Ep. 194: Future-Proofing Your Clinic in a Post–One Big Beautiful Bill Act World

PCMP (00:00) Hey, what's up walkins welcome fam Nick and Michael back with you for another episode and as we as we always want to help you grow your clinic sometimes we have to have uncomfortable conversations on a podcast, which we will try to make as comfortable as possible today because we're going to be talking about the one big beautiful bill act. Yeah, that should be fun. But it's important. Yeah. So where are we? We are late July. Right. Right now. So July 24 2025. bring that out there because boy things can change quickly. please don't ding us if you're listening to us in like three months for now. What are you talking about? Because things change. But yeah, so the big beautiful bill passed July 4th. July. Was that timed? Who knows? know, it's just like it's just positive. It's comical sometimes. But anyway, there's a lot of big things in that big beautiful build. more than what we're talking about today. But the big item that has urgent care is talking and we say that is we've talked to multiple urgent cares that are clients and are not clients and they brought that up as, hey, Medicaid is changing. it wasn't delivered quite that nicely. yes, yeah. So Medicaid is changing in a from a provider standpoint. They don't like the way it's changing from what we've heard so far. That's what we've heard. And so the goal of today's episode is to discuss it. Nothing political here other than simply there was a bill voted in and then these are what this is what the bill is saying. We'll go through that because like most you can't trust what the news tells you. Nothing political here just simply every single person that tells you something has a bias in what they're telling you. a paycheck attached to it. Right, period. Like I don't care on which side of the aisle you're on. If I am paid $100,000 a year to report news, I'm going to do whatever my boss says to a certain degree. And that's just the nature of it. So if I can encourage anybody here, if you're very curious about this bill, go to the government website that lists the actual bill with all the information and just read it or have chat as we're doing here, have some AI assistance. I did a multitude of things to research for this. I didn't spend an enormous amount of time, but what I did as I said, okay, I went to the site, That's what we write. That's where I wanted the information pulled from. And then I want to understand it a little better, because even that website that puts the information out there is still from the president. So it's going to come with its own perspective. Everything's got, everybody has their own angle of everything. So here's what I did. I took it and I said, I want a critical perspective and ⁓ a supportive perspective so I can give you both perspectives that exist. And then what we're going to do is we're going to show you how to break through that for your urgent care to be profitable when there is uncertainty and even from most urgent care standpoint, not looking good on this bill. yeah, and also that reminder to the what we're telling you now is to help prepare for what's coming. Like most bills, they don't magically just start happening like there's a time for all this stuff. Right. And if I'm not mistaken, can correct me. think majority of these changes, the overall effect is like a 10 year window, if I'm not mistaken. Yes, it's in here. think ⁓ there's a certain 20, 34, I think is, when most of it is going to unfold. But I would much rather you be ready. Yeah. Let's, let's get you ready for the next two to three years. Yeah, exactly. So here's, this is going to sound like me reading and I'm going tell you why. ⁓ because I'm reading. don't. Here's what I'm very, very careful to do. I don't want my bias in here at all. No, I don't want your bias in here at all. We're not here to debate politics. We're here to give you what we found and information. You can have your own opinion. I have my own as well. And at the end of day, if you what we tell you today, like I don't think that's correct. Great. Let us know. Let us know one to go do your own research. And this is a fun fact. Research is not looking at news sites. No, it's not because that's not all of the research there's there's like, because at like we just said, like there's, there's an opinion inside of any news article period. All right. So, all right, here we go. Strap in buckle up. We're going to help you get more patients, deliver better care, get repeat visits and scale. Part of that's attacking some of the things that are going on that you have no control over. let's start with the critical perspective. ⁓ This is considered a threat to access and equity opponents argue that OB BBA ⁓ That's a lot of B's in there, but that's what it is. The one big beautiful bill act. OBBA. OB-B-B-A. It imposes significant barriers to healthcare access, particularly for low income Americans, rural populations and immigrants. Key concerns include, Michael, massive Medicaid cuts, nearly a trillion dollars in reductions over 10 years, which could leave 10 to 12 million Americans uninsured. Work requirements. They're going to require people to, that are enrolled between the age of 19 and 64. They have to either work or they have to volunteer 80 hours a month to remain eligible in a policy. A policy critics say disproportionately affect those with unstable work or caregiving responsibilities. They have shortened the ACA support