Rebekah Bernard, M.D. 0:00
What if the best way to save rural hospitals is to let physicians own and operate them? Today, on Physicians Taking Back Medicine, you'll meet a doctor who did exactly that. When the only hospital in his rural hometown closed, dermatologist Dr. John Ward took matters into his own hands, assembling a group of physician investors. They bought the hospital, spending millions to bring it back to life. Along the way, Dr. Ward faced regulatory barriers, staggering losses, and months when he didn't know how he would make payroll. But today, North Walton Doctors Hospital is open, expanding services and proving once again that physicians can take back medicine. I'm

Speaker 1 1:01
John Ward. I am a Ward-certified dermatologist and Mo surgeon. I practice in Panama City, Florida, and my practice is in four states. We have 32 locations: Georgia, Florida, Mississippi, and Alabama. And that's really afforded me the ability to give back when it comes to to medicine. I also happen to be a hospital administrator on top of all of that because the town I grew up in had a small rural hospital, and it closed in 2022. I got a group of investors, primarily physicians, and we bought the hospital and we went through the process of reopening it. We brought it back. We opened in September of 2024, and we actually broke even for the calendar year 2025 when it came to profit and loss. We're the only physician-owned hospital that came about since 2010, or actually even before that, but 2010 is when they outlawed it.

Rebekah Bernard, M.D. 2:05
This is so great. You started from the ground up. You built this network of practices, and because of your work and your business that you developed over the years, you're now in a very nice financial situation where you could do a lot of different things with that money, you could retire, you could travel around the world, but instead, you did something so much better. You decided to put that money that you worked hard for into giving back to your community. So let's get into a little bit more on that story and and just talk me through that decision of how you how how this all happened? A

Speaker 1 2:41
physician colleague of mine who was CEO of another rural hospital had approached me about the hospital before it closed. It was Help Mark Regional Medical Center in Phuniac. They were 25 bed hospital, and everyone knew they were in financial distress. That was really near and dear to my heart, because I have friends and family who live in the area who had no access to emergency care, and we actually approached them to to do something with them before they closed, but they were very unreasonable about what that purchase price needed to look like, and it it just didn't make economic sense, so we walked away, and then they closed in 2022, and so around June of 2023 they re-upped the discussion, and the purchase price was much more reasonable. So we got a group together. We worked with the bank. We worked with a private lender as well that was a non-bank lender, and we put a package together that allowed us to buy the hospital. We closed on it in August of 2023, and then unfortunately, once a hospital closes, AKA in the state of Florida requires that hospital to come to the current building code for hospitals. If we had purchased it while it was still open, we could have not done a total renovation of the facility. But because we bought it after it had closed, and we got a new tax ID and all that, we had to bring it up to code. It was a significant investment. All in, it was about $16 million to bring that back, and we didn't do the inpatient wing. We actually converted what was the ICU to our inpatient observation areas. We're only licensed right now for two beds, but we do have that inpatient wing available for expansion. So we could go up to 20 plus beds if and when that makes economic sense.

Rebekah Bernard, M.D. 4:44
How long had that hospital been there?

Speaker 1 4:46
It was built in 1990, by a single private owner. It was a for-profit rural hospital.

Rebekah Bernard, M.D. 4:54
I see. I guess maybe is it possible that back in that era you could make money. Owning hospitals, or what changed between then and now?

Speaker 1 5:04
Well, you know, the individual that owned it was not a physician. It had gotten to the point where it didn't have the best reputations. the The ER was not physician staffed. It was all mid level staffed, and it actually gotten quite a stain on its reputation. We had a lot of work to do once we decided to go in there because we needed to get the trust of the community so that the community would access healthcare there.

Rebekah Bernard, M.D. 5:31
So you mentioned that this was not a physician owner, and I want to explore that a little bit because there is a law, and I believe it was linked to the Affordable Care Act, that physicians are no longer allowed to own hospitals, I guess, other than certain carve-outs. Give us a little bit of background of what you know on that law, and of course, the greater question of how in the heck is a non-physician more qualified and better to own a hospital makes no sense to me.

