A special treat for me on this episode as I get to interview one of my former students!
If you’re like me, and not a prolific writer, but have something to say, creating Youtube videos or your own podcast may be a legitimate outlet. That’s what Dr. Andrew Tisser discovered. A busy ER doc and relatively fresh out of residency, Andrew knew he wanted to help his fellow early career physicians but just didn’t have the time or inclination to start his own blog.
With podcasting, he is now able to reach thousands of doctors and it hasn’t stopped there. He’ll also discuss what he learned through my entrepreneur mentorship program, and the exciting opportunities that now await him.
LINKS MENTIONED:
Andrew Tisser DO’s website
Podblade – Help automate your podcast –
https://andrewtisserdo.com/podblade
Facebook Group for Early Career Doctors –
https://www.facebook.com/groups/earlycareerdocs
RAW TRANSCRIPT
Dr. Mike Woo-Ming
I am pumped for the doctor that I have on the program today. I think he I first got contacted with Andrew and you can probably refresh my memory because as you know, as I get older, the memory tends to go but you had reached out to me and said some nice things about my podcast. And you were interested in delving into podcasts and actually it started. I don’t know if you’d actually started it, but maybe we’re at the beginning stages of your podcast. And he has a podcast that you’re probably familiar with with called believe Talk to Me Doc, right? You don’t have to be doc right and has recently transitioned. Talking about early career physicians and himself as a, you know, emergency room physician also married to another early physician, just kind of all the trials and tribulations you get with that. And I thought it would be a kind of a cool podcast to talk about those things. We can talk about podcasting, about deciding to change careers, like the beginning of your career, as well as he was actually a student of mine and got some mentoring help and, and maybe he could talk about what he got out of that. So, Andrew, I know I did a crappy job of building you up, but I think a lot of people know who you are. I actually spotlighted you on my Facebook page because of some exposure that that you got out there really got national attention. So we’ll talk more about that little tease for the podcast. So Andrew, other than that, how are you doing?
Dr. Andrew Tisser
I’m good, Mike. I’m good. How are you doing?
Dr. Mike Woo-Ming
Good man. I’m seeing you everywhere you’re on podcasts are blowing up on social media. You know, you’re a rock star, like I said, when you’re in my mentoring program earlier this year. But I want to have my honest know bit more about you. I don’t think I did the best job of building yet, but let’s talk about it. You’re up in upstate New York emergency room doc married to a doctor, you know, that you had everything that you wanted to do, but decided that maybe things in medicine wasn’t what you initially thought about, right?
Dr. Andrew Tisser
Yeah, yeah, absolutely. I’m so yeah, my name is Andrew Tisser. I’m an emergency physician practicing in western New York. I I grew up down in New York City and escaped the city life and moved him a little more rural part of town which, which is good for the soul, I think. Yeah, I’m married to my wife Alicia. She’s a rheumatologist. So she is the smart one of the couple. You know, I’m just the cowboy But yeah, so briefly, when, when I got when I was in residency, I was in the thick of it and I always thought it would get a lot better once you got out and everyone tells you it’s better after residency. And of course, in some ways it is but a lot of times you come out and and you’re just disillusioned as to the state of medicine right now. So I followed my wife to Chicago for her fellowship, which was amazing, as in the city, but not the attending life. And I tried lots of different things. I honestly I looked into Medi spas, which is not for me, I did chart review. I was like, how do I get involved in insurance companies I was just like, oh my god, I got to do something else because I’m dying here working 150 hours a month in the ERC, and for patients in our with administrators breathing down your neck and everything. And but it all was put on hold until we moved back to Western New York because I didn’t like anything. thing. And then after that I kind of started my podcast and met Mike and got involved in his course. And a lot of things have happened since. So that’s the long winded approach.
Dr. Mike Woo-Ming
Other than that, everything you thought of when you entered medical school.
Dr. Andrew Tisser
Right, other than that.
Dr. Mike Woo-Ming
Talk to me about that. So this has actually happened in residency where you kind of were kind of disillusioned, is that right?
Dr. Andrew Tisser
Yeah, yeah, I, you know, I, I got, I got done with medical school and I picked emergency medicine because I liked it the best even though I wasn’t like super enthused by any of the specialties. And I mean, residency was tough as it is for everyone. My wife and I match two hours apart and I was driving like, crazy. I put like 100 plus thousand miles on my car and those three years driving back and forth. And, um, it’s, you know, I don’t have to explain residency to the listeners, but it was just like, Well, you know, hopefully when you’re making The big bucks and you have more time on your hands. It’ll be better. But, you know, I think all that changes from residency is the paycheck and maybe some hours or less.