enhancing premium subsidies that expire in 2025. Likely leading to higher cost for 20 million plus Americans. Administrative burdens more free. More frequent eligibility checks and new cost sharing rules may cause vulnerable people to lose coverage due to paperwork lapses rather than ineligibility. And finally, rural healthcare strain despite a $50 billion rural hospital fund, many warn it's not enough to offset closures and staff shortages exacerbated by reduced Medicaid revenue. This law risks undoing decades, this is a quote, this law risks undoing decades of progress in healthcare access particularly for the most at risk communities. That's for the healthcare advocacy groups. That is the, don't like this at all. And that's that. So that's the view of this will cause harm is the mindset, which makes sense on the front end. Yeah. I'm not going to debate that. think there is a case that things are going to be going through a painful period. Change is painful. I think in all big bills like this, there are winners and losers in each side. each one every time. Every there's no winners. Actually in the world of this country, there are no winners only. There are definitely losers that happen. there are. ⁓ It just depends on which team loses that day. Yeah, right. So that's the this is not a good idea, Bill. Yep. And for those who who are supportive, I want to give you that perspective as well. So the supportive perspective is a push towards sustainability and responsibility. Supporters frame the OB-BBA as a necessary course correction aimed to encourage independence, controlling cost and empowering local innovation. They highlight personal accountability, work requirements, promote self-reliance and community participation while preserving benefits for most or the most vulnerable. Fiscal sustainability, the cuts to Medicaid and the ACA Subsidies are framed as essential to curbing long term federal health care spending and reducing deficit growth. State flexibility. So this is a state's rights issue. States gain new authority to manage Medicaid, design innovative rural care models and reduce red tape through more frequent streamlined eligibility reviews. Rural investment. The dedicated rural hospital innovation fund aims to spur more modernized and prevent closures with smarter locally tailored strategy and market. rebalancing phasing out temporary ACA subsidies is seen as a return to a more sustainable competitive insurance marketing. The quote from the supporters this is about protecting the system for future generations by encouraging participation and eliminating efficiency. Okay, so I read two different sides of a coin. And there are two different groups of people. One of you were spitting and cussing and flipping me off at the radio, or wherever you're listening ⁓ with the first set. And that The second set of people did the exact same thing when I read the positives. Okay. So I'm just telling you, I already know that we are a divided country. already know that we have different thought processes on this and I also don't care. So that's, that's, that's where I'm going with that so that I can give you solutions that it doesn't matter. Cause you're going to have to deal with anything that comes at you no matter who's in office. So let's get you strategies that are going to keep you profitable, keep your patients covered and taken care of. and keep that impact that you're making on your local community. Let's keep that going. Well, ready? Yes. So the mindset is if you're upset on either side, does. That's yes, it's fine. But the reality of it is it's it's been voted in. It's it's happening. It's happening at least for the next four years until someone else tries to knock it out. Because that's welcome to politics like if somebody brings something in the next person that comes in if it's a different type person, they're going to try and knock out that. mean, it's just, it's always a back and forth game. Let's rewind to 2010 for just two seconds. Yeah. Obamacare gets signed into law, the Affordable Health Care Act. no matter where you fell politically, you still had to deal with the situation. That's what I'm getting at. So, and so this is where we're positioning this podcast episode. It's like, it's happening. Yay or nay, it's happening. And Well, we're here to talk to you about how do you stay ahead of it? Because on the surface, it seems like it may be painful for an urgent care. Ultimately, I'm just going to go ahead and throw out there. I think it's going to be if you don't do some of the things that we're going to talk about. Yeah. So there's going to be some pain for an urgent care. And so today we're saying, let's go ahead and get ahead of as much as you can. And even if the bill turns out to not do the damage that you thought or vice versa, you're probably better off anyway, because you're thinking ahead. Because I think that one of the biggest challenges that we find in the urgent care space, it's an insurance based industry. And there's always challenges with somebody else's paying the bill. There's always challenges with that. But here we go. Are you ready? Are you ready? Yeah. I've said that like five times because listen, this is outside of think Michael and I's comfort zone. Like we really don't like to bring any of this, but sometimes you just got to deal with it. Well, and now that you've like you said, you've had multiple urgent cares. bring it up to you. Absolutely. And so we're to the point where we ought to talk about