Speaker 1 5:59
Being physicians, we have some pretty strict requirements in order to own a hospital, which should blow all of our minds that that's not allowed. Staric laws, I think they came out in the late '80s, maybe mid mid to late '80s. Staric laws had specific exemptions, and one of the exemptions was the whole hospital exemption, so it governs what physicians can refer, when they can refer, when it's considered an inappropriate referral or Stark violation. But physician ownership was was allowed under the Stark law when it initially passed under the whole hospital exception, and when the Affordable Care Act passed in 2010, they basically removed the the whole hospital exemption, making it illegal for a physician who owns a hospital to refer patients to the hospital, which in effect also means you can't see patients in the hospital if you take Medicare or Medicaid patients, which basically under the current structure, a hospital that doesn't see Medicare or Medicaid can't be financially feasible. So we went in understanding that if we purchased this, the physicians who were owners could not refer patients to the hospital, which was okay for me because I'm a dermatologist, so I don't refer patients to the hospital. One of my partners is a retired ER physician. A lot of the people who owned are people who went into it knowing, hey, we're going to do this. We need to show that we can do it better, and we are going to do it, and we just know we can't refer patients to the hospital.

Rebekah Bernard, M.D. 7:45
I mean, I guess I see where their brain was going when they made this law. They're thinking like, "Oh, we don't want doctors to basically send people that don't really need to be hospitalized to the hospital just to make money. This whole idea that doctors are bad actors that are really out for self profit, but meanwhile, non physicians would never do that, right? Yeah,

Speaker 1 8:08
H HCA so altruistic. They they are not there to maximize profit on anyone ever. No way.

Rebekah Bernard, M.D. 8:15
Absolutely, it is just you know cuckoo. So meanwhile, as physicians, we of course recognize that yes, there are probably bad actors out there that might do the wrong thing. But realistically, most doctors didn't get into medicine to make tons of money. There's lots of better ways to make money that doesn't require 12 to 15 to 20 years of education and debt and all this stuff. But nonetheless, that was the rule that they made. And so, in order today to own a hospital, what you're saying is you can do it, but you cannot refer patients to that hospital. Am I understanding that correctly?

Speaker 1 8:54
Yeah, that's right. That is one way that physicians can own a hospital. There is a second way that a physician can own a hospital, so it's kind of a roundabout way of ownership. But you can own the building and land of the hospital as long as you don't own the operating entity. So you could buy a hospital, own the land and buildings, and refer to that hospital as long as the rent structure spare market value. That is also allowed, but you would not be able to make profit off of the operating entity's revenue. You can only make profit off of the fair market value rent, which actually, believe it or not, is a really interesting way that you can skin that cat and still make it worth the while of physicians who wanted to get together and do that.

Rebekah Bernard, M.D. 9:42
Talk to me about how you found other physicians and people who were willing to go in on this with you, because obviously it took a lot of money. Some of that you were able to self finance, but obviously you're going to need some help because we're talking about pretty big dollar amounts, just like in the renovation that you mentioned. So, what did you do?

Speaker 1 10:02
So, basically, using the the connections that we have, you know, like we go to medical association meetings. We have a really strong local medical association, and we just kind of pitched the concept to our colleagues, and we found enough that we were able to. I think we raised like $3.7 million initially, and then an interesting thing you can do for your physicians who don't own, but you want them to do work at your hospital. Physicians are allowed to make loans that, as long as you don't give preferential treatment to the physician on the loans, and you offer the loans to non-physicians as well. That is another mechanism whereby you get physicians involved. So we actually raised another three or $4 million from physicians who we need to refer to the hospital via promissory note loans, where they get paid up higher interest than you than you would if you got a conforming loan at a bank, but lower interest than private lenders that aren't banks too. Who

Rebekah Bernard, M.D. 11:06
else did you need on your team to help structure this? I'm guessing you needed finance attorneys. I was gonna say I'm guessing you needed a a lot of lawyers and a lot of finance experts.

Speaker 1 11:16
Yeah, yeah. So the bankers helped us get a SDA since we're in a rural area, helped us get a USDA business and industry loan. Another special loan product with zero interest is a USDA rural economic development loan, and then we even got a Department of Treasury, since it's also an economically depressed area. A Department of Treasury loan was about three and a half billion dollars, and that principal's forgiven after seven years, so it becomes like free money. So our our banking partners really really helped us be strategic about making the interest payments that we had to make affordable, um, so so that so that we could make this work. And it's still, by the way, Rebecca, it's still the first full calendar year we ended up, you know, breaking even. But the first like year where where we were doing the renovation, and then three and a half months of actually being open, we lost about $7 million, and we went into it knowing we were going to lose money that year. So so it it it is not cheap to even when you find a distressed property that you get it a good deal you spend the money to renovate it operations wise we lost $7 million on top of all of that.