Dr. Mike Woo-Ming
So I know with my residency, maybe they kind of sheltered me from like, all of the insurance claims and all that, you know, the focus was, of course, you know, treating the patient. Was there something like in particular women see that just didn’t jive with maybe the patient population or was it like the attendings or just just the whole the way that we treat medicine? Was there anything in particular that didn’t feel right to you?
Dr. Andrew Tisser
I think it was just the volume. Like I, I got really good training. I’m never gonna say I didn’t. But you know, the amount of patients that you have, that you had to see is good training for the real world because a lot of major hospitals you aren’t going to see that kind of volume, especially if you’re working in the community. So I think, you know, they I think there was some paper I read that anything over 1.6 or 1.7 patients an hour, you start missing things and making mistakes. And in Chicago, one of the places I was at I was seeing four patients an hour. And we always had 40 in the waiting room so like what? You know, that’s that’s the fast track to burnout.
Dr. Mike Woo-Ming
Yeah, yeah, that’s like primary care. And, you know, I was doing, you know, sometimes I was doing, obviously, er is different from, you know, failing medicine, but sometimes, you know, four to six an hour patient every seven to eight minutes. And you know, that there’s a lawsuit just like, your way if you’re, if you’re doing that amount of volume, no matter if you’re the best physician in the world, you’re going to make mistakes.
Dr. Andrew Tisser
Sure, yeah. So I mean, that’s and then it’s just, you know, push, push, push, but if you make any mistake, then you get it’s not even if it’s not a legal consequence, and maybe the the admins raining down on you or, or whoever. So, that was a big issue. I didn’t think you had enough time to see your patients and like it Are were sheltered from insurance issues but we see it on the other hand the dogs that people can’t get into see primary care or specialty met our specialist because of insurance issues and then they end up with us.
Dr. Mike Woo-Ming
Yeah. So you, Greg graduated from residency is you start looking at, like, where you could work at sounds like, you know, obviously, location of is going to be important. Obviously, you want to be where your your spouse is going to be. And you settling in western New York. And when you were working at it, were you also still looking at other things while you’re working. Are we just like so burnt out from you know, from work that, you know, turn on the TV and go to bed?
Dr. Andrew Tisser
Yeah, no, I, you know, I give credit to my wife, she’s most patient woman I’ve ever met, because honest, every third day, it was something else. I was like, I’m gonna be a full time, whatever a full time insurance person I’m going to be then I’m going to do admin then I’m going to do this Then I’m going to do that and it was like a whirlwind of just like how do I escape medicine and really, it wasn’t until I started you know, running towards something instead of a way that I I’ve been able to find peace with that. And and right now I’m in the it’s the organization I work for now is great. I don’t have any qualms about it, and, and all my other side projects just keep me fulfilled.
Dr. Mike Woo-Ming
Got it. So let’s, let’s, let’s get into the side projects now. And just so that our listeners have a kind of a timeframe. Um, how long have you been out of residency?
Dr. Andrew Tisser
Three years. So I graduated in 2017. Yes, so three years.
Dr. Mike Woo-Ming
So let’s say that when did you start like looking at different gigs and actually, like, decide? Maybe podcasting was away or when did you start? I guess, when did you start finding out that there are other doctors who had similar concerns as you?
Dr. Andrew Tisser
Probably like fresh, I think I started looking in residency because I knew this wasn’t like being a full time ER doc was never going to be the answer for me. And so I stumbled upon yourself and and john Rica and other people like that and started listening to their, I mean, I’ve been listening to john rica show forever and all about all the different things people do. So probably late residency, but I didn’t have a lot of time to consume all that. And then once I got out and realize it was just and I did full time locums when I got out, which gave me so much ability. Yeah, so it that gave me some flexibility with scheduling but it was still like, it wasn’t, you know, I was still too much so. So probably right after residency is when I started delving into it and then as far as making actual plans and deciding upon things that was two years later. So about a year ago, now that I really got into what I wanted to do.