it. And, we want your feedback too. We want to know what your thoughts are. Because at the end of the day, what we gave was just a non biased thought process. Correct. We gave both sides. We're not voting for either side. We're just giving the sides. What we are voting for is how to be ahead of the game. Well, and no matter what happens, we want people to get taken care of in their health care. And you provide that. Here we go. how OB-BBA may affect urgent care centers. Here's the expectation on the effects that you're going to see over the next 10 years, I think over the next two to three years. So you're going to get a reduced Medicaid volumes because if in fact the claim is that millions may lose Medicaid, are they're going to face those barriers to access? It's going to lead to fewer covered visits. I do wonder, I want to ask this to our crowd, what percentage of your patients are Medicaid based? Well, we're going to talk about that. Yeah, we're going to talk about that. So that's thing number one. Thing number two is you're going to get increased uncompensated care, right? So more people that are not going to have insurance benefits are going to be coming to see you because they need it. And if you're not equipped, they're all going to go to the emergency room because the emergency room is not allowed to turn them away. So you better get ahead of it now. Otherwise you're going to lose your business to free emergency room. That's going to train wreck another system. Number three, pressure on rural clinics. We don't deal with a whole lot of rural clinics, but we know you listen because you call us and we have conversations. So rural urgent care centers face financial risk if nearby hospitals close, right? Because that free ER is no longer available to them. Or if they lose Medicaid funding and then for patient confusion and drop off, eligibility changes and cost sharing may cause patients to delay care or skip it entirely. before I start talking about how we can fix these things or at least like, let's pop some vitamins and get you healthy into this situation rather than recover on the other side with surgery. Yeah. Right. So any thoughts on that so far, Michael, the challenge of reduced Medicaid volume, increased uncompensated care, pressure on rural clinics and patient confusion and drop off. So yeah, at the end of the day, if the eligibility requirements increase, and the funding decreases, your expected volume of patients will change. Correct. And then ⁓ because you're an urgent care is there to supplement an ER ultimately, right? Like to help relieve the ER. But now the urgent care can't see an X amount of people because they no longer can be funded for the ER is going to potentially suffer, right, which then may cause a domino effect. This is we're looking at from that standpoint, specifically because if we're going to prepare for something, we're preparing for that mindset, because you don't want to prepare for it's gonna be great. Because then nothing, you know, gosh, if we thought that way about business in general, we'd all be bankrupt. doubt about it. No doubt about it. All right. Well, let's talk about some solutions then. All right. ⁓ So we want to give you steps ⁓ that you as an urgent care can take. now to set yourself up for future volume drops, and you can maintain your volume. And it's funny that, again, I went and did my research, but I was saying this before I even knew what they were talking about, because they were talking at like our clinics were saying, Hey, we're going to see this patient volume drop off. And I'm like, this brings me to the first thing, enhance your cash pay options. One of the conversations I even had today on a call, because he was so concerned about this, as I said, we need to put a pricing menu on your website. so that for the people that don't have an option but to pay you cash, at least they know what they're paying for. You and I, Michael, have preached from the hilltops. They ask you answer framework. They ask you answer. Who you have to meet in person. did. get to meet Marcus Sheridan in person. What a great dude. is amazing. Yeah, he's a stud. There's no doubt about it. ⁓ But nonetheless, ⁓ the they ask you answer method is just simply if people are going to the internet and saying, longer have insurance, don't know, have Medicaid, whatever. How much does it cost for me to get the sprained ankle scene or whatever? And you answer it on your website. Yeah, they're gonna come to you and they're gonna pay you cash and you're gonna keep that that customer sunburn sprains like you pick the top, you know what the top 1520 services are that everybody calls you about. Put a pricing menu together, put it live on your website and then put it in front of front desk person. We recently had a front desk where they were making up pricing on the fly, For physicals, right? And they saw it's $200. And then the next call, oh, it's $100 next call $150. Well, what is it? Yeah, they were just making crap. They were just making stuff up. Oh, if it's Saturday is 250. You want to know why they were making crap up? They didn't know. They don't have a clue. Give your team a pricing menu. Yeah, it was. says, Hey, I need to come in there. I don't even want to use my insurance, right? For whatever reason, I don't even want to use my insurance. How much is it going to cost for me to come in here and get this sore throat checked out? Well, it's going to be $150. Sweet. When can I come in? Yeah. And I think that's