Rebekah Bernard, M.D. 12:34
Well, you're really having to look at long term projections. You can't go into something like this looking at one year, two years-you've got to be projecting out. I don't know, even possibly decades, or do you think it's a shorter timeline for being able to break a profit? And let's explore that because we are hearing about hospitals closing left, right, and center. So, how can someone break even and make a profit in a situation like this with a rural hospital,

Speaker 1 13:02
yeah. You really just have to have a plan and understand where your profit centers are. So we knew that outpatient surgery would be the the the profit center. So just as quickly as we could get on all of the insurance plans, which took some time, but we knew get on the insurance plans as quickly as we could, so that we could start doing outpatient surgery. And we had orthopedic and spine surgeons who had committed to doing their surgeries at the hospital. We knew the ER wasn't going to make money. We knew outpatient labs and imaging wasn't going to make money. We're like, we got to get these ORs open as soon as possible.

Rebekah Bernard, M.D. 13:41
That's so interesting, and that's something that I think a lot of doctors have no clue or understand. All of this part of it, why it is that? Well, why are these OBs floors closing, and why are these you know other things closing? It's because the way that reimbursement is structured, and I'm guessing also, charitable care aspect is has something to do with it too. Is that correct?

Speaker 1 14:06
Yeah, charity care is definitely something you know within within Tala. You know, in in the ER, you you have to see everybody. You cannot even talk about payment until you've done a medical screening exam. The amount of uninsured definitely is something that can have a negative impact on on your bottom line. There, there are federal and state subsidies for that, but it does not make you whole on on the uninsured care. It makes it palatable, and even Medicaid is really really tough. But the federal and state subsidies for Medicaid are actually decent for hospitals. So there's a program called the Direct Payment Program where you get a supplemental payment every year to make up for the losses on Medicaid. And here's the other interesting thing: you can't make a hospital work financially without your Medicaid supplement. Payments, and you don't get the payment the first year. It it's it's it's from your trailing year. So we got our first Medicaid supplemental payments last month. It was awesome. It was great, you know. But it was from the work we did from when we first opened.

Rebekah Bernard, M.D. 15:17
You had to have so much faith and upfront investment, and know that that was going to come if you could just hold on, and and then of course you hope it's going to continue to come because these are policy decisions that are made federally and state, right? As far as whether subsidies will continue to come, whether they'll be cut, whether they'll be expanded, so that's also a big act of faith that you're taking.

Speaker 1 15:39
Yeah, a lot of a lot of it's good fortune, you know. Like there was the one big beautiful bill did cut Medicaid in a significant way this year. It didn't affect the Lib program, which is the uninsured subsidy. It didn't affect the direct payment program, but it is going to affect them on a go forward basis. So that amount, those amount of payments are going to go down. Now, on the other hand, they put in $50 billion for rural hospitals, which is the rural health transformation program, and we got $4.6 million per from rural health transformation for this upcoming year, which is really exciting because we are bringing an MRI machine to the hospital with that money. We are bringing teleneurology and telepsychiatry and telecardiology to to the the hospital, and that's going to be great services for the community that we'll be able to do because of the the funding that we got from the federal and state government program.

Rebekah Bernard, M.D. 16:39
I want to take a minute because you and I, Don, are both real big fans of free market and cash pay whenever possible. Is that something that you're exploring with the hospital, like being able to just tell people without insurance, like, "Hey, here's how much a gallbladder surgery would cost.

Speaker 1 16:56
We are offering surgical procedures for people who either have insurance that we don't accept or that don't have insurance, I would say maybe in a month we do three surgeries like that, and we basically look and see what the Medicare rate would be, and typically just just say okay what you would pay out of pocket and self pay like that is good for a lot of people, you know. I mean, I I don't know what your insurance premiums are for you, but me and my family, we have like a $10,000 deductible, and I'm paying like 1500 bucks a month, which is like $18,000 a year, and we're doing surgeries on people at the hospital. I think the most we've ever charged a self-pay for a complicated spine surgery was like $20,000, you know. So,

Rebekah Bernard, M.D. 17:46
yeah, I'm kind of in that situation, and and as a direct primary care doctor, I am very attuned to what prices of different things are. A lot of my patients either have no insurance or have a high deductible plan. I'm like you; I get the the highest deductible I can. I still pay a fortune for it, and if I needed to have surgery, unless it was an emergency or it was something astronomically complicated, I would be investigating my cash price options, and I'd get in my car and drive a couple hours north. There's a rural hospital, believe it or not, that's doing very good work with general surgery procedures, or I might fly over to Oklahoma and get a transparent cash price for a surgery. I would certainly be investigating those options, and I think the more opportunities that we have for price transparency and people making that decision, it just makes a lot of sense. I love that you're able to offer that in your community.