Dr. Mike Woo-Ming
Okay, so you’re listening to guys like J,ohn and myself, you know what I love about a podcast is you know you can be doing other things hopefully you’re not doing a some type of procedure driving home you know just listening turning on the smooth sounds of John Jurica you know, but I guess with the exposure you know, have different interviews with different clinicians probably you know, at least gave you some hope, correct?
Dr. Andrew Tisser
It did and it and the one side It was very helpful to know that other people are very successful doing other things I mean, john Eureka his whole thing was let’s get you in a non clinical job that replaces your a similar income you know, so that was always a concern for me and and listening to how successful you’ve been and some of your guests as well. Definitely gave me hope. But on the other side of things, it was so much there was so much information like there were so many things you can do so I wanted to do it all I try everything you know that that’s because because I wanted out but it did it did give me a lot of hope and it was helpful and and just knowing that if I pick something and work towards it, I could I could do whatever I wanted really.
Dr. Mike Woo-Ming
So what in particular, eventually you just podcasting is as kind of your first vehicle to, to just talk about the issues. Why did you decide podcasting was a way versus like blogging or, you know, creating YouTube videos? What, why podcasting?
Dr. Andrew Tisser
Okay, well, I’ll give you a little secret Mike, I got really bad at writing. I don’t understand the comma. I don’t know where it goes. My wife proofread anything I write and she’s just like, no comment doesn’t go where you pause in your thoughts like it just there’s places to go. So blogging was out because I could never do consistent writing. I listened to a lot of podcasts and that I liked them. I liked it. I could listen on the commute, that there was no it really was kind of a low Stress vehicle in order to at least get some thoughts out there. And just being able to talk to people and different guests, I think fits with my personality. Again, my wife tells me I could talk to our rock because I, you know, I talked to everybody I meet and I guess, you know, I’m the guy talking on the plane, unfortunately, because that’s, but so that’s, that’s why I chose podcasting. And I, and I got into it because originally because when I was leaving Chicago, a security guard got me a gift. And I asked him why. And he said, because you talk to me, like I’m a person and I’m like, well, that’s weird. What do other people not and he’s like, you’d be surprised. And so that’s when I started talking to different healthcare team members to in the issue of communication and that kind of morphed into talking about issues as they relate to the healthcare worker experience in general. And then that kind of, like narrowed down my focus into talking about issues that are specific to the early career physician because All those different team members have a role to play and affect the way our jobs and our roles are as clinicians. But those are the issues that I’m passionate about. And that’s what I am.
Dr. Mike Woo-Ming
So your podcast is called Talk to Me Doc. And you know, I know the answer to kind of this story because, you know, as a mentor, you know, that was something that you’re struggling with, and maybe you could still consider struggling out there. I think now, at this point, you’ve decided where to go is like, we’re talking about a podcast, but then we also need to talk about well, how can I generate revenue, obviously, from a podcast, and you focused on communication, medical communications issues, and you got tremendous feedback, you know, from it, you know, you’ve got you’ve got a, you know, a lot of positivity, you know, you felt great with the podcast, but there are other things that you wanted to talk about. When did you decide to focus on, you know, early career phy
Dr. Andrew Tisser
icians? Well, I, I think it kind of coincided with the time that I started working with you as well. There, there was a lot of talk about about student debt and about where, where there, the life cycle of the current physician and how that’s going. And those are kind of the issues I was addressing a lot on the show. And, and it became communication that led to like burnout issues, and then those burnout issues when we start talking about like, how they relate it to myself, because I’m an early career doc. And that’s, that’s the experience I have. And that’s how it kind of funneled down into like, yeah, I want to talk about the issues that are pertain specifically to this demographic. And I arbitrarily chose seven years as people out of training for less than seven years. I thought 10 was too long, because I think the generations are different. But I thought five was not inclusive enough. So I thought seven years was a good place to start. And that includes residents as well. And so that’s that’s kind of where it where it ended up that I wanted to start talking about early career issues.
Dr. Mike Woo-Ming
And what’s been the feedback since you’ve transitioned to this, this area?
Dr. Andrew Tisser
Well, it’s been good I, I it’s been going that way for a while. I’m going to formally formally pivot the show I guess you hear heard it here. First, I’m going to formally pivot the show to only be about early career issues coming up after the 25th episode, which which airs next week. And the I’m still gonna have multi disciplinary guests on the show to discuss issues as they relate to their early career doc. But I think it’s, it’s given the show a little more vision and a little more clarity.
