bundling now. Now we can talk to payers and say, yes, we have the ASC. We don't own the anesthesia, but we negotiate with our anesthesiologist. We're gonna negotiate the surgeon fee, the facility fee, and now we're gonna give you the physical therapy, and that actually has been working very, very well as we go to employers and other models of neural networks. We focus a lot on capture rate, meaning if I see 100 patients and I capture 30% of them, that is only one number. The other number that's really important is actually the number of visits that your patients are getting. My arthroplasty guys are like 75 to 85% capture rate, but they have the lowest visits because they're having them seen in the recovery room, and it's nominal in terms of what they contribute. Now we have home PT transition where the first two weeks, we provide a therapist to the home. That's sort of a net neutral proposition, but what it does do is it engenders the patient to get back into our physical therapy center. So the PT has been huge for us and probably our largest revenue opportunity outside of the ASC. DME is another one. We were getting crushed in DME. We looked at our data compared to other peer groups, private practices, and we buckled down. It was mostly about inventory management. We were screwing that up in a big way. We have FTEs at all of our offices. We have them in our ASCs, and we have them at the hospital to make sure we capture all that business and the hospital doesn't step in. And we jumped up significantly. We quadrupled our revenues on DME once we started paying attention to it. I think, as I've said, the ASC is clearly the single most important ancillary. I'm just gonna leave it at that. Lou did a great job. I don't know if any of you were at the Biologics Association meeting on, was that Tuesday? It seems like a year ago. There's a lot of ethical issues, and it is fee-for-service. And we have all of our patients sign advanced beneficiary notices, which you can get on the CMS website. It allows you to charge cash, frankly, in a compliant way when there's an uncovered benefit. Most specifically, that's from Medicare, but we use it for all payers. You can find that advanced beneficiary notice online, CMS. The way we do adjunct, like bone marrow concentrate, PRP in the operating room, is the patient comes to me. I say, would you be interested in some adjunct to surgery? It's considered experimental, investigational. It's not stem cells. It's not regenerative. It might reduce re-retail rates. It might reduce post-operative pain. The data's still not yet convincing, but it's only money, right? So if this is of interest to you, and it's not considered a painful wallet biopsy, would you like to do this? And we're very transparent in how we discuss it with the patient about the limited data. Once they pay us, we have the hospital invoice us for their side of it that's been pre-negotiated. That way, the patient doesn't get two bills. So we give the hospital a little bit of time and materials and coverage for the capital equipment, the syringe, the troll cart, whatever it is, and we pay the facility. We don't let the hospital give them a separate bill because the patients are extremely angry after they've already paid on our side. So we have an arrangement with every facility where the patient pays us, we then get invoiced, and half the time, the hospital forgets to do it anyway, which we're not going back and telling them they didn't invoice us, but half the time, they forget to. And the ASCs all will invoice us, and we do a shared revenue model, which has proved to be quite good. We didn't, did we talk about it all, private equity, Lou? We didn't do anything, right? So here's one slide on private equity, okay? So, and Lou will tell me if I got it wrong, but I went two years with my group on private equity in terms of entertaining, and we just couldn't make it happen. We'll probably revisit it. But basically, it involves investing others' capital with an anticipated return on investment of three to four times over three to five years. You basically create a joint venture, MSO, separate from all the professional components of what you and I do every day. You can't buy our professional services, but you can lump all the other things into this management service organization, and usually there's sort of a transaction through a management service agreement for everything that we do. The way a private equity deal is funded is by something called retained earnings. So if you make $100, they will basically buy a portion of your $100, and they'll pay you some multiple based upon what's going to happen in the future. It's tax-efficient, it's considered long-term capital gains, and it basically creates a, it depends on a growth strategy. There's not a lot of minority private equity deals. Most of them are majority deals where the private equity group comes in and owns about 70%, somewhere in that range, and you continue to own the less. It's very tax-efficient. It reduces the risk on forward earnings. So if you're, basically