dr hartman sees me does an e.k.g. duplicative not hugely expensive but you multiply that by millions of times a year fee for service and it adds up he's going to and he's going to unquestionably do a stress test much more now than in the past twenty years because now they do stress tests at doctors' offices in the cardiologist's office fee for service and they have a cardiology office visit so the cardiologist is paid for reading the k.g. being the stress test and the cardiologist office visit. she dr hartmann let's say decide this is probably reflux and so then decides to do what. everybody in my audience everybody that i ever talked with has sent him to a g.i. doc but let's say this let's just say doctors are all right it's over in docility or stomach acid right but let's say dr hartman sensible and sends me back to primary care doc dr tom three weeks later i'm back with dr tom and you maybe have gotten a note from dr hartman maybe not that says thank you for saying peter beyond saying he doesn't have heart problems