Dr. Mike Woo-Ming
And let’s talk about early career physicians. What what Okay, what kind of the topics that or maybe Some of the things that really career physicians might have to worry about more than let’s say, you know, your mid to late physicians.
Dr. Andrew Tisser
Yeah. Well, I mean, I think first and foremost is student debt. The rising tuitions in medical school over the last decade have been astronomical, along with the usury type interest rates that have been placed upon us. For example, my final year of medical school, which was in 2014, it was $56,000 a year for tuition, plus living expenses on Long Island. So you were taken out like 80 grand a year at 7%. So, and with the elimination of subsidized loans, when you get done with a three to five year residency program, you’re adding 100 to $200,000 of interest on top of your principal. So you’re looking at 500 grand straight out of residency at seven 8%. So I think that that’s a big issue that You know, I think a lot of people used to talk about, well just live live below your means and pay them off in two to three years, which is certainly possible. But I for one did not want to live in a, like a broken down trailer and eat baked beans for five years and, you know, just shop at the dollar store after residency. You know, I didn’t believe in that I believed in abundance and creating more opportunities for yourself to help with those things. So I think student loans are a big one. It’s also a bit of a scam, when they tell you the average indebtedness of the class is 200 grand, but 50% of the class has no loans. So actually, it’s more hundred grand for the people that take out loans. So that’s a big issue. I think the everyone’s struggling with the insurance, the insurance companies kind of controlling medicine, which has only gotten worse over the last number of years. Corporate medicine as well. You’re not seeing small independent hospitals anymore, and I think now posts on and off we can say we’re post Coronavirus, but after the Coronavirus issue goes away if it does, we’re going to see a lot of smaller hospitals get gobbled up or disappear just because they can’t survive. And then just more and more loss of autonomy of physicians to, to both corporate medicine and to being replaced by physician extenders is, is a, I think a more of a now issue than it ever was. So those are a couple examples.
Dr. Mike Woo-Ming
One is that the schools are talking about doing anything other than being an employee. You don’t hear anybody starting their own practice or any, you know, business acumen given correct?
Dr. Andrew Tisser
I mean, I was told taught to us that private practice is dead and you got to join a group or you’re never survived, which is which is untrue. You know, especially with the direct primary care movement and some of the things people are doing with cash based practices and concierge medicine and Direct primary care I think that’s, that’s a force to be reckoned with.
Dr. Mike Woo-Ming
Yeah, and I guess a lot of times to, you know, the people are teaching or in academics and not necessarily are exposed to the different types of doctors which you know, that’s another story for another time but in terms of who’s actually training you guys so you’ve got the podcast in the name again is Talk Talk to me doc How can they listen to you? They’ve got a website.
Dr. Andrew Tisser
Yep. So any anywhere you get your podcast, it’s talked to me doc talk the number to me do see. You can go to my website at AndrewTisserDO.com and there’s a little podcast button which will take you to a site that’s fully dedicated to the podcast. But really anywhere you get your get your podcasts from there?
Dr. Mike Woo-Ming
I want to talk about also I’ve had inquiries about podcasting. You know in general. Dd you have to get a lot of equipment? You know, just just I know I do a podcast but they want to, you know, they the artist wants to know if for any budding podcasters out there, you know, in terms of like your equipment use, is there a certain place where you do your podcast? You fill me how your setup works?
Dr. Andrew Tisser
Sure, yeah, I mean I got this mic and this little boom arm thing I mean this all together was like 100 bucks or $150 right off my laptop pair of headphones. And that was really the startup cost, you know, you got there’s different platforms you host them on and things which are very nominal fees. And then, I mean, you don’t need a website to start either. You can just kind of get going. And usually I do my show in in the office but my wife seeing patients their telemedicine right now. So I moved to the dining room. With this lovely painting in the background but yeah, usually I just I’m just doing in my office and it’s all done via zoom. So really if you could, I mean you could have a crazy setup with all kinds of impressive audio machines and things but I’ve been told time and again I get great sound with this hundred dollar mic and so I got no reason to upgrade.
Dr. Mike Woo-Ming
You spent a lot of time with editing or you know, writing the show notes that kind of thing or do you outsource that?