Speaker 1 18:41
Yeah, legislatures are really focused on hospital price transparency. I really think that if you want to do that, you've got to also have insurance payment price transparency because it is it is so structurally unfair to rural hospitals who are trying to compete with Ascension and HCA and Advent Health and all these big health systems, who Blue Cross, United, Etna, all all of these insurers are paying them two to three times more to do the same work that we're doing at our rural hospital, but they will negotiate with us because they say they don't need us. You know, they're like, "Oh, well, you're just a little rural hospital in Moulton County, Florida. We don't need you. Here's the best rate: take it or leave it. And all of these larger systems are getting two to three times more to do the same work that we that we're doing.

Rebekah Bernard, M.D. 19:41
It's so true, and but it's also fascinating to see just recently here in my county in Lee County, our our major player, our big hospital, and I think they're still pretty much a monopoly. They just announced that they're dropping one of the bukas. I can't remember which one because of not feeling that they're being paid enough. And then I think also it happened over at Broward Health. So these really huge hospitals are also kind of playing this insurance game, and of course it leaves patients in a in a bind. And the number one issue, as exactly what you said, there's no transparency. All of these things are happening behind closed doors. No, nobody really knows what the pricing. Patients certainly have no idea. You can't have a free market when deals are being made behind closed doors, and you have no ability to actually compete. You hear all this angst. Why are coughing up closing? Why can't we keep rural? And ultimately, it is a very unfair system that needs to be changed. And I'm so appreciative that you're working on that and bringing this more to the front so that people understand what are the service lines that you guys are offering right now at the hospital.

Speaker 1 20:51
So right now we have outpatient labs and imaging. So any any routine lab that that someone needs, we have MRI, X ray, ultrasound. We will be having mammography at the end of the year. We got state funding for women's health clinic, which includes mammography. We also got state appropriation last year for a mobile lung cancer screening unit, so a CT scanner on wheels. So we're really excited about that. Taking it to large employers, the low dose CT lung cancer screening is covered for people with a history of smoking who are between the ages of I think it's 50 and 75, and then we're going to partner with firefighters who are also at higher risk for for lung cancer just just occupationally, and try to actually take our mobile unit potentially across the state to fire stations and offer the screening to them as well.

Rebekah Bernard, M.D. 21:52
And then you have you said outpatient surgery, so you've got orthopedics and general surgery. We

Speaker 1 21:57
don't have general surgery yet. We are actively working on that. We have orthopedics, spine surgery, and we have a couple of interventional pain doctors. But yes, we are actively talking to general surgeons. We have a general surgeon that's ready to come once we get the breast program up and running.

Rebekah Bernard, M.D. 22:16
That's fantastic. And then, of course, you have an emergency department.

Speaker 1 22:19
Absolutely, emergency room primarily with board-certified emergency medicine physicians. You do know in rural areas some of our shifts are less busy, and you get a good sense for when you're going to be busy and when you're not going to be busy. So we do have a few shifts covered by extremely experienced mid-level providers with a backup

Rebekah Bernard, M.D. 22:38
with an ER doctor. I'm sure backup

Speaker 1 22:40
on call, and then the two inpatient beds and two additional observation beds, which aren't inpatient beds, but we have it for observation. And then we have a medical office building where we actually have a cardiologist, a dermatologist, orthopedic, ENT. So we've got a bunch of specialties, and our telehealth is our telehealth program is going to be in our outpatient building as well as in our ER,

Rebekah Bernard, M.D. 23:04
and then you've got a whole nother wing just waiting to be expanded when the time comes.

Speaker 1 23:08
Absolutely, absolutely, and the time is coming soon. I mean, we we could use the inpatient beds now. It's just going to be about $5 million to bring that up to the current code. I do think, to some degree, the people that wrote the code for what you need it has a lot less to do with patient safety and has a lot to do with preventing market entry by making building these hospitals so expensive.

Rebekah Bernard, M.D. 23:34
So it sounds like that's an area maybe we should or be working on regulatorily or legislatively.

Speaker 1 23:41
Absolutely, absolutely. Like the the changes that they make to it are pushed by lobbyists in Tallahassee who represent the large hospitals, and they're like, "Oh, well, if we make the market entry too difficult for everyone, then nobody, there will be no new market entrance.