it says, look, I just got guaranteed 10 years of earnings today at a tax-efficient way. That's why it's appealing to a number of people. And if you sit in this room and say, well, life isn't going to change over the next 10 years, why would I do this? I think we're going to all be sorely disappointed. Things are going to change. The status quo will never be maintained. And I'm not even saying the status quo is great, but it's not going to necessarily get better. Reimbursements never go up. So there is a significant healthy appetite for these types of arrangements to get tax-efficient forward earnings. So what happens is you and I own a shrinking percent of the whole enterprise, but then there's sort of income accretion through growth. So while you give up something on the front end, so if you give up $30 of your $100 in earnings for the year, they'll pay you some multiple, could be seven to, who knows, 12, 14 times, whatever the environment is. So if it's $30 that you're selling every year, now I'm only going to make $70 next year. I'm selling my 30. They're going to pay me a multiple of that 30. That's called a multiple of EBITDA. And they'll pay me maybe, let's just say 10 times. So I just made, what's 30 times 10, is that 300? So I just made, is that right? $3,000, 300. So I just made $300. I paid long-term income tax on it, not long-term capital gains, not ordinary. And that's really tax-efficient. I got that money in my pocket now. Then you say, well, hell, the next 10 years I'm only getting $70. The premise is that they're investing in you to provide a strategic partner for growth, okay? So that no longer are you 70, next year you may be 80. Next year, all the things that they presumably bring to the table, you're at 100, 110, if that makes sense. That's sort of the vision, if you will. But there are absolutely pros and cons, and you'll hear different sides of this. This in and of itself should be a debate. And I have no strong opinion to say you should or should not do this or entertain it. I'm just going to tell you that the narrative is very complicated, and it matters in terms of where people are, the age of their practice, the size of the group. It's very good to talk about for smaller groups that are senior, older people heavy, okay? Not like one year left, but in the five to 10 year range. It is not ideal, as I found, for larger heterogeneous groups. It's just not ideal. What we're doing, and this is the last slide, is we're doing an aggregation. We said, look, why are we going to go with private equity when we're smart enough, we think, to do this on our own, at least initially? So we love getting dividends from all these answers that I talked about, but how do we grow quickly? I couldn't even add two people at a given time in my group. I go to my joint guys and say, look, how about this guy? Nope, not smart enough. How about this guy? He doesn't publish enough papers. It was brutal. So what we did is we looked at a group that we really, really had respect for in the area that we didn't overlap directly, and what we're doing is we're aggregating. We're creating, it's a divisional model. We're maintaining our brand, they're maintaining their brand, and we're meeting in the middle with a new holding company, okay, with a new tax ID. What happened? We're getting a rate lift with insurance companies because now we do a black box evaluation. We go back to the payers. We can now do value-based propositions with the carers because we have a much broader swatch. We now have 25 to 30 physical therapy centers, not just 15. We now have 12 ASCs, not just seven. So this becomes very appealing from a growth perspective if you want to control your own destiny and then maybe revisit it later, or you can actually keep it all yourself, create an MSO, and create an equity model where when you retire, I don't just hang up my shingle, don't get any, and I get nothing from surgery or anything else, help build all this value. You can actually create an equity bucket for you real time so that when you do retire, just like going in a surgery center, you basically are bought out by the people before you, okay? And it rewards you for all the time and effort that you've put into the existence of your career. So it's not that complicated, but it's basically a very safe, palatable way if private equity feels too threatening, too vulnerable, because this could actually be unwound at any given time, and you can maintain your brand. It's called aggregation, and behind the scenes is really an MSO, just like you would do in private equity. Happy to talk to you offline, but I'm just putting it out there as another option. So that's it. Stay engaged, ask questions, and I appreciate your time, and I know this is kind of rushed, but hopefully I gave you some high points, and I'm always happy to put myself offline and talk to you guys about this. Thanks. So I apologize for holding you late.

orthopedic doctors

practice management

patient care

value-based care

reimbursement rates

practice organizational structures