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I spent some time thinking about concierge medicine before I actually went forward with signature md I like the idea of better work-life balance and having some more time with my patients and you know maybe having a little bit of cushion of revenue so I looked at a couple of other options before I decided to go forward with signature md the first company that I met with was a model in which they it was sort of a pay or leave model and they so basically if if your patient did not could not afford the program they would need to find another doctor I didnt like that feeling you know when i when i joined signature md i was into practice I think 24 years at that point and a lot of the patients that I take care of have been my patients for 20 years you know long time 15 20 years and I Ive grown to really care about them and they care about me and I asked about my wife my kids you know so its a kind of a nice feeling and the idea of sending them off to another doctor or telling them that