Rebekah Bernard, M.D. 23:59
And that is why it's hard to have competition in a free market, so it sounds like that's definitely an area we need to be exploring, so that more people can do what you're doing without having this burden. Let's talk about the community. You mentioned that there was a bit of a barrier to entry because the hospital had gotten a bit of a bad reputation, but what's it like now? How did you overcome that, and how has the community been welcoming of the hospital?

Speaker 1 24:23
So we really overcame that by just focusing on how this is physician-led and physician-run, and bringing quality providers to a place that really had none. It was a healthcare desert. At first, we were pushing everyone that came through the ER, please leave a Google review. Please leave a Google review. But we have a 4.7 Google review for the hospital, which is actually the highest Google review in the whole area. So you know, take good care of patients. The word of mouth will spread, and then you know it. It really only took about six months. Of being open, and if you go look at our Facebook page, every time we post, we get we we get positive feedback. I mean, you're always going to have one or two people that leave a negative, but I mean, I'd say 90% of all of the comments are positive.

Rebekah Bernard, M.D. 25:15
That's just amazing. So now you're really serving a very vital role in the community. That's got to feel incredible to be able to do this, and then not only does it feel incredible, you're turning a profit, so you're going to be able to stay open, and you're going to be able to hopefully expand and expand soon.

Speaker 1 25:33
Yeah, and one thing I'd like to just just share with everyone is there are things we can do to level the playing field, and the biggest thing is trying to get physician ownership reallowed in the hospital setting. And I think we have we actually have a mechanism to do that through rural hospitals. You know, we got $50 billion into a bill for rural hospitals. You know, with politics, you don't want to ask for the whole enchilada. You want to do it incrementally, and I really think we could get together as physicians and say, "Hey, at least in in rural areas, why not let physicians own the hospital? Why not bring it back for rural? And we do that, and then we would have data to show that well, actually, rural hospitals that are owned by physicians are providing a higher level of care and higher patient satisfaction and a lower cost than the rural hospitals that aren't owned by physicians. I think there's actually pretty good data out there showing that before they changed the law, that physician and hospitals were highly quality care and were not costing as much. And now that corporate medicine and the hospital systems are even worse actors than they were back then, I think it would be super easy to show that physician-owned hospitals and physician-run hospitals would save the country money.

Rebekah Bernard, M.D. 27:08
I think so. I've seen some data looking at grandfathered hospitals owned by physicians, and just showing the things you've talked about: better outcomes, better cost savings. And then on the flip side, when you look at private equity-owned hospitals and facilities. There's absolutely no beneficial result of that. It's all bad. In no way does letting a corporate entity run healthcare make it better for patients in any way at all. So I totally agree with you. I think we need to get back to letting physicians run hospitals, own hospitals, and basically take back medicine.

Speaker 1 27:46
I agree, and it starts with those young medical students in residence who are looking at whether they're going to join corporate medicine or whether they're going to take control of their own lives. Because really, if you work for someone, you are not in control of your own life. You know, if you own your own business, if you want to take the day off, you can take the day off. Your patients may not like it a ton, but you have the autonomy to do that if you need to. And it's a and it's a thing of beauty, especially as you get older and you have children. And when it comes time, spend time with the people that you want to spend time.

Rebekah Bernard, M.D. 28:25
Such good advice. Did you always have this idea about being a practice owner?

Speaker 1 28:30
Actually, I didn't start my practice right out of residency because I didn't know the business of medicine at all. So I went and joined a existing single practitioner dermatology practice, and my experience is probably what a lot of young physicians experience. And it went on for that year that I was under contract, and I just looked at my wife, and I was like, "Hey, where we grew up in the Florida Bay Handle, there aren't many dermatologists. I was like, why? Why don't we just move back home and do this on our own? I spent time at that practice with their business manager, trying to understand how to make the business work.

Rebekah Bernard, M.D. 29:13
So I think your point that we we go through med school and we go through residency with very little, in some cases zero business training or experience, and then we wonder why isn't anybody choosing to go into private practice? So that was a good opportunity for you in a way because it sounds like they were very open to teaching you and giving you what you needed to learn how to run a business. What advice would you give someone who's graduating and saying like I want to own my own practice and do my own thing. What is the answer for

Speaker 1 29:47
them? I do think the answer is similar to my path because most GME runs are academic medical centers, and even their attendings don't really. Understand the business because it's all done outside of the academic medical center in the physician you practice, which is usually in an office that's a mile away from where the actual academic medical center is. So really, private practice experience is is where you're going to do it, but but you can't be your first year there, and you know, be a nine to 4p.m.er. You've got to take the time on top of that, and you go sit with the practice administrator and and ask questions and be like, okay, well, here are my collections. Where am I losing opportunity there? How can I make this better? What's our claim rejection rate? How does that benchmark against national standards? Just as much time as it took you to learn your specialty, you've got to take that time to learn the business. You can do it on your own. The resources are all there. You just have to really have the want. And any resident right now could start learning that maybe not in a business office and seeing it in real time, but the resources online are there to use right now.