Dr. Andrew Tisser
Well, I in the beginning I was doing it all myself I have outsourced at this point just because it’s it’s not worth my time. They’re much better editors than me. And I use, you know, a company to do that. And they, I send them the files, they put it together how I like it, turn it around in a few days. So so that’s been very helpful. They also create a like basic show notes. For me. I beef it up a little bit on my website, but And then I use some programs to help with the social media distribution. But all in all at besides I do the recording and then I spend maybe another hour on the actual episode, whether between promotion and getting the website ready and just putting it on the host. So that’s really all I’m doing now. So I learned.
Dr. Mike Woo-Ming
Do you mind sharing some of the companies or was it like through Upwork?
Dr. Andrew Tisser
Oh, no. So I use them for editing I use a company called Podblade, like a blade. They’re, they’re wonderful and I can share a link for you to put in the notes for them but basically, they’re very affordable and they do a lot of things. They post it on YouTube for me, they make a little video snippet and audio grand for social they do the show notes and do all the editing. It’s a really wonderful service that a lot of other companies charge double, triple the amount for so had nothing but good, good things to say about them.
Dr. Mike Woo-Ming
Awesome. Awesome. Yeah. Yeah, that’s, that’s, that’s really cool. I always want to know, like, what are people using? Because you shouldn’t be spending all the time doing it unless you love doing it, you know, you know, I like I like messing around with video, just cuz I like it, but no other things. I just completely outsource everything.
Dr. Andrew Tisser
I mean, it’s silly for the amount of if you like break down the cost on what you what you make at work for an hour. And it’s like, Why Why was I doing all that?
Dr. Mike Woo-Ming
And it often as docs, you know, we tend to be can have control freaks, and you know, this isn’t anything.
Dr. Andrew Tisser
I know. Well, that’s what happened with my website actually, like I was tinkering with it and tinkering with it. And I was like working on it for weeks and then it crashed and I lost everything. I couldn’t find the backup. And my wife was like, What are you doing? Like pay somebody to do this? Like you just spent like four weeks all this time and it’s gone. I’m like, Yeah, you’re right. Like, why not?
Dr. Mike Woo-Ming
So I want to I want to shift gears here. And so when we were doing there, the program and in helping to get get your name out there, something really interesting happened, I guess is the bit word for it. I remember, in my program, it’s a group coaching. So there’s a number of us dots, including Andrew. And Andrew was, you know, at that time COVID-19 he was really, I think was just beginning or you were getting really busy. And you had I remember you were saying you were getting an interview with I believe, like a local radio on if they wanted to talk about, I believe your loans and I’m gonna let you tell the rest of the story, but it led to some nationwide exposure. Can you can you talk about that?
Dr. Andrew Tisser
Yeah. So it was kind of funny chain of events, but so basically I was I helped Dr. Nisha Mehta with the COVID-19 pandemic physician Protection Act that was submitted to the Speaker of the House a number of months ago. So I helped author the section on student loans. And so I had a local TV reporter that I don’t know caught me some I don’t know how they found me, but they found me on social somewhere and wanted to do a little story. So they they were affiliated with NPR. So they published that story locally. And then an NBC reporter caught the NPR segment and reached out to me to see if I wanted to do a bigger segment. So I actually did an interview. And subsequently it was published in NBC News, national NBC about the the act and a student the student debt crisis. And so that kind of blew up and then I got an email from the NBC reporter. Hey, check this out, and it was senator bernie sanders tweet reading the article with my face on it. Oh, that was a Yeah, I feel up kind of my face a mask and a helmet on but yeah, that that so that led to a little bit of national press with my helmeted face by Senator Sanders.
Dr. Mike Woo-Ming
Yeah, yeah . I remember I think was France or Germany.
Dr. Andrew Tisser
Yeah I had like a French, there was like a French article about it. And then there was like, yeah, there was an article from the Netherlands and like different languages. I’m like, Oh my god, everybody’s using my face. All of a sudden now is pretty cool.
Dr. Mike Woo-Ming
And because of that, but what did that lead to? I know you got some like political things going on.
Dr. Andrew Tisser
Yeah, so the, I mean, that definitely led to some more, some more exposure and I’ve been working with what’s pushing some of the Some of the political changes we want for it along with the act and some of our senators and representatives. In regards to helping with student debt I, I think with some of the more recent current events that has been tabled for a little while, but at least we’re if we get the national attention, and we can always have the conversation going about the rising medical school tuition and the craziness of the debt right now, I think I think that’s a win just to have people talking about it.