the part too. Like, don't be afraid of your price. I think some people are probably have a fear of if I give a cash price, they're not going to come. Like, no, that's not how that works. My goodness, we're so trained. Like I was telling you, like I went to restaurant yesterday with three of us and it almost $60. Well, that means I could have gone to two restaurants yesterday and got my in the price of going to a non insurance claim doctor visit. It's just insane. ⁓ But now, like, don't be afraid of price. You talked about vitamin C, so vitamin cash, right? Vitamin cash of getting stuff indoor and be prepared for that and train your people on it. And you're going to honestly, like we said, you start doing this now, you're going to start benefiting from it now of there are at this very moment, there are uninsured people that want to pay cash for their services. Right. And if you don't have a clear way of answering that question, they're not going to call on you because there's, there's clinics we've talked to their cash only and they kill it. Yeah. And they tell you they kill it. And the best part with cash only is you're not relying on a third party vendor that may or may not like you. Well, I'll take it one step further. ⁓ I would go ahead and start thinking through a concierge model membership model as an option for your urgent care for, people who don't have insurance. You can ensure them. And what I mean by that is just simply say, here's our cash options, or you can have X amount. It's this much a month, $150 to $300, something like that for your whole family. And we'll see you anytime you want to come. You get priority. And also you get a discount on all of our menu options of 20%. Now think about this. Every HVAC company in the nation right now is offering this. Yeah, they are. Club. Well, here's the thing. Yeah, the Comfort Club, right? What they'll do is they'll come out in the fall and they'll come out in the spring and they'll check your units to make sure that you're ready to go. Well, that sounds a lot like a physical doesn't it? Yeah. Right. That's covered just as being a member. And then you get 10 % off of any service and you get 20 % off any install of a new unit if you ever have to have those things. Right. Well, there's not an insurance coverage for HVAC units out there, right? Maybe American Home Shield, but you got to fight them tooth and nail. And they're not gonna fight. sounds a lot like insurance. Do you see what I'm saying? Yeah. So people are buying these HVAC unit concierge plans like crazy. That's a number one driver of value for them because it's a retainer based model. It gives them two very clear cut visits, which I'm not saying model it after an HVAC unit. I'm just giving you an idea here is have a concierge model that people can buy into who don't have insurance so that they can self-insure through you. And guess what? Super freaking sticky. Yeah. Well, and so that model in the urgent care space, I've heard it called like direct care model. So you have direct care. And then you have concierge, which is like the higher end version, which I don't you know, that may not be urgent care focused because the because you can't have a lot of volume with computer concierge supposed to be like high touch. But but we actually have some urgent cares that run off of these monthly memberships. And the best part to me, it is just like a car wash, where the You know, you know the car wash you pay 20 bucks for nowadays. Try 40. The numbers are getting high. Right. They used to be $8 or $5 car washes. Now they're 20 plus. One time $20 car wash. And they always say, or if you do more than one car wash a month, you save money with the membership. Right. And what does that actually do? When it rains, they make money. When it doesn't rain, they make money. When they have their machine down for a day, they make money. And they're not living on that daily car wash volume. Right. Daily car volume. Same idea for an urgent care is you don't need and that's the thing. I bet if you did a split on car washes, it's probably like 30 % membership and whatever. But that 30 % is the difference between having a really crappy month and having a really good month. Right. Same concept for you guys. If you're pushing 25 patients per day and so you're doing, you know, maybe a thousand plus patients a month. What if 20 %? of your patients were membership based patients was mean they don't have to show up at the paid and all of sudden like it doesn't have to be your whole mix like all of sudden you have an additional income that's predictable because predictable income is so much nicer than hopes and prayers. It's awesome. But but Michael people won't prioritize their health care if they have to pay it out of pocket. They're paying it out of pocket anyway with every single paycheck that comes out of their company. I'm out of say so I think that's a lie that you that you are internalizing. They will prioritize their health care. We have excellent health care. My wife talks to me regularly about how we should get concierge. Yeah, she does. She's like, don't even want to deal with it. I just rather have concierge. I was like, but we have insurance. She's like, just pay extra. Yeah. Right. Well, it's true because, know, like nowadays, like we're in Blue Cross land here in Alabama, a single individual is paying four to six hundred dollars minimum a month. for insurance they don't use. And then also they paid $5,000 a year for insurance they haven't