Rebekah Bernard, M.D. 31:10
I don't know that you would have been able to own a hospital with your fellow physicians had you not been in a situation where your practice puts you in a great financial state to be able to have this flexibility. So let's take just another minute to explore how you went from one practice. I'm assuming you started one practice in the Panhandle, and how did you explode that into a multi-state platform?

Speaker 1 31:37
Well, it really took advantage of the structural issue within dermatology that no dermatologist goes to non-metro markets. So, I mean, basically, when we started our business, if you went to a place where dermatologists weren't, you were busy. It was the scenario like day one you're seeing 40 patients, and then we really focused it on skin cancer. Obviously, skin cancer pays more than warts and acne. Once you figure out how to make one location profitable, you've got your model, and then you just have to recruit and find a doctor that's willing to go there. Good, bad, or indifferent, we do utilize advanced practice practitioners, NPs and PAs, just because outside of rural markets we can't find dermatologists. To most of our primary offices do do have a dermatologist there all the time, but some of our rural clinics, you know, we just got to make it work.

Rebekah Bernard, M.D. 32:39
So, what advice would you give to our listeners? Maybe there's a doctor out there that is feeling a call to doing something like this. What would you advise them?

Speaker 1 32:50
Well, my first piece of advice would be to definitely model out your pro forma. Like the worst thing in the world would be to make a huge investment and realize that you don't have enough money to make it through the first year in which you probably are going to lose a lot of money. So it is a daunting task and undertaking. The next thing, don't make large capital expenditures unless you've got a plan around it. So yes, you're going to need X-ray and CT, but maybe don't buy that MRI machine that you really, really want because it's another $1 million of expense. You know, maybe you know when you when it's talking about your your lab, maybe have limited labs at at first, just what you absolutely need from your EP, and then work with a reference lab to you know with a good turnaround time for your sendouts. There, there are definitely ways you can save money and still do it and have high quality care. And there are definitely ways you can do it and spend a lot of money on things that you find out later that you didn't need.

Rebekah Bernard, M.D. 34:01
How do you feel just about being able to do something like this? You know, this is a huge deal, John. It

Speaker 1 34:07
is a big deal today. I feel good about it, but Rebecca, I will be so honest with you. There were moments, not in the last six months, but in the last 18 months, where I was literally so stressed out because I had no idea there were at least six months of payrolls that I was just like, okay, how are we going to pay for this? Like, like what, what am I going to do? And I and I think I hit rock bottom when I had to liquidate my investment accounts, not my retirement investment accounts, but the ones that I can access. Literally, like I just sell all my Bitcoin. I was just like, okay, if we can just hang on for a little bit longer, and unfortunately, we were able to, and we turned that corner because we knew it was right there, and it has all worked out.

Rebekah Bernard, M.D. 35:00
That's really the part that I think makes you so amazing and inspiring. Is that as hard as it was, you know, you hear these success stories like, "Oh, this person did this amazing thing, but what you don't often hear is how scary, how hard, and those moments where you weren't sure if it was going to work, and you kept going, and it really has paid off being able to do something so incredible for the people that you employ, because I'm sure now you're a significant employer in your community, and that is economically amazing. And for your patients, I mean, these are people that had no healthcare, and now they can see an emergency physician, they can see an orthopedic surgeon, they can see a cardiologist without having to drive hours away. This is just the most perfect example of the podcast theme, which is physicians taking back medicine. And so, I just want to be able to to share your story with listeners to say, you don't have to just go to a job, punch a clock and go home, and and also be miserable the whole time. You could own yourself just like you did. You could own your own practice. You could expand your practice, and if you wanted to, you could open or own a hospital and provide medical care to your community. You've done it, and so it can be done. Thanks so much for listening to this episode of Physicians Taking Back Medicine, a podcast from Medical Economics. I'm your host, Dr. Rebecca Bernard, bringing you true stories of day-to-day physicians just like you who are working to improve the healthcare system. We'll see you on the next episode.

Transcribed by https://otter.ai