Dr. Mike Woo-Ming
And recently, you’ve been working on coaching other doctors. Let’s talk about your coaching program.
Dr. Andrew Tisser
Yeah, sure. So talk to me doc has expanded into a taught to me consulting coaching program. So I personally work one on one with early career physicians on the issues of money, money, that is optimizing finances. Not just Student Loans but a couple of other issues we run into early career. So finances mindset issues that people have, like I talked about the issue of scarcity versus abundance and a couple other things that are drilled into us and medical school. imposter syndrome is a common one. And, and I like to say Making Moves or goal setting and achieving goals because, you know, I, my goal is not to remove people from medicine, I don’t think that’s going to be sustainable for the long time. If they want to leave medicine, great way. I know a lot of people they could talk to, but if they want to stay and be happy again and create a career that they’re happy with that like I have, then you can talk to me and we can work one on one and working through those issues.
Dr. Mike Woo-Ming
Awesome, awesome. So guys, if you’re an early career physician, and you need somebody, maybe to help you, who’s kind of been there, done that, I encourage you to go check out Andrew Your website again. What’s the best place.
Dr. Andrew Tisser
Yep, so it’s AndrewTisserDO.com. So Andrew T-I-S-S-E-R-D-O-dot com and all the information’s on there. You can find me on all the social media, Twitter, Facebook, LinkedIn, I’m everywhere as either Talk to me Doc or my name, and so I encourage you to reach out I’m, I’m pretty good at getting back to people.
Dr. Mike Woo-Ming
Awesome guys. And I may I may be a little bit biased because you know, you were my student. But you know, what was really cool is you know, the person gets to know the person behind it and the intentions of what they can do and what they can share. If you wouldn’t mind because people have been asking me about my own coaching program, maybe just talk about what you got out of it, you know, other than make me making you do a lot of work. A lot of busy work and taking you out of your your comfort zone.
Yeah, no, absolutely. Mike’s program is amazing. Mike has years of experience doing teaching people how to create multiple streams of income, as well as just focusing in on what really matters? I mean, the program. First of all, the group coaching model is awesome, like we learned from each other. But when Mike was there to be like, No, that doesn’t make any sense, or I told you to do XYZ and you’ve done nothing thus far, which is really sometimes a push in the right direction, plus just tips and tricks and the experience that he is able to share with his students. Like, so, you know, I’m not giving away any secrets, but when he you know, he would tell us a thing to do, I’d be like I have, I’ve never even heard of such a thing. And it works, you know, and it works. So, no, Mike is your guy. If you want to start a business and you’re, you’re looking for a little guidance. He will help you get everything sorted out. Get you in there. Right paths and how do you make a lot of money.
Awesome, awesome. Andrew, my friend, just see just more, you know, great stuff for you in the future. I still think you might have a role in politics even though you don’t know it, you know, right now, but in terms of what you’re doing, and I hear you’re reaching, I know your podcast, and your Facebook group is blowing up. You know, I’m looking at your podcast numbers. And they’re, you know, they’re, you’re doing some tremendous stuff. And so, congratulations again to your success. And any last minute words before we end the call today?
Dr. Andrew Tisser
Well, no, I think guys, I just I want all the physicians out there not only early career to know that it is able it is possible to create a career in medicine that you’re happy with. Really, we are the We are the most one of the most educated fields. There is. You have the most versatile degree that there is. So please leverage your credentials to create what you want to create and the possibilities are endless. And listen to Mike. He knows what he’s talking about.
Dr. Mike Woo-Ming
Thanks again, Andrew. Thanks everyone. Again, there is hope out there, there are doctors who are doing things that there are doctors that are doing things that you are interested in doing. You got to reach out and find them. That’s what Andrew did. That’s it, some of his, you know, former classmates, I guess you will for my students did as well. So whatever you do, you know, there are people like Andrew out there who can help you. And it really is about, you know, you know, paying things forward and paying it forward, as they like to say and that’s how, as physicians, you know, we can’t let other people who can’t rely on other people who are out there who are non physicians to get us where we want to be. I think that’s kind of what trouble is. We got in there in the first place. And if you want to help each other it’s possessions helping other physician. So, thanks again, Andrew. Thanks again for your time. And as always guys, keep moving forward.