used. And then that $150 twice a year or $50 a month or $100, $1,200 a year versus $5,000. You're saving them a fortune. You're doing you're doing them a service. And you're keeping your money instead of the insurance companies keeping your money. Because you get to directly bill them on a credit card. that's recurring. Build them points up. so it works. What do you mean the OB-BBA was a terrible? I'm just kidding. I'm I'm just kidding. But the best part is if this bill didn't exist, this concept has existed for a long time. This works either way. Well, I think people forget too that health insurance was not a thing. Right. Not that long ago. Right. But now we're trained by it. So like we had to abide by the rules and here we are. Well, next thing, double down on your digital marketing. I'm also serious. Biomatters. Digital marketing doesn't just mean running ads or getting found on Google. You can use text message marketing and you can use email of a group of patients and clients that you've already generated. And you can educate your patients on this new insurance rule. One, educate them from your perspective and how it's going to affect them. Put your politics in there. I don't care. Right, you get to say what you want to the people that have come to you in the first place. I would argue don't alienate people. But I'm just saying like, if you think this is going to have a profound impact, educate them on how it's going to affect your ability to give them care, and then show them a path to do business with you anyway. Yeah, I mean, because I think ⁓ that's key, right? That if you're presenting, communicating a problem, you must have a solution ready to go. Yes. If you're just communicating a problem, it's just all negative. That's called whining. Yeah, right. You're just belly aching. ⁓ And so, but if you put behind like, hey, this is happening for those who are, I because like, I actually know who's on Medicaid, who's not because I have first party data. Right. And it's like, hey, if you feel like you're going to be losing this coverage, we have now a new plan just designed for you to keep you healthy. That's right. ⁓ And for only $99, whatever the number is, click here to sign up. ⁓ And now you're educating and now, gosh, there's a whole campaign of, did you lose your Medicaid coverage? Click here and we'll take care of you. There's a whole thing. There's a whole campaign you can do there. And listen, we're not, this sounds like it's self-serving and that we're just trying to make more money for you. Honestly speaking, we're trying to help people get care that they need in a situation that they may be losing their care. Yeah. I hope you, I hope you feel that. I hope that's coming through. The way we can do that is to help you. clinic. we know because we've talked to a lot of our audience now you guys are quality providers. Correct. Like if you're listening to this podcast, you actually care. That's right. right. All right, target the underinsured. These are the people that are going to have like us really high deductibles. Yeah, right. And target them promote the services to those that are shifting from Medicaid because they'll be shifting from Medicaid to the most affordable access that they can get, which means the cheapest they can get, which means the highest deductible they can get. Usually. Yeah. Yeah, that's what that means. I mean, there's not really any any in between. It's just like any insurance that you can hot, you can pay more with low risk pay less with higher risk. That's right. And that's it. That's right. So you're going to target them. Well, how am going to target them? ads? Like, I don't, I don't know how to say it other than to say like, if you write an ad that says losing Medicaid and switching to insurance. We got a plan for that, right? That's an ad. You can do that through Facebook, Instagram, TikTok, I don't know, television, print, radio. If you are truly serving your community, send a postcard to everybody within reach of your community and let them know, hey, we know this is coming. If your plan is to do this, you need to come see us or at least scan this QR code where we can tell you all about how we can help you get the coverage that you need by or the care that you need by coming to our clinic. We have these options available to you. And then market your urgent care is a lower cost option to ER because what's going to happen is people are going to go to ER, let me just tell you how this going to unfold. People are going to lose their insurance if that's going happen, right? If that happens, they lose their insurance, they start going to the ER. What they don't understand is that it takes a lot. The ER has to see you, but that doesn't mean that they don't have to bill you. And now you're dealing with collections. You're dealing with bankruptcy. You're dealing with all these things. And I know I'm showing a very dark side of this or extreme white times. All the different things that are going on there. I would rather. Of course, I'm obviously not in a position where I'm about to lose my insurance right now, but I'm just thinking like I would rather pay something than have to deal with the back end hassle of trying to talk to collections and everything else. Let me tell you, it feels like another lifetime ago, but there was a time where we defaulted on something. And I got served papers and summoned to court to pay a bill that I couldn't afford to pay. Again, I was in my twenties at the time, but I wish I had paid upfront to not have to deal with the embarrassment and the hassle on the backend of something that I, at that time, I think I probably could have controlled it. just was negligent or something. don't know. That's not the point. I think the point I'm trying to make is if you, if you offer yourself as an alternative to that scenario, people are going to choose you. Yeah, mean, yeah, because I think the ER side things, you know, the ER is there to serve, right? That's right. And then they're there. I remind people like, they're going to treat you now if you are openly like they don't. This person has no coverage whatsoever. They're going to treat you at a minimal level. Right. But and then the aftercare doesn't exist because they know they can't collect on you. So why should they provide aftercare? That's right. And so It's real. So it's gonna be real interesting because, you know, as it stands right now, the ER system is still overwhelmed. I think the urgent care system has helped alleviate a lot of it, but it's still happening. I'm actually kind of hoping maybe this will force to be talked about, or the UCA talks about there's, you know, right now there's no actual code for urgent care yet. And they're trying to push for a code for urgent care, which makes total sense. Like, why wouldn't you at this point? Right? Maybe this will accelerate that, which would be awesome, because then that has more impact on that. But no, I mean, it's a real thing. Like at the end of the day, if you take away coverage and then your only option is the free option, and then the man will go up and that means longer lines and worser care tend to happen. Worser care. Worser care. Mo bad. Oh, that's good. Worsher. Worshershire. Worchestershire? You say that stupid word. Yeah, who knows? All right. Last bullet point, and then we'll wrap up and let you get on with your day. ⁓ I think it's worth following the money trails of where people are still going to be able to pay you. And it may be, it may be time to start looking into Ahmed. ⁓ And the reason I say that is employers are also going to be impacted, right? Their rates are going to go up. So having an option of a cash pay option or, or a flat rate, they can send as many employees to you as they want a month, whatever it is. Yeah. Cause I don't need an employee go to the ER for a cold. So, if we could, yeah, if we could create, if we could create at our clinics, a solution that's going to better serve the business community, that again is, I don't want to say guaranteed, but a higher likelihood of getting a stream of patients that you don't have to go to Google and pay for the ads for. You have businesses that are sending that to you. I mean, even if it's 20, 30 of their employees a month, like look for that, look for those opportunities in Ocmid and find some creative ways to serve businesses. ⁓ Again, we're just trying to prep you. If in fact the negative side of this comes down and you start having people drop off of Medicaid, Medicare, ADA, all that, all of those different kinds of things. ⁓ You could be the go-to solution to really make a positive impact in a dark situation. know, I still, I've mentioned this a long time ago, but I'm still away. want urgent care. If this urgent care is listening, I want you to contact me because I want to see it in person for the ocmed side. I want to see that mobile urgent care roll up in front of a manufacturer facility and just park it three days a week and take care of people coming in and out that simple. don't know why no one's like I only know about it because I had an optometrist that I was a patient for and he spent two days a week in front of Honda and would process like 200 employees at a time for glasses. Yeah. And of course Honda would pay happily for that. And so I'm just I'm curious, where's the mobile urgent care? I know mobile urgent care exists because we've talked to a couple in the past, but I've never talked to one that parked it in front of a business and just took care of the business or the school. Like I still want to see this happen. I want to see us. I know we told one of the bigger urgent care is, hey, get you a sports physical van type thing, park it in front of the school and say, get all your physicals today. I love that. Like just you got to be creative, right? You have the resources. You just got to be more creative with what you're currently doing at the end of the day. Like just be creative because what you were doing, if you're doing the exact same thing today that you were doing 20 years ago, of course you're going to get left behind. Right. Because things change. And what we're doing today in our agency is if we were doing the same thing five years ago, we would not be an agency anymore. You're right. So that's right. hey, I hope we've given you value today. If, ⁓ if you loved this podcast, share it with your other clinic buddies. ⁓ If you hated this podcast, share it twice with your buddies. Also, we love when we hear, ⁓ we recently got one where they said they share it with their leadership. I love it. I'm like, is awesome. That's right. ⁓ And I'll just do a, a, a special shout out to those clinics who, who are in the infancy of getting their clinic started. We know how hard it is. We got you if you need us. ⁓ Just reach out to us. We want to be a good resource for you as well. So y'all go out and crush it and try not to get too wrapped up in the politics and figure out how you can care for your for your patients.